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