Role of community health workers in evaluating a Hmong nutrition education project

Community health workers were integral contributors to a study that tested the application of an evaluation instrument that measures positive behavior changes for the California Expanded Food and Nutrition Education Program (EFNEP). This instrument, known as the Food Behavior Checklist (FBC), had not been previously evaluated for use with culturally unique subpopulations. Here we evaluated the utility and cultural appropriateness of the FBC questions for the Hmong population in the California Central Valley. Community health workers were trained to assess the effectiveness and cultural responsiveness of an adaptation of the Healthy Families EFNEP Curriculum, a series of interactive lessons aimed to improve nutrition and increase physical activity in limited resource families. This study revealed a major challenge in the Hmong population's ability to understand certain cognitive concepts, including the concepts of regularly scheduled “exercise”, of “planning ahead” by making shopping lists, and of reading food labels for nutritional content. The evaluation instrument was tested in the field and modified to address the key linguistic and cultural barriers. Overall, this study showed that community health care workers can serve as effective “bridging” agents to assist in the development and testing of methods to further health promotion among populations with special needs.