Background: Refugees resettling in the US historically follow a trajectory of declining health as they adopt American diet and physical activity.

Methods: This participatory research study explored health beliefs and behaviors of refugees from Burma currently resettling in New England. Community members and researchers adapted a healthy living bilingual educational flipchart, which was piloted in two workshops with a total of 20 adult men and women. An interpreter translated the audio taped discussions which were transcribed and analyzed using standard qualitative methods.

Conclusions/ Discussion: Refugee camps constrain food and physical activity related health behaviors. Refugees rely on traditional healing practices but are familiar with western public health care and preventive education. In camps, close living quarters encouraged social interaction and group play. Physical activity was built into daily life as transportation, occupation and food gathering method. Exercise was a byproduct of a busy day, walking to work or school, collecting bamboo in the woods. New arrivals are often housebound and isolated; they seek simple maps that assist in locating resources in their new communities. Asking about sleep appears to open the conversation about emotional and mental health problems. Refugees want specific information about healthy foods and better understanding of how to determine need for exercise. They also seek consistent information on prevention of health problems common in the US coupled with assistance preserving their traditional beliefs.

Discussion: Post-settlement in the US, retaining good health is challenging. Flipcharts and neighborhood map drawing provide avenues for open discussion leading to areas for Prevention Research Centers to partner for health.