Exam 2

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Unlawful Foods of the Qur'an

All swine, four footed animals that catch their prey with their mouths, birds of prey that seize their prey with their talons, and also by-products (gelatin) Improperly slaughtered animals - specific methods must be used such as cutting the front of the throat or carotid artery; blood is drained Blood and blood products Alcoholic beverages Drugs, unless for a medical reason

Other Components of a Nutritional Assessment

Anthropometric Measurements - height, weight, waist circumference Skinfold Measurements Body fat percentage Medical history Physical exam Laboratory measurements

Differences in BMI between Pima Indians in Mexico and Arizona Pima

Arizona Pima Indians have a higher BMI

Health Conditions Affecting Jewish Populations

Ashkenazi Jews 60-80% are lactose intolerant Genetic predisposition to inflammatory bowel disease

Classification of Mexicans in the United States - Chicanos

Born in the United States and descendants of wealthy Mexican Landowners

Foods of South Africa

Cuisines are influenced by Dutch, British, and French settlers Meat Dishes such as mutton in stews and grape-stuffed chicken Spicy fruit or vegetable relishes such as chutney

Examples of Illnesses - Empacho

Digestive ailment Symptoms: nausea, gas, and weakness Consumption of hot and cold foods Hot-cold imbalance due to emotional upset Treatment: herbal teas, stomach massage, pinching of the spine, prayer, and curandero

Ashkenzai

Dispersion of Jews outside of Israel to Germany, Northern France, and Eastern Europe

Sephardim

Dispersion of Jews outside of Israel to Spain, Southern Europe, and the Middle East

Five Pillars of Islam

Faith - proclamation of the unity of God Prayer - salat, performed five times during the day (dawn, noon, mid-afternoon, sunset, and nightfall), Fridays are day of public prayer in the Mosque Almsgiving - offering to the poor and act of piety Fasting - fulfilling a religious obligation to Allah, remove previous sins, appreciate the hunger of the poor and needy Pilgrimage to Mecca - hadj, white garments are to be worn, abstain from having a haircut, and avoiding harming any living thing, animal, or vegetable

Conservative Jews

Fall in between Orthodox and Reform Jews - hold middle ground

Characteristics of Chicano Family

Father is the head of household, decision maker, and wage earner Mother is the homemaker and provides childcare, however the role is changing in America with more women working and making decisions about the household Children are valued and taught to share and work together Grandparents are involved in childcare

Major Holidays - Dias de los Muertos (Day of the Dead) - November 1st and 2nd

Feast honoring the deceased Sugar paste used to mold skulls and skeletons of the dead

Foods served during Saints' Days

Fiambre: salad served in Guatemala

Regional Variations Gulf of California (west) and Gulf of Mexico (east)

Fish - Huachinago: red snapper in orange sauce, used as a taco filling Shark - Pan de Cazon: shredded shark layered between tortillas and beans

Type 2 Diabetes

For Mexican Americans, they have double the prevalence in comparison to whites More insulin resistance Health Complications: kidney failure, retinopathy

Jewish Dietary Laws - Process of Koshering Meat

For a food to be considered kosher heleb, blood, blood vessels, and sciatic nerve are required to be removed Soak the meat in water for 30 minutes Drain meat on slanted perforated surface Cover the meat with kosher salt for 1 hour Salt is rinsed from the meat Rinsing of the meat repeatedly to make sure that all blood and salt are removed

Counseling for Mexican Americans - Attitudes and Perceptions of Health

For males, it is considered inappropriate to acknowledge illness Modesty and primary are highly valued

Meal Composition

Four to five daily meals Desayuno (breakfast) - quick breakfast early in the morning Pan Dulce: sweet bread, pastry, or cake Fresh fruit Cafe con leche Almuerzo (coffee break) - similar to brunch Tortillas, eggs, meat, leftover beans, bolillos (wheat rolls) Comida or almuerzo (lunch) Soup, main course, salad, dessert Merienda (late afternoon snack) Light meal of sweet rolls, cake, cookies Coffee, hot chocolate, stole Cena (dinner) Leftovers, may be skipped entirely

Feast Day Foods in France and Italy

France - Yule log cake Italy - Panettone

Nutritional Status in Mexican Americans

Gallbladder Disease - genetics and diet Dental Health - cavities and gingivitis Elevated alcohol intake

Foods served during Christmas

Gallina relena navidena: chicken stuffed with papaya, tomatoes, and olives

Traditional Beliefs and Practices of Central Americans - Health Preservation

Good diet: fruits and vegetables Fresh Air Regular hours of work Exercise (Guatemalans and Panamanians) El Salvadorans believed being too thin causes sickness Guatemalans believe strength is maintained through the quality and quantity of blood

Examples of Illnesses - Caida de la mollera (fallen fontanel)

Infant falls Holding the baby vertically when it is too young Fontanel becomes depressed, resulting in dehydration Treatment: tight caps on the infant, application of olive oil

Nutritional Status: Infant and Child Feeding Practices

Infants were most likely to be breast fed Other fluids were administered such as water, formula, sweetened herbal teas, Baby-bottle tooth decay

Basic Competencies needed by Practitioners during Pre-Counseling Preparation

Information Transfer: verbal and nonverbal ability to convey object messages Relationship Development and Maintenance: Creating rapport, establishing trust, showing empathy and respect Compliance Gaining: obtaining client cooperation

Culturally Relevant Program Preparation Steps - Triangulation

Information gather through one source of method is used to confirm and extend information through other sources or methods

Reform Jews

Less strict, not all laws are permanently binding

Contemporary Food Habits of the United States - California

No unique cuisines Fast-food franchises and grocery stores

Counseling for Mexican Americans - Communication Style

Non-confrontational For challenging health care situations, a warm and direct-oriented approach between patient/provider is important Appreciate kindness and graciousness Handshake used

Pica

Practice of eating nonnutritive substances - clay, chalk, laundry, starch Research has indicated that pica is most often practiced among black women during pregnancy and the postpartum period Possible Causes: need for minerals, hunger or nausea, need for special treatment, cultural treatment

Major Religion of Central Americans

Roman Catholic

Major Holidays - Dia de los Santo Reyes (Three Kings Day) - January 6

Rosca de Reyes: Raisin-studded ring loaf bread Inside is a figurine of the infant Jesus The recipient is obligated to give a party on Candelaria Day on February 2nd

Regional Variations: Tropical Mexico

Seafood and Freshwater Fish Arroz a la Tumbada: rice cooked with tomatoes and garlic topped with fresh fish, shrimp, octopus, crabs, and clams Produce Tomatoes, bananas, plantains, guava, mango, pineapple, yucca, avocados Guacamole: mashed avocado with onions, tomatoes, chili peppers

Regional Variations: Southern Mexico

Similar to Yucatan, but more Indian influenced Cultivation of cacao trees - chocolate dishes Spicy sauces: base for thick stews with meats (mole) Meats: poultry, goat, pork Poblano de guaiolote: rich brown sauce with turkey Drinks: hot chocolate, coffee Atole: warm beverage of thin cornmeal Horchata: sweetened rice-based drink Desserts: ice cream, fruity ices, chocolate flan

Mestizo Definition

Somebody with Indian and Spanish ancestry

Foods served during Lent

Sopas de Cosquillas: soup with ring-shaped corn dumplings (Nicaragua)

Languages Spoken in Mexico

Spannish Nahuati (Indian)

Nutritional Status of Central Americans

Undernutrition due to lack of vitamins Beriberi - due to lack of thiamin in the diet - might have an enlarged heart and may struggle to walk correctly Pellagra - due to lack of niacin - inflammation of the skin and GI distress Scurvy - vitamin c deficiency - break down of gum and skin tissue surrounding the mouth Vitamin A deficiency Infectious diseases Tuberculosis Parasites Endemic Infections Cyclosporiasis: contaminated raspberries in Guatemala

Special Occasions - Christmas

Turkey with cornbread stuffing Baked ham Desserts: fruit cakes, cream pies, cobblers, coconut cake

Jewish Dietary Laws - Examples of Animals that are not Permitted for Food

Unclean animals such as swine, carnivorous animals, rabbits, birds of prey and unclean eggs, catfish, eels, rays, sharks, all shellfish, reptiles, amphibians, vertebrates

Regional Variations Northern Mexico

Cheese: quesa flameado (fondue like dish with chorizo crumbles) Wheat

Major Holidays - Cinco de Mayo - May 5th

Celebrates the Mexican's army victory over France during the Franco-Mexican War

Intercultural Nutrition Assessment is the initial step to estimate dietary intake. What are the components?

24 hour recall Food Diary: weekly food record of food and drinks consumed Food Frequency Questionnaire: categories of different types of food, evaluates how often the food is consumed over a period of time Diet History: dietary patterns and habits information

History of Mexicans in the U.S. - Mexican American War of 1848

75,000 Mexicans residing in the former Mexican territories became American citizens

Hanukkah (Festival of Lights)

8 day celebration in December Commemorate the recapture of the Temple in Jerusalem in 169 CE Lighting the menorah each night Latkes - potato pancakes Doughnuts - cooked in oil

Passover

8 day festival of spring and freedom Celebrates the anniversary of the Jewish exodus from Egypt Occurs in March or April Passover Seder - readings from the Haggadah (Seder Book) Festival meal: chicken soup, matzo balls, meat or chicken Matzah: white flour cracker, unleavened bread - signifies the lack of time Jews had when leaving Egypt, there was no time for the bread to rise The entire house must be cleaned, and foods that are subject to leavening are removed before Passover

Examples of Illnesses - Mal de Ojo (evil eye)

A person casts a strong look to another person Symptoms: fever and headaches Curandero required for treatment

Role of Food and Etiquette in Mexican Society

Activities related to food facilitate interaction between family members and define family roles Wife in charge of preparing the meals Guests should eat everything that is served so the host is not insulted The meal is consumed after the host says been provecho Fork is in the left hand, knife is in the right Dishes passed to the left Hand should remain above the table with wrists resting on the edge when not eating Leaving the table for any reason before others are finished is considered impolite

Examples of Illnesses - Nervios

Affects mainly adult women Symptoms: crying attacks, sadness, chills, itching, body aches Treatments: sedatives provided by a biomedical physician

Summative Evaluation

Assess program results after completing the effort

Therapeutic Uses of Food - Low Blood

Associated with anemia Caused by eating too may astringent and acidic foods (vinegar, lemon juice) and not enough red meat

Hinduism Dietary Practices

Avoiding foods that hinder the development of the body or mental abilities Cow - considered sacred and not to be killed or eaten Avoid: crabs, snails, crocodiles, ducks, parrots, camels, boars, bats Foods should be avoided if prepared by: actors, artists, carpenters, cobblers, doctors, musicians, spies, thieves Avoid contaminated foods (person sneezing on it, contact with animals, milk from an animal that just gave birth)

Therapeutic Uses of Food - Hot/Cold System of Diet and Health

Based on the concept that the worlds resources are limited and must remain in balance, and people must stay in harmony with the environment Hot: alcohol, aromatic beverages, beef, chili, corn husks, oils, onions, pork - associated with strength Cold: citrus fruits, dairy products, most fresh vegetables, goat, tropical fruits - associated with weakness Illnesses Hot Conditions: pregnancy, hypertension, diabetes, indigestion Cold Conditions: pneumonia, colic, empacho (blocking of the GI tract) Sour and Acidic Foods - avoided by menstruating women because it thins the blood and cramps

History of Africans during Emancipation

Began during the American Revolution Civil War - Confederates supported slavery and the Union opposed slavery Emancipation Proclamation was signed by President Lincoln in 1862 1865 marked Union victory over the Confederacy and all blacks were given their freedom in the U.S.

Examples of Illnesses - Bilis

Bile spills in the blood Symptoms: loss of appetite, vomiting, headaches, inability to urinate

Jewish Dietary Laws - Forbidden Parts of an Animal that cannot be consumed

Blood - egg yolk with blood spot cannot be consumed Heleb - fat not intermingled with the flesh, only for four footed animals

Regional Variations Mexican Plains

Bunuelo: fried circles of sweet pastry dough, cinnamon and sugar sprinkled on top Beverages Aguamiel: Manden Cactus sap or honey water Tequila: distillation of fermented augamiel

Major Holidays - Lent

Capirotada: Bread pudding with honey or brown sugar, cinnamon, nuts, and cheese

Eastern Orthodox Feast Days

Christmas Easter (most important holiday) Cheese Fare Sunday (Sunday before Lent) Meat Fare Sunday (Third Sunday before Lent)

Roman Catholic Feast Days

Christmas (birth of Christ) Easter (resurrection of Christ)

Traditional Food Habits: Spanish Contributions

Cinnamon, garlic, onions, rice, sugar cane, wheat, and hogs The foods contributed to the classic flavors and foods of Mexican cuisine when combined with native ingredients - corn tortillas with pork filling, salsas, rice and beans, frijoles refritos (pan fried-boiled beans) Introduced distillation of alcohol to native Mexican fermented beverages Tequila and Mescal

Jewish Dietary Laws - Examples of Animals that are Permitted for Food

Completely cloven foot and milk may be consumed Clean animals such as cattle, deer, goats, sheep, oxen, fish with fins and scales Crop Gizzard and extra talon (similar to chickens, ducks, geese, turkeys)

Traditional Food Habits: Foods from the Aztec Empire

Corn (staple grain), legumes, fruits vegetables, turkeys and dogs (raised for meat), game meat, chocolatl (hot, unsweetened chocolate drink)

Traditional Food Habits: Staple Foods

Corn: in the form of tortillas Rice: introduced by the Spanish Beans: usually simmered with spices, pureed, fried, or incorporated with rice - black beans (Guatemala) and red beans Soups/Stews: fruit or fruit juice along with coconut milk - Mondongo is a Nicaraguan tripe soup Fruits and vegetables Coffee and hot chocolate Refrescas (cold beverages) - mango and pineapple Fermented beverages - venado - distilled drink from sugar cane

Counseling - Barriers to Biomedical Care

Cost Language Unauthorized residents trying to avoid authorities Poly-chronistic Health is viewed day to day Unfamiliar with the concept of scheduled appointments

Special Occasions- Kwanzaa

Created in Southern California in 1966 A candle is lit each day to symbolize 1 of 7 principles Dishes from Africa, the Caribbean, and the southern U.S. are prepared

History of Mexicans in the U.S. - Bracero Program

Created in the United States after the Great Depression in order for industries to meet the need for cheap labor in agriculture and the railroad industry

Analyzing nutrient intake after conducting a nutritional assessment can produce large errors such as...

Cultural Unfamiliarity - people are unaware of what quinoa is or different types of cows milk Terminology Differences - American Indians have no word for vegetables Grouping of foods by different properties - medicinal properties or status Lack of differentiation between meals and snacks - granola bar Phantom Foods - foods not actually consumed Translation Mistakes - cultural vegetables Under and over reporting - not estimating actual amounts

Traditions and Foods of The Jewish Sabbath

Day of rest Before sundown on Friday until nightfall on Saturday Dedicated to prayer and rest, no work allowed Meals are prepared before sundown on Friday Challah - braided bread Kugel - pudding with noodles Chicken or coolant (bean or potato dish)

Hindu Fast Days

Depends on one's caste, family, gender, and degree of beliefs Not eating or abstaining from specific foods First day of the new or full moon of each month

Ingredients and Common Foods: Mexicans in the United States

Diets are similar to that of their homeland Fat sources differed in one study about acculturation Less acculturated: whole milk More acculturated: fast food Mexican Immigrants in the Southwest U.S. More consumption of red meat, white bread, sugared cereals, caffeine-containing beverages, and soft drinks than their socioeconomic counterparts in Mexico or white neighbors Latinos and Mexican Americans in Southern California and Washington State High intake of fast and convenience food, salty snacks, chocolate, added fat with bread and potatoes Low intake of fruits, vegetables, beans, and peas

Four Noble Truths of Buddhism

Dukkha - The Noble Truths of Suffering - birth, old age, sickness, and death, failing to obtain what they want Samudaya - The Noble Truth of the Cause of Suffering - suffering is caused by cravings in life - pleasure, possessions, cessation of pain Nirodha - The Noble Truth of the Cessation of Suffering - cessation of dukkah - craving is cured by detachment from oneself and other things Magga - The Noble Truth to the Path leading to the Cessation of Suffering - eightfold path; search for happiness through the pursuit of pleasure

Roman Catholic Fast Days

During fast days are allowed one full meal at midday Abstinence - meat is forbidden but not eggs, dairy products or side dishes made with animal fat United States: Ash Wednesday Lent

Successful Intercultural Communication - CRASH

Effective intercultural communication begins when the speaker is mindful of his or her own communication behaviors C - Culture: Consider in all patient-practitioner interactions R - Respect A - Assess/affirm: Intracultural differences due to language skills, acculturation, and other factors, recognizing each individual as an expert on his or her own beliefs and practices S - Sensitive: To issues that may be offensive or interfere with trust in the relationship, show self-awareness regarding personal biases that cause miscommunication H - Humility: Apologizing quickly and accepting responsibility for communication missteps

Islam - Feast Days

Eid al-Fir (Feast of Fast Breaking) - celebrates the end of Ramadan Nau-Roz (New Year's Day) Malud n'Nabi - Birthday of Mohammad

Eastern Orthodox

Emerged when there was a split in the Roman Catholic Church Majority are Greek Predominant religion in Russia, Romania, Serbia, and Greece

Foods Consumed during Enslavement and Emancipation

Enslavement Travel on Ships: staples of each region, dried salted cod Fieldworkers: foods consumed were based on the owner, common items included salted pork and corn, some slaves were allowed to grow their own vegetables, encouraged to raise hogs and chickens Cooks in the owner's home: fried chicken, fried fish, vegetable stews, green leafy vegetables Emancipation Pork, corn, greens, sweet potatoes, squash

Classification of Mexicans in the United States - Unauthorized Migrants

Enter the country illegally

Nutrient Deficiency in Ethiopian Immigrants

Ethiopian immigrants in Israel... Rickets: due to vitamin d deficiency in children Xerophatalamia and Night Blindness: due to lack of vitamin A Deficient in iodine and calcium Ethiopia: enset: banana leaf plant associated with esophageal cancer

In-Depth Interviews determine the many iceberg issues that may affect communication and cooperation in health care such as...

Ethnicity Age Acculturation/Bicultural adaption Socioeconomic status Health condition Religion Education background

Traditional Health Beliefs and Practices - Causes of Illness

Excess emotion Dislocation of organs Magic Imbalance of hot or cold Considered an Angelo disease (pneumonia and appendicitis)

Traditional Beliefs and Practices of Central Americans - Hot and Cold Balance

Extreme changes in temperature are believed to contribute to illness Strong emotions

Traditional Health Beliefs and Practices - Importance of Religion

Health is considered a gift from God, illness occurs due to outside forces Prayer and lighting candles for someone who is sick Pilgrimages to religious shrines

Traditional Health Beliefs and Practices - Reasons why disharmony and illness occur

Health is maintained through harmony In Africa, traditional beliefs include the influence of natural, supernatural, and social forces are important causes for events and illnesses Disharmony and illness occurs when someone either living or dead, the gods, or nature is intentionally malevolent or the evil eye causes illness and misfortune by sending negative energy through

Traditional Health Beliefs and Practices - Health Care Treatment

Help from mothers, grandmothers, wives, or older female neighbors Use of home remedies and over the counter medications Botanicas - pharmacies that sell traditional herbal remedies Professionals include... Yerbero: Herbalist Sobador: Massage therapist or occupational therapist Patera: Midwife specializing in the care of small children Curandero(a) sees patients without an appointment and usually do not charge for their services, but they may accept gratuities, deal with a variety of complaints (social and medical), diagnose the underlying causes of a condition (natural or supernatural)

Counseling for Mexican Americans - Greater use of Herbal Remedies and Curanderos

Herbal remedies are used by 20-81% of Mexican Americans Higher use was related to fewer visits to biomedical practitioners - lack of insurance

Metabolic Syndrome

High blood pressure, dyslipidemia, elevated blood glucose levels Large waist circumference

Health Status of African Americans

Higher morbidity and mortality rates for African American mothers and their infants - teenage pregnancies, lack of prenatal care, low folate intake, higher risk for low birth weight infants Breast feeding and Infant Feeding Practices - breastfeeding may be avoided because of fear of passing harmful substances through the milk. Mothers tended to quickly introduce solid food into the infants diet Hight rates of overweight and obesity - perception of ideal body size, fast food intake, limited access to healthy foods, lack of access to recreational facilities, family relationships defined through cooking, lack of family support for weight loss Type 2 diabetes Hypertension is a risk factor for coronary heart disease Iron Deficiency Anemia Pica: consumption resulting in anemia for pregnant women and newborns Sickle Cell Anemia

Family Structure of Central Americans

Highly valued Father is the head of household Costa Rican perception of family: father and mother in the home Family disintegration in refugee camps due to overcrowding and unemployment Family members were forced to immigrate separately

Hindu Feast Days

Holi - Spring Equinox, throwing of powdered dyes Divali - November Beginning of the new year, new clothes, pay off old debts, settle arguments, wish good fortune

Jewish Dietary Laws - Example of a Food Consumed from Forbidden Animals

Honey - a product of unclean animals It is an exception because it does not contain any organs or parts from the insect

Immigration Patterns of Central Americans

Immigration until the 1980s by well educated professional men looking for employment and women who searched for temporary domestic jobs. Settlements in New York, Los Angeles, San Francisco, Miami, and Chicago. Late 1970s to early 1980s refugees from El Salvador, Guatemala, Nicaragua walked to the United States to escape civil war. Experienced severe malnutrition, vitamin and mineral deficiencies.

History of Africans during Enslavement

In 1619, Dutch traders sold 20 West Africans to colonists in Jamestown VA Slaves identified themselves with their tribal groups, rather than their native country or Africa as a whole New slaves were housed outside of the plantations until they were acclimated, then they worked closer to the main plantation house Development of a black Creole native-born culture

Counseling Strategies

In-depth interviews: variability with region, socioeconomic conditions, ethnic identity

Counseling for Mexican Americans - Access to biomedical health care is affected by...

Income and transportation No health insurance Language Barriers

Traditional Health Beliefs and Practices - Traditional Health Care in Mexico

Indian Supernatural Rituals European Folk Medicine from Spain

Requirements of Intercultural Counseling

It is a relaxed give and take exchange (not scripted) Allows for the practitioner to gain more information from the client The practitioner is attentively listening to client needs and learns about client expectations Effective intercultural counseling requires an open attitude, cultural knowledge, and intercultural communication skills

Buddhism Feasts and Fasts

July to October: Buddhist monks remain in retreat and meditate to coincide with the rainy season and sprouting of rice Ends with pravarana - end of rainy season Worshippers offer gifts to the monks, invite them to a meal Vesak - Honoring Buddha in April or May Buddhist monks fast 2 times a month and on the days of the new or full moon No consumption of solid food after noon

Family Structure of African Americans and Africans

Kinship defined the form of African societies African American Homes Large and extended family structure Multigenerational homes Family Structure in Africa Patriarchal Arranged marriages Families immigrating to the United States caused conflict between parents and children

Seventh Day Adventists - Vegetarianism

Lacto-ovo vegetarians Avoid tea, coffee, alcohol, tobacco products Water should be consumed before and after a meal Hot spices are avoided Whole grains are encouraged Eating between meals is discouraged to ensure the food is properly digested

Special Occasions - Sunday Dinners

Large family meal Fried chicken, spare ribs, black-eyed peas, greens, potato salad, rice Sweet potato pie Homemade fruit wines

Culturally Relevant Program Preparation Steps - Targeting the Audience

Learning about the cultural dynamics of the group Creating surveys to obtain demographic information about language, gender, average age, socioeconomic status, education attainment, religious affiliation Involve members of the target audience in the planning process

Contemporary Food Habits in the United States

Little data available about acculturation Foods consumed were mostly similar to their homeland Use ingredients in the Latino communities where they settle Salvadoran Refugees - notes that the quality of their diets declines, primarily due to the lack of fresh ingredients, cost of fruits and vegetables, and more consumption of junk food

Regional Variations Northern Plains

Longhorn Cattle, dairy cattle, and wheat were introduced by the Spanish Cecinas: air-dried beef in thin slices, used in stews, soups, fillings in other foods Goat and Sheep: Birria: kid or lamb meat stewed in a sauce with roasted chills and vinegar

Nutrient Deficiencies and Obesity

Low protein, iron, and vitamin C intake associated with low hemoglobin levels in young children and pregnant women Calcium and riboflavin - low consumption of dairy Obesity is prevalent in men, women, and children Low socioeconomic status and physical activity

Jewish Dietary Laws - Law of Meat and Milk

Meat and dairy may not be eaten together If you consume meat, you must wait 6 hours to consume any dairy If you consume dairy, you must wait 1 hour to consume meat Olives are considered dairy if they are prepared in lactic acid Separate sets of pots, dishes, and utensils are used for meats and dairy

Contemporary Food Habits of the United States - Texas

Mexican food modified into American Dishes Tamale pie and nachos Foods retained some of the Mexican heritage Chili con carne: developed after the Mexican American War Anacucos: BBQ chili-spiced meat kebobs Capriotada: drunken pudding - pudding with whiskey sauce Enchiladas: thought to originate in Texas

Islam - Nations where the religion is predominant

Middle East, Northern Africa, Pakistan, Indonesia, and Malaysia

Contemporary Food Habits of the United States - Southern Arizona and Sonora (state in Mexico)

Mider chiles are preferred Beef is the favored meat Machaca: dried, shredded beef jerky used for stuffed foods Wheat tortillas Burritos and deep-fried chimichangas (fried version of burrito)

Regional Variations: Yucatan

Most residents are descendants of the Mayans Pibil: Steaming foods wrapped in banana leaves Salbutes: small corn tortillas, fried until puffed Citrus fruits: orange and lime juices used in chicken dishes or soups Other common foods: shrimp, eggs with tortillas, black beans, cheese, tomato sauce

Orthodox Jews

Most strict, all Jewish laws must be observed

Major Religion of Mexicans

Nearly 75% of Mexican American are Roman Catholic Protestant

Culturally Relevant Program Preparation Steps - Goals and Objectives

Need to be realistic Goals - What does the program seek to accomplish? Ex: increased knowledge and consumption of fruits and vegetables by children, increased lifestyle change, such as exercise, in promoting weight loss Objectives - the steps taken to accomplish goals. Ex: nutrition education session on fruits and vegetables, followed by a food sampling activity with children. Creating handouts and a lesson about the benefits of exercise and then a Zumba session.

Contemporary Food Habits of the United States - New Mexico

New Mexico Chile used as a seasoning Sauces made with red chili peppers vs. multiple types of chili peppers in Mexico

Celebration of Rosh Hashanah and Foods

New Year in September or October (based on lunar months) Challah - round shape to symbolize life without end and a year of uninterrupted health and happiness Apples dipped in honey Consumption of the head from sheep or fish Special sweets No sour or bitter foods

Use of Appropriate Language by Medical Providers

Non-native English Speakers - apply common terms and avoid vague terms, focus on specific verbs Slang and idioms can be misinterpreted in other cultures Medical jargon leads to confusion and clients might be embarrassed to admit they do not understand Avoid yes and no questions because they provide you with insufficient information The American Communication style assumes that each person is saying what he or she means

Yom Kippur (Day of Atonement)

Occurs 10 days after Rosh Hashanah Holiest day of the year Atones for sins, aims to improve and follow Jewish laws Fasting day from sunset to sunset

Examples of Illnesses - Susto

Occurs due to excess emotion, such as shame or anger Symptoms: depression, lack of appetite, nightmares, shaking, paleness Treatments: sugar or water (mild), going to the curandero (severe)

Traditional Health Beliefs and Practices - Voodoo

Originated in the Caribbean, practiced in the South Cure unnatural illness through spells, magic powders, stones, and herbs

Characteristics of Nonprofessional Interpreter

Patients may be reluctant or embarrassed to discus their health in front of relatives Family members may decide that information by the practitioner is not necessary for the patient so the interpretation may be inaccurate Dialects may differ to regions using different terminology Children as interpreters are a barrier to treatment and care because they may be scared of medical procedures

Characteristics of Physician Communication with use of Interpreter

Practitioner: Speaks directly to the client when an interpreter is used Watches the client when the interpreter translates May need to follow-up with the interpreter for any clarifications, sometimes the interpreter may answer for the patients and is familiar with their past medical history Positive tone of voice, use of short and direct phrases, repeating important information Interpreter: May take longer to interpret to include certain cultural interpretations and explanations Back interpretation can effectively prevent miscommunication Instructions are repeated back to the clinician Client can ask questions

Traditional Beliefs and Practices of Central Americans - Health is a Balance between spiritual and social worlds

Prayer is used to restore harmony during illness Guatemalans: botanical remedies Nicaraguans: use of witchcraft to cure illness

Marketing Mix 4 P's

Product - well-developed message that advances program goals and objectives Price - message presented is at minimal cost to target audience Placement - how will the audience receive this message or product to increase recruitment of clients, advertising, open houses, seminars Promotion - communication modes of presenting the product to the audience

Islam - Fast Days

Ramadan - Abstaining from food, drink, smoking from dawn to sunset for those ages 15 years and older Exemption from fasting: illness, traveling, pregnancy, lactation, menstruation, elders

Typical Dietary Habits of African Americans

Reported to be high in fat associated with high consumption of meat, fast food consumption, and frying foods High Sodium intake Inadequate consumption of dairy products, vegetables, fruits, and whole grains

History of Mexicans in the U.S. - Original Residence

Resided in the American Southwest for hundreds of years before the U.S. declared independence from Britain in 1776 They welcomed American settlers, but the population of Mexicans became outnumbered in the Southwest, losing economic and political control

Foods of Ethiopia, Eritrea, Somalia, and Sudan (West Africa)

Staple Foods: Millet (teff), sorghum (cereal produced on a stalk), plantains Coffee is the leading export crop Ethiopian Cuisine Halal Dietary Practices Berbere: hot spices Eritrean and Somali Food More seafood consumption Italian influences due to occupation of the region Sudan Mix of Middle Eastern and African Cuisine Use fava beans with okra stew and Kisra (staple bread)

Foods of West Africa

Staple foods are based on the region Sierra Leone: corn, millet, rice Nigeria: Yam Congo and Angola: Cassava and Plantains Preparation: fufu is potatoes that are boiled into a paste

Culturally Relevant Program Preparation Steps

Targeting the Audience Establishing Goals and Objectives Triangulation Developing the Message

Therapeutic Uses of Food - High Blood

Thought to be caused by excess blood moving to one part of the body, usually the head, and consuming an excess amount of rich foods, sweet foods, or red colored foods (red wine, red meat, beets)

Major Religion of Africans Americans

The first black church (Baptist) was founded during the 1770s in South Carolina Largest denomination: National Baptist Convention of the U.S.A. Other Religions Followed Methodist Episcopal Churches Pentecostal Denominations (Church of God in Christ) Islam Religions followed by African Immigrants Christianity, Eastern Orthodox

Culturally Relevant Program Preparation Steps - Developing the Message

The health message should be basic for the target audience's survival, social needs, and safety to be effective The message components must satisfy the individual's need to gain knowledge or offer a solution to a perceived problem Message: direct and explicit within cultural norms Relevant language and common words Making the message personal so the client can relate Positive and culturally congruent body language by health educator

Seventh Day Adventists - Holiday Observed

The seventh day of the week (Saturday) is declared a Holy Day Entire day is dedicated to the religion Meal preparation and chores are completed the day before and day after

Dietary Restrictions of the Mormons

The use of tobacco, strong drinks (alcohol), and hot drinks (tea and coffee) are prohibited Many do not use products that contains caffeine Followers are advised to eat meat sparingly, and eat a grain-based diet (wheat) Required to have a year's supply of food and clothing for each person in the family Many fast for one day per month (money spent on food for that day is usually donated to the poor)

Therapeutic Uses of Food - Other Perceptions of Blood Content

Thin Blood: the body is not well-nourished, causes chills Bad Blood: hereditary, natural or supernatural contamination Unclean Blood: impurities collect over the winter months and blood carries more heat Clots: the blood thickens and settles in one area, usually associated with menstruation or stomach or leg cramps

Staple Foods of Mexico

Tortillas: made by hand, the corn kernel dough (masa marina) are heated in lime solution Beans: present in most Mexican meals Caldos: soups or stews, used as a dinner entree Meats: prepared over high heat Carne asada - grilled beef strips Chicharrones - fried pork rind Sausages Stuffed Foods: tacos, enchiladas, quesadillas, tamales, burritos Vegetables: potatoes, greens, tomatoes, onions, chilli Chiles en nogada: Independence Day dish - chili is stuffed inside the meat, accompanied by white sauce, green cilantro, and red pomegranate seeds Sugar cane Desserts Flan: sweetened egg custard with cartelized sugar Dulce de leche: boiled condensed milk so the sugars carmelize Huevos reales: egg yolks, pine nuts, cinnamon, sugar, sherry, raisins Cajeta: goat's milk with cinnamon Beverages Coffee - cafe con leech Aguas Naturales - fresh fruit with water and sugar Tequila, mescal, beer

Process Evaluation

Tracking progress throughout the program (quality control) Identifying barriers and issues with the program or project

Meal Composition and Cycle

Traditional Southern meal patterns: large breakfast with fried foods, large dinner with boiled foods, supper Common meal patterns: lighter breakfasts, sandwiches for lunch, dinner is the biggest meal, frequent snacking Food preparation: frying, boiling, and baking Importance of sharing food

Characteristics of Designing a Successful Nutrition Program

Understand the cultural beliefs, attitudes, and values of a target audience Develop education programs within the context of those perceptions Using culturally appropriate and consistent verbal and nonverbal messages Keep in mind the possible negative outcomes such as non-participation, drop out, non-adherence, poor result

Traditional Health Beliefs and Practices - Root Doctor

Use home remedies or charms to remove evil

Major Holidays - Christmas

Use of pinatas

Perception of Being Overweight

Valued as a sign of health

Foods of Kenya, Uganda, and Tanzania (East Africa)

Vegetarian Cuisines influenced by Arab, Asian, Indian, and British Food Chapatis: unleavened flat bread Mandazi: slightly sweet doughnut bread Kitumbua: rice fritter Kenay: cattle is an indicator of wealth in Kenya, ugali is a thick doughy cornmeal porridge and is the national dish Uganda: peanuts are a staple food and used as a sauce/base for stews Tanzania: use of plantains

Cultural Influence Channels

Ways in which message materials are transmitted to the target audience Ex: TV, mail, video, telephone, computers, newsletters, radio, social media, magazines, email Effective presentation of a message requires a combination of pictures, sounds, and words Use of multiple influence channels and frequent repetition of the message

In-Depth Interviews ask open ended questions such as...

What do you think caused your problem? What problems has your sickness caused for you personally? For your family? At work? Do you eat certain foods to keep healthy? Do you avoid certain foods to prevent illness? Are there foods you will not eat, and why?

Classification of Mexicans in the United States - Braceros

Work in the United States legally, remain Mexican citizens


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