Date of Award:


Document Type:


Degree Name:

Doctor of Philosophy (PhD)


Nutrition, Dietetics, and Food Sciences

Committee Chair(s)

Nedra K. Christensen


Nedra K. Christensen


Korry Hintze


Ann M. Berghout Austin


Heidi Wengreen


J. Nicholls Eastmond


Recently resettled refugees are at high risk for food insecurity and its health consequences. This observational study evaluated the effectiveness of integrating nutrition lessons into English as a Second Language (ESL) classes at a work-site training center for refugees. The lessons focused on making healthy choices with a limited budget. Through the assistance of ESL teachers, nutrition educator assistants (NEAs) from the Supplemental Nutrition Assistance Program (SNAP) taught nutrition lessons to 98 refugees from 17 different countries for 12 weeks. Food frequency questionnaires (FFQ) for 49 participants were matched pre and post 12 weeks of class. A Wilcoxon test was used to determine differences in intake of fruits, vegetables, meats, whole grains, refined grains, dairy, sugar, fat, and alcohol. No significant difference was found between median intake for fruit, vegetables, whole grains, refined grains, sugar, and alcohol. The median intake of meat (2.5 to 1 servings per day, p=0.006), dairy (2.5 to 1 servings per day, p=0.013), and fat (1 to 0.7 servings per day, p=0.01) significantly decreased. Food purchase receipts were gathered to evaluate feasibility of assessing food expenditures in this population. Fifty percent (49/98) of the refugees completed all 12 lessons. Receipts were collected from 59 different participants and 93% (55/59) of the participants had receipts that used SNAP funds. Receipts reflected food purchased from supermarkets and ethnic food stores by 92% (54/59) and 59% (35/59) of the participants. The model of delivering nutrition education through ESL classes addressed barriers refugees face. Further research is needed to develop culturally sensitive nutrition education and validated assessment tools for refugees.




This work made publicly available electronically on May 10, 2012.