Culture and health communication

The percentage of Dutch citizens with unhealthy lifestyles, including overweight and excessive smoking, is above the global average and has been increasing over the past years (e.g., de Ruijter et al., 2022; Hecker et al., 2022). On an individual level, these unhealthy behaviours reduce the quality of life and health and increase the probability of cancer, cardiovascular diseases, or even early death (e.g., Afshin et al., 2019; Roth et al., 2017). Societally, unhealthy behaviours increase pressure on the healthcare system (Fernandes et al., 2019; Luben et al., 2020).
According to the Lifestyle Monitor of the Dutch Ministry of Health, Welfare, and Sports (VWS), Dutch citizens with a non-western migration background are overrepresented in this health problem (RIVM, 2020). Compared to native Dutch citizens, more individuals smoke, are overweight and engage less in physical activity (CBS, 2022). Dutch citizens with a Turkish migration background (Turkish-Dutch citizens, the largest migrant group in The Netherlands) are among the most overrepresented in these unhealthy behaviours (Knoops et al., 2020). Differences exist between Dutch and Turkish-Dutch citizens that may account for these health disparities, including cultural differences (Teuscher et al., 2015). Importantly, in this project, and by previous studies (Betsch et al., 2016), we assume that cultural differences are crucial for health behaviours and may be essential factors explaining how Turkish-Dutch citizens process and respond to health messages.

People share the same values and norms within a particular culture and pass them on from generation to generation (Hornikx et al., 2014). Importantly, studies indicate that home culture orientations of ethnic minority groups reduce with each generation but do not disappear completely (Perez & Padilla, 2000). Therefore, it is likely that the home culture orientation of Turkish-Dutch citizens will also reduce with each generation and, in turn, affect their social norms and practices regarding health behaviour. However, no studies demonstrate (a) which cultural characteristics remain over generations within this group and (b) to what extent these characteristics influence the health communication process (i.e., message exposure, responses to the message about message characteristics, and health behaviour). For these reasons, the current project focuses on three generations of Turkish-Dutch citizens, the largest migrant group in the Netherlands, as a case study to better understand the health communication process. It considers each generation's cultural differences as a moderator of the health communication process. The general research question considers whether, how, and for whom among Turkish-Dutch citizens, messages with cultural elements are effective in mass-mediated health campaigns. More specifically, a comprehensive model will be assessed, including message characteristics, responses to the message, and predictors of health behaviour.

We do this by setting up four studies. In study 1, we focus on the cultural characteristics of Turkish-Dutch and native Dutch citizens. Study 2 will focus on the extent to which mass-mediated health messages in the Netherlands use cultural references of Turkish-Dutch citizens. Studies 3 and 4, however, are experiments in which we look at the effects of culturally (in)congruent health message characteristics on health message responses and health behaviour.