263189 Primary prevention for refugees: Discovering the burden of choice

Tuesday, October 30, 2012

Heather-Lyn Haley, PhD , Family Medicine and Community Health, UMass Medical School, Worcester, MA
Meredith Walsh, RN , Graduate Entry Pathway, UMass Graduate School of Nursing, Worcester, MA
Nang H. Maung, PhD , Post-doctoral Associate, Tufts Medical School, Boston, MA
Clara Savage, EdD , MA Dept of Public Health CHNA8, Common Pathways, Worcester, MA
James Madson II , MA Dept of Public Health CHNA-8, Common Pathways, Worcester, MA
Suzanne Cashman, ScD , Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA
Refugees resettling in the US historically follow a trajectory of declining health as they adopt American habits of poor diet and low levels of physical activity and sleep. This participatory research study explored health beliefs and behaviors of the new community of refugees from Burma currently resettling in New England from refugee camps. Community members and researchers worked together to adapt a healthy living curriculum entitled “Eat Walk Sleep for Health” (EWS), creating a bilingual educational flipchart. The flipchart was piloted in two workshops with a total of 20 adult men and women. Workshop discussion focused on participants' prior and current health behaviors as well as their current health challenges. An interpreter translated during the discussions which were audio taped, then transcribed and analyzed using standard qualitative methods. Refugee camps constrain food and physical activity related health behaviors. Refugees rely on traditional healing practices but accept western health care. New arrivals are often housebound and isolated; they seek simple maps that prevent them from getting lost in their new communities. Asking about sleep appears to open the conversation about emotional and mental health problems. Refugees want specific information about healthy foods and better understanding of their need for exercise. They also seek information on prevention of health problems common in the US coupled with assistance preserving their traditional beliefs. Post-settlement in the US, retaining good health is challenging. Bilingual flipcharts and neighborhood map drawing provide avenues for open discussion leading to areas for Prevention Research Centers to partner for health.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Discuss the use of culturally relevant flipcharts for advancing health promotion and prevention conversations with recently arrived refugees. Explain how constructing simple maps can help reduce refugees’ isolation Describe relevant health-related environmental and structural conditions in refugee camps in Thailand List three ways that resettled refugees’ health behaviors are affected by familiar camp conditions and now challenged by their new environment in the US. Identify opportunities for Prevention Research Centers to partner with local refugee communities to promote health.

Keywords: Refugees, Primary Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a sociologist and assistant professor working with community-engaged medical and graduate nursing students in a department of Family Medicine and Community Health. My areas of expertise include student reflective writing, service learning, primary care faculty development, and patient-provider communication skills training. I have experience with conducting community-based participatory research, as well as quantitative and qualitative analyses.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.