Refugees’ Perceptions of Healthy Behaviors

Abstract

This descriptive study explored refugees' knowledge and perceptions of nutrition, physical activity and smoking behaviors using the Health Promotion and Transtheoretical Models. A one-time interview used both closed- and open-ended questions. The sample included 31 adults from Bosnia, Iran, and Cuba. Refugees had some knowledge of a healthy diet and physical activity, and were aware of both benefits and barriers for health behaviors. They had a realistic perception of their weight (55% overweight), and none thought obesity was a positive characteristic. Changes in diet, physical activity and smoking since arrival in the US have been positive for some and negative for others. For all categories discussed, refugees were in the pre-contemplation stage of change. There is a need to study refugees' health behaviors over time after arrival. Health behavior interventions must be specific to ethnicity in order to accurately document progress and to be culturally appropriate.

A Systematic Examination of Food Intake and Adaptation to the Food Environment by Refugees Settled in the United States

“…In a study of Bosnian, Cuban, and Iranian refugees, 60% reported consumption of excessive energy, in general: 50%, too many sweets and 19%, too much fat (30). Cuban, Cambodian, and Hmong refugees indicated that an abundance of available food (18,23,30) and a variety of cuisines in the United States (23) compared with near-starvation and restricted food availability in regions of origin and/or refugee camps contributed to excess food consumption (23). Except for one intervention study (20,21), all were cross-sectional studies.…”

“…In addition, one study showed that a supplementary program for B-12 deficiency resulted in increased refugee consumption of meat, eggs, and dairy products (20,21). Finally, a fairly common finding was that the consumption of sweets, sweetened beverages, fruit juices, and fast food increased in refugees after US resettlement (27,28,30,(31)(32)(33). The longer refugees lived in the United States, the more likely they were to consume added sugars, oils, seasonings, hot drinks, and vegetables (P < 0.05) (27).…”

“…Refugees were uncomfortable with the availability of fruits and vegetables not typically in season; most had never seen such a variety of food in their lifetime (24). Because most refugee families in Cambodia, Laos, Bosnia, and Cuba owned rice paddy lots, vegetable gardens, and/or livestock, they were accustomed to conveniently and readily accessing seasonal fruits, vegetables, grains, and fresh protein (17,30,32). These families reported challenges finding desired foods in the United States.…”

“…Several studies reported refugee concerns about excessive energy intake (30), overweight, and obesity (19, 23-25, 28, 30). Indeed, they were aware of the expanding waistlines in their communities.…”

“…Multiple refugee groups wanted to learn more about healthy foods in the United States (17,26,28,29). In 2 studies, refugees reported improvements in diets since US resettlement (30,32); however, more refugees considered US diets less healthy than preresettlement diets (16,23,30,31). Perceived healthy foods included fruits (30), oranges (33), vegetables (30,33), whole grains (25), beef (33), chicken (33), boiled water (31), and foods with less fat and sugar (30) or small portion size (30).…”