Community Dialogue

Welcome to RHTAC Community Dialogue, a forum for refugee providers to share resources and learn from each other's experiences. Join the dialogue by posting a new comment or replying to an existing comment.

January 2012 Dialogue: Domestic Health Orientation

Continue the dialogue from the CAL and RHTAC December 5, 2011 webinar Refugee Health Orientation Continuum: Overseas and Domestic Perspectives. Webinar participants' comments relate to these main themes:

Comments will be closed on January 31, 2012

Resources and Tools for Domestic Health Orientation

Resources reinforce learning and provide additional information on the U.S. health care system to refugees receiving domestic health orientation. Continue the dialogue from the December 5, 2011 webinar, Refugee Health Orientation Continuum: Overseas and Domestic Perspectives, co-sponsored by Cultural Orientation Resource Center, Center for Applied Linguistics (CAL) and RHTAC.

What resources (videos, activities, websites, fact sheets, etc.) are you using for refugee domestic health orientation? Are these resources available at no-cost? Are these resources available in languages other than English? Leave your comments below.

13 thoughts on “Resources and Tools for Domestic Health Orientation

  1. Catherine Dickson

    We are having issues obtaining resources of illiterate clients who need help remembering the dosage and times for their prescriptions. Does anybody have any solutions that have worked for them? Or know of any resources available, such as stickers or pictures to place on the prescription bottles? Thank you.

    February 20, 2012 at 5:56 pm Reply
    • Paul Geltman

      How to improve comprehension of and adherence with medication instructions for individuals who are not literate in English is a never-ending challenge. Really, only a licensed medical provider or pharmacist should be labelling medication bottles for patients. However, a variety of strategies have been tried to reduce errors, but most have been frought with problems. In one study, use of simplified labeling with specific medication schedules has been promising, but huge regulatory and pragmatic hurdles would need to be overcome to introduce such a systematic change at the pharmacy level. See the study by Shrank WH, et al., in Contemp Clin Trials. 2010 Nov;31(6):564-71. Epub 2010 Jul 18. At a less formal level, a common strategy to help people keep track of their medications and doses has been to use calendars and pictures of rising/setting suns, moons, etc… to signify times of day for dosing medication, but even this can be confusing. The “pill card” is an example. See
      I hope this is helpful.
      Paul Geltman, MD, MPH
      Medical Director, RIHP and RHTAC, Mass. Dept. of Public Health

      March 14, 2012 at 4:37 pm Reply
      • Catherine Dickson

        Dr. Geltman,
        Thank you for the pill card example and link to instructions and template. I hope my organization will be able to utilize this in the near future.

        Thank you,
        Catherine Dickson
        Case Management Coordinator
        Catholic Charities San Antonio

        March 21, 2012 at 5:05 pm Reply
  2. Sanja Bebic

    The Cultural Orientation Resource Center at the Center for Applied Linguistics hosts a variety of general health-related orientation materials on its website, The health section of the Overseas Service Provider toolkit ( is comprised of lesson plans used by different Resettlement Support Centers in overseas orientation. While designed for pre-arrival use to give refugees initial exposure to basic U.S. concepts and systems regarding health, these lesson plans are very relevant in the domestic context as well. In addition, the health section of the Domestic Service Provider toolkit ( includes resources developed by national or local resettlement agencies in response to identified needs, such as providing information on nutrition, working with a refugee to make their own doctor’s appointment, and so on.

    January 31, 2012 at 4:44 pm Reply
  3. Sarah Russell

    Ohio is happy to share copies of our DVD, “Safe, Smart & Healthy: Keys to Success in Your New Home.” It is available in 34 languages with chapters on: Medical Care & Health Insurance, Family Issues & Domestic Violence, Medications & Home Remedies, Personal Hygiene, Substance Use/Abuse, Food Safety & Housekeeping. If you have any questions about developing the DVD just let me know.

    January 17, 2012 at 10:39 am Reply
    • Nancy Swyers

      Sounds good how do I get a copy(copies) of the DVD?

      January 21, 2012 at 6:07 pm Reply
    • Mohamed Ali

      As a multi-ethnic refugee community association in the State of Idaho we are looking and interested to have one for any Medical Care or Health Awarness film, DVD or in CD. So please Sarah how can get a copy of the DVD you have. We would like English, French, Somali & Arabic.
      Please Let me know.
      Thank You

      January 22, 2012 at 1:42 pm Reply
  4. Lauren Swain

    Ethnomed has recently posted our multilingual refugee health orientation videos, produced for the Refugee Preventive Health Program of Colorado Department of Public Health and Environment This program teaches newcomer refugees how to properly access medical care, get immunizations, use medications, and live a healthy lifestyle, among many other topics. Although some of the information provided is specific to Colorado, most of the material can be of value to immigrants and refugees nationwide.

    View them at

    Please feel free to email me if you would like to receive a detailed outline of the content of this video.
    I am interested in any feedback you may have.

    Lauren Swain

    January 14, 2012 at 12:41 pm Reply
  5. Kyi-Sin Than

    I came across this radio show HEARMe (Health Education via Airwaves for Refugees) from Atlanta, GA, led by former African refugees. The show is very popular and it now broadcasts in Somali, Swahili, Amharic, and Bhutanese. HEARMe provides radio shows on important topics such as H1N1, Hep-B but it is not only limited to health conditions; it also offers shows like “life as a teenage refugee in the U.S.” What makes this project possible and impressive is the partnership between the community, a local university (Emory University), and WRFG 89.3 FM Atlanta, local radio station. The community leaders provide an influential voice on the show with help from Emory University students and faculty, made possible with technical support from WRFG.

    Radio shows could be great ways to deliver health education (if the local infrastructure supports it) since literacy among refugees varies. And radio drama makes health education exciting and accessible to refugees from all backgrounds and levels of education.

    This innovative approach has great potential for cities or towns with large refugee communities!

    If you would like to learn more, visit their website –

    January 13, 2012 at 3:51 pm Reply
  6. Mary Alice Gillispie

    Healthy Roads Media ( is a web-based multilingual health education resource that focuses on hard to reach groups with a focus on refugees. There are free materials in written, audio and video formats in many languages and topics. A number of the topics are relevant to refugee health orientation. We worked with the Minnesota Dept of Health to adapt part of the refugee health guide mentioned in the previous message.
    Also, Ohio has developed a fantastic DVD called Safe, Smart and Healthy that focuses on refugee health orientation. This DVD was done in many languages. Sarah Russell, the Ohio state refugee health coordinator, contacted Healthy Roads Media to see if we might be able to adapt the DVD content into web resources to make it accessible to more people. We have been able to adapt the English version of the DVD and are seeking funding to work in more languages. We are also working to develop a mobile optimized website and have posted the English language Safe Smart and Healthy content there ( Any feedback about these materials is very helpful in guiding the work so that it is as useful as possible.

    January 11, 2012 at 1:20 pm Reply
  7. Christine Ross

    Refugee health liaison in my organization is a brand new position, and I am excited to jump in and educate the refugees more about preventative measures. Being a refugee myself I know what I wish was done for us right away. We right now don’t have any resources at our disposal. What are the resources out there to be utilized by people like me?

    January 10, 2012 at 3:38 pm Reply

Strategies and Techniques for Domestic Health Orientation

Techniques and content of domestic health orientations can be tailored to fit the needs of refugee audiences. Continue the dialogue from the December 5, 2011 webinar, Refugee Health Orientation Continuum: Overseas and Domestic Perspectives, co-sponsored by Cultural Orientation Resource Center, Center for Applied Linguistics (CAL) and RHTAC.

What strategies help adult refugees learn and use information from domestic health orientation? What teaching styles work well with refugees? What strategies would you recommend for refugees who are not literate? What strategies would you recommend for health orientations where refugees of various languages and cultures learn together? Leave a comment below.

14 thoughts on “Strategies and Techniques for Domestic Health Orientation

  1. Angela

    We are using physicians who are in their residency training years to conduct the health orientation sessions. Due to limited time, we have chosen thus far to focus on health insurance, accessing health care (the differences between PCP, ER, urgent care, pharmacy, specialists, etc…), and women’s health. The residents work closely with translators and staff at the resettlement agency.

    January 11, 2012 at 11:46 am Reply
    • Paul Geltman

      Angela, I’m wondering if you find that the residents have sufficient knowledge on some of these topics and how they apply to refugees? For example, eligibility for medicaid.

      January 18, 2012 at 6:14 pm Reply
      • Angela

        Our residents are Preventive Medicine residents, so they already have an interest in serving such a population. We also have the residents see patients in our Refugee Health Clinic. However, it did take some extra effort from the residents for them to learn about specific details of refugee issues. But it was not too time consuming and it the residents like learning about these ‘bigger’ issues affecting the refugees, other than their specific medical condition.

        January 24, 2012 at 5:22 pm Reply
        • Judith

          Angela, I would like to know if and how the process of a PCP referring the patient to a specialist is explained in the orientation sessions. Is the idea of insurance participation/authorization discussed?

          April 9, 2012 at 7:55 pm Reply
    • Sr. Mary Duddey

      When do you do this?

      January 21, 2012 at 11:02 am Reply
      • Angela

        We worked with the residents’ schedules & found a time that worked for most. We have one talk per week lasting 1.5 hours.

        January 24, 2012 at 5:23 pm Reply
  2. Webinar Participant

    We recruit student volunteers to accompany recent arrivals to their first medical appointments to help them navigate the appointment. Has anyone done something similar to orient recently arrived refugees into the health care system here?

    January 10, 2012 at 4:09 pm Reply
  3. mchiang

    In our area, our program has found that health orientation provided directly by community health workers (CHWs) has been an effective and supportive way to educate and empower refugees around domestic health issues and health care services. Our CHWs are bi-cultural and bi-lingual, many from refugee community themselves. For this reason, our CHWs are particularly well-received by refugees in a way in which traditional, printed materials often might not be. Additionally, our CHWs receive training so that they may develop expertise in healthcare, health issues and health related resources locally.

    To the extent possibly, all health orientation and education are delivered in home visit settings by the CHWs. This creates a level of comfort and accessibility for newly arrived refugees. Such a strategy also facilitates the process of CHWs becoming part of the refugee community itself. Often our CHWs are viewed as leaders by the community, and allowing them to become key informants that provide feedback into and influence our local, mainstream healthcare providers that work with refugees.

    January 10, 2012 at 8:39 am Reply
    • Christine Ross

      The idea of CHWs is a great one, first of all Majority of the refugees were being taught by CHWs in the various camps that they came from, and the set up of CHW where the individuals are from the very community that they serves, creats some kind of trust and make explaining health problems or even educating them more easy. I would like to set up a CHWs here in Omaha, I need help. I believe it would work very well.

      January 10, 2012 at 3:47 pm Reply
      • mchiang

        Hi Christine, Perhaps we can have a more in depth conversation to discuss various models of CHW and outreach. It is a resource heavy strategy, but as you alluded, in many ways, it is an investment in prevention and education that really pays off in the long run.

        January 20, 2012 at 4:53 pm Reply
        • Elizabeth

          I am very interested in the CHW program. How is it funded? How are the chw’s trained, through the local hospital or through a community college setting?

          January 26, 2012 at 9:33 am Reply
    • Natasha Curtis

      Here in Akron, OH, we are exploring the possibility of implementing a CHW program. I’d love to connect with you regarding this issue. Please let me know how we can connect. You may e-mail me at las(a)

      January 18, 2012 at 1:59 pm Reply
    • Sr. Mary Duddey

      This is a great idea! Sorry I am not familiar with “CHW” ? Who are they, Staff, etc. Do you take interpreters with you? Please give more infornmation. Thanks

      January 21, 2012 at 11:06 am Reply
      • mchiang

        CHW stands for community health worker. In our program, CHW staffing is mixed, with some full time, others part time. Our priority is also to hire CHWs who speak refugee langauages, many come from refugee communities, along with other qualifications as laid out in the job description. Regardless there are still instances in which language is a barrier to communication.

        January 24, 2012 at 3:54 pm Reply

Evaluation and Research for Domestic Health Orientation

Evaluation and research provide insight into effective domestic health orientation techniques and affects of health orientation on refugee health behaviors. Continue the dialogue from the December 5, 2011 webinar, Refugee Health Orientation Continuum: Overseas and Domestic Perspectives, co-sponsored by Cultural Orientation Resource Center, Center for Applied Linguistics (CAL) and RHTAC.

What evaluation methods are being used to measure knowledge and skills gained by refugees after participating in domestic health orientations? What research projects are studying the effectiveness of refugee health orientations? Leave your comments below.