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Dorsman H, de Hollander E, Wendel-Vos W, van Rossum C, Kemler E, Hupkens C, Hosper K, de Beurs D, Hiemstra M. Stability of clustering of lifestyle risk factors in the Dutch adult population and the association with mental health. Eur J Public Health 2023; 33:1001-1007. [PMID: 37555829 PMCID: PMC10710343 DOI: 10.1093/eurpub/ckad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Lifestyle factors often co-occur in clusters. This study examines whether clusters of lifestyle risk factors, such as smoking, alcohol use, physical inactivity, poor diet, sexual risk behaviour, cannabis and other drug use, change over time in a representative sample of Dutch adults. Additionally, the association between mental health and self-reported depression of lifestyle clusters was examined. METHODS Each year cross-sectional data of approximately 7500 individuals of 18 years and older from the annual Dutch Health Survey of 2014-2019 were used. Clusters were determined by a two-step cluster analysis. Furthermore, regression analyses determined the association between clusters of lifestyle risk factors and mental health. RESULTS Results show six clusters composed of one, multiple or no lifestyle risk factors. The clusters remained relatively stable over time: in some clusters, the number of people slightly changed between 2014 and 2019. More specifically, clusters that increased in size were the cluster with no lifestyle risk factors and the cluster with multiple lifestyle risk factors. Furthermore, results show that clusters with none to a few lifestyle risk factors were associated with better mental health and a lower prevalence of self-reported depression compared with clusters with multiple lifestyle risk factors. CONCLUSIONS The clustering of lifestyle risk factors remained stable over time. People with multiple lifestyle risk factors had poorer mental health than those without risk factors. These findings may emphasize the need for intervention strategies targeting this subgroup with multiple lifestyle risk factors.
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Affiliation(s)
- Hannah Dorsman
- National Institute for Public Health and the Environment (RIVM), Center for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| | - Ellen de Hollander
- National Institute for Public Health and the Environment (RIVM), Center for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| | - Wanda Wendel-Vos
- National Institute for Public Health and the Environment (RIVM), Center for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment (RIVM), Center for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| | - Ellen Kemler
- Dutch Consumer Safety Institute, Amsterdam, The Netherlands
| | | | | | | | - Marieke Hiemstra
- National Institute for Public Health and the Environment (RIVM), Center for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
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Ronteltap A, Bukman AJ, Nagelhout GE, Hermans RCJ, Hosper K, Haveman-Nies A, Lupker R, Bolman CAW. Digital health interventions to improve eating behaviour of people with a lower socioeconomic position: a scoping review of behaviour change techniques. BMC Nutr 2022; 8:145. [PMID: 36482430 PMCID: PMC9733085 DOI: 10.1186/s40795-022-00635-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
Specific approaches are needed to reach and support people with a lower socioeconomic position (SEP) to achieve healthier eating behaviours. There is a growing body of evidence suggesting that digital health tools exhibit potential to address these needs because of its specific features that enable application of various behaviour change techniques (BCTs). The aim of this scoping review is to identify the BCTs that are used in diet-related digital interventions targeted at people with a low SEP, and which of these BCTs coincide with improved eating behaviour. The systematic search was performed in 3 databases, using terms related to e/m-health, diet quality and socioeconomic position. A total of 17 full text papers were included. The average number of BCTs per intervention was 6.9 (ranged 3-15). BCTs from the cluster 'Goals and planning' were applied most often (25x), followed by the clusters 'Shaping knowledge' (18x) and 'Natural consequences' (18x). Other frequently applied BCT clusters were 'Feedback and monitoring' (15x) and 'Comparison of behaviour' (13x). Whereas some BCTs were frequently applied, such as goal setting, others were rarely used, such as social support. Most studies (n = 13) observed a positive effect of the intervention on eating behaviour (e.g. having breakfast) in the low SEP group, but this was not clearly associated with the number or type of applied BCTs. In conclusion, more intervention studies focused on people with a low SEP are needed to draw firm conclusions as to which BCTs are effective in improving their diet quality. Also, further research should investigate combinations of BCTs, the intervention design and context, and the use of multicomponent approaches. We encourage intervention developers and researchers to describe interventions more thoroughly, following the systematics of a behaviour change taxonomy, and to select BCTs knowingly.
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Affiliation(s)
- Amber Ronteltap
- grid.438049.20000 0001 0824 9343Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA Utrecht, The Netherlands
| | - Andrea J. Bukman
- grid.438049.20000 0001 0824 9343Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA Utrecht, The Netherlands
| | - Gera E. Nagelhout
- IVO Research Institute, The Hague, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Roel C. J. Hermans
- grid.5012.60000 0001 0481 6099Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands ,grid.491176.c0000 0004 0395 4926Netherlands Nutrition Centre, The Hague, The Netherlands
| | | | - Annemien Haveman-Nies
- grid.4818.50000 0001 0791 5666Consumption and Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Remko Lupker
- grid.36120.360000 0004 0501 5439Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- grid.36120.360000 0004 0501 5439Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
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Gademan MG, Hosper K, Deutekom M, Engelbert RH, Myers J, Stronks K. A poor association was found between self-reported physical activity and estimated maximal oxygen uptake of sedentary multiethnic women. J Clin Epidemiol 2014; 67:462-7. [DOI: 10.1016/j.jclinepi.2013.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 10/25/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
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Nierkens V, Hartman MA, Nicolaou M, Vissenberg C, Beune EJAJ, Hosper K, van Valkengoed IG, Stronks K. Effectiveness of cultural adaptations of interventions aimed at smoking cessation, diet, and/or physical activity in ethnic minorities. a systematic review. PLoS One 2013; 8:e73373. [PMID: 24116000 PMCID: PMC3792111 DOI: 10.1371/journal.pone.0073373] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 07/25/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. AIM To systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness. METHODS Systematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997-2009). INCLUSION CRITERIA a) effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b) interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c) primary outcome measures included smoking cessation, diet, or physical activity. RESULTS Out of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity. CONCLUSION This review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a higher intensity of the intervention. More systematic experiments are needed in which the aim is to gain insight in the best mix of cultural adaptations among diverse populations in various settings, particularly outside the US.
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Affiliation(s)
- Vera Nierkens
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Marieke A. Hartman
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Mary Nicolaou
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Charlotte Vissenberg
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Erik J. A. J. Beune
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Karen Hosper
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Irene G. van Valkengoed
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public Health, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
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Devillé W, Hosper K, Groen S, Bartels K, Starmans R, van Dijk R, Rohlof H, van Tulder M, Tempelman D. Cultural Interview by mental health nurses in diagnosis and treatment of non-western patients in primary care, The Netherlands, 2013. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt124.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gademan MGJ, Deutekom M, Hosper K, Stronks K. The effect of exercise on prescription on physical activity and wellbeing in a multi-ethnic female population: A controlled trial. BMC Public Health 2012; 12:758. [PMID: 22963588 PMCID: PMC3490781 DOI: 10.1186/1471-2458-12-758] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 08/27/2012] [Indexed: 11/16/2022] Open
Abstract
Background In Western countries, individuals from multi-ethnic disadvantaged populations are less physically active than the Western population as a whole. This lack of physical activity (PA) may be one of the factors explaining disparities in health. Exercise on Prescription” (EoP), is an exercise program to which persons are referred by primary care. It has been developed to suit the needs of physically inactive women from diverse ethnic backgrounds living in deprived neighborhoods in the Netherlands. The effectiveness of this program has however, not yet been proven. Methods A total of 514 women from diverse ethnic backgrounds were included in this study (192 EoP, 322 control group). Women in the EoP group participated in 18 sessions of supervised PA. The control group received care as usual. At baseline, 6 and 12 months the women attended an interview and a physical examination. Outcome measures were PA, BMI, weight circumference, fat percentage, oxygen uptake, mental well-being, subjective health and use of care. Results Of the participants 59% had a low educational level and 90% of the women were overweight or obese. Compliance was high, only 14% dropped out during the course of the program. Total PA did not change, PA during leisure time increased at 6 and at 12 months and PA during household activities increased at 12 months (PEoPvsControl < 0.05). EoP had no significant effect on the other outcome variables. Conclusions EoP was successful in recruiting its target population and compliance was high. The effect of EoP on PA, health and mental well-being was limited. In this format EoP does not seem to be effective for increasing PA and the health status of non-Western migrant women. Trial registration Dutch Trial register: NTR1294
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Affiliation(s)
- Maaike G J Gademan
- Department of Public Health, Academic Medical Center, Meibergdreef 9, Postbus 22660, 1100 DD Amsterdam, The Netherlands.
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van Poppel MNM, Hartman MA, Hosper K, van Eijsden M. Ethnic differences in weight retention after pregnancy: the ABCD study. Eur J Public Health 2012; 22:874-9. [PMID: 22315462 DOI: 10.1093/eurpub/cks001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Postpartum weight retention contributes to the development of overweight and obesity in women of childbearing age and is more pronounced in ethnic minority groups. This study examined ethnic differences in postpartum weight retention and the explanatory role of socio-economic status (SES), mental health and lifestyle. METHODS In the Amsterdam Born Children and their Development (ABCD) study, a large multi-ethnic cohort study conducted in The Netherlands, women filled out questionnaires in the first trimester of pregnancy and 3-5 months postpartum. A total of 4213 women provided data on weight gain, ethnicity, SES, mental health and lifestyle during and after pregnancy. Postpartum weight retention was defined as a difference of ≥5 kg between self-reported pre-pregnancy and postpartum weight. The influence of ethnicity on postpartum weight retention was assessed in logistic regression analyses. Whether the role of ethnicity was attenuated by adding SES, mental health and lifestyle factors were subsequently investigated. RESULTS Marked differences in weight change during and after pregnancy were found between ethnic groups. Turkish women had significantly more weight retention than Dutch women. This difference could not be explained by other factors. CONCLUSION In the prevention of postpartum weight retention, no single approach seems applicable to all ethnic groups. During pregnancy, health professionals should focus on Turkish women in particular, as they appear to have the highest risk of weight retention.
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Affiliation(s)
- Mireille N M van Poppel
- Department of Public and Occupational Health, VU University Medical Center Amsterdam, The Netherlands.
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8
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Hosper K, Nicolaou M, van Valkengoed I, Nierkens V, Stronks K. Social and cultural factors underlying generational differences in overweight: a cross-sectional study among ethnic minorities in the Netherlands. BMC Public Health 2011; 11:105. [PMID: 21324156 PMCID: PMC3048530 DOI: 10.1186/1471-2458-11-105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 02/16/2011] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of overweight appears to vary in people of first and second generation ethnic minority groups. Insight into the factors that underlie these weight differences might help in understanding the health transition that is taking place across generations following migration. We studied the role of social and cultural factors associated with generational differences in overweight among young Turkish and Moroccan men and women in the Netherlands. Methods Cross-sectional data were derived from the LASER-study in which information on health-related behaviour and socio-demographic factors, level of education, occupational status, acculturation (cultural orientation and social contacts), religious and migration-related factors was gathered among Turkish and Moroccan men (n = 334) and women (n = 339) aged 15-30 years. Participants were interviewed during a home visit. Overweight was defined as a Body Mass Index ≥ 25 kg/m2. Using logistic regression analyses, we tested whether the measured social and cultural factors could explain differences in overweight between first and second generation ethnic groups. Results Second generation women were less often overweight than first generation women (21.8% and 45.0% respectively), but this association was no longer significant when adjusting for the socioeconomic position (i.e. higher level of education) of second generation women (Odds Ratio (OR) = 0.77, 95%, Confidence Interval (CI) 0.40-1.46). In men, we observed a reversed pattern: second generation men were more often overweight than first generation men (32.7% and 27.8%). This association (OR = 1.89, 95% CI 1.09-3.24) could not be explained by the social and cultural factors because none of these factors were associated with overweight among men. Conclusions The higher socio-economic position of second generation Turkish and Moroccan women may partly account for the lower prevalence of overweight in this group compared to first generation women. Further research is necessary to elucidate whether any postulated socio-biological or other processes are relevant to the opposite pattern of overweight among men.
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Affiliation(s)
- Karen Hosper
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands.
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van Dijk TK, Agyemang C, de Wit M, Hosper K. The relationship between perceived discrimination and depressive symptoms among young Turkish-Dutch and Moroccan-Dutch. Eur J Public Health 2010; 21:477-83. [DOI: 10.1093/eurpub/ckq093] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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10
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Agyemang C, van Valkengoed I, Hosper K, Nicolaou M, van den Born BJ, Stronks K. Educational inequalities in metabolic syndrome vary by ethnic group: evidence from the SUNSET study. Int J Cardiol 2009; 141:266-74. [PMID: 19144421 DOI: 10.1016/j.ijcard.2008.12.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 11/17/2008] [Accepted: 12/03/2008] [Indexed: 01/22/2023]
Abstract
BACKGROUND Compared with Whites, many ethnic minority groups have higher prevalence of metabolic syndrome. The reasons for these ethnic inequalities in health are incompletely understood. The main objective was to examine whether socio-economic position (SEP) as measured by education was related to the prevalence of metabolic syndrome in different ethnic groups in Amsterdam, The Netherlands. METHODS A random sample of healthy adults aged 35-60 years. SEP was measured by educational level (secondary school and below (low), and vocational school and above (high)). Metabolic syndrome was measured according to the International Diabetic Federation guidelines. RESULTS Low education was negatively related to metabolic syndrome but only in White-Dutch people. Among White-Dutch men, the age adjusted prevalence ratio (95% confidence intervals) for low education was 1.46 (95% CI: 1.01-2.10) versus high education. Among White-Dutch women, the adjusted odds ratios for low education was 2.26 (95% CI: 1.39-3.68) versus high education. In both White-Dutch men and women, low education was related to several components of metabolic syndrome. Among African-Surinamese and Hindustani-Surinamese, no significant associations were found between low education and metabolic syndrome and its components. CONCLUSION Low education is associated with increased risk of metabolic syndrome among White-Dutch people but not among other ethnic groups. Community-based strategies to improve metabolic profiles may have to be ethnically devised. Among White-Dutch, targeting people with lower SEP may have an impact. However, among ethnic minority groups, both low and high socio-economic groups may have to be equally targeted to have an impact in reducing ethnic inequalities in health.
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Affiliation(s)
- Charles Agyemang
- Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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11
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Hosper K, Deutekom M, Stronks K. The effectiveness of "Exercise on Prescription" in stimulating physical activity among women in ethnic minority groups in the Netherlands: protocol for a randomized controlled trial. BMC Public Health 2008; 8:406. [PMID: 19077190 PMCID: PMC2631485 DOI: 10.1186/1471-2458-8-406] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Accepted: 12/10/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lack of physical activity is an important risk factor for overweight, diabetes, cardiovascular disease and other chronic conditions. In the Netherlands, ethnic minority groups are generally less physically active and rate their own health poorer compared to ethnic Dutch. This applies in particular to women. For this reason women from ethnic minority groups are an important target group for interventions to promote physical activity.In the Netherlands, an exercise referral program ("Exercise on Prescription") seems successful in reaching women from ethnic minority groups, in particular because of referral by the general practitioner and because the program fits well with the needs of these women. However, the effect of the intervention on the level of physical activity and related health outcomes has not been formally evaluated within this population. This paper describes the study design for the evaluation of the effect of "Exercise on Prescription" on level of physical activity and related health outcomes. METHODS The randomized controlled trial will include 360 inactive women from ethnic minority groups, with the majority having a non-Western background, aged between 18 and 65 years old, with regular visits to their general practitioner. Participants will be recruited at healthcare centres within a deprived neighbourhood in the city of The Hague, the Netherlands. An intervention group of 180 women will participate in an exercise program with weekly exercise sessions during 20 weeks. The control group (n = 180) will be offered care as usual. Measurements will take place at baseline, and after 6 and 12 months. Main outcome measure is minutes of self reported physical activity per week. Secondary outcomes are the mediating motivational factors regarding physical activity, subjective and objective health outcomes (including wellbeing, perceived health, fitness and body size) and use of (primary) health care. Attendance and attrition during the program will be determined. CONCLUSION This trial will provide information on the effectiveness of an exercise referral scheme on the short and long term among women from ethnic minority groups, mainly non-Western, in the Netherlands. The results of this study will contribute to the evidence base for interventions in ethnic minority populations.
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Affiliation(s)
- Karen Hosper
- Department of Social Medicine, Academic Medical Centre, Amsterdam, the Netherlands.
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Hosper K, Nierkens V, van Valkengoed I, Stronks K. Motivational factors mediating the association between acculturation and participation in sport among young Turkish and Moroccan women in the Netherlands. Prev Med 2008; 47:95-100. [PMID: 18378289 DOI: 10.1016/j.ypmed.2008.02.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 02/15/2008] [Accepted: 02/15/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Acculturation of migrant women has been associated with increased participation in physical activity, including participation in sport. We assessed which motivational factors mediate this association among Turkish and Moroccan migrant women in the Netherlands. METHODS Data were available from a cross-sectional study conducted in 2003-2004, on health-related behavior among Turkish and Moroccan ethnic groups in Amsterdam, The Netherlands. In total, we included 258 Turkish and 170 Moroccan women (aged 15-30) who participated in a structured interview including questions on participation in sport, acculturation (defined as 'the level of cultural orientation towards Dutch culture'), and motivational factors including attitudes, social influences, and self-efficacy. RESULTS Acculturation was strongly associated with participation in sport among Turkish women, but not among Moroccan women. Greater participation in sport among the higher acculturated Turkish women was accounted for by "culturally specific beliefs" and to a lesser extent by "perceived disadvantages" and "self-efficacy." CONCLUSION These results emphasize that in order to stimulate participation in sport among low acculturated Turkish women, the culturally specific beliefs should be taken into account when developing a culture-sensitive intervention. Further research is necessary to understand why acculturation leads to increased participation in sport in some ethnic groups and not in others.
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Affiliation(s)
- Karen Hosper
- Department of Social Medicine, J2, Academic Medical Center - University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
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13
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Hosper K, Klazinga NS, Stronks K. Acculturation does not necessarily lead to increased physical activity during leisure time: a cross-sectional study among Turkish young people in the Netherlands. BMC Public Health 2007; 7:230. [PMID: 17767715 PMCID: PMC2034552 DOI: 10.1186/1471-2458-7-230] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Accepted: 09/03/2007] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Non-Western migrant populations living in Western countries are more likely to be physically inactive during leisure time than host populations. It is argued that this difference will disappear as they acculturate to the culture of the host country. We explored whether this is also true for migrants who experience contextual barriers such as having children, living in a less attractive neighbourhood, or having occupational physical activity. METHODS Cross-sectional data were obtained from the LASER-study (2003-2004) on health related behaviours in first and second generation Turkish young people living in the Netherlands. For this study we included 485 Turkish participants aged 15-30 years, who participated in a structured interview during a home visit. Acculturation was indicated by level of 'cultural orientation towards the Dutch culture' and 'social contacts with ethnic Dutch' with persons being low oriented towards the Dutch culture and having few social contacts with ethnic Dutch as reference group. The measured barriers were 'having children', 'occupational physical activity' and 'living in a less attractive neighbourhood'. Logistic regression analyses were used to assess the associations between acculturation and physical activity during leisure time, stratified by these contextual barriers. RESULTS Greater cultural and social integration was associated with increased physical activity during leisure time. Odds ratio's were 1.85 (CI: 1.19-2.85) for 'cultural orientation' and 1.77 (CI: 1.15-2.71) for 'social contacts with ethnic Dutch'. However, these associations were not present or less strong among people who had children, or who were living in a less attractive neighbourhood or who engaged in occupational physical activity. CONCLUSION Physical activity during leisure time increased with greater acculturation, however, this relationship was found only among participants without children, living in a attractive neighbourhood and having no occupational activity. Interventions aimed at migrant populations should not only focus on the least integrated. Instead, effectiveness might be enhanced when interventions are sensitive to the contextual barriers that might inhibit physical activity behaviours during leisure time.
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Affiliation(s)
- Karen Hosper
- Department of Social Medicine, Academic Medical Centre – University of Amsterdam, P.O. Box 22700, 1100 DD Amsterdam, the Netherlands
| | - Niek S Klazinga
- Department of Social Medicine, Academic Medical Centre – University of Amsterdam, P.O. Box 22700, 1100 DD Amsterdam, the Netherlands
| | - Karien Stronks
- Department of Social Medicine, Academic Medical Centre – University of Amsterdam, P.O. Box 22700, 1100 DD Amsterdam, the Netherlands
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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; 22:163-72. [PMID: 17334819 PMCID: PMC2781098 DOI: 10.1007/s10654-007-9104-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2006] [Accepted: 01/01/2007] [Indexed: 10/26/2022]
Abstract
Migrant mortality does not conform to a single pattern of convergence towards prevalence rates in the host population. To understand better how migrant mortality develops, it is necessary to further investigate how the underlying behavioural determinants change following migration. We studied whether the prevalence of behavioural risk factors over two generations of Turkish and Moroccan migrants converge towards the prevalence rates in the Dutch population. From a random sample from the population register of Amsterdam, 291 Moroccan and 505 Turkish migrants, aged 15-30, participated in a structured interview that included questions on smoking, alcohol consumption, physical inactivity and weight/height. Data from the Dutch population were available from Statistics Netherlands. By calculating age-adjusted Odds Ratio's, prevalence rates among both generations were compared with prevalence rates in the host population for men and women separately. We found indications of convergence across generations towards the prevalence rates in the host population for smoking in Turkish men, for overweight in Turkish and Moroccan women and for physical inactivity in Turkish women. Alcohol consumption, however, remained low in all subgroups and did not converge towards the higher rates in the host population. In addition, we found a reversed trend among Turkish women regarding smoking: the second generation smoked significantly more, while the first generation did not differ from ethnic Dutch. In general, behavioural risk factors in two generations of non-Western migrants in the Netherlands seem to converge towards the prevalence rates in the Dutch population. However, some subgroups and risk factors showed a different pattern.
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Affiliation(s)
- Karen Hosper
- Department of Social Medicine, Academic Medical Centre--University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
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