nutrition and food security: working with community health workers prepared by: marti woolford for...
TRANSCRIPT
Nutrition and Food Security: Working with Community Health Workers
Prepared by:
Marti Woolford
for the
International Rescue [email protected]
All photos by Marti Woolford
PurposeNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• The purpose of the Community Health Worker program is to share information on basic nutrition, food safety, and exercise and wellness education with newly resettled refugees.
GoalsNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• The goals of the program are to– Encourage clients to eat foods from each of the food
groups– Teach clients the importance and benefits of eating a
balanced diet– Introduce clients to healthy American food at each
class– Teach food safety– Increase food security– Teach clients the importance of exercise and introduce
the group to new forms of exercise– Empower women and build community
DefinitionsNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• Food Security– High food security- No reported indications of
food-access problems or limitations– Marginal food security- One or two reported
indications; typically of anxiety over food sufficiency or shortage of food in the house. Little or no indication of changes in diets or food intake
– Low food security- Reports of reduced quality, variety, or desirability of diet. Little or no indication of reduced food intake
– Very low food security- Reports of multiple indications of disrupted eating patterns and reduced food intake
Source: Nord & Coleman-Jensen, 2009
DefinitionsNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• Community Health Worker– Provide their communities with information about
health issues that affect them and link individuals with the health and social services they need to achieve wellness.
• Refugee– A person who “owing to a well-founded fear of being
persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his or her nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country”
Source:http://www.unhcr.org/pages/49da0e466.html
DefinitionsNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• WIC– Formal title is the Special Supplemental Nutrition
Program for Women, Infants, and Children– This program serves to safeguard the health of
low-income women, infants, and children up to age 5 who are at nutritional risk by providing nutritious foods to supplement diets, information on healthy eating and referrals to health care.
Source: http://fns.usda.gov/wic/aboutwic/wicataglance.htm
Community Health Workers (CHWs)Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
• CHWs are usually women, who are not working, and who speak English.
• CHWs are trained as they attend and provide interpretation for the 8-week nutrition sessions.– Classes are held one time a week for two hours– Classes are held in the CHWs apartment or home– Participants live in the same apartment complex or near
by– Participants are from the same cultural group
• CHWs are introduced and learn how to prepare healthy American food at each class.
• Upon completion of training CHWs are then ready to teach their communities on their own.
MethodsNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• The CHW administers nutrition and food security, food safety, and healthy eating assessments at the appropriate class.
• An International Rescue Committee staff member is present during the training period to answer any questions.
Nutrition and Food Security Assessment
Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
• The Nutrition and Food Security assessment has two parts1.Part one collects demographic data, food
preparation data, food acculturation questions, transportation use, and food assistance participation.
2.Part two consists of a food security questionnaire.
Nutrition and Food Security Assessment Results
Nutrition and Food Security: Working with Community Health Workers by Marti Woolford • Demographic data
– In 12-months the Community Health Worker program trained seven CHWs. CHWs were from Bhutan, Burma, Somalia, and Eritrea. These CHWs in turn assisted in teaching 33 different households about healthy eating, food safety, and exercise and wellness.
– Of these 33 households, 39% were Bhutanese, 33% were Burmese, 18% were Somali, and 9% were Eritrean.
Percentage of Participants by Country
N=33Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
Somalia18%
Bhutan40%
Burma33%
Eritrea9%
SomaliaBhutanBurmaEritrea
Nutrition and Food Security Assessment Results
Nutrition and Food Security: Working with Community Health Workers by Marti Woolford • Demographic Data cont.
– The average age of group participants was 26 years old with an average household size of 4 people.
– Gender of group participants was divided evenly with 15 (45%) being female, 15 (45%) being male, and 3 (9%) not responding to the gender question.
Food Assistance ParticipationN=33
Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
75%
24%
36% 36%
6%
54%
18% 21%
0% 0%
64% 64%
0%
10%
20%
30%
40%
50%
60%
70%
80%
FoodStamps
WIC FreeSchool
Breakfast
FreeSchoolLunch
Participate
Do NotParticipateUnknown
Not Applicable
Food SecurityNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• Of the 33 participants, 32 answered the food security questionnaire.
• The food security questionnaire found that 11 (34%) were food secure, 8 (25%) had marginal food security, 9 (28%) had low food security, and 4 (12%) had very low food security.
Food Security Questionnaire Results N=32
Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
35%
25%
28%
12%
Food Secure
Marginal FoodSecurityLow Food Security
Very Low FoodSecurity
Food Safety & Healthy Eating Assessment
Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
• The assessment asked participants knowledge of specific food safety & healthy eating issues before the food safety lesson and their knowledge after the food safety lesson.
• A likert scale was used to determine knowledge-1 being no knowledge and 10 being complete knowledge.
• A change score was then calculated by subtracting the before lesson score from the after lesson score (before score - after score = change score).
• The median value of all change score was then calculated. Results are shown on the next two slides.
Food Safety Assessment Results Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
Food Safety Assessment Results Median Change Score
Questions n=321. Symptoms of foodborne illness 4.152. Groups of people who are at an 2.88 increased risk of getting foodborne illness3. Proper way to wash hands 1.74. How to keep food safe at home 3.55. How to keep food safe at the grocery 3.5 store
Healthy Eating Assessment Results
Nutrition and Food Security: Working with Community Health Workers by Marti Woolford
Healthy Eating Assessment Results Median Change Score
Questions n=271. The five food groups 2.922. How many servings of each food group 3.07 to eat a day3. How to eat to prevent chronic disease 3.384. Maintaing my weight or losing weight 2.57
DiscussionNutrition and Food Security: Working with Community Health Workers by Marti Woolford
• The results of the Nutrition and Food Security assessment indicate that the refugees who attended the CHW classes experienced high rates of food insecurity and as a result may be experiencing difficulty acquiring healthy and nutritious food.
• The results of the food safety and healthy eating assessments indicate that participant’s knowledge increases after they receive the lessons. The results indicate also that some participant’s arrive in the U.S. with prior food safety and healthy eating knowledge.
Contact InformationNutrition and Food Security: Working with Community Health Workers by Marti Woolford
Amelia SelfHealth Program [email protected]
International Rescue Committee231 East 400 South, Suite 50Salt Lake City, Utah 84101