The Challenge of Reaching a Culturally Diverse Audience

Nevada's tremendous population growth has dramatically changed the state's racial and ethnic picture. The Hispanic population grew 131% between l980 and 1990. Of the 124,000 Hispanics in Nevada in 1990, nearly 70 percent were from Mexico. Additional immigrants came from other Central and South American countries as well as Puerto Rico and Cuba. The booming job market in Nevada offered primarily poverty level or near- poverty level wages to many of these non-English speaking and unskilled workers.

Southern Nevada nutrition specialists conducted a needs assessment in 1992. During this process local agencies expressed concern regarding the lack of educational programs for Hispanic families. Coordinators for WIC (a supplemental, nutritional program for Women, Infants and Children) reported that there were 5,223 Hispanic participants (35% of total) in the WIC program in Clark County. Difficulties were identified in meeting the needs of these clients since many did not speak English and needed more intensive nutrition education than WIC was able to provide. Initial screenings indicated a growing number of Hispanics at a high nutritional risk.

In a recent study, Eliades and Suitor (1994) document food- related problems that immigrants experience in their new environment. Some of these problems are: a) difficulty in obtaining familiar foods and spices; b) when obtained, the cost of these foods is high; c) inability to locate acceptable substitutes for familiar food items; and d) inability to read labels and information on food packages.

The desire of Cooperative Extension to collaborate with WIC resulted in the development of Extension Service/WIC Nutrition Education Initiative, Project Number 93-ENED-1-7510. Nevada was one of 17 states that received funding through the competitive grant program. Nevada seized this opportunity to address an identified need. Culturally sensitive and appropriate Spanish language nutrition education materials for this diverse population were not readily available. After a thorough review of materials, the decision was made to adapt an existing curriculum from California's Expanded Food and Nutrition Education Program (EFNEP).

A bilingual registered dietitian with experience in community-based education was hired as project coordinator. Although the coordinator was Hispanic, her cultural background was different from the population to be served. Prior to hiring staff, she visited Hispanic neighborhoods and familiarized herself with local supermarkets and bakeries and the food products available.

An important factor considered in the hiring of paraprofessional staff was to recruit Hispanic individuals knowledgeable about cultural beliefs and dietary norms and practices. Applicants were recruited through advertisements in local media targeting the Hispanic population. The staff hired represented several cultures including Mexican, Puerto Rican, and Venezuelan and were indigenous to the neighborhoods to be served. Two were familiar with the home visitor teaching model because of their participation in the Expanded Food and Nutrition Education Program.

The paraprofessional staff was trained using a home visitor model. Training focused on teaching the curriculum including experiential activities, and interviewing techniques for using food recalls and surveys. Representatives from agencies serving low-income families provided information on program services and how to access services. Intensive nutrition education lessons over a six-week period prepared the staff for their home visiting experiences. The varied backgrounds of the paraprofessionals encouraged an exchange of information that facilitated the learning process. As Mexican eating habits were discussed, it became apparent that there were many variations in food preparation throughout Mexico.

Joint training sessions between Cooperative Extension and WIC staff were held periodically. The two agencies gave a thorough orientation of their program, delivery method, and procedures. This allowed an understanding of how each achieved their common goal of providing nutrition education to low income families.

An intensive nutrition education program was presented to participants in a series of 12-16 lessons taught weekly in the home. Supermarket tours, food preparation experiences, and other exercises which required interaction between the paraprofessional and client were included. Traditional food practices were supported and ideas offered to modify unhealthy food preparation methods.

The project is completing its third and final year. During this time, 695 families were enrolled and 440 families were graduated. Significant improvement in nutrition, food safety, and resource management practices was demonstrated among participants receiving the educational program as compared to a control group.

The paraprofessional staff reported that one of the most satisfying aspects of using the home visitor model was the opportunity provided for continual learning and exchange of information between "the teacher" and "the student."

Eliades, D. C., & Suitor, C. W. (1994). Celebrating Diversity_Approaching Families Through Their Food. Arlington, VA: National Center for Education in Maternal and Child Health.