Skip to main content
Top
Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

Exploring strategies to reach individuals of Turkish and Moroccan origin for health checks and lifestyle advice: a mixed-methods study

Authors: Andrea J. Bukman, Dorit Teuscher, Jamila Ben Meftah, Iris Groenenberg, Mathilde R. Crone, Sandra van Dijk, Marieke B. Bos, Edith J. M. Feskens

Published in: BMC Primary Care | Issue 1/2016

Login to get access

Abstract

Background

Low participation rates among ethnic minorities in preventive healthcare services are worrisome and not well understood. The objective of this study was to explore how adults of Turkish and Moroccan origin living in the Netherlands, aged 45 years and older, can be reached to participate in health checks for cardio-metabolic diseases and follow-up (lifestyle) advice.

Methods

This mixed-methods study used a convergent parallel design, to combine data of one quantitative study and three qualitative studies. Questionnaire data were included of 310 respondents, and interview data from 22 focus groups and four individual interviews. Participants were recruited via a research database, general practitioners and key figures. Quantitative data were analysed descriptively and qualitative data were analysed using a thematic approach.

Results

Regarding health checks, 50 % (95 % CI 41;59) of the Turkish questionnaire respondents and 66 % (95 % CI 57;76) of the Moroccan questionnaire respondents preferred an invitation from their general practitioner. The preferred location to fill out the health check questionnaire was for both ethnic groups the general practitioner’s office or at home, on paper. Regarding advice, both groups preferred to receive advice at individual level rather than in a group, via either a physician or a specialised healthcare professional. It was emphasised that the person who gives lifestyle advice should be familiar with the (eating) habits of the targeted individual. Sixty-one percent (95 % CI 53;69) of the Turkish respondents preferred to receive information in their native language compared to 37 % (95 % CI 29;45) of the Moroccan respondents. Several participants mentioned a low proficiency in the local language as an explanation for their preference to fill out the health check questionnaire at home, to receive advice from an ethnic-matched professional, and to receive information in their native language.

Conclusions

The general practitioner is considered as a promising contact to reach adults of Turkish and Moroccan origin for health checks or (lifestyle) advice. It might be necessary to provide information in individuals’ native language to overcome language barriers. In addition, (lifestyle) advice must be tailored. The obtained insight into preferences of Turkish and Moroccan adults regarding reach for preventive healthcare services could help professionals to successfully target these groups.
Literature
1.
go back to reference Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367(9524):1747–57.CrossRefPubMed Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367(9524):1747–57.CrossRefPubMed
2.
go back to reference van Dieren S, Beulens JWJ, van der Schouw YT, Grobbee DE, Neal B. The global burden of diabetes and its complications: an emerging pandemic. Eur J Cardiovasc Prev Rehabil. 2010;17(1):S3–8.CrossRefPubMed van Dieren S, Beulens JWJ, van der Schouw YT, Grobbee DE, Neal B. The global burden of diabetes and its complications: an emerging pandemic. Eur J Cardiovasc Prev Rehabil. 2010;17(1):S3–8.CrossRefPubMed
3.
go back to reference Agyemang C, Bindraban N, Mairuhu G, van Montfrans G, Koopmans R, Stronks K. Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study. J Hypertens. 2005;23(11):1971–7.CrossRefPubMed Agyemang C, Bindraban N, Mairuhu G, van Montfrans G, Koopmans R, Stronks K. Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study. J Hypertens. 2005;23(11):1971–7.CrossRefPubMed
4.
go back to reference Oosterberg EH, Devillé WLJM, Brewster LM, Agyemang C, van den Muijsenbergh METC. Chronische ziekten bij allochtonen: handvaten voor patiëntgerichte zorg bij diabetes, hypertensie en COPD [Chronic disease in ethnic minorities: tools for patient-centred care in diabetes, hypertension and COPD]. Ned Tijdschr Geneeskd. 2013;157(16):A5669.PubMed Oosterberg EH, Devillé WLJM, Brewster LM, Agyemang C, van den Muijsenbergh METC. Chronische ziekten bij allochtonen: handvaten voor patiëntgerichte zorg bij diabetes, hypertensie en COPD [Chronic disease in ethnic minorities: tools for patient-centred care in diabetes, hypertension and COPD]. Ned Tijdschr Geneeskd. 2013;157(16):A5669.PubMed
5.
go back to reference Kurian AK, Cardarelli KM. Racial and ethnic differences in cardiovascular disease risk factors: a systematic review. Ethn Dis. 2007;17(1):143–52.PubMed Kurian AK, Cardarelli KM. Racial and ethnic differences in cardiovascular disease risk factors: a systematic review. Ethn Dis. 2007;17(1):143–52.PubMed
7.
go back to reference Uitewaal PJM, Manna DR, Bruijnzeels MA, Hoes AW, Thomas S. Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review. Prev Med. 2004;39(6):1068–76.CrossRefPubMed Uitewaal PJM, Manna DR, Bruijnzeels MA, Hoes AW, Thomas S. Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review. Prev Med. 2004;39(6):1068–76.CrossRefPubMed
8.
go back to reference Ujcic-Voortman JK, Baan CA, Seidell JC, Verhoeff AP. Obesity and cardiovascular disease risk among Turkish and Moroccan migrant groups in Europe: a systematic review. Obes Rev. 2012;13(1):2–16.CrossRefPubMed Ujcic-Voortman JK, Baan CA, Seidell JC, Verhoeff AP. Obesity and cardiovascular disease risk among Turkish and Moroccan migrant groups in Europe: a systematic review. Obes Rev. 2012;13(1):2–16.CrossRefPubMed
9.
go back to reference Ujcic-Voortman JK, Schram MT. Jacobs-Van der Bruggen MA, Verhoeff AP, Baan CA: Diabetes prevalence and risk factors among ethnic minorities. Eur J Public Health. 2009;19(5):511–5.CrossRefPubMed Ujcic-Voortman JK, Schram MT. Jacobs-Van der Bruggen MA, Verhoeff AP, Baan CA: Diabetes prevalence and risk factors among ethnic minorities. Eur J Public Health. 2009;19(5):511–5.CrossRefPubMed
10.
go back to reference Penn L, White M, Lindström J, den Boer AT, Blaak E, Eriksson JG, et al. Importance of weight loss maintenance and risk prediction in the prevention of type 2 diabetes: analysis of European Diabetes Prevention Study RCT. PLoS One. 2013;8(2), e57143.CrossRefPubMedPubMedCentral Penn L, White M, Lindström J, den Boer AT, Blaak E, Eriksson JG, et al. Importance of weight loss maintenance and risk prediction in the prevention of type 2 diabetes: analysis of European Diabetes Prevention Study RCT. PLoS One. 2013;8(2), e57143.CrossRefPubMedPubMedCentral
11.
go back to reference Yusuf PS, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–52.CrossRefPubMed Yusuf PS, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–52.CrossRefPubMed
12.
go back to reference Ujcic-Voortman JK, Bos G, Baan CA, Verhoeff AP, Seidell JC. Obesity and body fat distribution: ethnic differences and the role of socio-economic status. Obes Facts. 2011;4(1):53–60.CrossRefPubMed Ujcic-Voortman JK, Bos G, Baan CA, Verhoeff AP, Seidell JC. Obesity and body fat distribution: ethnic differences and the role of socio-economic status. Obes Facts. 2011;4(1):53–60.CrossRefPubMed
13.
go back to reference Hosper K, Nierkens V, Nicolaou M, Stronks K. Behavioural risk factors in two generations of non-Western migrants: do trends converge towards the host population? Eur J Epidemiol. 2007;22(3):163–72.CrossRefPubMedPubMedCentral Hosper K, Nierkens V, Nicolaou M, Stronks K. Behavioural risk factors in two generations of non-Western migrants: do trends converge towards the host population? Eur J Epidemiol. 2007;22(3):163–72.CrossRefPubMedPubMedCentral
14.
go back to reference Vermeer B, van den Muijsenbergh METC. The attendance of migrant women at the national breast cancer screening in the Netherlands 1997-2008. Eur J Cancer Prev. 2010;19(3):195–8.CrossRefPubMed Vermeer B, van den Muijsenbergh METC. The attendance of migrant women at the national breast cancer screening in the Netherlands 1997-2008. Eur J Cancer Prev. 2010;19(3):195–8.CrossRefPubMed
15.
go back to reference Dryden R, Williams B, McCowan C, Themessl-Huber M. What do we know about who does and does not attend general health checks? Findings from a narrative scoping review. BMC Public Health. 2012;12(1):723.CrossRefPubMedPubMedCentral Dryden R, Williams B, McCowan C, Themessl-Huber M. What do we know about who does and does not attend general health checks? Findings from a narrative scoping review. BMC Public Health. 2012;12(1):723.CrossRefPubMedPubMedCentral
16.
go back to reference Klijs B, Otto SJ, Heine RJ, van der Graaf Y, Lous JJ, de Koning HJ. Screening for type 2 diabetes in a high-risk population: study design and feasibility of a population-based randomized controlled trial. BMC Public Health. 2012;12(1):671.CrossRefPubMedPubMedCentral Klijs B, Otto SJ, Heine RJ, van der Graaf Y, Lous JJ, de Koning HJ. Screening for type 2 diabetes in a high-risk population: study design and feasibility of a population-based randomized controlled trial. BMC Public Health. 2012;12(1):671.CrossRefPubMedPubMedCentral
17.
go back to reference Godefrooij MB, van de Kerkhof RM, Wouda PJ, Vening RA, Knottnerus JA, Dinant G-J, et al. Identification of risk factors in primary care: development, implementation and yield of a cardiometabolic health check. Fam Pract. 2012;29:174–81.CrossRefPubMed Godefrooij MB, van de Kerkhof RM, Wouda PJ, Vening RA, Knottnerus JA, Dinant G-J, et al. Identification of risk factors in primary care: development, implementation and yield of a cardiometabolic health check. Fam Pract. 2012;29:174–81.CrossRefPubMed
18.
go back to reference Brill PA, Kohl HW, Rogers T, Collingwood TR, Sterling CL, Blair SN. The relationship between sociodemographic characteristics and recruitment, retention, and health improvements in a worksite health promotion program. Am J Health Promot. 1991;5(3):215–21.CrossRefPubMed Brill PA, Kohl HW, Rogers T, Collingwood TR, Sterling CL, Blair SN. The relationship between sociodemographic characteristics and recruitment, retention, and health improvements in a worksite health promotion program. Am J Health Promot. 1991;5(3):215–21.CrossRefPubMed
19.
go back to reference Pagoto SL, Schneider KL, Oleski JL, Luciani JM, Bodenlos JS, Whited MC. Male inclusion in randomized controlled trials of lifestyle weight loss interventions. Obesity. 2012;20(6):1234–9.CrossRefPubMed Pagoto SL, Schneider KL, Oleski JL, Luciani JM, Bodenlos JS, Whited MC. Male inclusion in randomized controlled trials of lifestyle weight loss interventions. Obesity. 2012;20(6):1234–9.CrossRefPubMed
20.
go back to reference Stronks K, Ravelli ACJ, Reijneveld SA. Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health. 2001;55(10):701–7.CrossRefPubMed Stronks K, Ravelli ACJ, Reijneveld SA. Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health. 2001;55(10):701–7.CrossRefPubMed
21.
go back to reference Assendelft WJ, Nielen MM, Hettinga DM, van der Meer V, van Vliet M, Drenthen AJ, et al. Bridging the gap between public health and primary care in prevention of cardiometabolic diseases; background of and experiences with the Prevention Consultation in The Netherlands. Fam Pract. 2012;29 suppl 1:i126–31.CrossRefPubMedPubMedCentral Assendelft WJ, Nielen MM, Hettinga DM, van der Meer V, van Vliet M, Drenthen AJ, et al. Bridging the gap between public health and primary care in prevention of cardiometabolic diseases; background of and experiences with the Prevention Consultation in The Netherlands. Fam Pract. 2012;29 suppl 1:i126–31.CrossRefPubMedPubMedCentral
22.
go back to reference Johnson RB, Onwuegbuzie AJ, Turner LA. Toward a definition of mixed methods research. J Mix Methods Res. 2007;1(2):112–33.CrossRef Johnson RB, Onwuegbuzie AJ, Turner LA. Toward a definition of mixed methods research. J Mix Methods Res. 2007;1(2):112–33.CrossRef
24.
go back to reference Groenenberg I, Crone MR, van Dijk S, Gebhardt WA, Ben Meftah J. Middelkoop BJC et al: ‘Check it out!’ Decision-making of vulnerable groups about participation in a two-stage cardiometabolic health check: a qualitative study. Patient Educ Couns. 2015;98(2):234–44.CrossRefPubMed Groenenberg I, Crone MR, van Dijk S, Gebhardt WA, Ben Meftah J. Middelkoop BJC et al: ‘Check it out!’ Decision-making of vulnerable groups about participation in a two-stage cardiometabolic health check: a qualitative study. Patient Educ Couns. 2015;98(2):234–44.CrossRefPubMed
25.
26.
go back to reference Bukman AJ, Teuscher D, Feskens EJM, van Baak MA, Meershoek A, Renes RJ. Perceptions on healthy eating, physical activity and lifestyle advice: opportunities for adapting lifestyle interventions to individuals with low socioeconomic status. BMC Public Health. 2014;14(1):1036.CrossRefPubMedPubMedCentral Bukman AJ, Teuscher D, Feskens EJM, van Baak MA, Meershoek A, Renes RJ. Perceptions on healthy eating, physical activity and lifestyle advice: opportunities for adapting lifestyle interventions to individuals with low socioeconomic status. BMC Public Health. 2014;14(1):1036.CrossRefPubMedPubMedCentral
27.
go back to reference Nielen MMJ, Assendelft WJJ, Drenthen AJM, van den Hombergh P, van Dis I, Schellevis FG. Primary prevention of cardio-metabolic diseases in general practice: a Dutch survey of attitudes and working methods of general practitioners. European Journal of General Practice. 2010;16(3):139–42.CrossRefPubMed Nielen MMJ, Assendelft WJJ, Drenthen AJM, van den Hombergh P, van Dis I, Schellevis FG. Primary prevention of cardio-metabolic diseases in general practice: a Dutch survey of attitudes and working methods of general practitioners. European Journal of General Practice. 2010;16(3):139–42.CrossRefPubMed
28.
go back to reference Vos HMM, van Delft DHWJM, De Kleijn MJJ, Nielen MMJ, Schellevis FG, Lagro-Janssen ALM. Selective prevention of cardiometabolic diseases in general practice: attitudes and working methods of male and female general practitioners before and after the introduction of the Prevention Consultation guideline in the Netherlands. J Eval Clin Pract. 2014;20(4):478–85.CrossRefPubMed Vos HMM, van Delft DHWJM, De Kleijn MJJ, Nielen MMJ, Schellevis FG, Lagro-Janssen ALM. Selective prevention of cardiometabolic diseases in general practice: attitudes and working methods of male and female general practitioners before and after the introduction of the Prevention Consultation guideline in the Netherlands. J Eval Clin Pract. 2014;20(4):478–85.CrossRefPubMed
29.
go back to reference Scheppers E, van Dongen E, Dekker J, Geertzen J, Dekker J. Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract. 2006;23(3):325–48.CrossRefPubMed Scheppers E, van Dongen E, Dekker J, Geertzen J, Dekker J. Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract. 2006;23(3):325–48.CrossRefPubMed
30.
go back to reference Knipscheer JW, Kleber RJ. A need for ethnic similarity in the therapist-patient interaction? Mediterranean migrants in Dutch mental-health care. J Clin Psychol. 2004;60(6):543–54.CrossRefPubMed Knipscheer JW, Kleber RJ. A need for ethnic similarity in the therapist-patient interaction? Mediterranean migrants in Dutch mental-health care. J Clin Psychol. 2004;60(6):543–54.CrossRefPubMed
31.
go back to reference Lamkaddem M, Spreeuwenberg PM, Devillé WL, Foets MM, Groenewegen PP. Importance of quality aspects of GP care among ethnic minorities: role of cultural attitudes, language and healthcare system of reference. Scan J Public Health. 2012;40(1):25–34.CrossRef Lamkaddem M, Spreeuwenberg PM, Devillé WL, Foets MM, Groenewegen PP. Importance of quality aspects of GP care among ethnic minorities: role of cultural attitudes, language and healthcare system of reference. Scan J Public Health. 2012;40(1):25–34.CrossRef
32.
go back to reference te Riele S. Moroccans have fewer problems with the Dutch language than Turks. In: Web magazine. Statistics Netherlands; 2008 te Riele S. Moroccans have fewer problems with the Dutch language than Turks. In: Web magazine. Statistics Netherlands; 2008
33.
go back to reference Bell TS, Branston LK, Newcombe RG, Barton GR. Interventions to improve uptake of breast screening in inner city Cardiff general practices with ethnic minority lists. Ethn Health. 1999;4(4):277–84.CrossRefPubMed Bell TS, Branston LK, Newcombe RG, Barton GR. Interventions to improve uptake of breast screening in inner city Cardiff general practices with ethnic minority lists. Ethn Health. 1999;4(4):277–84.CrossRefPubMed
34.
go back to reference Bader A, Musshauser D, Sahin F, Bezirkan H, Hochleitner M. The Mosque Campaign: a cardiovascular prevention program for female Turkish immigrants. Wien Klin Wochenschr. 2006;118(7-8):217–23.CrossRefPubMed Bader A, Musshauser D, Sahin F, Bezirkan H, Hochleitner M. The Mosque Campaign: a cardiovascular prevention program for female Turkish immigrants. Wien Klin Wochenschr. 2006;118(7-8):217–23.CrossRefPubMed
35.
go back to reference Schmidt M, Absalah S, Nierkens V, Stronks K. Which factors engage women in deprived neighbourhoods to participate in exercise referral schemes? BMC Public Health. 2008;8:371.CrossRefPubMedPubMedCentral Schmidt M, Absalah S, Nierkens V, Stronks K. Which factors engage women in deprived neighbourhoods to participate in exercise referral schemes? BMC Public Health. 2008;8:371.CrossRefPubMedPubMedCentral
Metadata
Title
Exploring strategies to reach individuals of Turkish and Moroccan origin for health checks and lifestyle advice: a mixed-methods study
Authors
Andrea J. Bukman
Dorit Teuscher
Jamila Ben Meftah
Iris Groenenberg
Mathilde R. Crone
Sandra van Dijk
Marieke B. Bos
Edith J. M. Feskens
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0476-1

Other articles of this Issue 1/2016

BMC Primary Care 1/2016 Go to the issue