Postpartum Food Traditions of Bhutanese Refugee Women: a Qualitative Study

Bhutanese refugees represent one of Canada’s most recent immigrant populations, and little is known about their dietary traditions and habits. The purpose of this study was to improve the wellbeing and health of re-settled refugee Bhutanese women by understanding how culturally informed postpartum food choices are practiced post-migration. As part of a larger community-based participatory research project, semi-structured interviews were conducted with 12 Bhutanese refugee women. The traditional dietary choices that Bhutanese women revealed to be important in the postpartum period were organized into five themes: (1) “foods consumed as part of a regular healthy diet,” (2) “foods to regain strength and heal the body,” (3) “foods to ward off back and joint pain,” (4) “foods to promote lactation,” (5) “foods avoided due to negative effects.” Traditional foods and culturally situated beliefs in the postpartum period play a significant role in the lives of Bhutanese women. Healthcare workers in countries of re-settlement should work with the traditional health and nutritional beliefs of women in this community in order to provide optimal dietary and health recommendations.     

Acceptability,Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York

Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive–compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen’s d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States.