More NorCal Reflections

My last visit in California before we headed north was with Dr. Lucia Kaiser.  Lucia is an Extension Nutrition Specialist with University of California at Davis and is in the final stages of her career at UC.  I was somewhat familiar with Dr. Kaiser's work having seen it highlighted at professional meetings.  I had never met her before and was charmed by her warmth and her commitment to her current project.  I was glad I had the opportunity to interview her.

Lucia in her office.

Her project focuses on delivering messages about parenting and obesity prevention to newly immigrated residents of the Central Valley in a rural area near Fresno.  About 400 parents are involved in the study and only about half participate. About 79% are Mexican immigrants and there is a fairly low acculturation level in the group.  Some of the things they are learning are that parenting around food is a difficult thing to influence, especially when the cultural norms are different from those being taught.  The more hands on, the more impact on and involvement of the students.  They have gone to having a promotora teaching hands on cooking classes and moved away from some of the more didactic classes. They also have formed a walking club to promote physical activity.  This fits with what we have experienced as well.   Lucia shared that the mothers are getting mixed messages about the obesity risk their children face.  They are using health report cards to share with the parents weight and Body Mass Index (BMI) information.  Lucia was not understanding why the report cards were not really influencing behavior until she dug a little deeper.  The area physicians were advising the parents not to worry, not to put their kids on diets and were assuring them they would "grow out" of their fat stage.  This is a common concern in our country and it speaks to the need to help the medical community understand the importance of non-diet interventions for children.  I am working on a study that is focusing on helping both parents and preschoolers understand about satiety and becoming aware of their cues for satisfaction and fullness.  Lucia and her team took a community awareness approach and used simple graphic examples to compare the obesity rates in the general population and in the targeted community.

The color of the folders represent obesity rates in the normal population and then the targeted community. Green represents normal weight, yellow, at risk and red obese.  The comparisons between the right side (average population) and the targeted community (left) speak for themselves.

The parents were able to see the differences and Lucia reported that the "lights went on" (my words).

Lucia hopes to continue this work in a consulting role in other communities after she retires this fall.

We had a very interesting discussion about the role of trauma in her study community and in the immigrant community as a whole.  I have been asking about trauma all along the way on this trip and about teen parents and the status in each community where I have made program visits.  I shared my experience of visiting with the women in the Kino women's shelter in Nogales, Sonora.  I shared what I learned about the high incidence of rape for women who attempt the border crossing.  Lucia and I shared tears.  It was good to see that she was not hardened to the reality of what was happening.  She spoke about rape as well.  She has colleagues in school of nursing who are finding rape is an issue with teens and that some of the evidence points to the field workers.  I am concerned about the culture of sexual assault that is created by the inhumane conditions on the borders and during the journeys through both Mexico and the US.  I know it is compounded by impoverished lives folks are forced to lead and the shadows in which many exist.   I am aware that the fear of reporting a rape can be exacerbated by fear of the law, immigration issues, cultural silence about rape.  It is not a good situation.  This was not the first time I heard concerns about sexual assault of young Latinas on the trip.  

I cannot help but think that the trauma exists at the community level and is exemplified in a variety of ways.  I wonder how much trauma, post traumatic stress and the threat of loss and grief affects the choices people are making about food and their weight? Good questions to which I do not have the answers.  To assume that there is no impact would be a mistake.  Lots to think about.

I am almost half way through this sabbatical and I have more questions than I have answers.  I suspect this is part of the process.  I am certainly learning a great deal so far and look forward to the next 3 months.  I will continue to blog.  I am finding it very helpful for my own learning.  One of the gifts of this time away from my normal duties is having the time to reflect and process.  I have always enjoyed journaling and I am finding a renewed energy for that in this blog.  Upcoming is a trip to Arizona, a trip to New York City, work with a colleague and scholar in Oregon and time to start working on fund proposals for our Fortaleciendo Familias program revision.

Thanks for reading.