Center of Excellence in Newcomer Health

Spotlight

Contact Info
Refugee Health Program
651-201-5414
refugeehealth@state.mn.us

Contact Info

Refugee Health Program
651-201-5414
refugeehealth@state.mn.us

Health Education: Minnesota Center of Excellence in Newcomer Health

Centers of Excellence in Newcomer Health Minnesota

Effective delivery of newcomer health orientation  requires accessible information, consistency and reinforcement from all partners who support newcomers during resettlement. The Minnesota Center of Excellence in Newcomer Health (MN COE)  convenes a diverse group of partners, including Resettlement Agencies (RAs), community-based organizations, clinicians, and members of the Association of Refugee Health Coordinators to develop, adapt, vet, and disseminate newcomer health orientation resources. 

The team works toward consistent health messaging, prioritizing ease of delivery and innovation. The MN COE:

  • Develops accessible health education resources for refugees.
  • Explores the possibility of enhancing a mobile application for dissemination.
  • Develops and shares enhanced health orientation curricula developed with feedback from new arrivals.

Process for vetting health education materials

The MN COE and the Nationalities Service Center (NSC) developed a material vetting process to assess and improve access to quality health orientation and education materials and, ultimately, improve health outcomes for newcomers.

Step 1: Assessment of health education and orientation needs

Identify the health education and orientation materials needed by partnering with newcomer communities, service providers, and health care providers. 

Step 2: Material collection

Before developing new materials, collect and review existing materials. Consider materials from local, national, and global sources.

Assess the availability of existing translated materials in a range of languages. 

Step 3: Preliminary vetting

Vet materials using the following four criteria:

  • Use of culturally sensitive and appropriate images
  • Use of absolute numbers instead of percentages
    • Example: Use "one in four people need health insurance" not 25% of people need insurance.
  • Availability in multiple languages
  • Readability score at or below a fourth grade reading level.  

Consider materials which do not pass these vetting criteria for revision and adaptation.

Readability scoring tools:

  • The Flesch Kincaid Grade Level readability formula is widely used to approximate the reading grade level of text. Texts with a score of 4.0 are considered easily understandable by an average fourth grader, 5.0 by an average fifth grader, and so on.
  • The Flesch Reading Ease formula can also be used to assess the difficulty of text written in English. Texts with scores between 90-100 are considered easily understandable by an average fifth grader.
  • Microsoft Word can generate these readability scores. On the top menu bar, select “Review.” Then select “Editor.” Under the header, “Insights,” select “Document stats.”
  • Refer to Flesch Kincaid Calculator for calculating readability scores (i.e., Flesch Reading Ease Score and Flesch-Kincaid Grade Level).
Step 4: Secondary vetting
  • Identify and recruit a diverse group of health educators, newcomers, and health care providers who work with newcomers to vet the materials advanced from the preliminary vetting.
  • Use a Modified Patient Education Materials Assessment Tool (PEMAT) (PDF) originally developed by the Agency for Healthcare Research and Quality (AHRQ), to evaluate the material.
Step 5: Adapt and finalize materials

For any materials which did not pass vetting, adapt and revise as needed. 

Step 6: Translate materials and seek feedback
  • Translate vetted materials, as needed. Seek community feedback on translations.
  • Integrate revisions in the English and translated versions before dissemination.

Example of sample material that did not pass vetting:

sample material that did not pass vetting: Hepatitis Type B PDF

Reasons for exclusion:

  • Medical terms may not be familiar and are not defined
  • Buries the one key action the user is invited to take - get a test
  • Photos are needed, but in a different layout

Example of sample material that passed vetting:

sample material that passed vetting: World Relief PDF (important documents and community services)
Credit: World Relief

Reasons for inclusion:

  • Photos utilized
  • Text is minimal and simple language is used

Refer to MN COE's Health Orientation Repository (PDF) to learn more about how the MN COE and NSC applied this process.

Authors and contributors to this project include Katina Cummings, Juliana Davis, Hyojin Im, Patricia Kirshenbaum, Joanne Morales, Laura Newman, Douglas Price, Nationalities Service Center (NSC), University of Minnesota (UMN), and various community partners.

Organizations interested in creating new health education materials may find this Guidance and Checklist for Content Validation (PDF) from the National Resource Center for Refugees, Immigrants, and Migrants helpful.

Improving health orientation for newcomers

The MN COE worked with the International Organization for Migration (IOM) to improve continuity of refugee health orientation and education for refugees resettling in the U.S.

Goals of this project:

  • Identifying challenges in disseminating health messages in multi-national refugee settings. 
  • Identifying current processes and best practices for improving development and dissemination of health education materials for refugees.

The workgroup identified the following strategies to improve health messaging:

  • Develop standardized resource materials 
  • Strengthen counseling and training skills of providers
  • Engage partners in collaborations on a regular basis to address consistency and targeted messaging
  • Incorporate health messages for emerging health issues (e.g., COVID-19)

Learn more about this project by viewing the Improving Continuity of Refugee Health Orientation and Education for Refugees Resettling in the U.S. (PDF) presentation from the North American Refugee Health Conference in September 2020.

Authors and contributors to this project include Cultural Orientation Resources Exchange (CORE) and International Organization for Migration (IOM).

Newcomer health education resources

The following newcomer health orientation and education resources were collected and vetted by the MN COE, the NSC, and additional partners. Some resources have been adapted and/or translated. These resources are intended to be utilized by resettlement agencies, public health departments, health care providers, and other organizations that assist newcomers. 

To submit health orientation and education resources for potential inclusion in this repository, please email refugeehealth@state.mn.us. We will update this section as new resources become available and are vetted.

Health insurance 
Hepatitis B

What do I need to know about Hepatitis B testing and vaccination? English (PDF)
International Organization for Immigration (IOM)

Stanford University: Know HBV: What every Asian and Pacific Islander should know about hepatitis B and liver cancer: English (PDF)

Immunizations 
Mental health 
Orientation to U.S. health care system 

Health Care Visit: What to bring to your appointment and where to go: English (PDF)
Catholic Charities, Arizona State University School of Social Work, Dignity Health, and International Rescue Committee

SettleIn: Healthcare in the United States: English

Pediatrics 

Health Information Translations: Child Safety Checklist: English (PDF)

Health Information Translations: Vaccines for Young Children: English (PDF)

CDC Milestone Moments Brochure: English (PDF)

CDC Milestone Moments Checklist: English (PDF)

Preventive health 
Women's health 

Safe Relationships: English (PDF)
Colorado Department of Human Services

Your Birth Control Choices: English (PDF)
CDC

Health Information Translations: Female Exam and Pap Smear: English (PDF)

Office of Refugee Resettlement video series 
Somali with option of English or Somali subtitles

Partner health education resources

Colorado Center of Excellence in Newcomer Health

  • Translated Materials
    This database of translated materials in 64 languages (fact sheets, posters, multimedia, and videos) was developed by the Colorado Center of Excellence in Newcomer Health (CO COE) to support outreach and messaging to communities with limited English proficiency (including refugees, immigrants, and others). 
  • Cultural Navigation
    This website serves to provide cultural navigation to support the case interview, contact tracing, and health education components of the COVID-19 pandemic response and other complementary public health efforts.

Other organizations

Minnesota Center of Excellence in Newcomer Health Updates
Receive email updates from the Minnesota Center of Excellence in Newcomer Heath, including CareRef, screening guidance, webinars, Immigrant Health Matters quarterly articles, and other resources.
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Last Updated: 06/18/2024