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Nutrition education for Cambodian refugees
GEM NO. 154
Nutrition Education for Cambodian Refugees Alvin E. Winder* School of Public Health Arnold House University of Massachusetts Amherst, MA 01003
newly arrived compatriots. Team members intervieweu many local Cambodians about their food practices, visited the local southeast Asian grocery store and spent several mealtimes with Cambodian families. After having completed the needs assessment the next step was to set objectives. These were: • To reinforce positive and health-promoting aspects of the Cambodian diet. • To provide mformation about the relationship between disease and certain diet deficiencies and excesses. • To inform the Cambodian community. of the existence of available supplemental food programs. • To increase the viewers' knowledge of the advantage of selectively incorporating some western foods into the Cambodian diet. To meet these objectives, we developed two separate nutrition education tools for the Cambodian population. The first of these was a nutrition information pamphlet. This pamphlet was prepared initially in English and then translated into Khmer. It is a single 9 x 12 inch sheet of paper folded to reveal 8 sections of photographs with captions in Khmer. Pages 1 and 2 of the foldout are addressed to pregnant women and children. These pages stress the importance of calcium and iron in the diets. These pages also address the health dangers of using too much sugar and salt. Pages 3 and 4 discuss the dangers to health of eating "junk foods," and offer alternative suggestions for a healthy diet.
Barbara A. Poremba School of Nursing Salem State College Salem, MA 01970 Regine C. Beakes South Central WIC Program 29 Pine Street Southbridge, MA 01550 *Address for correspondence. Since 1975 more than 1.5 million people have fled their homes in southeast Asia because of war, political turmoil and famine (1). By 1979 the United States had resettled almost 500,000 of these refugees. Cambodians are the single largest group of southeast Asians resettled in Massachusetts, constituting 47% of the recent refugee population in the state (2). A Massachusetts Nutritional Survey completed in 1983 reported that the incidence of undernutntion in the state is greatest for southeast Asian children. The survey also reported that southeast Asian refugees were found to be vulnerable to the effects of mass advertising and therefore prone to develop food habits detrimental to their health (3). The authors (a health educator, a public health nutritionist and a nurse) proposed to develop a nutrition education tool for this population. Our intention was to design a nutrition education tool for Cambodian refugees that was culturally sensitive and relevant in terms of their current values and dietary practices. The first step in this process was to assemble a team to work on the project. Two of us beca1lle part of a seven member team otherwise composed of students in a graduate course in community health education. The third author, a faculty member, acted as consultant to the team. Our team first conducted a nutritional needs assessment among the newly arrived local Cambodian population. to obtain the needs assessment, the students had to gain entry into the Cambodian community. This was accomplished with the cooperation of several Cambodian members of the community who had been living in the area for a number of years and who had achieved some status among their '
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1 Hoang, G.N. and R.V. Erickson. Guidelines for providing medical care to Southeast Asian refugees. Journal of the Amer-
Figure 2. While visiting a Cambodian home, nutritionist Regine Beakes learns about traditional eating patterns.
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itive aspects of the traditional Cambodian diet, as well as by recognizing the cultural significance of certain of their culinary practices. The presentation consists of 12 minutes of slides, with a narration in Khmer and an accompanying 9-minute English translation. The slides focused on the areas of concern that had been identified by the nutritional needs assessment. These areas were calcium, iron, salt, sugar and cholesterol. The link between poor nutritional habits and risks to health is maintained as the central theme throughout the presentation. The pamphlets and set of slides were distributed to Cambodian families by the WIC program in the State and were placed in the local southeast Asian food stores. The set of slides is also currently in use by the ESL program sponsored by the Amherst library (4). NOTES AND REFERENCES
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Figure 3. Cambodian woman shopping in a traditional market.
'
Figure 1. Since cuisine is an integral part of Cambodian culture, nutritional advice must be culturally sensitive in order to be effective.
Simple words were used to assure comprehension of the information being conveyed. The level of comprehension and vocabulary for the text were pretested with the help oflocal Cambodians. In order to create an upbeat, colorful pamphlet, photographs picturing local Cambodians were used. These were taken at a Cambodian home, a southeast Asian food store and a restaurant, as well as at the Cambodian New Year's celebration. Since not all the Cambodians can read and since we were informed that Cambodians would respond to action-oriented media, the authors also decided to produce a second tool, a set of slides entitled "Choosing Cambodian Foods Wisely." In addition to the previous objectives, a further purpose of the slides was to educate Cambodians to shop for foods that would provide the essential nutrients for a h'ealthv diet. The video material set out to accom'plish this by placing an emphasis on the pos-
ican Medical Association 248(6):710-14, 1982. 2 The Commonwealth of Massachusetts, Executive Office of Human Services, Massachusetts Office of Refugee Resettlement. Demographic data on refugees in Massachusetts. Boston, Massachusetts, 1987, pp. 1-5. 3 The Commonwealth of Massachusetts, Division of Family Health Services. Massachusetts Department of Public Health, Massachusetts nutrition survey, October, 1983. 4 For a set of slides and pamphlets, please send $25.00 to: Alvin E. Winder, School of Public Health, Arnold House, University of Massachusetts, Amherst, MA 01003.
JOURNAL OF NUTRITION EDUCATION 23:82D, 1991
Nutrition Education for Cambodian Refugees Alvin E. Winder* School of Public Health Arnold House University of Massachusetts Amherst, MA 01003
newly arrived compatriots. Team members intervieweu many local Cambodians about their food practices, visited the local southeast Asian grocery store and spent several mealtimes with Cambodian families. After having completed the needs assessment the next step was to set objectives. These were: • To reinforce positive and health-promoting aspects of the Cambodian diet. • To provide mformation about the relationship between disease and certain diet deficiencies and excesses. • To inform the Cambodian community. of the existence of available supplemental food programs. • To increase the viewers' knowledge of the advantage of selectively incorporating some western foods into the Cambodian diet. To meet these objectives, we developed two separate nutrition education tools for the Cambodian population. The first of these was a nutrition information pamphlet. This pamphlet was prepared initially in English and then translated into Khmer. It is a single 9 x 12 inch sheet of paper folded to reveal 8 sections of photographs with captions in Khmer. Pages 1 and 2 of the foldout are addressed to pregnant women and children. These pages stress the importance of calcium and iron in the diets. These pages also address the health dangers of using too much sugar and salt. Pages 3 and 4 discuss the dangers to health of eating "junk foods," and offer alternative suggestions for a healthy diet.
Barbara A. Poremba School of Nursing Salem State College Salem, MA 01970 Regine C. Beakes South Central WIC Program 29 Pine Street Southbridge, MA 01550 *Address for correspondence. Since 1975 more than 1.5 million people have fled their homes in southeast Asia because of war, political turmoil and famine (1). By 1979 the United States had resettled almost 500,000 of these refugees. Cambodians are the single largest group of southeast Asians resettled in Massachusetts, constituting 47% of the recent refugee population in the state (2). A Massachusetts Nutritional Survey completed in 1983 reported that the incidence of undernutntion in the state is greatest for southeast Asian children. The survey also reported that southeast Asian refugees were found to be vulnerable to the effects of mass advertising and therefore prone to develop food habits detrimental to their health (3). The authors (a health educator, a public health nutritionist and a nurse) proposed to develop a nutrition education tool for this population. Our intention was to design a nutrition education tool for Cambodian refugees that was culturally sensitive and relevant in terms of their current values and dietary practices. The first step in this process was to assemble a team to work on the project. Two of us beca1lle part of a seven member team otherwise composed of students in a graduate course in community health education. The third author, a faculty member, acted as consultant to the team. Our team first conducted a nutritional needs assessment among the newly arrived local Cambodian population. to obtain the needs assessment, the students had to gain entry into the Cambodian community. This was accomplished with the cooperation of several Cambodian members of the community who had been living in the area for a number of years and who had achieved some status among their '
..,
1'[. • I
l
~l
"~
....
1 Hoang, G.N. and R.V. Erickson. Guidelines for providing medical care to Southeast Asian refugees. Journal of the Amer-
Figure 2. While visiting a Cambodian home, nutritionist Regine Beakes learns about traditional eating patterns.
•
,:1:-: :('.o;'~.\. ./
'.
J.(,~~
'/~:'''' ;::'" ..
I ~{;.~
;.
..
•-=:~~ ~-ft.I>.
itive aspects of the traditional Cambodian diet, as well as by recognizing the cultural significance of certain of their culinary practices. The presentation consists of 12 minutes of slides, with a narration in Khmer and an accompanying 9-minute English translation. The slides focused on the areas of concern that had been identified by the nutritional needs assessment. These areas were calcium, iron, salt, sugar and cholesterol. The link between poor nutritional habits and risks to health is maintained as the central theme throughout the presentation. The pamphlets and set of slides were distributed to Cambodian families by the WIC program in the State and were placed in the local southeast Asian food stores. The set of slides is also currently in use by the ESL program sponsored by the Amherst library (4). NOTES AND REFERENCES
,.•
~
~j'
Figure 3. Cambodian woman shopping in a traditional market.
'
Figure 1. Since cuisine is an integral part of Cambodian culture, nutritional advice must be culturally sensitive in order to be effective.
Simple words were used to assure comprehension of the information being conveyed. The level of comprehension and vocabulary for the text were pretested with the help oflocal Cambodians. In order to create an upbeat, colorful pamphlet, photographs picturing local Cambodians were used. These were taken at a Cambodian home, a southeast Asian food store and a restaurant, as well as at the Cambodian New Year's celebration. Since not all the Cambodians can read and since we were informed that Cambodians would respond to action-oriented media, the authors also decided to produce a second tool, a set of slides entitled "Choosing Cambodian Foods Wisely." In addition to the previous objectives, a further purpose of the slides was to educate Cambodians to shop for foods that would provide the essential nutrients for a h'ealthv diet. The video material set out to accom'plish this by placing an emphasis on the pos-
ican Medical Association 248(6):710-14, 1982. 2 The Commonwealth of Massachusetts, Executive Office of Human Services, Massachusetts Office of Refugee Resettlement. Demographic data on refugees in Massachusetts. Boston, Massachusetts, 1987, pp. 1-5. 3 The Commonwealth of Massachusetts, Division of Family Health Services. Massachusetts Department of Public Health, Massachusetts nutrition survey, October, 1983. 4 For a set of slides and pamphlets, please send $25.00 to: Alvin E. Winder, School of Public Health, Arnold House, University of Massachusetts, Amherst, MA 01003.
JOURNAL OF NUTRITION EDUCATION 23:82D, 1991