Pictures, posters, and preferences: Determining fish consumption patterns among limited English proficiency anglers

Limited English proficiency populations who are subsistence anglers have disproportionate risk of adverse health effects from contaminants in fish. Cultural and economic considerations work together to increase the reliance of these populations on fish in their diet. In order to address this environmental justice issue, public health educators must have a qualitative and quantitative understanding of fish consumption patterns in the target population. In Minnesota, Hmong anglers constitute a vulnerable population that may not have the same consumption patterns as the general population. However, determining these fish consumption patterns is complicated by a language barrier. In collaboration with a local chapter of Hmong sportsmen, St. Paul-Ramsey County Department of Public Health and the Minnesota Department of Natural Resources, Minnesota Department of Health staff conducted a needs assessment with novel techniques to engage participants in active responses using pictures, video and spoken words. Participants were animated and enthusiastically provided qualitative and quantitative data on fish preferences and eating frequencies. Through networking in the broader Hmong community, this needs assessment was replicated several times in other Hmong community groups and the results were aggregated. The results will be used in refining risk communication messages and methodologies for Hmong, especially around fish species that are more desirable or consumed more frequently. Needs assessment of limited English proficiency populations requires the active participation of the target population. Using pictures conjoined with oral communication, the participants can provide quantitative and qualitative responses that provide information for the community as well as public health staff.