Date of Award

January 2016

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Rafael Pérez-Escamilla


Previous research suggests acculturation (i.e. exposure and assimilation to local culture) is associated with changes in dietary patterns among immigrants. This study investigates this association in a refugee population using time in refugee settlement as a proxy for acculturation. A cross-sectional survey was conducted among a convenience sample to: (i) identify dietary patterns in Liberian refugees and Ghanaians living in or near a refugee settlement; (ii) compare adherence to these dietary patterns between groups; and (iii) investigate the association between acculturation and dietary patterns in Liberian refugees. Time in refugee settlement was assessed by self-report; food consumption was assessed by food frequency questionnaire (FFQ). Principal component analysis was used to identify dietary patterns; generalized linear model was used to test the association of interest. Participants were Liberian and Ghanaian women with young children living in Buduburam Refugee Settlement or Awutu in Ghana (n=480; 50% Liberian; mean age 28.0, SD=6.3, range=16-48, years). Three distinct dietary patterns emerged: Healthy, Sweets, and Fats. Ghanaians were more adherent to the Healthy pattern than Liberians (p<0.05). Liberians were more adherent to the Sweets and Fats patterns than Ghanaians (p<0.05). There were no significant differences in dietary pattern adherence among the Liberians based on time in settlement. Ghanaians living in Awutu were more adherent to the Healthy pattern than Ghanaians who lived in settlement (p<0.05). Differences in dietary patterns were observed between Liberian refugees and Ghanaians. These differences were not associated with acculturation. The reasons for these differences warrant further investigation.


This is an Open Access Thesis.

Open Access

This Article is Open Access