First Foods Nutrition Curriculum for New Immigrant Families: A Pilot Study

Background: Immigrant families arrive in the US from a variety of nutritional landscapes and educational experiences. Early childhood is a key time to intervene to set children on a healthy path. Creating nutritional education programs tailored for immigrant families may improve nutrition and health outcomes. Objective: To evaluate the First Foods curriculum as a tool for knowledge and behavior change for new immigrant families of young children. Methods: Immigrant caregivers of children less than 2 years old were invited to attend First Foods, a 4-class series. Each series was offered in 1 of 5 different languages (Arabic, Dari, Somali, Burmese, and Nepali). Recruitment occurred through community organizations, primary care clinics and Women, Infants, and Children (WIC), and classes were held in King County, Washington. The curriculum was developed and taught by a registered pediatric dietitian with input from general pediatricians, all experienced in the care of immigrant families. Classes were interpreted in the relevant language and course materials were translated. The classes were based on 4 themes -- 1) Child Eating and Development, 2) Eating Together, 3) Food Safety, and 4) Health Living -- and incorporated positive parenting and child development. Attendees completed pre- and post-surveys in their respective languages or in English. Descriptive statistics, chi-squared analyses, t-tests, and a multi-level linear regression model were conducted in Stata v14.0. Results: Participants in the classes included 47 caregivers (91% mothers). Nearly one-third had previously lived in a refugee camp. They had lived in the US a mean 5.5 years (95% CI: 3.8-7.2 years), attended a mean 8.6 years of school (95% CI: 7.1-10.1 years), and had a mean of 2.8 children (95% CI: 2.3-3.3 children). Classes ranged in size from 5 to 14 caregivers. Caregivers reported an improved understanding of 2 out of 4 methods to decrease risk of dental caries (drinking tap water, p = \u3c0.001; going to the dentist, p=0.02). They reported a decreased use of food as a reward from the pre- to the post-survey (p=0.027). Additionally, the caregivers reported increased frequency of considering sugar content in family foods (p=0.033), and decreased frequency of purchasing food at a convenience store, after participating in the curriculum (p=0.001). Conversely, there were several domains where caregivers did not show a change in their response. Conclusion: First Foods, a community-tailored, early childhood feeding curriculum for immigrant parents of young children, improved knowledge and behavior among caregivers from a variety of immigrant communities in some domains. In the other domains, there may be opportunities to further optimize the educational messages and approach

The Community Health Response Team: a culturally and linguistically tailored community response to COVID-19 addressing barriers to testing and vaccinations for refugee, immigrant and migrant communities in Atlanta, Georgia

The International Rescue Committee (IRC) in Atlanta and Community Organized Relief Effort (CORE) established a Community Health Response Team in May 2020. The team members represented refugee, immigrant and migrant populations and had expertise in health care and public health. These 18 individuals were recruited from IRC Atlanta's Career Development program, had a variety of backgrounds and spoke 20 languages. They implemented a community-centered COVID-response intervention model of pairing education and outreach efforts with testing and vaccination clinics. Due to their team makeup, the Community Health Response Team conducted tailored outreach and education that was culturally and linguistically congruent with their target communities. They administered over 16,000 COVID-19 tests at mobile community sites within the first 6 months. Once COVID-19 vaccinations were available, the Community Health Response Team coordinated a total of 834 vaccination events in communities with a high number of refugees and in partnership with refugee- and immigrant-trusted community-based organizations, resulting in 31,888 vaccinations. Hiring staff from refugee, immigrant and migrant populations created a sustainable staffing model. Also, embedding culturally specific strategies in their model of pairing education and outreach led to long-term relationships and greater trust with community members. This approach of engaging and empowering community members to create tailored public health responses should serve as guidance for future public health campaigns

Perspectives of public health organizations partnering with refugee, immigrant, and migrant communities for comprehensive COVID-19 case investigation and contact tracing

ObjectivesTo understand public health organizations’ experiences providing comprehensive COVID-19 case investigation and contact tracing, and related promising practices with refugee, immigrant and migrant communities.MethodsWe interviewed public health professionals (September 2020 to February 2021) from local and state health departments using a geographically stratified, purposive sampling approach. A multidisciplinary team at the National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) conducted a thematic analysis of the data.ResultsSix themes were identified: understanding community and public health context, cultivating relationships, ensuring linguistic and cultural concordance, communicating intentionally, evolving response, and implementing equity. The interconnection of themes and promising practices is explored.ConclusionAs public health continues to learn from and build upon COVID-19 response experiences, the thematic findings and potential promising practices identified in this project may foster proactive, community-engaged solutions for public health, and other organizations working and partnering with refugee, immigrant, and migrant communities. Implementing these findings with COVID-19 into current and future public health crisis responses may improve public health, collaborations with refugee, immigrant, and migrant communities, and staff wellbeing

“Beyond just the four walls of the clinic”: The roles of health systems caring for refugee, immigrant and migrant communities in the United States

This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’IntroductionRefugee, immigrant and migrant (hereafter referred to as “immigrant”) communities have been inequitably affected by the COVID-19 pandemic. There is little data to help us understand the perspectives of health systems on their role, in collaboration with public health and community-based organizations, in addressing inequities for immigrant populations. This study will address that knowledge gap.MethodsThis qualitative study used semi-structured video interviews of 20 leaders and providers from health systems who cared for immigrant communities during the pandemic. Interviewees were from across the US with interviews conducted between November 2020–March 2021. Data was analyzed using thematic analysis methods.ResultsTwenty individuals representing health systems participated with 14 (70%) community health centers, three (15%) county hospitals and three (15%) academic systems represented. The majority [16 health systems (80%)] cared specifically for immigrant communities while 14 (70%) partnered with refugee communities, and two (10%) partnered with migrant farm workers. We identified six themes (with subthemes) that represent roles health systems performed with clinical and public health implications. Two foundational themes were the roles health systems had building and maintaining trust and establishing intentionality in working with communities. On the patient-facing side, health systems played a role in developing communication strategies and reducing barriers to care and support. On the organizational side, health systems collaborated with public health and community-based organizations, in optimizing pre-existing systems and adapting roles to evolving needs throughout the pandemic.ConclusionHealth systems should focus on building trusting relationships, acting intentionally, and partnering with community-based organizations and public health to handle COVID-19 and future pandemics in effective and impactful ways that center disparately affected communities. These findings have implications to mitigate disparities in current and future infectious disease outbreaks for immigrant communities who remain an essential and growing population in the US

Inflation and Dark Energy from spectroscopy at z > 2

The expansion of the Universe is understood to have accelerated during two epochs: in its very first moments during a period of Inflation and much more recently, at z < 1, when Dark Energy is hypothesized to drive cosmic acceleration. The undiscovered mechanisms behind these two epochs represent some of the most important open problems in fundamental physics. The large cosmological volume at 2 < z < 5, together with the ability to efficiently target high-$z$ galaxies with known techniques, enables large gains in the study of Inflation and Dark Energy. A future spectroscopic survey can test the Gaussianity of the initial conditions up to a factor of ~50 better than our current bounds, crossing the crucial theoretical threshold of $\sigma(f_{NL}^{\rm local})$ of order unity that separates single field and multi-field models. Simultaneously, it can measure the fraction of Dark Energy at the percent level up to $z = 5$, thus serving as an unprecedented test of the standard model and opening up a tremendous discovery space

Crowdsourcing hypothesis tests: Making transparent how design choices shape research results

To what extent are research results influenced by subjective decisions that scientists make as they design studies? Fifteen research teams independently designed studies to answer fiveoriginal research questions related to moral judgments, negotiations, and implicit cognition. Participants from two separate large samples (total N > 15,000) were then randomly assigned to complete one version of each study. Effect sizes varied dramatically across different sets of materials designed to test the same hypothesis: materials from different teams renderedstatistically significant effects in opposite directions for four out of five hypotheses, with the narrowest range in estimates being d = -0.37 to +0.26. Meta-analysis and a Bayesian perspective on the results revealed overall support for two hypotheses, and a lack of support for three hypotheses. Overall, practically none of the variability in effect sizes was attributable to the skill of the research team in designing materials, while considerable variability was attributable to the hypothesis being tested. In a forecasting survey, predictions of other scientists were significantly correlated with study results, both across and within hypotheses. Crowdsourced testing of research hypotheses helps reveal the true consistency of empirical support for a scientific claim.</div

The Association between Early Antibiotic Exposure and Obesity Development in Childhood

Thesis (Master's)--University of Washington, 2015Young children are frequently exposed to antibiotics, an improved understanding of the relationship between antibiotic exposure in early life and adiposity in childhood is warranted. We hypothesize early childhood antibiotic exposure is associated with overweight development. We formed a longitudinal birth cohort from 2002-2010, born in a health care system in WA. Antibiotic exposure was defined as courses of antibiotics (1 course = 1-14 days) received from 0-47 months of age. The outcome was overweight (BMI % ≥ 85th%) at 48-59 months. Multivariable logistic and linear regression models were used.72% of children were antibiotic exposed. In a multivariable logistic regression model, there was association between antibiotic exposure and overweight development (OR: 1.03, 95% CI: 1.01. 1.05). Children had a 3% higher odds of overweight development at 48-59 months for each additional course of antibiotics at 0-47 months. This association affords an opportunity to explore a physician-modifiable risk factor for overweight