Formative Assessment Using Mixed Methods to Identify the Nutrition Education Needs of Refugees in Rhode Island

Shephard, Hanna

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Year:: 2020
Contributor:: Shephard, Hanna (creator); Risica, Patricia (Advisor); Harrison, Abigail (Reader); Amin, Sarah (Reader); Balestracci, Kate (Reader); Hetzler, Heidi (Reader); Brown University. School of Public Health (sponsor)
Genre:: theses
Subject:: Refugees; Supplemental Nutrition Assistance Program (U.S.) (SNAP); refugee health; Nutrition--Education
Extent:: , None p.
DOI: https://doi.org/10.26300/3btb-4e84

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Abstract:: Meeting the Nutrition Education Needs of Rhode Island Refugees Through the Supplemental Nutrition Education Program (SNAP-Ed) By: Hanna Shephard, Sarah Amin, Abigail Harrison, Heidi Hetzler, Kate Balestracci, and Patricia Risica Background: The literature suggests that U.S. resettled refugees face many barriers to healthy nutrition such as low food literacy, lack of access to culturally appropriate foods, difficulty navigating the U.S. food environment, and low-income. Nutrition education has been identified as a key strategy to reduce these barriers. However, the federally standardized curriculum implemented by the Supplemental Nutrition Assistance Education Program (SNAP-Ed) may lack cultural relevance for U.S. resettled refugees. Objectives: We aim to understand whether or not a SNAP-Ed curriculum designed to improve nutrition behaviors and food resource management skills among low-income adults is relevant for a group of refugee Community Health Workers (CHWs) in Rhode Island, gatekeepers to a wider refugee audience. Moreover, after establishing evidence for further nutrition education delivered by refugee CHWs, we aimed to better understand the nutrition education needs of a sample of East African refugees in Rhode Island Methods: We employed a mixed methods approach. First, qualitative research methods were used to gain an in-depth understanding of refugee CHW’s perceptions of a SNAP-Ed curriculum. Focus group methodology and key informant interviews were utilized as the primary formative assessment methods. Refugee CHWs were invited to participate in a SNAP-Ed nutrition training facilitated at a refugee resettlement agency in Rhode Island. Following the nutrition training, a focus group (n=6) and in-depth interviews (n=8) were held with the refugee CHWs. Next we administered surveys to refugees (n=21) from the East African refugee community to inform the design of a professional development series for refugee CHWs to prepare them to deliver the SNAP-Ed curriculum to a broader refugee audience. The survey included questions about dietary change, barriers and facilitators to navigating the U.S. food environment, interest in receiving nutrition education from CHWs and, finally, participants were presented with several potential nutrition topics to learn about and were asked to rank the importance of each concept. Results: From the focus groups and interviews, three major themes emerged. The first theme identified was that CHWs proposed suggestions for cultural adaptation of SNAP-Ed to reduce the cultural and language barriers they anticipate their refugee clients facing. The second theme was that CHWs believe trust, empathy, and relationship building are critically important to bridge nutrition knowledge sharing. The third and final theme was that despite CHWs having provided suggestions for incorporation of multimedia materials to enhance the cultural relevance of SNAP-ED, the CHWs described themselves as the primary tool for cultural adaptation of SNAP-Ed. From the survey, we found that a sample of refugees from the East African community were most interested in learning how to find healthy foods at the grocery store and how to cook healthy foods from their own culture. They were least interested in learning how to cook recipes that took only 30 minutes or less to cook. 95% of participants were either interested or very interested in participating in a nutrition education class taught by their CHWs. Conclusions: This research established evidence in support of a CHW model to improve the cultural appropriateness of SNAP-Ed in an effort to better meet the nutrition education needs of refugees resettling in Rhode Island.
Notes:: Thesis (M. P. H.)--Brown University, 2020

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Rights: In Copyright
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Shephard, Hanna, "Formative Assessment Using Mixed Methods to Identify the Nutrition Education Needs of Refugees in Rhode Island" (2020). Public Health Theses and Dissertations. Brown Digital Repository. Brown University Library. https://doi.org/10.26300/3btb-4e84

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Public Health Theses and Dissertations

Theses and Dissertations for the Public Health department.
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