GEM NO. 158
Nutrition Education for the Hmong Joanne P. Ikeda, B.S., M.A.' Department of Nutritional Sciences, 9 Morgan Hall University of California, Berkeley, CA 94720 Stephanie Chan, B.S., MA. Former Dietetic Trainee Janice O. Harwood, B.S., MA. Home Economist, Merced County Kimberly A. Lucke, B A. Home Economist, San Joaquin County Jeanette Sutherlin, B.S., M.S. Home Economist, Fresno County, Cooperative Extension University of California
* Author for correspondence. California has been the destination of choice for the majority of Hmong who have immigrated to the United States since the early 1980s. Originally farmers from Southeast Asia, the Hmong were forced to flee their homeland after fighting on the side of the U.S. during the war in Viet Nam. Many Hmong experienced "culture shock" on their , arrival in the U. S. In order to help the Hmong adjust to the living and cooking conditions in their new country, as well as to help them learn about the strange processed and packaged foods for sale in supermarkets, we undertook a series of activities to enable dietitians and nutritionists to reach the Hmong with relevant food and nutrition information. BUilding on the results of a research project On Hmong food habits, our first activity was the production of a slide set and accompanying audiotape summarizing the descriptive information on food habits. A number of Hmong families in Fesno, California, opened their homes to a University photographer who photographed food preparation, family meals, and other scenes. We also received a grant to develop a videotape on kitchen safety and food sanitation for use with the Hmong. In producing the video, a Hmong Nutrition Education Assistant, who was a popular community leader, was identified as the "authority figure" who demonstrated how to keep the kitchen safe and sanitary. A series of handouts targeted specifically towards the Hmong was also developed. One of the most popular of these handouts features a food wheel that can be used to teach about the need to include a wide variety of foods in the daily diet. The center circle of the wheel features staple foods that the Hmong eat every day, while the outer circle shows foods from the basic food groups. Ihe message is simple: "The foods in the small circle are good foods that many Hmong eat every day. Hmong also need to eat some foods from each part of the larger circle every day for good health." Another handout is a pictorial representation of "American" foods that can be eaten "any day," "some days," and "not many days." Nutritionists, Dietitians, and Nutrition Education Assistants working with the Hmong can use this tool to explain that not all
"American" foods are equally nutritious in terms of nutrient density, and that some foods may be eaten more often than others. Because Hmong homemakers were particularly interested in learning how to make bread in order to save money, we developed an information sheet about bread. The handout points out that store-bought bread is often less expensive than homemade, and that it takes skill plus a lot of time to make homemade bread. The handout also presents information on buying, storing and using bread. To satisfy the Hmong women's desires to learn how to make "American" baked products, especially cookies, we developed a series of pictorial recipe sheets showing how to make peanut butter, molasses, and oatmeal-raisin cookies. Because of the need for information on food storage and how to read labels, handouts were also developed on these topics. All of these handouts were translated into Hmong, but English versions have also been made available so they can be used in English as a second language (ESL) classes. The English handouts are also used with Hmong children who have learned English, and who can share them with their parents. In addition to these educational materials designed for use by the Hmong themselves, we also developed a series of information sheets for the use of health professionals, featuring basic information on the nutrients most apt to be low in the Hmong diet. These sheets present suggestions on how to increase the consumption of foods rich in the at-risk nutrient, in ways that make sense in terms of current Hmong food habits. In order to extend this information and resources to the greatest number of professionals, Cooperative Extension agents and specialists held a series of three workshops in Fresno, Stockton, and Merced, California. The objectives of this training were that participants would: • become familiar with the eating habits of the Hmong; • feel more confident about providing nutrition education to Hmong clientele; • increase the effectiveness of their nutrition education with the Hmong; • use the culturally appropriate nutrition education materials that had been developed for the Hmong; and • use the resource material summarizing eating habits and critical nutrient infor-
Figure 1. Counseling session. mation about the typical Hmong diet. The program for each workshop included a discussion of the traditional cultural health practices and beliefs of the Hmong by a representative of the Hmong community; the presentation of the findings of the food habits study presented by the Cooperative Extension Nutrition Education SpeCialist (1); suggestions for nutrition education activities with the Hmong and the presentation of the nutrition education materials and resource sheets (2) by the County Extension Home Economists; and a food demonstration by bilingual Hmong Nutrition Education Assistants who had participated in the original research study. Approximately 200 health professionals attended these workshops and gave them a high rating. This project would not have been possible without the cooperation and support of Lao Family Community, Inc., in Stockton, Merced and Fresno, California. These Hmong organized and operated community organizations provided invaluable guidance and advice to Cooperative Extension staff throughout this project. We thank them! NOTES AND REFERENCES 1 Ikeda, J.P., D.R. Ceja, R.S. Glass, J.O. Harwood, K.A. Lucke, and J.M. Sutherlin. Food habits of the Hmong living in central California. Journal of Nutrition Education 23: - , 1991. 2 The Hmong Educational Materials Packet is available from: Joanne Ikeda, Nutrition Education Specialist, Cooperative Extension, Department of Nutritional Sciences, 9 Morgan Hall, University of California, Berkeley, California 94720-0001. There is a $10.00 charge; checks should be made payable to "uc Regents."
HMONG FOOD GUIDE
Figure 2. Food wheel (available in English and Hmong).
JOURNAL OF NUTRITION EDUCATION 23:260B, 1991