Nile Sisters Improves Health Literacy Through Visuals and Cultural Activities

NEWS // October 1, 2015

Nile Sisters Improves Health Literacy Through Visuals and Cultural Activities

Refugee and immigrant families frequently arrive in the United States without basic knowledge of the English language.  They often experience culture shock because they are also unfamiliar with the legal, social, health, employment, and transportation systems in the United States. The Nile Sisters Development Initiative (NSDI) has been offering training and support programs for the past 16 years to help refugee and immigrant women and their families resettle more seamlessly in San Diego County. NSDI offers English tutoring, driver’s education, vocational training, parenting techniques, and health classes that are sensitive to the needs of low English-literacy learners. NSDI serves more than 2,000 refugees and immigrants per year.

Many of these people that NSDI serves only speak their native language, making it difficult for them to understand complex information and health data.  In 2009, Health Literacy San Diego found that one in three people in the United States are not able to understand health recommendations that include percentages or other numbers, such as “lose 10% of your body weight.” Visuals and tools that explain health in simple, easy-to-understand ways help to address these gaps (National CLAS Standards).  For example, the MyPlate program shows healthy portion sizes using familiar measurements like a fist to estimate one cup.  

More than language barriers, refugees and immigrants have a hard time staying healthy in a new environment.  Eating healthy is challenging because refugees are eating foods atypical in their home countries and many have resettled in areas with limited access to healthy foods.  Moreover, many resettlement communities lack sufficient outdoor spaces for regular physical activity. Socio-economic factors including poverty and lack of education about preventative practices also exacerbate the situation by creating an information gap for under-served populations.

In recent years there has been an increase in the number of refugees that develop chronic conditions like type 2 diabetes. A 2007 health assessment by the County of San Diego found that diabetes was a growing health issue for refugees after resettlement.  In 2011, the Refugee Health Technical Assistance Center confirmed that trend across the United States. Furthermore, type 2 diabetes is one of four diseases that result in over 50 percent of deaths in San Diego County.

Based on this information, NSDI adopted and implemented a health initiative called Type 2, Not You! (T2NY!), a type 2 diabetes education and prevention program funded by Kaiser Permanente.

“We know that Chronic conditions develop due to limited health literacy,” said Rebecca Paida, Senior Program Manager. “Our program Type 2 Not You! is a culturally proficient way of addressing the knowledge gap of awareness and education about type 2 diabetes among our residents.”

Learning more about healthy eating, exercise and diabetes prevention can help reduce the risk of developing type 2 diabetes. T2NY! relies on culturally appropriate information and methods to create healthy behavior changes, such as increasing physical activity through ethnic dancing and offering community workshops that teach participants  convenient, healthy and culturally sensitive recipes. Through theT2NY! Program, NSDI strives to provide equal access to healthy food and physical activity and aims to eliminate health disparities that disproportionately burden refugee communities. Programs like these help refugees better manage their health in a new environment and set them up for long-term success.


To learn more about Nile Sisters Development Initiative programs, visit:

To watch a video about the Type 2 Not You! Program, visit: