Pilot Feasibility Study of a Digital Storytelling Intervention for Immigrant and Refugee Adults With Diabetes
RHCP developed and tested a culturally and linguistically tailored digital storytelling intervention to support diabetes self-management among Somali and Latino immigrants with type 2 diabetes. The intervention consisted of a 12–13 minute video featuring four personal stories, an introduction, and a closing educational message, all created through a participatory process.
The Diabetes Educator 2017
RHCP developed and tested a culturally and linguistically tailored digital storytelling intervention to support diabetes self-management among Somali and Latino immigrants with type 2 diabetes. The intervention consisted of a 12–13 minute video featuring four personal stories, an introduction, and a closing educational message, all created through a participatory process. Delivered during routine clinic visits, the video was rated highly by participants for its usefulness, interest, and motivational impact. After viewing, 96% felt more confident managing their diabetes, and 92% reported intentions to change specific behaviors. A1C levels decreased significantly among Latino participants, particularly those with higher baseline values, suggesting potential clinical benefits.
The intervention’s success was rooted in its CBPR framework, which emphasized community ownership, cultural relevance, and authentic storytelling. Participants identified key messages aligned with diabetes self-management—healthy eating, physical activity, medication adherence, and glucose monitoring—and expressed willingness to share the video with others. While the pilot study was nonrandomized and limited in size, it demonstrated feasibility and acceptability across diverse clinical settings. These findings support further research into scalable, narrative-based interventions to address chronic disease disparities in immigrant and refugee populations.
Diabetes Knowledge, Attitudes and Behaviors Among Somali and Latino Immigrants
A community-based participatory research effort led by RHCP assessed diabetes knowledge, attitudes, and behaviors among Somali and Latino immigrants with type 2 diabetes in Rochester, Minnesota. Through a culturally and linguistically adapted survey administered by trained community partners, 78 participants shared their experiences managing diabetes.
Journal of Immigrant and Minority Health Dec 2015
A community-based participatory research effort led by RHCP assessed diabetes knowledge, attitudes, and behaviors among Somali and Latino immigrants with type 2 diabetes in Rochester, Minnesota. Through a culturally and linguistically adapted survey administered by trained community partners, 78 participants shared their experiences managing diabetes. Despite high engagement with healthcare providers and strong self-reported confidence in managing their condition, actual diabetes knowledge was low. Participants reported significant disease burden, negative emotional impacts, and barriers to physical activity and glucose monitoring. However, they also demonstrated high levels of self-efficacy and social support, particularly from family members.
Findings revealed striking similarities between Somali and Latino participants, suggesting that shared experiences of immigration, socioeconomic challenges, and limited English proficiency may play a more significant role in shaping diabetes management than cultural differences alone. These insights underscore the importance of tailoring interventions to address systemic barriers and leveraging community strengths. The data will inform future behavioral interventions aimed at improving diabetes outcomes and reducing health disparities among immigrant and refugee populations in the U.S.
Relationship Between Negative Mood and Health Behaviors in an Immigrant and Refugee Population
Baseline data from RHCP’s Healthy Immigrant Families project revealed a strong link between mood and health behaviors among immigrant and refugee adolescents and adults in Rochester, Minnesota. Adolescents with positive mood were significantly more active, consumed less soda, and reported greater social support for physical activity.
Journal of Immigrant and Minority Health Sept 2016
Baseline data from RHCP’s Healthy Immigrant Families project revealed a strong link between mood and health behaviors among immigrant and refugee adolescents and adults in Rochester, Minnesota. Adolescents with positive mood were significantly more active, consumed less soda, and reported greater social support for physical activity. Adults with positive mood showed higher self-efficacy for physical activity, snacked more frequently on fruits and vegetables, and rated their physical well-being more positively. These findings suggest that mood may influence both motivation and engagement in healthy behaviors, with social support and self-confidence acting as key mediators.
The study highlights the importance of integrating mood assessment and management into health interventions targeting immigrant populations. While physical activity levels among adults did not differ significantly by mood, their confidence and perceived well-being did, indicating potential for future behavior change. The results underscore the need for culturally tailored, community-based programs that address emotional health alongside nutrition and physical activity. RHCP’s CBPR approach, which emphasized trust, cultural relevance, and community ownership, provides a promising model for addressing health disparities in immigrant and refugee communities.
Treatment Fidelity Among Family Health Promoters Delivering a Physical Activity and Nutrition Intervention to Immigrant and Refugee Families
RHCP implemented a culturally tailored physical activity and nutrition intervention for Hispanic, Somali, and Sudanese immigrant and refugee families in Rochester, Minnesota, using a CBPR approach. Family Health Promoters (FHPs) from each community delivered 12 modules through home visits and follow-up calls, focusing on behavior change strategies grounded in social cognitive theory and motivational interviewing.
Health Education & Behavior Jun 2016
RHCP implemented a culturally tailored physical activity and nutrition intervention for Hispanic, Somali, and Sudanese immigrant and refugee families in Rochester, Minnesota, using a CBPR approach. Family Health Promoters (FHPs) from each community delivered 12 modules through home visits and follow-up calls, focusing on behavior change strategies grounded in social cognitive theory and motivational interviewing. The intervention emphasized family engagement, cultural relevance, and flexibility, with sessions conducted in participants’ native languages and adapted to their schedules. Fidelity was monitored across five domains—design, training, delivery, receipt, and enactment—using standardized manuals, structured training, session checklists, and follow-up assessments.
Despite challenges such as language barriers, scheduling conflicts, and limitations in recording sessions, RHCP maintained high treatment fidelity through rigorous training, supervision, and community involvement. FHPs demonstrated strong adherence to protocols, with over 97% of sessions documented and an average adherence rate of 84.3%. The participatory development and delivery of the intervention fostered trust and cultural sensitivity, while fidelity monitoring ensured consistent implementation and allowed for real-time adjustments. This model highlights the importance of integrating community expertise into intervention design and fidelity planning to enhance effectiveness and sustainability in underserved populations.
Lessons Learned from Community-Led Recruitment of Immigrants and Refugee Participants for a Randomized, Community–Based Participatory Research Study
RHCP successfully recruited 45 Hispanic, Somali, and Sudanese immigrant and refugee families—totaling 160 individuals—for a randomized trial evaluating a culturally tailored physical activity and nutrition intervention. Recruitment was entirely community-led, with local partners designing messages, identifying effective communication strategies, and facilitating outreach.
Journal of Immigrant and Minority Health Mar 2016
RHCP successfully recruited 45 Hispanic, Somali, and Sudanese immigrant and refugee families—totaling 160 individuals—for a randomized trial evaluating a culturally tailored physical activity and nutrition intervention. Recruitment was entirely community-led, with local partners designing messages, identifying effective communication strategies, and facilitating outreach. Pretesting revealed that verbal explanations and multiple contacts were more effective than written materials. Language-congruent staff and culturally sensitive approaches, such as oral consent and community-based enrollment events with interpreters, transportation, and childcare, were essential to building trust and ensuring participation.
Key lessons included the importance of engaging community partners throughout the research process, tailoring recruitment strategies to each cultural group, and maintaining frequent, personalized contact with potential participants. Somali families, in particular, required more in-person interactions and community validation before enrolling. The study achieved 97.7% of its family recruitment goal and 94.4% of its individual target, with strong retention and intervention completion rates. These findings underscore the effectiveness of CBPR in overcoming barriers to clinical trial participation among immigrant and refugee populations and offer a replicable model for inclusive, community-driven research.
Stories for Change: Development of a Diabetes Digital Storytelling Intervention for Refugees and Immigrants to Minnesota Using Qualitative Methods
RHCP partnered with Somali and Latino communities in Rochester, Minnesota to co-develop a culturally and linguistically tailored digital storytelling intervention aimed at improving type II diabetes management. Using a CBPR approach, they conducted focus groups to explore lived experiences across four domains: medication management, glucose monitoring, physical activity, and nutrition.
BMC Public Health 2015
RHCP partnered with Somali and Latino communities in Rochester, Minnesota to co-develop a culturally and linguistically tailored digital storytelling intervention aimed at improving type II diabetes management. Using a CBPR approach, they conducted focus groups to explore lived experiences across four domains: medication management, glucose monitoring, physical activity, and nutrition. Participants shared barriers such as cultural norms, family responsibilities, misinformation, and structural challenges like cost and transportation. Despite these obstacles, many found motivation through family support, faith, and fear of complications, and adopted strategies like adapting healthy behaviors to daily routines and seeking reliable health information.
Building on these insights, RHCP collaborated with the Center for Digital Storytelling to train eight community members—selected for their storytelling abilities—to create personal narratives reflecting their diabetes journeys. These stories were developed through a four-and-a-half-day workshop and compiled into two intervention packages (Somali and Spanish, both with English subtitles). The process fostered community ownership, empowerment, and capacity building, and the final products were described as powerful and motivational. While the intervention’s efficacy will be evaluated in future work, this participatory model offers a replicable framework for other communities seeking to address chronic disease disparities through culturally grounded storytelling.
Healthy Immigrant Families: Participatory Development and Baseline Characteristics of a Community-Based Physical Activity and Nutrition Intervention
RHCP developed and tested a culturally tailored physical activity and nutrition intervention for immigrant and refugee families in Rochester, Minnesota, using a community-based participatory research (CBPR) approach. The intervention was co-created by academic and community partners from Hispanic, Somali, and Sudanese backgrounds and delivered by trained bilingual Family Health Promoters (FHPs) through home visits and follow-up calls.
Contemporary Clinical Trials Dec 2015
RHCP developed and tested a culturally tailored physical activity and nutrition intervention for immigrant and refugee families in Rochester, Minnesota, using a community-based participatory research (CBPR) approach. The intervention was co-created by academic and community partners from Hispanic, Somali, and Sudanese backgrounds and delivered by trained bilingual Family Health Promoters (FHPs) through home visits and follow-up calls. The program included 12 modules covering physical activity, nutrition, and behavior change strategies grounded in social cognitive theory. Baseline data showed that while participants engaged in moderate levels of physical activity and had relatively high fruit and vegetable intake, most were overweight or obese and did not meet dietary guidelines.
The intervention design emphasized community ownership, cultural relevance, and family engagement. Focus groups revealed that shared immigration experiences shaped health behaviors more than cultural differences, and social support was a key motivator for change. Recruitment and implementation were led by community partners, resulting in high participation and trust. The randomized trial design included a delayed-intervention control group, with measurements taken at multiple time points. RHCP’s approach demonstrates the feasibility and impact of participatory, family-focused interventions in addressing cardiovascular risk and promoting health equity among immigrant populations.
Lessons Learned: Cultural and Linguistic Enhancement of Surveys Through Community-Based Participatory Research
RHCP collaborated with Somali, Hispanic, and Cambodian community partners to adapt and translate a diabetes survey for use in Rochester’s immigrant and refugee populations. The original 135-item survey was reduced to 110 items through a participatory process that included editing for cultural relevance, forward and back translation, and extensive group deliberation.
National Institutes of Health Public Access 2014
RHCP collaborated with Somali, Hispanic, and Cambodian community partners to adapt and translate a diabetes survey for use in Rochester’s immigrant and refugee populations. The original 135-item survey was reduced to 110 items through a participatory process that included editing for cultural relevance, forward and back translation, and extensive group deliberation. This approach ensured semantic, cultural, and conceptual equivalence with the original instruments. Community partners played a central role in revising language for clarity, eliminating ethnocentric content, and addressing literacy challenges by recommending an interview format and visual aids for Likert scales.
The participatory process not only improved the survey’s cultural and linguistic relevance but also shaped its implementation strategy. Community input led to recommendations for gender-concordant facilitators, familiar survey settings, and pre-survey dialogue to build trust. Group deliberation emerged as the most impactful step, fostering community ownership and enhancing the likelihood of meaningful engagement and accurate data collection. RHCP’s experience demonstrates that participatory survey adaptation is feasible and beneficial, strengthening both the quality of the instrument and the partnership’s capacity to address health disparities through culturally grounded research.
Perceived Impact of Human Subjects Protection Training on Community Partners in Community Based Participatory Research
An adapted Human Subjects Protection Training (HSPT) program was implemented by RHCP to address barriers faced by community partners in participating fully in community-based participatory research (CBPR). Seven participants from diverse immigrant and refugee backgrounds completed the training, which was modified from Mayo Clinic’s institutional curriculum to better suit community needs
National Institute of Health Public Access 2014
An adapted Human Subjects Protection Training (HSPT) program was implemented by RHCP to address barriers faced by community partners in participating fully in community-based participatory research (CBPR). Seven participants from diverse immigrant and refugee backgrounds completed the training, which was modified from Mayo Clinic’s institutional curriculum to better suit community needs—emphasizing flexible scheduling, minimal jargon, and a safe, discussion-based learning environment. The training was delivered in a small group setting with contextualized discussions linking ethical principles to RHCP projects. Participants reported high acceptability (mean score 4.5/5), improved understanding of research safeguards, and increased trust in the research process.
Focus group feedback highlighted that successful HSPT for community partners should be interactive, culturally sensitive, and tailored to CBPR contexts. Participants emphasized the importance of shared learning experiences, which fostered camaraderie, transparency, and empowerment within the partnership. They advocated for broader dissemination of research ethics concepts to community members, suggesting that informed communities would be more likely to engage in ethical research. RHCP’s approach demonstrates that co-designed HSPT can strengthen CBPR partnerships by building capacity, enhancing mutual respect, and promoting equitable participation in research.
A Focus Group Study of Healthy Eating Knowledge, Practices, and Barriers among Adult and Adolescent Immigrants and Refugees in the United States
This qualitative study examines how adult and adolescent immigrants and refugees from Somali, Mexican, Cambodian, and Sudanese communities in Minnesota understand and practice healthy eating. Using a community-based participatory research approach, researchers conducted 16 focus groups to explore participants’ knowledge, eating habits, and barriers to healthy eating.
International Journal of Behavioral Nutrition and Physical Activity 2014
This qualitative study examines how adult and adolescent immigrants and refugees from Somali, Mexican, Cambodian, and Sudanese communities in Minnesota understand and practice healthy eating. Using a community-based participatory research approach, researchers conducted 16 focus groups to explore participants’ knowledge, eating habits, and barriers to healthy eating. Across all groups, participants recognized the importance of balanced meals and avoiding processed and fatty foods, but they also faced significant challenges such as cravings, time constraints, financial limitations, and cultural traditions. Generational differences emerged, with adolescents often more aware of healthy eating guidelines but constrained by family norms and limited autonomy in food choices.
The study found that acculturation influences dietary patterns in complex ways, with both adults and youth adopting aspects of American food culture—often less healthy—while retaining traditional practices. Structural barriers like cost and time, along with cultural expectations and family dynamics, were key obstacles to healthier eating. Participants expressed a strong desire for family-based and community-level interventions, including education on preparing healthier traditional meals and promoting dietary change through culturally sensitive outreach. The findings suggest that effective health promotion strategies must address intergenerational differences and the broader social context shaping immigrant families’ food choices.
Perspectives on Physical Activity Among Immigrants and Refugees to a Small Urban Community in Minnesota
RHCP conducted a qualitative study in Rochester, Minnesota, to explore how immigrants and refugees from Cambodian, Mexican, Somali, and Sudanese backgrounds perceive and engage in physical activity. Through 16 gender- and age-stratified focus groups with 127 participants, the research identified shared and unique barriers and motivators to physical activity.
Journal of Immigrant and Minority Health Sept 2013
RHCP conducted a qualitative study in Rochester, Minnesota, to explore how immigrants and refugees from Cambodian, Mexican, Somali, and Sudanese backgrounds perceive and engage in physical activity. Through 16 gender- and age-stratified focus groups with 127 participants, the research identified shared and unique barriers and motivators to physical activity. While participants recognized the health benefits of being active, many faced challenges such as unfamiliarity with exercise norms in the U.S., time constraints, weather, cost, and limited access to culturally appropriate facilities. Gender and generational differences also emerged, with women more likely to cite household responsibilities and cultural clothing norms as barriers, and adolescents more comfortable navigating gym environments.
Despite these obstacles, participants expressed strong motivation to be active, especially when supported by family, friends, and community. Social support, role modeling, and a sense of “togetherness” were key motivators, as was the desire to prevent disease and follow medical advice. The study emphasized that shared experiences of immigration—such as language barriers and socioeconomic challenges—play a more significant role in shaping physical activity behaviors than cultural differences alone. These findings suggest that effective interventions should be community-driven, culturally responsive, and designed to address both individual and structural barriers, ideally implemented soon after immigration to prevent declines in physical activity.
Physical Activity Among Somali Men in Minnesota: Barriers, Facilitators, and Recommendations
A community-based participatory research (CBPR) project led by RHCP explored barriers and facilitators to physical activity among Somali men in Rochester, Minnesota. Through age-stratified focus groups and interviews with 20 participants, the study identified a range of challenges, including competing priorities like employment, embarrassment about exercise attire, unfamiliarity with gym environments, fear of harassment, high costs, limited transportation for elders, and harsh winter weather.
American Journal of Men’s Health Jan 2014
A community-based participatory research (CBPR) project led by RHCP explored barriers and facilitators to physical activity among Somali men in Rochester, Minnesota. Through age-stratified focus groups and interviews with 20 participants, the study identified a range of challenges, including competing priorities like employment, embarrassment about exercise attire, unfamiliarity with gym environments, fear of harassment, high costs, limited transportation for elders, and harsh winter weather. Participants noted a decline in daily walking compared to life in Somalia, where walking was a routine part of daily activities. Despite these barriers, there was a strong awareness of the health benefits of physical activity and a desire to be active, especially when inspired by peers or supported by community networks.
Facilitators included high levels of knowledge about exercise, motivation from success stories within the community, and strong social cohesion that could support group-based activities. Participants recommended culturally sensitive programming that avoids structured classes but offers a variety of activities, including walking groups and buddy systems. They emphasized the importance of creating inclusive, low-cost opportunities that align with their daily routines and cultural norms. The study concluded that interventions should leverage existing community strengths while addressing multilevel barriers, and that early engagement after immigration is critical to sustaining healthy behaviors. These findings offer actionable insights for designing effective physical activity programs for Somali immigrant men in the U.S.
Evaluation of a Tuberculosis Education Video Among Immigrants and Refugees at an Adult Education Center: A Community-Based Participatory Approach
RHCP and the Hawthorne Education Center (HEC) in Rochester, Minnesota, collaborated to create and evaluate a tuberculosis (TB) education video using a community-based participatory research (CBPR) approach. The project aimed to address TB knowledge gaps among immigrant and refugee learners, a population at elevated risk for TB.
Journal of Health Communication Dec 2012
RHCP and the Hawthorne Education Center (HEC) in Rochester, Minnesota, collaborated to create and evaluate a tuberculosis (TB) education video using a community-based participatory research (CBPR) approach. The project aimed to address TB knowledge gaps among immigrant and refugee learners, a population at elevated risk for TB. Focus groups with learners and staff identified key misconceptions and emotional barriers, which informed the development of a culturally tailored video. The video featured narratives from HEC community members and was designed, scripted, and produced collaboratively by learners, staff, and academic partners. It was shown to all classrooms during World TB Day, and pre- and post-surveys assessed its impact on knowledge, self-efficacy, and acceptability.
The evaluation showed significant improvements in TB knowledge (from 56% to 82% correct) and self-efficacy (from 73% to 90%) after viewing the video. The vast majority of learners (94%) rated the video as highly acceptable, citing its clarity, helpfulness, and relevance. Teachers also found it valuable and recommended its continued use. The participatory process enhanced cultural relevance, literacy alignment, and community ownership, though it required substantial time and resources. This initiative demonstrated that adult education centers can serve as effective venues for health education and that CBPR-guided video production can be a powerful tool for engaging diverse communities in public health promotion.
Capacity Building Through Focus Group Training in Community-Based Participatory Research
RHCP and the Hawthorne Education Center (HEC) in Rochester, Minnesota, collaborated to build community research capacity through focus group training within a community-based participatory research (CBPR) framework. The initiative aimed to empower community members - primarily immigrants and refugees - with qualitative research skills to explore health concerns, particularly tuberculosis.
Education for Health Dec 2011
RHCP and the Hawthorne Education Center (HEC) in Rochester, Minnesota, collaborated to build community research capacity through focus group training within a community-based participatory research (CBPR) framework. The initiative aimed to empower community members - primarily immigrants and refugees - with qualitative research skills to explore health concerns, particularly tuberculosis. Twenty-seven participants, including both community and academic members, underwent a structured training program that included workshops, practice sessions, and real-world application through ten focus groups. These sessions were designed and led by the trainees, who took on roles such as moderators, note-takers, and analysts. The training emphasized cultural sensitivity, active listening, and participant engagement, resulting in improved trust, stronger partnerships, and enhanced community ownership of the research process.
The program evaluation showed that community members gained proficiency in focus group facilitation, with noticeable improvements in data quality over time. The initiative also fostered institutional change at HEC, where focus groups became a standard tool for informing policy and programming. Despite challenges such as participant attrition and the time-intensive nature of training, the project demonstrated the feasibility and value of equipping community members with research skills. The model has since been replicated, and trained individuals have applied their skills in other community contexts, contributing to broader health equity efforts. This approach highlights the potential of CBPR to not only generate meaningful data but also build sustainable research infrastructure within underserved communities.
Physical Activity and Nutrition Among Immigrant and Refugee Women: A Community-Based Participatory Research Approach
RHCP developed and evaluated a culturally tailored physical activity and nutrition program for immigrant and refugee women in Rochester, Minnesota, using a community-based participatory research (CBPR) approach. The program was informed by focus groups and a fitness retreat, where participants provided input on preferred exercise styles and nutrition education methods.
Women’s Health Issues Oct 2011
RHCP developed and evaluated a culturally tailored physical activity and nutrition program for immigrant and refugee women in Rochester, Minnesota, using a community-based participatory research (CBPR) approach. The program was informed by focus groups and a fitness retreat, where participants provided input on preferred exercise styles and nutrition education methods. A six-week pilot included twice-weekly classes combining aerobic dance, strength training, and nutrition education, with support services like childcare, transportation, and culturally relevant materials. The program attracted 45 women from Hispanic, Somali, Cambodian, and African American communities, with high attendance and strong satisfaction scores across all domains, including enjoyment, learning, and stress reduction.
Participants reported significant improvements in physical activity and quality of life, with trends toward better biometric outcomes such as reduced weight, waist circumference, and blood pressure. The program also increased self-efficacy for exercise and healthy eating. Key lessons included the importance of family involvement, language-specific nutrition education, and flexible programming to address shifting barriers. While the study lacked a control group and was underpowered for clinical outcomes, it demonstrated the feasibility and acceptability of CBPR-driven interventions. The findings support the value of community-led, socioculturally responsive health programs in addressing disparities among immigrant and refugee populations.
Screening for Tuberculosis at an Adult Education Center: Results of a Community-Based Participatory Process
RHCP partnered with the Hawthorne Education Center (HEC) to address tuberculosis (TB) among immigrant and refugee learners through a community-based participatory research (CBPR) approach. The collaboration involved focus groups to understand community perceptions of TB, followed by culturally tailored education and voluntary TB skin testing.
American Journal of Public Health July 2011
RHCP partnered with the Hawthorne Education Center (HEC) to address tuberculosis (TB) among immigrant and refugee learners through a community-based participatory research (CBPR) approach. The collaboration involved focus groups to understand community perceptions of TB, followed by culturally tailored education and voluntary TB skin testing. Of the 259 adult learners tested, 18.5% had positive results, with nearly all positive cases occurring among individuals from Africa, Latin America, and Asia. The participatory process—featuring community input at every stage—led to significantly higher testing participation compared to previous traditional approaches and helped reduce stigma and increase trust in the testing process.
The initiative demonstrated that adult education centers serving large immigrant populations can be effective venues for TB prevention. Learners and staff were actively engaged in planning and implementation, which contributed to high follow-through rates for evaluation and treatment. The CBPR model not only improved participation but also fostered a sense of ownership and empowerment among community members. While the findings may not be generalizable to all settings, they suggest that similar partnerships could be replicated in other communities to enhance TB control efforts. Future research should explore the long-term impact of participatory approaches on stigma reduction and treatment adherence.
Perceptions of Tuberculosis Among Immigrants and Refugees at an Adult Education Center: A Community-Based Participatory Research Approach
RHCP collaborated with the Hawthorne Education Center (HEC) in Rochester, Minnesota, to explore perceptions of tuberculosis (TB) among immigrant and refugee learners and staff. Using a community-based participatory research (CBPR) approach, the team conducted ten focus groups with 83 participants from diverse cultural backgrounds.
Journal of Immigrant Minority of Health Sept 2010
RHCP collaborated with the Hawthorne Education Center (HEC) in Rochester, Minnesota, to explore perceptions of tuberculosis (TB) among immigrant and refugee learners and staff. Using a community-based participatory research (CBPR) approach, the team conducted ten focus groups with 83 participants from diverse cultural backgrounds. The findings revealed widespread misconceptions about TB transmission, limited understanding of latent TB, and strong emotional responses such as fear, shame, and secrecy. These perceptions were shaped by past experiences in participants’ home countries and contributed to barriers in testing and treatment, including low awareness, stigma, and practical challenges like transportation and work conflicts. Despite these barriers, participants showed a growing openness to discussing TB, especially when education was delivered in trusted, culturally sensitive environments.
The project emphasized the importance of involving community members in the design and implementation of TB education programs. Recommendations included clarifying the difference between active and latent TB, addressing misconceptions, and linking education to accessible testing and treatment resources. The study also highlighted the potential of adult education centers like HEC as effective venues for TB prevention, particularly among foreign-born populations. Participants’ willingness to share personal experiences and engage in dialogue suggested a readiness to learn, which is a key factor in successful adult education. The CBPR approach fostered trust and empowered the community, reinforcing the value of collaborative, culturally informed public health interventions.