Dietary guidelines made useful in migrant networks

Abstract

Abstract Globally, many deaths and DALY:s are attributed to unhealthy diets. Short education, low income and migration are risk factors. Healthy food cost more and is less available while unhealthy food is cheaper and heavily advertised. Health guides (HG) speak Swedish and at least one more language and have networks among migrants. Their work draw on the Right to health framework - availability, accessibility, acceptability and quality for all (AAAQ). HG transfer viewpoints from their groups to health care and contribute to culturally accessible and acceptable information and support. Public Health Unit of a local hospital initiated a project with the aim to develop a method to make information about healthy food accessible for a wider range of people. How to make food based dietary guidelines useful for recent migrants? How to avoid that official guidelines, when transferred by laymen, become distorted by personal experiences rather than being enriched by them? Systematic collection of viewpoints from inhabitants, helped of HG, implied that “shop walks” have potential to increase health equity. During a shop walk the guide shows healthy alternatives and transfers knowledge on different options. The intervention was developed during 2019. The first shop walks were conducted in February 2020. Dietary guidelines were made useful by a process including cooperation between HG, nutritionally skilled staff and the communication department. A detailed manuscript and a participant folder were developed together with a mandatory education including theory and practice. 14 HG speaking six languages were included. During the first three weeks six shop walks were conducted. Qualitative evaluation implies that shop walks are functional arenas for strengthening AAAQ. By structured shop walks HG can contribute to making dietary guidelines relevant for recent migrants. AAAQ is supported by participation of stakeholders in the population in collaboration with professional expertise. Key messages If food based dietary guidelines are to be made useful outside the majority population, methods that allow those most concerned to participate in planning, execution and evaluation should be used. Availability, accessibility, acceptability and quality - The Right to health framework – should be used when developing public health interventions that aim at health equity.