Similarities and differences in underlying beliefs of socio-cognitive factors related to diet and physical activity in lower-educated Dutch, Turkish, and Moroccan adults in the Netherlands: a focus group study

Abstract

BackgroundUnhealthy eating patterns and a lack of physical activity (PA) are highly prevalent in most Western countries, especially among lower-educated people, including people of non-Western origin. The aim of this study was to investigate and compare the beliefs and barriers that underlie socio-cognitive and planning constructs related to healthy eating and PA among lower-educated Dutch, Turkish, and Moroccan adults.MethodsFocus group interviews were conducted with 90 Dutch, Turkish, and Moroccan lower-educated adults between March and August 2012. Five semi-structured group interviews were conducted with Dutch participants, five with Turkish participants, and four with Moroccan participants. Men and women were interviewed separately. The question route was based on the Theory of Planned Behavior and self-regulation theories. The theoretical method used for the qualitative data analysis was content analysis. The interviews were recorded, transcribed, and analyzed by applying the framework approach.ResultsSome participants seemed to lack knowledge of healthy eating and PA, especially regarding the health consequences of an unhealthy lifestyle. Important attitude beliefs concerning healthy eating and PA were taste and health benefits. Participants suggested that social support can encourage the actual performance of healthy behavior. For instance, exercising with other people was perceived as being supportive. Perceived barriers to PA and cooking healthily were a lack of time and tiredness. These previously mentioned beliefs arose in all the ethnic groups. Differences were also found in beliefs between the ethnic groups, which were mainly related to religious and cultural issues. Turkish and Moroccan participants discussed, for example, that the Koran contains the recommendation to eat in moderation and to take care of one’s body. Furthermore, they reported that refusing food when offered is difficult, as it can be perceived as an insult. Finally, men and women usually cannot exercise in the same location, which was perceived as a barrier. These factors did not emerge in the Dutch groups.ConclusionsThe same cognitive beliefs were discussed in all three ethnic groups. The importance of cultural and religious factors appeared to be the most significant difference between the Turkish/Moroccan groups and the Dutch groups. Accordingly, interventions for all three ethnic groups should focus on socio-cognitive beliefs, whereas interventions for Turkish and Moroccan populations can additionally take religious and cultural rules into account.

An exploration of perceptions and preferences for healthy eating in Dutch consumers: A qualitative pilot study

“…The results showed that how people perceived a healthy diet was mostly represented at the level of food product (vegetables and fruit) and the content/nutrient level (carbohydrates); whereas how they would like to eat healthily was mostly represented at the level of food processing (processing), food product (vegetables) and dietary patterns (amount) [7,19]. This is in line with previous studies in which many participants named fruit and vegetables as part of a healthy diet [11][12][13]. A striking finding was that only five participants explicitly called the Wheel of Five as how they would describe a healthy diet.…”

“…Another study found that more fish and more lean meat were also part of the healthy eating definition in a large Spanish sample [12]. A more recent study found that low-educated Dutch, Turkish, and Moroccan adults living in the Netherlands considered mainly fruit and vegetables as part of a healthy diet [13]. Thus, fruit, vegetables, (avoiding or limiting) meat, balance/variety/moderation, and less fat seem to constitute a healthy diet according to many consumers; these elements were also identified by a review [14].…”

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“…Further, in the present study, the samples originated from 31 different countries. It is likely that cultural context influences the moderating effect of SES on the relationships between TPB variables and diet, as cross‐cultural research shows that different countries have different attitudes towards food (Rodriguez‐Arauz, Ramirez‐Esparza, & Smith‐Castro, ) and different cultural norms regarding eating behaviours (Romeike, Abidi, Lechner, de Vries, & Oenema, ). Furthermore, how dietary behaviour was measured (e.g.…”

An investigation of physical activity among adults in Turkey using the Omaha System

“…Lack of social support from relatives was another constraint (Koca et al, ). Religious customs and the absence of recreational facilities where men and women can exercise separately can be additional barriers (Ozturk & Koca, ; Romeike, Abidi, Lechner, de Vries, & Oenema, ). Notably, <10 participants in this study had a Spirituality, Caretaking/parenting, or Interpersonal relationship problem.…”