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Anum A, Washington-Nortey M, Dzokoto V. Strategic planning in LAMIC mental health research: A Ghana case study. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1719621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | | | - Vivian Dzokoto
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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2
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Baratin C, Beune E, van Schalkwijk D, Meeks K, Smeeth L, Addo J, de-Graft Aikins A, Owusu-Dabo E, Bahendeka S, Mockenhaupt FP, Danquah I, Schulze MB, Spranger J, Boateng D, Klipstein-Grobusch K, Stronks K, Agyemang C. Differential associations between psychosocial stress and obesity among Ghanaians in Europe and in Ghana: findings from the RODAM study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:45-56. [PMID: 30859237 DOI: 10.1007/s00127-019-01682-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 02/25/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE Psychosocial stress is associated with obesity in some populations, but it is unclear whether the association is related to migration. This study explored associations between psychosocial stress and obesity among Ghanaian migrants in Europe and non-migrant Ghanaians in Ghana. METHODS Cross-sectional data from the RODAM study were used, including 5898 Ghanaians residing in Germany, the UK, the Netherlands, rural Ghana, and urban Ghana. Perceived discrimination, negative life events and stress at work or at home were examined in relation to body mass index (BMI) and waist circumference (WC). Linear regression analyses were performed separately for migrants and non-migrants stratified by sex. RESULTS Perceived discrimination was not associated with BMI and WC in both migrants and non-migrants. However, negative life events were positively associated with BMI (β = 0.78, 95% CI 0.34-1.22) and WC (β = 1.96, 95% CI 0.79-3.12) among male Ghanaian migrants. Similarly, stress at work or at home was positively associated with BMI (β = 0.28, 95% CI 0.00-0.56) and WC (β = 0.84, 95% CI 0.05-1.63) among male Ghanaian migrants. Among non-migrant Ghanaians, in contrast, stress at work or at home was inversely associated with BMI and WC in both males (β = - 0.66, 95% CI - 1.03 to - 0.28; β = - 1.71 95% CI - 2.69 to - 0.73, respectively) and females (β = - 0.81, 95% CI - 1.20 to - 0.42; β = - 1.46, 95% CI - 2.30 to - 0.61, respectively). CONCLUSIONS Negative life events and stress at work or at home are associated with increased body weight among male Ghanaians in European settings, whereas stress at work or at home is associated with reduced body weight among Ghanaians in Ghana. More work is needed to understand the underlying factors driving these differential associations to assist prevention efforts.
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Affiliation(s)
- Clarissa Baratin
- Department of Public Health, Amsterdam Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Amsterdam University College, Amsterdam, The Netherlands
| | - Erik Beune
- Department of Public Health, Amsterdam Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | | | - Karlijn Meeks
- Department of Public Health, Amsterdam Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Liam Smeeth
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.,Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Joachim Spranger
- Department of Endocrinology and Metabolism, DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Center for Cardiovascular Research (CCR), Charite Universitätsmedizin Berlin Charite Center for Cardiovascular Research (CCR), Berlin, Germany
| | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karien Stronks
- Department of Public Health, Amsterdam Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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Cramm JM, Nieboer AP. Acculturation is associated with older Turkish immigrants' self-management abilities. BMC Public Health 2019; 19:1228. [PMID: 31488086 PMCID: PMC6727562 DOI: 10.1186/s12889-019-7471-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 08/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The few previous studies investigating acculturation and self-management have suggested that increased participation in (or adaptation to) the host culture is associated with better health and disease management. However, research on the relationship between acculturation strategies (attachment to the Dutch and Turkish cultures) and broader self-management abilities among older Turkish immigrants in the Netherlands is lacking. This study aimed to investigate this relationship in this population. METHODS Turkish immigrants aged > 65 years and residing in Rotterdam, the Netherlands (n = 2350), were identified using the municipal register. In total, 680 respondents completed the questionnaire (32% response rate). RESULTS The average age of the respondents was 72.90 (standard deviation, 5.02; range, 66-95) years and 47.6% of respondents were women. The majority (80.3%) of respondents reported having low educational levels. Women, single individuals, less-educated respondents, and those with multimorbidity experienced lower levels of attachment to the Dutch culture and reported poorer self-management abilities. Slightly stronger relationships were found between self-management and attachment to the Dutch culture than attachment to the Turkish culture. Multimorbidity negatively affected the self-management abilities of older Turkish people living in the Netherlands. CONCLUSIONS The study findings indicate that especially attachment to the Dutch culture matters for the self-management abilities of older Turkish immigrants in the Netherlands. Given the high prevalence of multimorbidity in this population, investment in their self-management abilities is expected to be beneficial. Special attention is needed for women, single individuals, less-educated people, and those with multimorbidity. Interventions aiming to better integrate these groups into Dutch society are also expected to be beneficial for their self-management abilities.
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Affiliation(s)
- Jane M Cramm
- Department of Social Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, Rotterdam, DR, The Netherlands.
| | - Anna P Nieboer
- Department of Social Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, Rotterdam, DR, The Netherlands
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4
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Boamah E. Information culture of Ghanaian immigrants living in New Zealand. GLOBAL KNOWLEDGE, MEMORY AND COMMUNICATION 2018. [DOI: 10.1108/gkmc-07-2018-0065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Eric Boamah
- The Open Polytechnic of New Zealand, Wellington, New Zealand
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5
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Predictors of mental health among Angolan migrants living in Portugal. INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2018. [DOI: 10.1108/ijmhsc-03-2017-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose
The purpose of this paper is to examine the determinants of mental health among Angolan migrants living in Portugal. Three research questions guided this work: What is the influence of demographic factors on the mental health of Angolan migrants? What is the influence of acculturation factors on their mental health? What is the influence of adaptation factors on their mental health?
Design/methodology/approach
The sample consisted of 252 Angolan migrants living in Portugal (50.8 percent females) with a mean age of 36 years. The mean duration of stay in Portugal was 21 years.
Findings
The predictive factors – demographic, acculturation and adaptation factors – were significantly associated with Angolan migrants’ mental health. However, acculturation and adaptation factors accounted for a larger proportion of the explained variance in mental health problems than demographic factors. The major predictors of mental health problems were sociocultural adaptation, perceived discrimination and loneliness. Implications of the findings for future research and psychosocial interventions are discussed.
Originality/value
This study shed some light on the predictive factors of mental health problems among adult Angolan immigrants in Portugal, a previously neglected group of migrants in the research literature. Adding to existing knowledge on the mental health outcomes of migration, the findings suggest that, for this group, sociocultural adaptation, perceived discrimination and loneliness were the main predictors of psychological problems, rather than demographic factors. This evidence may be useful in the development of psychosocial interventions and policy to support Angolan migrants in their adaptation to Portuguese culture.
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Cabout M, Brouwer IA, Visser M. The MooDFOOD project: Prevention of depression through nutritional strategies. NUTR BULL 2017. [DOI: 10.1111/nbu.12254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M. Cabout
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research; Faculty of Earth and Life Sciences; Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - I. A. Brouwer
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research; Faculty of Earth and Life Sciences; Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - M. Visser
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research; Faculty of Earth and Life Sciences; Vrije Universiteit Amsterdam; Amsterdam The Netherlands
- Department of Internal Medicine; Nutrition and Dietetics; VU University Medical Center; Amsterdam The Netherlands
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Abstract
BACKGROUND Within the United States, there are individuals who retain the traditions and beliefs of cultural groups that vary from the general majority population. Both healthcare providers and researchers have reported that many individuals who live in but are less affiliated with the dominant culture tend to have less positive health outcomes. OBJECTIVE The purpose of this study is to use factor analysis to assess the psychometric properties of Mood's 18-item Strength of Cultural Affiliation Scale (SCAS). METHODS The SCAS was administered to 604 participants from a randomized clinical trial of cancer patients who were treated with radiotherapy at a large central city hospital located in the Midwest. RESULTS Confirmatory Factor Analyses using Principal Component Analysis with Oblimin Rotation indicated a 16-item, 4-factor final solution with the following subscales: factor 1, lifestyle (7 items); factor 2, language and cultural-specific holidays (3 items); factor 3, relationships (4 items); and factor 4, cultural health practices (2 items). CONCLUSION The SCAS demonstrated high reliability and content, construct, discriminant, convergent, divergent, and predictive validity. IMPLICATIONS FOR PRACTICE The SCAS seems to be a reliable and valid tool for practitioners to use to assess a patient's strength of cultural affiliation to provide the best culturally sensitive care possible for the patient.
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Haverkamp GLG, Loosman WL, van den Beukel TO, Hoekstra T, Dekker FW, Chandie Shaw PK, Smets YFC, Vleming LJ, Ter Wee PM, Honig A, Siegert CEH. The association of acculturation and depressive and anxiety symptoms in immigrant chronic dialysis patients. Gen Hosp Psychiatry 2016; 38:26-30. [PMID: 26724601 DOI: 10.1016/j.genhosppsych.2015.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/04/2015] [Accepted: 09/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Among immigrant chronic dialysis patients, depressive and anxiety symptoms are common. We aimed to examine the association of acculturation, i.e. the adaptation of immigrants to a new cultural context, and depressive and anxiety symptoms in immigrant chronic dialysis patients. METHODS The DIVERS study is a prospective cohort study in five urban dialysis centers in the Netherlands. The association of five aspects of acculturation ("Skills", "Social integration", "Traditions", "Values and norms" and "Loss") and the presence of depressive and anxiety symptoms was determined using linear regression analyses, both univariate and multivariate. RESULTS A total of 249 immigrant chronic dialysis patients were included in the study. The overall prevalence of depressive and anxiety symptoms was 51% and 47%, respectively. "Skills" and "Loss" were significantly associated with the presence of depressive and anxiety symptoms, respectively ("Skills" β=0.34, CI: 0.11-0.58, and "Loss" β=0.19, CI: 0.01-0.37; "Skills" β=0.49, CI: 0.25-0.73, and "Loss" β=0.33, CI: 0.13-0.53). The associations were comparable after adjustment. No significant associations were found between the other subscales and depressive and anxiety symptoms. CONCLUSION This study demonstrates that less skills for living in the Dutch society and more feelings of loss are associated with the presence of both depressive and anxiety symptoms in immigrant chronic dialysis patients.
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Affiliation(s)
- Gertrud L G Haverkamp
- Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands; Department of Psychiatry, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
| | - Wim L Loosman
- Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands; Department of Psychiatry, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
| | | | - Tiny Hoekstra
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Yves F C Smets
- Department of Nephrology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | | | - Pieter M Ter Wee
- Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan Honig
- Department of Psychiatry, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
| | - Carl E H Siegert
- Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
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9
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Relationship between short sleep duration and cardiovascular risk factors in a multi-ethnic cohort – the helius study. Sleep Med 2015; 16:1482-8. [DOI: 10.1016/j.sleep.2015.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/16/2015] [Accepted: 08/19/2015] [Indexed: 01/03/2023]
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10
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Salo CD, Birman D. Acculturation and Psychological Adjustment of Vietnamese Refugees: An Ecological Acculturation Framework. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 56:395-407. [PMID: 26443380 DOI: 10.1007/s10464-015-9760-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Acculturation to the culture of the host society as well as to one's heritage culture have been shown to impact immigrants' adjustment during the years following resettlement. While acculturation has been identified as an important factor in adjustment of Vietnamese immigrants (Birman and Tran in Am J Orthopsychiatr 78(1):109-120. doi: 10.1037/0002-9432.78.1.109 , 2008), no clear pattern of findings has emerged and too few studies have employed an ecological approach. The purpose of this paper is to contextualize the study of acculturation and adjustment by taking an ecological approach to exploring these relationships across several life domains, using a bilinear scale, and examining mediators of these relationships for adult Vietnamese refugees (N = 203) in the United States. We call this approach the Ecological Acculturation Framework (EAF). Results of a structural equation model (SEM) showed that job satisfaction fully mediated the relationship between American acculturation and psychological distress, demonstrating that this relationship was specific to an occupational domain. However, while Vietnamese acculturation predicted co-ethnic social support satisfaction, it did not predict reduced psychological distress. Implications for a life domains approach, including domain specificity, are discussed.
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Affiliation(s)
- Corrina D Salo
- Department of Psychology (M/C 285), University of Illinois at Chicago, BSB 1009, 1007 West Harrison Street, Chicago, IL, 60607-7137, USA.
| | - Dina Birman
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, 5202 University Drive, Coral Gables, FL, 33146, USA.
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Nap A, van Loon A, Peen J, van Schaik DJ, Beekman AT, Dekker JJ. The influence of acculturation on mental health and specialized mental healthcare for non-western migrants. Int J Soc Psychiatry 2015; 61:530-8. [PMID: 25488952 DOI: 10.1177/0020764014561307] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The level of acculturation of migrants varies and is associated with variations in mental health. However, this association is complex and may differ among migrant groups. AIM The aim of this study is to explore the association between acculturation, mental health and treatment effect. METHODS In a longitudinal cohort study of patients treated in specialized mental health facilities, different dimensions of acculturation (skills, social integration, traditions, norms/values and feelings of loss) were explored for Moroccan, Turkish and Surinamese migrants in the Netherlands. Furthermore, the associations between acculturation status and symptom levels, quality of life, care needs and effects of mental health treatment were examined. Data were analyzed with analysis of covariance, correlation analysis and multiple regression analysis. RESULTS Acculturation status differed among migrant groups. Turkish migrants showed most original culture maintenance (traditions, norms/values), Surinamese migrants showed most participation in Dutch society (skills, social integration), while Moroccan migrants were situated in between. Higher cultural adaptation was associated with less need for care, lower symptom levels and a higher quality of life. Participation significantly predicted lower symptom levels (p < .001) and higher quality of life (p < .001) 6 months after the start of treatment. CONCLUSION This study confirms that acculturation status is associated with symptom levels, quality of life and perceived need for care of migrants. Moreover, participation in Dutch society appears to be a favorable factor for treatment effect. It is of importance for professionals in clinical practice to be attentive to this.
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Affiliation(s)
- Annelies Nap
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
| | | | - Jaap Peen
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
| | - Digna Jf van Schaik
- Research Department, GGZinGeest, Amsterdam, The Netherlands Department of Psychiatry, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Aartjan Tf Beekman
- Research Department, GGZinGeest, Amsterdam, The Netherlands Department of Psychiatry, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jack Jm Dekker
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
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Morawa E, Erim Y. Acculturation and depressive symptoms among Turkish immigrants in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:9503-21. [PMID: 25222474 PMCID: PMC4199032 DOI: 10.3390/ijerph110909503] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/25/2014] [Accepted: 09/04/2014] [Indexed: 11/16/2022]
Abstract
The present study explores the impact of acculturation on depressive symptoms among Turkish immigrants in Germany, taking into account different dimensions of cultural orientation. A total of 471 patients from two selected samples (254 primary care patients and 217 outpatients of a psychosomatic department) participated. Levels of acculturation were measured as orientation towards culture of origin (CO), and orientation towards the host culture (HC). Acculturation strategies (integration, assimilation, separation, and marginalization) were also assessed as well as their association with depressive symptoms (BDI). Furthermore, gender- and migration-related differences in terms of acculturation and levels of depressive symptomatology were analyzed. Integration was the acculturation strategy associated with the lowest level of depressive symptoms (M = 14.6, SD = 11.9), while marginalization was associated with the highest (M = 23.5, SD = 14.7). Gender was not found to have a significant impact on acculturation but influenced depressive symptoms, with women (M = 21.8, SD = 13.3) reporting higher levels of depressive symptomatology than men (M = 15.1, SD = 14.0; p < 0.001). In first generation immigrants, significantly higher CO (M = 46.6, SD = 8.3; p < 0.001), lower HC (M = 31.0, SD = 9.6; p < 0.001), and higher levels of depressive symptoms (M = 20.2, SD = 14.1; p < 0.001) were found in comparison to second generation immigrants (CO: M = 41.3, SD = 7.4; HC: M = 36.2, SD = 8.8; depressive symptoms: M = 14.0, SD = 12.9). Our results suggest that orientation towards both the heritage and the host culture has a positive effect on the mental health status of immigrants. Future research needs to include representative samples of migrants from different cultures to further explore the association between acculturation and mental health.
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Affiliation(s)
- Eva Morawa
- Department of Psychosomatic and Psychotherapeutic Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
| | - Yesim Erim
- Department of Psychosomatic and Psychotherapeutic Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
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Ünlü Ince B, Fassaert T, de Wit MAS, Cuijpers P, Smit J, Ruwaard J, Riper H. The relationship between acculturation strategies and depressive and anxiety disorders in Turkish migrants in the Netherlands. BMC Psychiatry 2014; 14:252. [PMID: 25189615 PMCID: PMC4172911 DOI: 10.1186/s12888-014-0252-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 08/27/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Turkish migrants in the Netherlands have a high prevalence of depressive and/or anxiety disorders. Acculturation has been shown to be related to higher levels of psychological distress, although it is not clear whether this also holds for depressive and anxiety disorders in Turkish migrants. This study aims to clarify the relationship between acculturation strategies (integration, assimilation, separation and marginalization) and the prevalence of depressive and anxiety disorders as well as utilisation of GP care among Turkish migrants. METHODS Existing data from an epidemiological study conducted among Dutch, Turkish and Moroccan inhabitants of Amsterdam were re-examined. Four scales of acculturation strategies were created in combination with the bi-dimensional approach of acculturation by factor analysis. The Lowlands Acculturation Scale and the Composite International Diagnostic Interview were used to assess acculturation and mood and anxiety disorders. Socio-demographic variables, depressive, anxiety and co-morbidity of both disorders and the use of health care services were associated with the four acculturation strategies by means of Chi-Squared and Likelihood tests. Three two-step logistic regression analyses were performed to control for possible, confounding variables. RESULTS The sample consisted of 210 Turkish migrants. Significant associations were found between the acculturation strategies and age (p < .01), education (p < .01), daily occupation (p < .01) and having a long-term relationship (p = .03). A significant association was found between acculturation strategies and depressive disorders (p = .049): integration was associated with a lower risk of depression, separation with a higher risk. Using the axis separately, participation in Dutch society showed a significant relationship with a decreased risk of depressive, anxiety and co-morbidity of both disorders (OR = .15; 95% CI: .024 - .98). Non-participation showed no significant association. No association was found between the acculturation strategies and uptake of GP care. CONCLUSIONS Turkish migrants who integrate may have a lower risk of developing a depressive disorder. Participation in Dutch culture is associated with a decreased risk of depressive, anxiety and co-morbidity of both disorders. Further research should focus on the assessment of acculturation in the detection of depression.
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Affiliation(s)
- Burçin Ünlü Ince
- Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands ,EMGO Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands
| | - Thijs Fassaert
- Public Health Service Amsterdam, Epidemiology and Health Promotion, Amsterdam, The Netherlands
| | - Matty AS de Wit
- Public Health Service Amsterdam, Epidemiology and Health Promotion, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands ,EMGO Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands ,Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany
| | - Jan Smit
- EMGO Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands ,GGZ inGeest, Regional Mental Health Service Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jeroen Ruwaard
- Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
| | - Heleen Riper
- Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands ,EMGO Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands ,Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany
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14
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Agyei B, Nicolaou M, Boateng L, Dijkshoorn H, van den Born BJ, Agyemang C. Relationship between psychosocial stress and hypertension among Ghanaians in Amsterdam, the Netherlands--the GHAIA study. BMC Public Health 2014; 14:692. [PMID: 25001592 PMCID: PMC4099212 DOI: 10.1186/1471-2458-14-692] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 07/02/2014] [Indexed: 12/15/2022] Open
Abstract
Background Hypertension is highly prevalent among recent sub-Saharan African (SSA) migrants in western countries and some tend to associate their hypertension to psychosocial stress. However data on the relationship between hypertension and psychosocial stress among SSA migrants are rare. We assessed the relationship between psychosocial stress and hypertension among the largest SSA migrant population (Ghanaians) in Amsterdam, the Netherlands. Methods Data were obtained from structured interviews along with medical examination among 212 participants from a cross-sectional study: the GHAIA study in 2010 in Amsterdam. Blood pressure was measured with a validated Oscillometric automated digital blood pressure device. Psychosocial stress was assessed by questionnaires on perceived discrimination, depressive symptoms and financial problems. Binary logistic regression was used to study associations between psychosocial stress and hypertension. Results The overall prevalence of hypertension was 54.7%. About two thirds of the study population experienced a moderate (31%) or high (36%) level of discrimination. 20.0% of the participants had mild depressive symptoms, whilst 9% had moderate depressive symptoms. The prevalence of financial stress was 34.8%. The psychosocial stresses we assessed were not significantly associated with hypertension: adjusted odds ratios comparing those with low levels and those with high levels were 0.99 (95% CI, 0.47–2.08) for perceived discrimination, 0.81 (95% CI, 0.26–2.49) for depressive symptoms and 0.71 (95% CI, 0.37–1.36) for financial stress, respectively. Conclusion We did not find evidence for the association between psychosocial stress and hypertension among recent SSA migrants. More efforts are needed to unravel other potential factors that may underlie the high prevalence of hypertension among these populations.
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Affiliation(s)
| | | | | | | | | | - Charles Agyemang
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam, The Netherlands.
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15
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Kim KM, Kim M. [Adaptation experiences in South Korea of men defecting from North Korea]. J Korean Acad Nurs 2013; 43:431-41. [PMID: 23893233 DOI: 10.4040/jkan.2013.43.3.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The study was done to explore meanings and essence of the experience in South Korea of men defectors from North Korea. METHODS Data were collected from March, 2011 to May, 2012, through in-depth interviews with ten men defectors. Data analysis was conducted using the process of hermeneutic phenomenological reflection. RESULTS Eight essential themes were extracted; 'buoyant expectation for a new life', 'feeling guilty about family left behind in North Korea', 'inability to become acclimatized due to communication difficulties', 'inability to socialize with South Koreans due to different lifestyles', 'finding strength through trustworthy acquaintances', 'continuing reconciliation with oneself while trying to assimilate into South Korean culture', 'self-realization of one's original self', and 'continuing to feel out the possibility of a future in South Korea'. CONCLUSION The findings indicate that North Korean men who defect to South Korea shape their identity through three phases: forming self-image during escape from North Korea, trying to become accustomed to South Korean society, and finding their own identity by self-realization of their original self. Eventually, the whole process enables them to recover their identity, to feel a sense of belonging, and to discover possibilities for a better future.
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Affiliation(s)
- Kyoung Mi Kim
- Department of Nursing, Gimcheon University, Gimcheon, Korea
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16
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Verhagen I, Ros WJ, Steunenberg B, de Wit NJ. Culturally sensitive care for elderly immigrants through ethnic community health workers: design and development of a community based intervention programme in the Netherlands. BMC Public Health 2013; 13:227. [PMID: 23497392 PMCID: PMC3614887 DOI: 10.1186/1471-2458-13-227] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/07/2013] [Indexed: 11/22/2022] Open
Abstract
Background In Western countries, health and social welfare facilities are not easily accessible for elderly immigrants and their needs are suboptimally addressed. A transition is needed towards culturally sensitive services to overcome barriers to make cure and care accessible for elderly immigrants. We developed an intervention programme in which ethnic community health workers act as liaisons between immigrant elderly and local health care and social welfare services. In this study we evaluate the effectiveness and the implementation of this intervention programme. Methods/design In a quasi experimental design, the effectiveness of introduction of community health workers, health needs assessment, and follow-up intervention programme will be evaluated in three (semi) urban residential areas in the Netherlands and compared with a control group. Community health workers are selected from local ethnic communities and trained for the intervention. Data on health perception, quality of life, and care consumption are collected at baseline and after the intervention programme. Elderly’s informal care givers are included to examine caregiver burden. The primary outcome is use of health care and social welfare facilities by the elderly. Secondary outcomes are quality of life and functional impairments. The target number of participants is 194 immigrant elderly: 97 for the intervention group and 97 for the control group. Implementation of the intervention programme will be examined with focus groups and data registration of community health worker activities. Discussion This study can contribute to the improvement of care for elderly immigrants by developing culturally sensitive care whereby they actively participate. To enable a successful transition, proper identification and recruitment of community health workers is required. Taking this into account, the study aims to provide evidence for an approach to improve the care and access to care for elderly immigrants. Once proven effective, the community health worker function can be further integrated into the existing local health care and welfare system. Trial registration Trial registration number:
ISRCTN89447795
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Affiliation(s)
- Ilona Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Mailbox 85500, Utrecht, GA 3508, The Netherlands.
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17
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Boateng L, Nicolaou M, Dijkshoorn H, Stronks K, Agyemang C. An exploration of the enablers and barriers in access to the Dutch healthcare system among Ghanaians in Amsterdam. BMC Health Serv Res 2012; 12:75. [PMID: 22443162 PMCID: PMC3348030 DOI: 10.1186/1472-6963-12-75] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 03/24/2012] [Indexed: 11/18/2022] Open
Abstract
Background Sub-Saharan African populations are growing in many European countries. Data on the health of these populations are rare. Additionally, many sub-Saharan African migrants are confronted with issues of low socio-economic status, acculturation and language difficulties, which may hamper their access to health care. Despite the identification of some of those barriers, little is known about the enabling factors. Knowledge about the enablers and barriers in access to healthcare experienced is important in addressing their health needs and promoting healthcare access. This study aimed to investigate the enabling factors as well as barriers in access to the Dutch healthcare system among the largest sub-Saharan African migrant group (Ghanaians) living in Amsterdam, the Netherlands. Methods Six focus groups were conducted from November 2009 to February 2010. A semi-structured interview guideline was used. Discussions were conducted in English or Twi (Ghanaian dialect), recorded and transcribed verbatim. Analysis was based on the Andersen model of healthcare utilisation using MAXQDA software. Results Knowledge and perceived quality of the health system, awareness of diseases, family and community support, community initiatives and availability of social support were the main enablers to the healthcare system. Difficulties with the Dutch language and mistrust in health care providers were major barriers in access to healthcare. Conclusions Access to healthcare is facilitated mainly by knowledge of and the perceived efficiency and quality of the Dutch healthcare system. However, poor Dutch language proficiency and mistrust in health care providers appear to be important barriers in accessing healthcare. The enablers and barriers identified by this study provide useful information for promoting healthcare access among this and similar Sub-Saharan African communities.
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Affiliation(s)
- Linda Boateng
- Department of Public Health, Academic Medical Centre, University of Amsterdam, The Netherlands.
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18
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Dorn T, Ceelen M, Tang MJ, Browne JL, de Keijzer KJC, Buster MCA, Das K. Health care seeking among detained undocumented migrants: a cross-sectional study. BMC Public Health 2011; 11:190. [PMID: 21443761 PMCID: PMC3078097 DOI: 10.1186/1471-2458-11-190] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 03/28/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As in many European countries, access to care is decreased for undocumented migrants in the Netherlands due to legislation. Studies on the health of undocumented migrants in Europe are scarce and focus on care-seeking migrants. Not much is known on those who do not seek care. METHODS This cross-sectional study includes both respondents who did and did not seek care, namely undocumented migrants who have been incarcerated in a detention centre while awaiting expulsion to their country of origin. A consecutive sample of all new arrivals was studied. Data were collected through structured interviews and reviews of medical records. RESULTS Among the 224 male migrants who arrived at the detention centre between May and July 2008, 173 persons were interviewed. 122 respondents met inclusion criteria. Only half of the undocumented migrants in this study knew how to get access to medical care in the Netherlands if in need. Forty-six percent of respondents reported to have sought medical help during their stay in the Netherlands while having no health insurance (n = 57). Care was sought most frequently for injuries and dental problems. About 25% of these care seekers reported to have been denied care by a health care provider. Asian migrants were significantly less likely to seek care when compared to other ethnic groups, independent from age, chronic health problems and length of stay in the Netherlands. CONCLUSION The study underlines the need for a better education of undocumented patients and providers concerning the opportunities for health care in the Netherlands. Moreover, there is a need to further clarify the reasons for the denial of care to undocumented patients, as well as the barriers to health care as perceived by undocumented migrants.
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Affiliation(s)
- Tina Dorn
- Public Health Service, Department of Epidemiology, Documentation and Health Promotion, P.O. Box 2200, 1000 CE Amsterdam, The Netherlands.
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19
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Fassaert T, De Wit MAS, Tuinebreijer WC, Knipscheer JW, Verhoeff AP, Beekman ATF, Dekker J. Acculturation and psychological distress among non-Western Muslim migrants--a population-based survey. Int J Soc Psychiatry 2011; 57:132-43. [PMID: 19933252 DOI: 10.1177/0020764009103647] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Political and social developments point at increasing marginalization of Muslim migrants, but little is known about its consequences for the mental health of this particular group. AIM To explore the relationship between acculturation and psychological distress among first-generation Muslim migrants from Turkey and Morocco in the Netherlands. METHODS A cross-sectional study. Respondents were interviewed in their preferred language. Acculturation was measured with the Lowlands Acculturation Scale (LAS) and psychological distress with the Kessler Psychological Distress Scale (K10). Data were complete for 321 subjects and analyzed with multivariate linear regression. RESULTS Less skills for living in Dutch society was associated with distress (p = 0.032). Feelings of loss were related to distress among Moroccans (p = 0.037). There was an interaction between traditionalism and ethnic background (p = 0.037); traditionalism was related to less distress among Moroccans (p = 0.020), but not among Turkish. Finally, there was an interaction by gender among Turks (p = 0.029); conservative norms and values seemed to be related to distress among men (p = 0.062), not women. CONCLUSION Successful contact and participation in Dutch society, and maintenance of heritage culture and identity were moderately associated with less psychological distress. Improving mastery of the dominant language in host societies, and allowing migrants to preserve their traditions, might be effective measures in improving the mental well-being of migrants.
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Affiliation(s)
- Thijs Fassaert
- Department of Epidemiology, Documentation and Health Promotion, Municipal Health Service, Amsterdam, the Netherlands.
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20
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Udahemuka M, Pernice R. Does Motivation to Migrate Matter? Voluntary and Forced African Migrants and Their Acculturation Preferences in New Zealand. JOURNAL OF PACIFIC RIM PSYCHOLOGY 2010. [DOI: 10.1375/prp.4.1.44] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
As there is no research on forced migration of African migrants to New Zealand, in particular on the interrelations among psychological motives to migrate and psychological acculturation preferences, the present study aims to address this gap. One hundred and five forced and voluntary African migrants to New Zealand completed a questionnaire, which included two measures (a) the Psychological Motives to Migrate (Tharmaseelan, 2005) and (b) the Psychological Acculturation Index (Mace, 2004). Demographic information, including data on the New Zealand government immigration categories through which the migrant gained entry and length of time in New Zealand, was also collected. Multivariate analyses indicated that motivations to migrate do matter when it comes to acculturation preferences. Further, it was found that psychological motives to migrate were better predictors of acculturation preferences than the government immigration categories. Specifically, voluntary migrants (those motivated by ‘family life improvement’ and ‘exploration’) preferred to adapt to New Zealand culture, while forced migrants (those motivated by ‘escaping’) had a higher preference to maintain their culture of origin. Duration of time in New Zealand was correlated with acculturation preferences. Implications of the findings point to the importance of assessing motivations to migrate from a psychological perspective.
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Fassaert T, Hesselink AE, Verhoeff AP. Acculturation and use of health care services by Turkish and Moroccan migrants: a cross-sectional population-based study. BMC Public Health 2009; 9:332. [PMID: 19744326 PMCID: PMC2749828 DOI: 10.1186/1471-2458-9-332] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2009] [Accepted: 09/10/2009] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There is insufficient empirical evidence which shows if and how there is an interrelation between acculturation and health care utilisation. The present study seeks to establish this evidence within first generation Turkish and Moroccan migrants, two of the largest migrant groups in present-day Western Europe. METHODS Data were derived from the Amsterdam Health Monitor 2004, and were complete for 358 Turkish and 288 Moroccan foreign-born migrants. Use of health services (general practitioner, outpatient specialist and health care for mental health problems) was measured by means of self-report. Acculturation was measured by a structured questionnaire grading (i) ethnic self-identification, (ii) social interaction with ethnic Dutch, (iii) communication in Dutch within one's private social network, (iv) emancipation, and (v) cultural orientation towards the public domain. RESULTS Acculturation was hardly associated with the use of general practitioner care. However, in case of higher adaptation to the host culture there was less uptake of outpatient specialist care among Turkish respondents (odds ratio [OR] = 0.90, 95% confidence interval [CI] = 0.82-0.99) and Moroccan male respondents (OR = 0.81, 95% CI = 0.71-0.93). Conversely, there was a higher uptake of mental health care among Turkish men (OR = 0.81, 95% CI = 0.71-0.93) and women (OR = 0.81, 95% CI = 0.71-0.93). Uptake of mental health care among Moroccan respondents again appeared lower (OR = 0.74, 95% CI = 0.55-0.99). Language ability appeared to play a central role in the uptake of health care. CONCLUSION Some results were in accordance with the popular view that an increased participation in the host society is concomitant to an increased use of health services. However, there was heterogeneity across ethnic and gender groups, and across the domains of acculturation. Language ability appeared to play a central role. Further research needs to explore this heterogeneity into more detail. Also, other cultural and/or contextual aspects that influence the use of health services require further identification.
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Affiliation(s)
- Thijs Fassaert
- Department of Epidemiology, Documentation and Health Promotion, Amsterdam Municipal Health Service, Amsterdam, the Netherlands
- Department of Social Medicine, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - Arlette E Hesselink
- Department of Epidemiology, Documentation and Health Promotion, Amsterdam Municipal Health Service, Amsterdam, the Netherlands
| | - Arnoud P Verhoeff
- Department of Epidemiology, Documentation and Health Promotion, Amsterdam Municipal Health Service, Amsterdam, the Netherlands
- Department of Sociology and Anthropology, University of Amsterdam, Amsterdam, the Netherlands
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