Introduction: The refugee population is at risk for lower health literacy and higher rates of illness compared to the general population. Refugees resettled by Integrated Refugee and Immigrant Services (IRIS) in Connecticut identified four pediatric health topics, nutrition, safety, oral health, and parenting, as areas of particular interest for further education. We therefore developed an innovative family-based, interactive pediatric health education curriculum addressing these topics for local refugee families. Program Report: We created four one-hour-long interactive classes based on literature review and expert input. A multi-disciplinary team including pediatric residents, dental and medical students, and nurses taught these classes between October, 2018 and April, 2019. Classes were held on-site at IRIS with in-person interpreters in Pashto, Dari, Arabic, Swahili, and Kinyarwanda. Hands-on, play-based activities for infants and toddlers including a My Healthy Plate puzzle, street-crossing simulation, tooth-brushing demonstration, and block play activity were integrated into discussion with parents using visual aids. We assessed knowledge acquisition and class satisfaction using pre-and post-test questionnaires. Each class was attended by between 9 and 12 adults (56-67% female, ages 19-57) and 3 and 5 toddlers. Educational attainment among adult attendees ranged from no school to community college after resettlement. Class facilitators reported that children were engaged during the activities, which fueled discussion among the adult participants. Paired t-test analysis of pre- and post-test questionnaires demonstrated a non-statistically significant increase in scores for the classes on child nutrition (4.17 to 4.5, p=0.17) and child safety (4.17 to 4.83, p=0.09). Participants indicated that they learned from the classes and would recommend them to others. Discussion: This series of four classes demonstrated that using family-based activities and discussion is an accepted and effective means to convey child health information to refugee families in a culturally-inclusive manner. This class format facilitated delving into content typically only briefly covered in well-child visits and enabled cross-cultural sharing and relationship building between refugee families. While average test scores improved after two of the classes, the absence of statistical significance is likely attributable to small sample size and varied baseline educational levels of the participants. Based on these results, we plan to expand the availability of these classes, develop similarly formatted curricula on additional topics of interest, and explore more robust means of evaluating knowledge acquisition. Conclusion: Using family-based activities and discussion facilitated by in-person interpretation in various languages is an accepted and effective means of conveying child health information to refugee families. Further expansion of curricular topics and evaluation methods is warranted.
Healthy Child Curriculum for Refugees: a family-based pediatric health education program for refugees
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Henna A. Shaikh, Nan Du, Riana Riffle, Ginger Holton, Zaneta Forson-Dare, Bonnie Hawkins, Amanda Ocran, Prisca Takundwa, Shannon O'Malley, Nicole Jubelirer, Umar Qadri, Camille Brown, Pooja Agrawal, Frances Cheng; Healthy Child Curriculum for Refugees: a family-based pediatric health education program for refugees. Pediatrics July 2020; 146 (1_MeetingAbstract): 294. 10.1542/peds.146.1MA4.294a
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