“Whenever I have a problem or troubles, Sapna always comes to mind first. I believe that if I come to Sapna, my problems will be solved. And even if they aren’t completely solved, that I will have found a path forward.” Tamanna, community member

Funded by the Department of Youth & Community Development (DYCD), this case management program is designed to help women set goals and access the services they need. Women participate in intakes, set goals, and continue to meet with staff over a one-year period. In this program we understand that physical health, mental health, and empowerment all intersect and that creating healthy families means addressing all three areas.

Whether the goal directly relates to a health issues, such as lowering A1C scores or is centered around educational knowledge such as becoming proficient in English, the case management allows our community to work towards their goals in a productive and balanced manner. Often, our women place the needs of their families and children before their own and our case management work focuses on also making their own needs a priority as well, with the knowledge that improved health and greater knowledge will only benefit the family and children.

After several years of partnering with the Komen Foundation on an intensive education program on breast health, Sapna now regularly provides health education around cancer prevention and detection, along with regular community health events to bring screening to our communities. We are increasing awareness on the importance of regular prevention to allow for early detection and treatment. We regularly host community health events doing everything from mammograms to skin cancer checks to pap smears in partnership with hospitals like Montefiore, organizations like Project Renewal, and doctors who volunteer their time.

New South Asian immigrants are characterized by high levels of need, especially a lack of health insurance, financial issues, lack of English skills, and housing problems. A study of South Asian women immigrants over 40 found that 40% reported an income under $25,000, 54% had no health insurance; 29% had not received screening in the past two years, a third had no regular source of medical care, and nearly half reported low English proficiency. This lack of English language proficiency results in reluctance to seek services and difficulty navigating the complex health care institutions. Sapna NYC first began working on cancer through its Komen Foundation funded SABHA breast health program.

SABHA (South Asian Breast Health Awareness)

The South Asian immigrant community faces many barriers to breast health. Lack of knowledge presents a major barrier to seeking services. Breast cancer is the second most common cancer in women living in South Asia, yet a 2006 survey of women age 40 and older living in Bangladesh showed that 9% had never heard of breast cancer, 26% had never heard of mammograms or breast self-exams. Cultural and religious restrictions present a major barrier to seeking and receiving breast health screenings. In some cases, women’s gender roles discourage assertiveness, with the result that women are often unlikely to confront their physicians with direct questions or requests. Among South Asian immigrants, as with many other groups, there is little awareness of the importance of disease prevention.  Our SABHA breast health program addressed this lack of awareness. In each year of this project, roughly 300 women received one-to education and over 200 women had mammogram screenings in Bronx and Queens.

“I meet the women every week to walk. I feel safe walking together and like talking to my new friends.” Walking Club Participant

We recognize that physical and mental health are intertwined and that we often hold trauma and stress in our bodies. We offer a variety of wellness and fitness programs throughout the year, allowing women to explore different types of physical activity from dance to yoga to aerobics. They are able to find the forms of exercise that feel right for them with these options that are always linguistically accessible and culturally appropriate.

Sapna NYC hosts a weekly Walking Club in the East Bronx which allows both women to connect with each other as well as to exercise. Walking together addresses safety concerns and also creates accountability to help motivate participants. Women are welcome to join weekly or whenever they are able to make it. The session starts with breathing exercises and light stretching followed by a group walk in the neighborhood. Women in our community often share that they feel stuck at home or feel lonely having left all their friends and family when they immigrated. This walking club helps women focus on building both mental and physical wellness.

Sapna NYC regularly offers Yoga workshops for our community. South Asian culture has a longstanding history of practicing yoga as a spiritual, physical, and emotional tool. As such, our yoga and mindfulness program both educates our community on the connection between mental and physical health, as well as teaches methods of breathing, meditation, stretching, and yoga that help release some of the tension we hold. This is paired with group conversation and support around trauma.

“We have an elder son who has serious cavities. We used to give him sweet drinks and snacks and he fed from the bottle until 3 years old. We usually do not go to the dentist if we have teeth problems such as pain or bleeding gums. I wish I did for that son what I am now doing for this baby. I wish you came before when my elder son was a baby.” Rubina, CHALO! mom

CHALO! Child Health Action to Lower Obesity– Intervention-based research study that addresses feeding problems, oral health, and obesity in young South Asian children. We work with infants starting at 6-months all the way up to 18 months throughout the Bronx, Queens, Brooklyn, and New Jersey. The project combines education with goal-setting and follow-up phone calls to help women develop healthy habits for their children. We include patient navigation as well as doc talk cards, dental lists, and culturally competent and linguistically accessible health information.

The CHALO! Project encourages:

• Healthy eating and nutrition
• Progressing to solid foods in a timely manner
• Transitioning from the bottle to the cup
• Dental hygiene and regular visits to the dentist
• Active play and no screen time

“When I came to the U.S., I gained a lot of weight and started suffering from knee pain—the doctor said that I needed surgery. Hearing that, I joined APPLE and lost 15 pounds. My knee pain has improved, and my life has become a lot easier.” Lafi, APPLE participant

SAATHI & APPLE-APPLE (“Activating People to Pursue Lifestyle change through Empowerment”) and SAATHI (“South Asians Acting Together for Health Improvement”) are community participatory interventions that address diabetes and obesity through lifestyle change. Participants learn about nutrition, self-care, exercise and weight loss though a multi-phase learningprocess. Group education is paired with individual goal setting sessions to help participants lose weight and lower A1C scores.  Each participant is assigned aBondhu (“friend”) partner within the group to provide social and emotional support throughout the program. In the final phase of the project, participants develop outreach projects that are designed to share knowledge with the larger community.

SAATHI is an extension of the APPLE project for community members identified as pre-diabetic. Similar in most respects to APPLE, SAATHI is designed to address the high prevalence of diabetes and other metabolic and cardiac diseases in the South Asian community. Our CDC accredited, culturally competent diabetes prevention curriculum is tailored to the community we serve. It takes into account the diet, cultural practices, and habits of our community.

An important component of both SAATHI and APPLE is our emphasis on fitness. We offer culturally competent fitness classes in an environment where our women feel comfortable. Due to cultural customs money constraints, enrolling in a gym is not always feasible. Our classes focus on full body exercises that can be done at home without any machines.

APPLE & SAATHI Outcomes:

• Over 125 women enrolled in the Bronx and Queens
• 68% retention rate
• 8% reduction in BMI
• Average of at least 6,000 steps walked per day
• Significant reduction in HgA1C with several participants moving from diabetic to prediabetic range

“I used Surma for many years and never knew that it was made of lead. In Bangladesh many people use it. After I learned in my Sapna Action Group training, that Surma has so much lead, I asked my doctor for a blood lead test. He didn’t want to test me, but I insisted that it was my right. I found out I had high lead levels and now stopped using Surma.” – Tamanna, Lead Action Group member

Sapna NYC is collaborating with the NYC Department of Health and MentalHygiene (NYC DOHMH) to address lead poisoningawareness and prevention in NYC’S South Asian community.We created culturally and linguistically accessible outreach materials, including a community made outreach video, doc talk card, ESOL session, and brochures. Sapna NYC also administered workshops on lead poisoning in the Bronx, Brooklyn, and Queens in collaboration with other non-profit organizations and cultural centers. Additionally, we have been doing provider education with health professionals at hospitals and clinics to provide training on specific South Asian cultural and religious products and practices that might lead to an increased risk of lead poisoning.

New York City’s South Asian children and adults are especially at risk for lead poisoning. A 2016 study found South Asian children in the city were six times more likely to have high blood lead levels than children citywide, and adults were four times more likely to have high levels. Exposure to lead can cause serious health problems in both children and adults. Children can develop learning and behavior problems. In adults, lead exposure can increase the risk of miscarriage in pregnant women and infertility in both men and women.  In addition to lead paint and occupational lead hazards, elevated blood lead levels in the South Asian  community have been associated with the use of traditional consumer products, like surma, sindoor, and spices brought back  from home countries.

For more information on our lead poisoning awareness project and Bengali resources, visit our lead page.

For more information on lead poisoning visit the NYC DOHMH site.