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Perspectives of Caregivers on the Effects of Migration on the Nutrition, Health and Physical Activity of their Young Children: A Qualitative Study with Immigrant and Refugee Families

  • Elizabeth Dawson-HahnEmail author
  • Lorren Koceja
  • Elizabeth Stein
  • Beth Farmer
  • H. Mollie Grow
  • Brian E. Saelens
  • Jason Mendoza
  • Suzinne Pak-Gorstein
Original Paper

Abstract

To explore perspectives on nutrition, health and physical activity among immigrant parents with young children before and after migration. We conducted focus groups in five languages (Arabic, Somali, Dari, Burmese and Nepali), then conducted a phenomenological analysis of the transcripts. Fifty caregivers participated; 42% spent time in a refugee camp. Within the domain Change in Environment, four themes emerged: (1) food access; (2) family experiences with weight and growth; (3) differences in physical activity and perceptions of safety; and (4) health care experience. Within the domain of Parenting Behaviors and Experiences, two themes emerged: (1) Sociocultural differences in early feeding behaviors and (2) concern about feeding behaviors. To support health outcomes for refugee and immigrant families with young children, key focus areas for programming would include access to fresh foods, safe places for physical activity, and feeding practices following a family history of food scarcity.

Keywords

Refugees Immigrants Children Feeding Nutrition 

Notes

Acknowledgements

We appreciate all of Zac Eskenazi’s work in facilitating the logistics of the First Foods program at Refugees Northwest, as well as the interpreters that supported each focus group. Thank you to Andrea Hoopes, MD, MPH for her feedback on early stages of this manuscript. Dr. Dawson-Hahn’s salary was funded by the Ruth L. Kirchstein National Research Service Award (T32HP10002), and the focus groups were funded by a grant from the Seattle Children’s Center for Diversity and Health Equity, and a Community Solutions Grant from United Way (PI: Farmer).

Funding

Dr. Dawson-Hahn’s time and effort was funded by the Ruth L. Kirschstein National Research Service Award (T32HP10002) and the Seattle Children’s Center for Child Health, Behavior and Development Mentored Scholars Award. Dr. Dawson-Hahn received grant funding for this project from the Seattle Children’s Hospital Center for Diversity and Health Equity Small Grant Funding. Ms. Farmer received grant funding for this project from Washington-Rotary International and a United Way Community Solutions Grant.

Compliance with Ethical Standards

Conflict of interest

There are no conflicts of interest to report.

References

  1. 1.
    Migration Policy Institute. Children in U.S. Immigrant Families (By Age Group and State, 1990 versus 2015). https://www.migrationpolicy.org/programs/data-hub/charts/children-immigrant-families (2015). Accessed 24 Nov 2017.
  2. 2.
    Office of Admission-Refugee Processing Center, Department of State, Bureau of Population, Refugees, and Migration. Summary of Refugee Admissions as of October 31, 2016. http://www.wrapsnet.org/Reports/AdmissionsArrivals/tabid/211/Default.aspx2016.
  3. 3.
    Martin DC, Yankay J. Refugees and Asylees: 2013. 2014.Google Scholar
  4. 4.
    Javier JR, Festa N, Florendo E, Mendoza FS. Children in immigrant families: the foundation for America’s future. Adv Pediatr. 2015;62(1):105–36.CrossRefGoogle Scholar
  5. 5.
    Mendoza FS. Health disparities and children in immigrant families: a research agenda. Pediatrics. 2009;124(Suppl 3):S187–95.CrossRefGoogle Scholar
  6. 6.
    Zimmerman C, Kiss L, Hossain M. Migration and health: a framework for 21st century policy-making. PLoS Med. 2011;8(5):e1001034.CrossRefGoogle Scholar
  7. 7.
    Calam R. Public health implications and risks for children and families resettled after exposure to armed conflict and displacement. Scand J Public Health. 2016;45:209–11.CrossRefGoogle Scholar
  8. 8.
    Doocy S, Sirois A, Anderson J, et al. Food security and humanitarian assistance among displaced Iraqi populations in Jordan and Syria. Soc Sci Med. 2011;72(2):273–82.CrossRefGoogle Scholar
  9. 9.
    UNICEF. Uprooted: The growing crisis for refugee and migrant children. UNICEF;2016.Google Scholar
  10. 10.
    Fazel M, Reed R, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012;379:266–82.CrossRefGoogle Scholar
  11. 11.
    Baker EH, Rendall MS, Weden MM. Epidemiological paradox or immigrant vulnerability? Obesity among young children of immigrants. Demography. 2015;52(4):1295–320.CrossRefGoogle Scholar
  12. 12.
    Dawson-Hahn E, Pak-Gorstein S, Matheson J, et al. Growth trajectories of refugee and nonrefugee children in the United States. Pediatrics. 2016;6:e20160953.CrossRefGoogle Scholar
  13. 13.
    Yeh MC, Parikh NS, Megliola AE, Kelvin EA. Immigration status, visa types, and body weight among new immigrants in the United States. Am J Health Promot. 2016;32:771–8.CrossRefGoogle Scholar
  14. 14.
    Ryan-Ibarra S, Sanchez-Vaznaugh EV, Leung C, Induni M. The relationship between food insecurity and overweight/obesity differs by birthplace and length of US residence. Public Health Nutr. 2017;20(4):671–7.CrossRefGoogle Scholar
  15. 15.
    Creighton MJ, Goldman N, Pebley AR, Chung CY. Durational and generational differences in Mexican immigrant obesity: is acculturation the explanation? Soc Sci Med. 2012;75(2):300–10.CrossRefGoogle Scholar
  16. 16.
    Careyva B, LaNoue M, Bangura M, et al. The effect of living in the United States on body mass index in refugee patients. J Health Care Poor Underserved. 2015;26(2):421–30.CrossRefGoogle Scholar
  17. 17.
    Oza-Frank R, Cunningham SA. The weight of US residence among immigrants: a systematic review. Obes Rev. 2010;11(4):271–80.CrossRefGoogle Scholar
  18. 18.
    Greves HM, Lozano P, Liu L, Busby K, Cole J, Johnston B. Immigrant families’ perceptions on walking to school and school breakfast: a focus group study. Int J Behav Nutr Phys Act. 2007;4:64.CrossRefGoogle Scholar
  19. 19.
    Steinman L, Doescher M, Keppel GA, et al. Understanding infant feeding beliefs, practices and preferred nutrition education and health provider approaches: an exploratory study with Somali mothers in the USA. Matern Child Nutr. 2010;6(1):67–88.CrossRefGoogle Scholar
  20. 20.
    Tiedje K, Wieland ML, Meiers SJ, et al. A focus group study of healthy eating knowledge, practices, and barriers among adult and adolescent immigrants and refugees in the United States. Int J Behav Nutr Phys Act. 2014;11:63.CrossRefGoogle Scholar
  21. 21.
    Starks H, Trinidad SB. Choose your method: a comparison of phenomenology, discourse analysis, and grounded theory. Qual Health Res. 2007;17(10):1372–80.CrossRefGoogle Scholar
  22. 22.
    Ngum Chi Watts MC, Liamputtong P, McMichael C. Early motherhood: a qualitative study exploring the experiences of African Australian teenage mothers in greater Melbourne, Australia. BMC Public Health. 2015;15:873.CrossRefGoogle Scholar
  23. 23.
    Vue W, Wolff C, Goto K. Hmong food helps us remember who we are: perspectives of food culture and health among Hmong women with young children. J Nutr Educ Behav. 2011;43(3):199–204.CrossRefGoogle Scholar
  24. 24.
    Renzaho AM, McCabe M, Swinburn B. Intergenerational differences in food, physical activity, and body size perceptions among African migrants. Qual Health Res. 2012;22(6):740–54.CrossRefGoogle Scholar
  25. 25.
    Barlow SE, Expert C. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120(Suppl 4):S164–92.CrossRefGoogle Scholar
  26. 26.
    Fisher JO, Birch LL. Restricting access to palatable foods affects children’s behavioral response, food selection, and intake. Am J Clin Nutr. 1999;69(6):1264–72.CrossRefGoogle Scholar
  27. 27.
    Steiner H, Kwan W, Shaffer TG, et al. Risk and protective factors for juvenile eating disorders. Eur Child Adolesc Psychiatry. 2003;12(Suppl 1):I38–136.Google Scholar
  28. 28.
    Masten AS, Narayan AJ. Child development in the context of disaster, war, and terrorism: pathways of risk and resilience. Annu Rev Psychol. 2012;63:227–57.CrossRefGoogle Scholar
  29. 29.
    El-Behadli AF, Sharp C, Hughes SO, Obasi EM, Nicklas TA. Maternal depression, stress and feeding styles: towards a framework for theory and research in child obesity. Br J Nutr. 2015;113(Suppl):S55–71.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PediatricsUniversity of WashingtonSeattleUSA
  2. 2.Seattle Children’s Research InstituteCenter for Child Health, Behavior and DevelopmentSeattleUSA
  3. 3.Harborview Medical CenterSeattleUSA
  4. 4.Refugees Northwest, Lutheran Community Services NorthwestSeatacUSA
  5. 5.Department of Psychiatry & Behavioral SciencesUniversity of WashingtonSeattleUSA
  6. 6.Cancer Prevention ProgramFred Hutch/UW Cancer ConsortiumSeattleUSA
  7. 7.Department of Global HealthUniversity of WashingtonSeattleUSA

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