Navigating a strange and complex environment: experiences of Sudanese refugee women using a new nutrition resource

BACKGROUND Refugees experience dietary changes as part of the daily challenges they face resettling in a new country. Sudanese women seek to care and feed their families, but face language barriers in the marketplace, limited access to familiar foods, and forced new food choices. This study aimed to understand the acceptability of a purse-sized nutrition resource, "The Market Guide", which was developed to help recently immigrated Sudanese refugee women identify and purchase healthy foods and navigate grocery stores. METHODS Eight women participated in a focus group, four of whom were also observed during accompanied grocery store visits. Individual interviews were conducted with four health care workers at the resettlement center to gather perceptions about the suitability of The Market Guide. Focus groups and interviews were audiotaped and transcribed. Data from field notes and transcripts were analyzed using grounded theory for preliminary open codes, followed by selective and theoretical coding. RESULTS The Market Guide was of limited use to Sudanese women. Their response to this resource revealed the struggles of women acculturating during their first year in Calgary, Canada. We discovered the basic social process, "Navigating through a strange and complex environment: learning ways to feed your family." Language, transportation, and an unfamiliar marketplace challenged women and prevented them from exercising their customary role of "knowing" which foods were "safe and good" for their families. The nutrition resource fell short of informing food choices and purchases, and we discovered that "learning to feed your family" is a relational process where trusted persons, family, and friends help navigate dietary acculturation. CONCLUSION Emergent theory based on the basic social process may help health care professionals consider relational learning when planning health promotion and nutrition activities with Sudanese families.