National Health Outreach and Engagement Conference 2024

Greder, K, Bartholomae,S, Ouya, V, Dan Karami, N, Bakhshalizadeh, F, and Banda, A.
Background: Immigration has played a pivotal role in shaping Iowa's demographic landscape,
contributing to 40 percent of the state's population growth since 2010(1). Iowa’s Latino
population grew 46.4% during this time and is projected to double (14.8%) by 2060(2).
Furthermore, the Congolese population is the second largest Black population in Iowa(3), and
during 2021-2022, over 900 Afghan refugees made Iowa home(4). Refugees and immigrants in
Iowa faced various obstacles, such as language proficiency, cultural adaptation, healthcare
navigation, transportation, and childcare. Overcoming these hurdles is vital for their successful
integration and overall well-being, and affects their ability to break free from poverty and
achieve a high-quality life1.

Theory: Socio-ecological theory posits that individual choices that influence health exist within
a system of contextual factors that collectively influence health(5). When people or
communities are adversely affected by such factors, health equities are created. Racial and
ethnic minorities and those residing in rural areas commonly experience the greatest
inequities(6). It is important to examine such factors to identify ways to address them and
improve health. According to the Cooperative Extension’s National Framework for Health
Equity and Well-Being (5), health can be improved by promoting healthy behaviors through
education and communication and/or creating healthy communities by addressing obstacles in
obtaining health.

Purpose: In this descriptive study we explored experiences and perspectives among first-
generation Latino immigrants and Afghan and Congolese refugees in Iowa related to their
health and wellbeing. Findings from this study can help inform human sciences extension and
outreach programming in Iowa.

Approach/method: In 2023, 13 focus groups were conducted across three Iowa communities
that have substantial Latino immigrant or Afghan and Congolese refugee populations. The
project team identified members of each population group who were trusted in their community
and who had strong communication skills to be trained as focus group facilitators and recruit
participants. Participants were of immigrant or refugee status, parents, age 18 or older, and
received a $50 gift card to compensate them for their time and expertise. The interviews were
transcribed verbatim and then translate into English by the facilitator or another member of the
community who was skilled in transcription and translation.

Thematic analysis(7) was conducted to identify patterns of meaning (themes) within the
interview data. Team members (5 extension specialists, 5 graduate students) individually
reviewed the transcripts in MaxQDA22 and then used a team-based approach(8) to develop a
coding scheme based on the identified areas of interest (e.g., food, financial wellbeing, health-
emotional, mental, physical, raising children in the US). Additional codes were created as new
constructs that represented participants’ experiences and perspectives were identified in the
data.

Produces measurable results for communities or individuals: A summary report for each area of
interest will be created based on the study’s findings. Reports will include themes and
associated details, as well as salient quotes that represent participants’ perspectives and
experiences. The reports will serve as resources to guide discussion and program development
for Iowa State University Human Sciences Extension and Outreach.