Abstract

Culture of Health – Advancing Together (CHAT) is a nonprofit organization in the Gulfton community of Houston, Texas. CHAT integrates newly arrived immigrant and refugee youth and families into a new life in the US. CHAT uses art as a vehicle to respond to immigrant and refugee needs at individual and community levels. This chapter describes the CHAT story, its history and mission, challenges to immigrant and refugee integration for youth and families, and how CHAT has responded to these challenges with arts-and-culture-based programs designed to engage, educate, train, and inspire. CHAT programs provide after-school academic and language education, social-emotional learning, life skills training, and social support on a foundation of writing, music, dance, photography, storytelling, and visual art. The resultant visual and performance art products have been featured in books, presentations, and community murals as a means of telling stories of immigration and declaring their creators’ future aspirations.

Keywords: immigrant and refugee health, social-emotional learning, culture and health, art and health, visual art, performance art

Introduction

Raul was nine years old when he moved alone from Honduras to Houston. Lonely and unable to communicate in English, he struggled to make friends. Within two weeks of joining CHAT Academy, he made friends. His mom couldn’t hold back tears of joy when she saw Raul on a theater stage at the end of the CHAT summer camp, delivering dialogue in English in a theater performance.

Raul’s experience mirrors that of numerous immigrant and refugee youth who have benefited from the programs of Culture of Health – Advancing Together (CHAT), a nonprofit organization in the Gulfton community of Houston, Texas. CHAT integrates newly arriving youth and families into a new life in the US. Integration refers to the process in which immigrant individuals and communities adapt to the economic, social, cultural, and political fabric of their host country (Bloemraad 2006). Through this process, immigrants can become full and active members of their new society, maintaining their cultural identity while also adopting the values, norms, and cultural practices of the host community. Earmarks of successful integration are cultural adaptation, social inclusion within networks and institutions, and economic self-sufficiency that culminate in a sense of belonging and acceptance (Portes and Rumbaut 2001). Metrics of successful integration include access to education, employment, and housing, and political participation (Alba and Nee 2003).

CHAT’s programs provide after-school education, English language development, social-emotional learning curricula, social support, and life skills training to facilitate integration (WHO 2023). Culture and the arts are intrinsically linked within these programs as a means to engage, educate, and inspire participants, and as a channel to broadcast stories of immigrants and their future aspirations to the broader community. This chapter describes the history and purpose of CHAT, the challenges that CHAT is meeting to achieve immigrant and refugee integration, and how CHAT is using art as a vehicle in an array of programs that respond to immigrant and refugee needs at the individual and community level.

Culture of Health – Advancing Together

Immigrants and refugees, when newly arrived in the United States, face distinct challenges to integrate into their adopted society and often struggle with language and cultural barriers. Many grapple with challenges of past trauma and feelings of isolation and loss of control in a world of new norms. Acculturative stress is related to deficiencies in spoken English and limited formal education that then compromise integration and employment. Mental health issues among immigrants and refugees are closely linked to acculturative stress (Silove et al. 2017).

CHAT was founded in 2015 as a 501(c)(3) nonprofit organization to fill a void between a continually expanding population of newcomers and inadequate coping assistance after their initial move. The CHAT vision is to build a healthy community that is self-sufficient and meets the everyday challenges of living in a diverse society. The CHAT mission is to foster the health and wellbeing of immigrant and refugee communities through education, arts, advocacy, and access to care. CHAT is, in essence, a safety-net organization that connects these communities to much-needed resources. There are many organizations within the US that are dedicated to immigrant and refugee populations. Two examples are the Global Refuge (which provides financial support, foster care, family reunification, job linkage, and other social services) and the US Committee for Refugees and Immigrants (USCRI, which provides legal, social, and health services and advocates for immigrant and refugee policies, practices, and laws). CHAT differs from these organizations in that CHAT is immersed in the community it serves and takes a broad approach to positively impacting social determinants of health.

CHAT works with immigrants and refugees to tackle social determinants of health (Image 1). These comprise the daily life conditions in which people are born, grow, work, play, live, and age. They include income, education, employment, food, housing, basic amenities, environment, social inclusion, and healthcare services. These can be compromised by language and cultural barriers and, when present as “resettlement obstacles,” can lead to post-migration trauma. Such trauma can include the following: financial stress; income insecurity; barriers to education, employment, food, housing, basic amenities, the environment, and social inclusion; problems accessing affordable healthcare services; lack of trust in the host country’s medical system; and problems with law enforcement and the legal system (Crosby 2013; Ellis et al. 2008; Millington 2010; Rodríguez-Valls and Torres 2014; Rubesin 2016).

Social determinants can be as, or more, important than healthcare or lifestyle choices in influencing health (WHO 2023). With a multifaceted approach targeting the social determinants of health through support, networking, and community engagement, CHAT is unique among Houston organizations in its ability to improve immigrant and refugee health and wellbeing by reducing their isolation, facilitating acculturation, and connecting them with additional resources.

Image 1: The CHAT Tree exemplifies social determinants of health in graphic form.

CHAT is an agile organization comprising a governing board of five members, a CEO, two staff, and a large cohort of volunteers (e.g., community health workers, trainees, students, “minute women”) that has most recently occupied offices in an apartment complex in the Gulfton community in Houston. This central and immersed proximity to the priority population has enabled CHAT to provide services and amenities. The community describes the CHAT family next door as tight knit, always available, and supportive. CHAT’s fiscal support comes from a diversified donor pool of individuals and businesses, plus government and foundation grants.

CHAT emerged from the desire of its founder, Dr. Aisha Siddiqui, to help Houston’s newly arrived immigrants and refugees experience and get oriented to the city’s diversity. Her passion for equity and equality in health and healthcare was born from her own immigrant experience and the challenges she faced when integrating into American culture. Basic tasks like navigating the streets of a new city and finding a job were daunting. Her doctoral research at the University of Texas School of Public Health enabled her to apply her passion for equity in the context of public health. She researched the experiences and challenges of South Asian women, documenting their efforts to achieve health in the midst of daily demands of raising children in an unfamiliar social system while encountering feelings of increasing isolation. Founding CHAT represented a natural evolution from this work.

Challenges to Immigrant and Refugee Integration

CHAT serves Houston’s immigrant and refugee families who live in part of southwest Harris County. Houston receives more refugees than any other city in the United States, according to the Complete Communities Initiative. This area of the city is an astonishing multiethnic tapestry, with 68% of the population speaking a language other than English at home. Over 60 languages are spoken in Gulfton, Sharpstown, and the surrounding areas. Many immigrants hail from communities ravaged by war and violence, were forced to leave successful lives in their original homeland, and find themselves marginalized in their new American home, making acceptance, acculturation, and advancement formidable goals.

Immigrants and refugees add social capital and tangible value to American society, both culturally and economically (Ghertner et al. 2024). A 2023 report by the American Immigration Council titled “Starting Anew: The Economic Impact of Refugees in America” determined that the majority of refugees with over 20 years residency become citizens (89.9%) and own homes (59.2%), have a median household income exceeding that of the median income of all US households, and have a rate of entrepreneurship exceeding that of nonrefugee immigrants and the US-born population (American Immigrant Council 2023). These findings were supported by a 2024 Health and Human Services study that attributed a positive net fiscal impact of $123.8 billion to refugees and asylees over the previous 15-year period, a revenue that exceeded government expenditures for refugees and asylees by $31.5 billion.

Despite this positive longitudinal data, new arrivals often face considerable challenges, such as the rudimentary functions of running a household and maintaining employment. In addition to poverty and stigma, immigrant and refugee families contend with linguistic isolation and loneliness (Linton and Green 2019; Buruss et al. 2021). Approximately 47% of immigrant adults report having limited English proficiency (Schumaker et al. 2023). Additionally, 30% report social isolation (Löbel 2022), which is associated with symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and feelings of powerlessness (Fazel et al. 2012; Kowitt et al. 2016; Sleijpen et al. 2017; Anderson et al. 2003). Since its inception, CHAT has worked to understand immigrant and refugee experiences and the concomitant challenges and needs of these communities in their journey to integration. Ongoing needs assessments through focus groups, interviews, literature, and best practices have supported organizational planning that serves adults and youth.

Challenges to Integrating Immigrant and Refugee Adults

CHAT’s needs assessment surveys and interviews established that the most pressing barrier affecting the health of the community is linguistic. The inability to speak English reduces the potential for educational attainment, parent engagement with youth, civic engagement within the community, transportation (e.g., driving), ability to use local resources, and even the ability to socialize with their neighbors—all factors that are critical to integrating successfully (UNHCR 2024). This finding is consistent with the five pillars for successful refugee integration, a guiding source document for CHAT, that cites English language proficiency as focal to successful integration (Fenstermacher 2016). Other supporting pillars are a clear path to citizenship and economic, civic, and (for children) educational integration. CHAT’s needs assessment also established that many immigrant and refugee adults lacked hobbies, community engagement, and workforce skills. Participants asked for evening classes that offer the opportunity to learn different skills, collaborate in mutual hobbies, and engage with individuals who otherwise do not show interest in community events.

Challenges to Integrating Immigrant and Refugee Youth

CHAT’s needs assessment survey determined a need for children’s programming. Parents expressed concern about limitations in their ability to guide their children in how to best prepare themselves for their future education. Parents perceived a loss of control in the acculturation process and inability to support their children within an unfamiliar educational and social milieu. The youth corroborated concerns reported in the literature, which include feeling “out of place,” “isolated,” “not belonging,” and anxious about being in an unfamiliar educational setting within a new country (Watkins et al. 2012; Fazel et al. 2018).  Trauma experiences from their past and uncertainty about their future, including perceived discrimination, contribute to depression, anxiety, and PTSD, as previously mentioned (Jared 2021; Fazel et al. 2012; Kowitt et al. 2016; Sleijpen et al. 2017; Anderson et al. 2013). These psychosocial sequelae can adversely affect refugee children’s academic performance. Current literature recommends a focus on resilience to overcome these psychosocial challenges and prepare for adapting to initial “adverse” circumstances (Sleijpen et al. 2017). Positive and supportive experiences for these children may offer protective factors for mental health (Fazel et al. 2012).

Creative arts therapy programs delivered by qualified therapy professionals have been identified as effective for adolescents affected by adversity (Quinlan et al. 2016). Examples include the Home of Expressive Arts in Learning (HEAL) school-based creative arts therapy program to reduce behavioral difficulties and emotional symptoms (Quinlan et al. 2016), a narrative-based intervention to reduce teacher-reported hyperactivity and peer problems (Durà-Vilà et al. 2013), and other arts-based programs that positively impact prosocial behavior, emotional conduct, and peer problems (Buruss et al., 2021).

Mental health services for children and adolescents are mostly provided by schools. However, refugee youth are often resettled in neighborhoods zoned to underresourced schools. Refugee children often attend low-performing schools where services are insufficient or inadequate in relation to the scale of their needs. These schools may also lack interpreters who can facilitate communication between students and school staff. Additionally, language and cultural barriers hinder parental involvement in their children’s education. To mitigate these barriers, CHAT has positioned itself to facilitate arts-based programs for immigrant and refugee youth.

Responding to Immigrant and Refugee Needs Through Art and Culture

Art has been part of CHAT’s programming since the organization began. Art is integral in CHAT Academy enrichment classes, in social-emotional learning activities for CHAT’s Girls’ Club for Success, and in enhancing community cohesion and aesthetics through CHAT’s Gulfton Story Trail. Social-emotional learning (SEL) is the process through which individuals acquire and apply skills to understand and manage emotions, build positive relationships, and make responsible decisions (Durlak et al. 2011). CHAT’s SEL program is an integral component of its efforts to promote the holistic wellbeing of immigrant and refugee youth. The SEL curriculum is designed to be culturally responsive, taking into account the diverse backgrounds and experiences of participants. CHAT’s approach is founded on evidence that creative workshops in the classroom can have a beneficial effect on the self-esteem and trauma-related symptoms of immigrant and refugee children from various cultures and backgrounds (Lee et al. 2021). SEL effectiveness can be increased through evidence-based techniques such as mindfulness practices, conflict resolution strategies, social skills training, positive reinforcement, collaborative learning experiences, and fostering a supportive school or community environment. Creative self-expression undergirds CHAT programs. The power of arts and artistic expression, whether visual art (photography, painting, community murals) or performance art (music, dance, theater), transcends language and cultural barriers and can serve as a tool to improve the health and wellbeing of immigrants and refugees. Creative projects give refugees opportunities to express themselves in a manner that is salient to them, giving voice to their past experiences, present challenges, and future aspirations (Rubin et al. 2021; Edmonds et al. 2021).

CHAT has devoted its resources toward establishing arts enrichment programs for school-aged children in the Gulfton community. Initially, CHAT connected with local artists on large community-based projects by networking through the city’s Mayor’s Office of Cultural Affairs and through local arts organizations. CHAT seeks artists who, in addition to artistic skill, have the empathy, cultural sensitivity, and pedagogical understanding necessary to create meaningful and impactful art experiences for young people. These collaborations are unique because most of the collaborating artists have an immigrant or refugee background. They bring this perspective to their interactions with community members as they seek to produce artwork that will resonate deeply with others in the immigrant and refugee communities CHAT serves. CHAT provides training and orientation to artists who work in youth school programming.

To be considered sufficiently qualified to work with youth, an artist must satisfy a combination of criteria, including practical experience, knowledge of youth development, cultural competency, ability to use strength-based approaches, and cultural awareness of the priority community. Practical experience is defined as a background in art education or a related field, with demonstrated experience working with young people. A formal degree in arts education is preferred but not essential if the artist has a history of prior success in leading art workshops or classes. Studies have demonstrated that effective arts-based interventions can be developed without access to a graduate-level art therapist (Buruss et al. 2021). It is also important that artists have an understanding of youth development principles to enable developmentally appropriate engagement using arts-based methods and that they have a passion for working with young people from diverse backgrounds. CHAT provides training in cultural competency to ensure the artists understand and respect the cultural backgrounds of the youth they work with. CHAT encourages artists to adopt a strengths-based, action-oriented approach, focusing on the positive assets inherent in each youth. Addressing the pathological and traumatic aspects of immigration is important but overemphasis on these aspects can be detrimental to both the health and public perception of refugees and immigrants (De Anstiss et al. 2009; Porter and Haslam 2005; Summerfield 1999). Strength-based approaches can build confidence and self-esteem and engender positive community connections among participants to improve mental health (Tedeschi and Calhoun 2004). Artists undergo orientation sessions where they learn about the specificities of the community they will be working with, equipping them to tailor their approach and content to be culturally relevant for the participants and the environment. These immigrant artists play a crucial role in CHAT’s programming, whether it’s conducting workshops at Houston Independent School District schools or organizing community art projects. Their presence and contributions add a rich cultural dimension to CHAT’s initiatives, creating a space where diversity and creativity thrive. Through art, these artists help bridge cultural divides, foster understanding, and empower marginalized youth to express themselves freely.

CHAT strongly believes in the transformative power of art. The organization subscribes to the tenet that art is not just about creating aesthetically pleasing works but also about the healing and affirmatory nature of the creative process itself. Immigrant artists, with their unique backgrounds and insights, contribute significantly to this perspective, making art a vehicle for empowerment, healing, and positive change within immigrant and refugee communities. Creating art and perceiving art are both ways of making and finding meaning, which is monumental for immigrants and refugees. They have the capacity to express themselves creatively with the process, regardless of the creative product.

The use of arts-based practices is not unique to CHAT. CHAT’s mission aligns with organizations such as ARTogether, the Immigrant Artist Resource Center, and Americans for the Arts. These groups promote mental health and overall wellbeing among immigrants and refugees by developing and presenting their work, fostering community and belonging, and focusing on the assets and initiatives of the immigrant experience. CHAT strives to translate the cultural and arts experience to empower the immigrant and refugee community for improved quality of life. Programs such as the CHAT Academy and Girls’ Club for Success enable children to gather and use their imagination to create beautiful art pieces (Image 2). There is an established association between engagement with the creative arts and health outcomes, specifically the health effects of music engagement, visual arts, movement-based creative expression, and expressive writing (Jackson 2021; Moss 2014).

Image 2: CHAT Academy youth involved in artistic self-expression, collaborating on the “Together We Play” mural.

CHAT Academy

CHAT Academy commenced in the summer of 2017 to provide after school academic tutoring. CHAT Academy is the primary focus of CHAT. It employs one refugee woman alongside dedicated volunteer support tutors. The academy was originally housed in a storefront with no running water; bathroom facilities were in an adjacent mosque. After two relocations, the academy was most recently housed in a three-bedroom apartment within a neighborhood apartment complex at the CHAT office. The academy has created community buy-in through parents’ increased trust of CHAT and youth enthusiasm for the program. There is so much enthusiasm that youth are reluctant to leave! Active partnerships have led to the arts being incorporated at all levels of the academic program (Table 1). Beyond homework, program offerings include writing, photography classes, visual arts classes, dance, music, theater, and STEM workshops. These art forms have been documented as transformative for immigrant and refugee participants, helping them give voice to their experiences (Lenette 2019). Formal integration of the arts within CHAT’s programming emerged from initial community engagement projects that were designed to empower youth for successful integration and acculturation. Evaluation of the children’s interest lead to the Arts and Health Project, a hands-on program to build bridges across cultures and enhance cross-cultural understanding (Image 3). The program takes an integrated approach by providing youth with rich exposure to one or more cultures while developing valuable artistic skills. A partnership with teaching artists and community organizations enabled cultural exploration through visual art during after-school hours. Program participants produced interdisciplinary art exhibitions and projects such as quilts, plays, songs, collages, murals, and paintings. Such participatory school-based arts approaches have been described in the context of participatory research as enabling the youth to tell their story (Sonn et al. 2013).

“Can we only come to CHAT Academy and not go to school because we love the art and CHAT Academy?”

—CHAT youth attendee

Table 1: CHAT Academy: Using arts to facilitate education and integration of immigrants and refugees.

Image 3: CHAT tutors and students at a museum visit, building bridges to enhance cross-cultural understanding.

Music Program

Refugee children’s experiences of war and life in the refugee camps invoke psychological distress, loss of familiar networks, and a perceived loss of control that compromises health and wellbeing (Silove et al. 2017). Creative involvement with music offers these children a form of connectedness and provides opportunities for social integration and language development. A partnership with Nameless Sound, a local nonprofit organization, enabled weekly music classes at CHAT Academy. Nameless Sound’s mission is to provide experiential learning using improvisational methods. This provides rapid immersion into the joy of music making and a shared musical experience to underserved youth. The partnership with Nameless Sound grew from an introductory class that the CHAT students loved. The music program is likely to have a positive impact on youth wellbeing because it strives to enable the development of emotional expression, improved social relations, self-knowledge, positive self-identification, and a sense of belonging (Image 4). Virtual music class was maintained during the COVID shutdown, but difficulties were encountered in engaging the youth. As a result, the instructor modified lesson content to focus on more creative strategies including musical storytelling, structured improvisation, and graphic scoring (using nontraditional notation to inform musical ideas and pieces). The instructor encouraged and reassured the youth to enable them to overcome feelings of performance anxiety as they progressed on their musical journey.

Image 4: CHAT Academy students performing with Nameless Sound for creative involvement to build connectedness.

Dance Program

A dance therapy activity called “Dance with Shamsa” explored body-based approaches to relieve stress in a positive and happy environment. Moving the body to music is an old art form in almost every culture. However, recently, movement-based strategies such as dance therapy have been given added attention for mental health treatment (Harvard Health 2021). This dance program, in concert with other CHAT programs, was designed to help address trauma in refugee children. The tenet is that dance movement may not only provide a way to express oneself but could also offer a path toward healing and lifelong strategies for managing stress.

Theater Program

In collaboration with the Brave Little Company, CHAT Academy students write, direct, and perform plays. Brave Little Company is a Houston-based nonprofit organization with a mission to involve youth in the creative and self-affirming experience of theater. They are devoted to enabling children to “create art on their own” that reflects Houston’s diversity. The partnership with Brave Little Company started with the idea of producing a play within one of CHAT’s summer camps. It was a six-week-long program that significantly boosted the confidence and self-esteem of the students. CHAT also offers theater classes within the Girls’ Club for Success program. Theater can be a useful method for social inclusion and refugee integration (Jackson 2021). The process of theater provides a humanistic and antidiscriminative learning atmosphere. Using theater as an educational tool can also improve empathy, break barriers and stereotypes, and increase intercultural learning and team building. Theater is believed to facilitate the personal expression of internal conflicts and the rehearsing of alternative choices through role play, improvisation, and storytelling. With roles and costumes, participants can process their stress and other insecurities by acting out their experiences in a safe environment, playing through imagination, and trying on different identities. Imagined roles in a self-created safe space offers an opportunity for engagement with oneself. Brave Little Company collaborates with students through the Wish You Were Here curriculum to create an original play told through the senses and shared with one or two audience members at a time (Image 5).

Image 5: Girls’ Club for Success participating in a theater program, a chance to try on different identities.

Photography Program

The FotoFest photo book project brought together women from different ethnic and cultural backgrounds and offered them a platform for cross-cultural communication and expression through photography (Image 6). FotoFest is a Houston-based nonprofit contemporary arts organization dedicated to advancing photography and visual culture through exhibits, public programs, and publications. The partnership with FotoFest originated in 2017 with a journaling program for women and has continued, offering photography programs at the CHAT Academy and the Girls’ Club for Success. In collaboration with the FotoFest, ten women were involved in a participatory photography project. Over a period of one month, they took and shared photographs every day and engaged in storytelling and self-reflection through writing and dialogue. This valuable format allowed them to re-establish a social and peer community in which they could benefit from each other’s experiences and backgrounds. Photography has great utility as an art form because it is accessible (particularly given the ubiquity of cell phone cameras), unobtrusive (can be used in varied locations and times), familiar, and doesn’t require extensive hand-eye dexterity or professional training. The project culminated in a published Blurb Book. It enabled a positive form of personal expression, drawn from the social and emotional aspects of immigrant life experiences, created in a supportive group context. These activities provide a creative and therapeutic offering to improve emotional health (Sonke et al. 2022).

Image 6: Expression through photography, pages from the CHAT/FotoFest photo book.

Visual Arts Programs

The arts serve as a psychological and educational tool to cross language barriers. They give a voice to those who might otherwise stay silent. In 2020 and part of 2021, CHAT offered virtual arts classes in partnership with the Museum of Fine Arts, Houston (MFAH). The MFAH is the premier fine arts institution in Houston that curates arts events and provides arts education to the public. In the service of this mission the MFAH partners with community nonprofit organizations. MFAH Glassell School of Art teachers regularly travel to classrooms across the city for Glassell-on-the-Go. The partnership with the MFAH was initiated through an online program in 2021 during the COVID pandemic. The MFAH provided an introduction to world cultures through art and artifacts from the museum’s permanent collection and temporary exhibitions to improve communication skills and vocabulary via interactive sessions. It provided an enjoyable and aesthetic experience with hands-on art activities through the kits that the museum staff delivered to the CHAT Academy. The program covered Texas State Board art requirements such as line, design, geometry, color harmony, and spatial awareness. Through this partnership children explored the work of professional artists, learned to apply art techniques and principles in creating art, and developed the vocabulary and confidence to talk about their own art and that of professional artists.

CHAT’s Art in the Park workshop provided children in the CHAT Academy with the opportunity to tell their stories through visual art. In 2020 CHAT was the co-sponsor of the University of Texas Medical Branch Annual Conference on Migration and Health. A feature at the conference was a virtual art gallery that displayed the artwork created through Art in the Park. CHAT Academy children also expressed their stories by designing their own fabric squares and created a quilt for the exhibit. The quilt was created to signify their journey to Houston. Each fabric square was decorated to express their perceptions of how far they have come on their life journey. The art and the quilt were auctioned online and the proceeds were used to compile an art book. The hardcover art book, titled Reflections from Refuge, represents images from around the world compiled from the artwork of CHAT Academy students ages 8 to 14 (Image 7). Included in the book are quotes from the students about their memories of their home countries, what they miss, and what they enjoy about Houston. The book was provided to attendees of the 2023 Migration and Health conference, held at the University of Houston, to commemorate that event.

Image 7: Cover for the Reflections in Refuge art book, a compilation of images from around the world.

Storytime

Storytime was initiated in 2016 as a weekly community engagement project (Image 8). It became one of the most popular programs because it gave children an opportunity to connect with volunteers and the community they lived in. Not only was Storytime effective in teaching English, but the program used drawing and storytelling to help immigrant and refugee children build bridges between the past and the future. The main themes were family, friends, and home, to address psychological distress and the children’s ability to adjust in a bicultural world.

“Storytime is the best! Why can’t we have it every day?”

—CHAT youth attendee

Image 8: A Storytime gathering, one of the most popular shared art experiences.

Girls’ Club for Success

Girls’ Club for Success is a social-emotional learning program born from a partnership between the CHAT Academy after-school enrichment program, the Houston Center for Photography (HCP), and FotoFest, and the social-emotional learning programs in the Houston Independent School District schools of Las Americas Newcomers School and Jane Long Academy (Image 9). The Houston Center for Photography is a nonprofit organization with a mission to “increase societal understanding of photography and its evolving role in contemporary culture.” Educational outreach is a core strategy to achieve this. The partnership with the HCP started in 2016 after the CHAT CEO attended a presentation about their youth programming. It was a collaboration to provide an opportunity to immigrant and refugee youth to creatively explore their identity and how they relate to their environment while aiding in their acculturation process by providing access to photography as a tool for self-expression. HCP staff brought cameras to the class every week. This became the highlight of CHAT Academy students’ week. The program gave the students an opportunity to visually present the world that they live in through their own eyes. For some children this was a healing experience. The twelve-week curriculum is part of HCP’s module titled “Picture This – The World Around Me: Exploring the Environment.”

Girls’ Club for Success brings together girls from different ethnic and cultural backgrounds in interactive workshops on personal wellness, physical and mental health, creativity, artistic expression, and positive cross-cultural communication in an open discussion format. This ‘180 Degree’ curriculum is designed to enhance lives one degree at a time. It is founded on the CASEL framework to address five competencies: self-awareness, self-management, social awareness, relationship skills, and informed decision-making (CASEL 2020). The curriculum enabled them to explore leadership, teamwork, and interpersonal communication.

A major draw of the program for students has been the art component, which features varied art forms: music, dance, photography, and storytelling. The students used photography and storytelling to examine their communities and reflect on their home and health. They were introduced to the genres of documentary and environmental photography and learned to combine photography and creative writing to introspect and compose personal narratives.

Over the course of the semester, Girls’ Club for Success became a safe space for participants. The social-emotional curriculum included traditional lessons and theater that taught the girls how to navigate their own emotions and engage in healthier relationships with others. By the end of the semester, the girls had made new friends and performed theatrical pieces they created together. Positive changes were observed in the immigrant and refugee girls’ behavior after being exposed to the semester-long Girls’ Club for Success program. They were much more engaged and were receptive to the program. In exit surveys after each session, over two-thirds of the girls reported that “feeling happy” is their favorite part of the Girls’ Club. Many girls reported feeling very happy during the check-in evaluation in expectation of attending and having fun with their friends and teachers. Many of the girls who reported feeling down, or just “okay,” during check-in experienced improved mood and reported feeling happier after participating. The school staff also reported that they had never seen the girls that happy, and some of them no longer needed the therapy sessions that they were attending before participating in the Girls’ Club. The Girls’ Club for Success is a place where girls from numerous backgrounds can come together and express themselves through creativity and imagination.

“We have come to wholeheartedly trust CHAT to deliver these services year-round—they have a long-standing slot in our programming rotation. They provide a safe space for our girls to grow individually and together—a special time they look forward to each week. Our relationship with CHAT is incredibly unique. It is not your standard campus-provider working relationship—it is much more than that as we have grown as a true community and family. Gulfton is special that way. They service these families inside and outside of the classroom; with limited funding and a revolving door of resources—they make the magic happen. CHAT makes learning fun and approachable for students trying to find ‘their place’ in school and at home.”

—Partnering school representative

Image 9: Girls’ Club for Success students working on their photo project.

In 2022, the Girls’ Club for Success held a total of 45 two-hour sessions at two elementary schools. The combined attendance for these sessions was 382 students (Images 10a and 10b).

Image 10a: Girls’ Club for Success: attendance and session hours at Jane Long Elementary.

Image 10b: Girls’ Club for Success: attendance and session hours at Las Americas Elementary.

Gulfton Story Trail

Nestled within Gulfton’s global cuisines and eclectic shops are 12 inspiring murals created by some of Houston’s most talented street artists (Image 11) (Najarro 2018). Each vibrant piece is multidimensional, born from poetry written by Gulfton students, expressed visually by muralists, and experienced by residents and visitors, blending Gulfton’s stories with their own. Collectively, they are called the Gulfton Story Trail. CHAT designed the Story Trail project to elevate the spirit of the community and invite visitors to infuse further energy into the neighborhood. This art intervention was aimed at increasing the residents’ health and wellbeing through the empowerment of their own cultural creations. The Story Trail was made possible by a grant awarded by the Houston Mayor’s Office of Cultural Affairs and the Houston Arts Alliance. It is part of the Visit My Neighborhood program for Mayor Sylvester Turner’s Complete Communities Initiative to empower Houston’s underserved communities to reach their full potential. CHAT proposed the Gulfton Story Trail Project to celebrate the cultural heritage of the international Gulfton community. Artists were invited to contribute to the development of a series of enduring community art murals that capture the community’s story through a combination of poetry and visual art. CHAT coordinated this project, collaborating with the Houston Arts Alliance, Mayor’s Office of Cultural Affairs, UTHealth School of Public Health, the Sharpstown Civic Association, Gulfton Super Neighborhood Council, YMCA, and others.

Public art, including mural art, is an important component of the built environment or human-modified design. Enhancing the built environment can have cultural and economic benefits for neighborhoods while providing aesthetic and inspirational value, strengthening community identity and pride, helping to shape behaviors toward health and wellbeing, and discouraging graffiti or gang “tagging” (Levin et al. 2006; Srinivasan et al. 2003; Galea 2021). Access to the arts has often been considered a luxury, but street art is easily accessible to all and has the potential to be transformative, uplifting and inspiring people to overcome challenges and envision a better future.

The Story Trail helps make Gulfton a must-see destination for cultural enrichment. Visitors can spend the day discovering the thought-provoking art while enjoying delicious food and unique local businesses. Every block is a fresh chapter in the story of what makes Gulfton special, a diverse tapestry made of more than 100 unique cultures and 60 different languages. Whether you’re a native Houstonian or a visitor, the Gulfton Story Trail will leave you energized and empowered by the area’s fascinating and often untold history. Every visit to the trail brings more resources to Gulfton and contributes to the community’s strength and sustainability.

In a mixed-methods study, CHAT graduate school interns examined the association between mural installations (in predominantly minority schools) that capture immigrant and refugee experiences and student and faculty perceptions of health and wellbeing. This work is one of very few that examines the benefits of improving the built environment in schools using murals and suggests that visual art is associated with improved interpersonal relationships and benefits to the school community and neighborhood that include economic growth through cultural tourism (UNWTO; Shegog et al. 2023).

“The murals have changed Gulfton’s fabric.”

—Community member

The Gulfton Story Trail is an ongoing project for CHAT. More murals continue to be added. CHAT often responds to calls from Gulfton residents who ask for murals to be added to walls that many locals consider graffiti magnets. An example was a mural installed on a wall adjacent to two schools that a resident reported was “graffiti prone.” The city council had painted over the wall multiple times, but graffiti continued to return. A collaborating artist conducted a town hall meeting with the residents and school children to discuss what they wanted to see on the wall, resulting in “A Children’s Story” (Image 12). Two other murals, “Together We Play” and “All Hands In,” were also created in response to community need and in collaboration with CHAT Academy students (Images 13 and 14). These mural installations are fun-filled, hands-on art projects for children from the community who benefit from the vibrant artwork. Efforts like these can help to build safer communities where people want to live, work, and play.

Image 11: Gulfton Story Trail: The “Celebration of Diversity” mural.

Image 12: “A Children’s Story” mural.

Image 13: Drawing for the “Together We Play” mural.

Image 14: “All Hands In” playground mural gives the court a new look.

Conclusion

CHAT programs provide after-school education, language skills training, social-emotional learning curricula, social support, and life skills training to immigrant and refugee youth and families with an aim to influence social determinants of health. Culture and the arts are intrinsically linked to these programs. The use of creative arts with immigrant and refugee children and adults empowers them to create a personal connection and build trust with others in the community. To date, hundreds of youth have benefitted from the engagement, education, and inspiration that these programs have provided. The visual and performance art products created in these programs have been broadcast in books, presentations, and community murals as a means of telling immigrants’ stories and declaring their future aspirations. The programs facilitate social connection with other refugees and members of the community, which in turn engenders trust.

Research on the health impact of arts and culture on new immigrant and refugee populations is underdeveloped. CHAT has a potential contribution in this domain. CHAT’s engagement of students from the University of Texas School of Public Health to provide program evaluation plans, grant-based COVID programs, and a recent research manuscript on the Story Wall represent steps in this direction. Academic partnerships with Baylor College of Medicine, the University of Houston, UTHealth, and Rice will help to hone CHAT’s capability to provide a more systematic approach to program evaluation for data-driven decision making. This requires that data collection, analysis, and dissemination protocols be more systematic and institutionalized. Evaluation of efficacy, effectiveness, and efficiency is important for justification of worth and as a guide to iteratively enhance program offerings. These academic partnerships also offer a pool of volunteers and interns who are the backbone of capacity building. CHAT will continue to grow its internship, fellowship, and volunteering opportunities to contribute to the health and wellbeing of immigrant and refugee communities while evolving the pipeline of future professionals and nonprofit leaders. This experience provides an opportunity to explore new career paths and enhance skills. In 2019, all the CHAT premed volunteers and interns were accepted into medical schools, and their experience at CHAT Academy played a significant role in that accomplishment (Images 15 and 16). CHAT’s community collaborations and arts- and culturally-informed programs help Houston’s new immigrants and refugees to thrive in their new home.

Image 15: Schweitzer fellows Matthew and Maria enjoying their CHAT experience.

Image 16: CHAT volunteers, fellows, and interns.

Acknowledgments

CHAT is grateful to the numerous volunteers, partners, and donors that make its work possible. It “takes a village,” so thanks go to the interns and volunteer tutors who engage the youth and families. Also vital are the partners that include the Houston Center for Photography. FotoFest, Houston Museums, the Mobile Library Services, and the Texas Children Mobile Clinic, and academic institutions including UTHealth, University of Houston, Rice University, and Baylor College of Medicine. The funders of this valuable work deserve acknowledgment for providing the resources to enable the work to continue. Thanks go to funding agencies and foundations that include the Community Health Choice, Menninger Foundation, Connect Community, Engage Houston, Houston Arts Alliance, and the Learning Initiative Support Corporation, and to the numerous private donors who are giving back to their community. Finally, CHAT thanks the indefatigable immigrants and refugees who are contributing to a strong and diverse United States.

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