Turkish Migration Background Research Articles

Facial attractiveness does not modify the perceived trustworthiness of ethnic minority men

Immigrants, and particularly immigrant men, are often stereotyped as untrustworthy in European societies. However, little research has examined how stereotypes of characteristics other than ethnicity might impact natives’ perceptions of the trustworthiness of immigrants. Here, I test whether facial attractiveness, a trait associated with a variety of positive stereotypes, might modify ethnic biases in trustworthiness perceptions. I vary facial attractiveness and ethnicity using photo and name stimuli presented in a hypothetical “lost wallet” vignette, in which respondents assess the likelihood of the pictured man returning their lost wallet. Results from an German online panel survey indicate that while attractiveness has a modest positive effect on perceived trustworthiness, the value of attractiveness does not differ between ethnic majority German men and men with a Turkish migration background. Rather, the largest differences in the perceived trustworthiness of Turkish-origin men are found between respondents with inclusionary and exclusionary immigration attitudes, with inclusionary respondents reporting that Turkish-origin vignette persons are more trustworthy than ethnic majority German vignette persons. These results suggest that physical attractiveness does not act as a substantial moderator of ethnic biases in trustworthiness perceptions, but that immigration attitudes are highly relevant.

Objective assessment criteria reduce the influence of judgmental bias on grading

Past research has indicated that students with a migration background are graded worse than those without a migration background, despite them showing the same level of academic performance. Negative implicit associations of teachers associated with these student characteristics could explain these findings. Objective assessment criteria, such as error tables, provide user-independent rules for the interpretation of results and could therefore help to ensure that the influence of student characteristics on assessment is reduced. To test this hypothesis, 157 pre-service teachers assessed a dictation. Two aspects were varied: the presentation of an error table for assessment and the name of the student who had written the dictation (with vs. without a supposed Turkish migration background). An implicit association test measured implicit associations of the pre-service teachers toward the performance of Turkish and German people. When no error table was used and the pre-service teachers had negative implicit associations toward the performance of people with a Turkish migration background, they graded students with a migration background worse than students without a migration background. No grading disparities were found when the error table was used. To reduce judgmental bias, the use of objective assessment criteria can therefore be recommended.

Health Literacy of People with Former Soviet Union and Turkish Migration Background in Germany

So far, there are hardly any data on the health literacy of persons with a migration background in Germany. The aim of the article was to analyse the health literacy of this population group - particularly persons who originate in Turkey and the former Soviet Union (FSU). In summer 2020, face-to-face interviews with 525 persons with FSU and 512 persons with Turkish migration background above the age of 18 were carried out across Germany. The interviews were conducted in German, Russian or Turkish. Health literacy was assessed using the internationally developed HLS19-Q47 instrument. Bivariate and multivariate analyses were carried out for each immigration group separately considering demographic, socioeconomic, linguistic and migration-specific variables. Overall, around half of the respondents had low health literacy, with no differences between the immigration groups. In both groups, low educational levels, socioeconomic disadvantages, limited German literacy skills, older age, multiple chronic illnesses and personal experience of immigration were linked with lower health literacy. In multivariate analyses, associations between health literacy and literacy skills, social status, financial deprivation, and chronic illness remained; however, after adjustment, no significant difference persisted by immigration generation. While a significant proportion of persons with Turkish or FSU migration background in Germany have difficulty dealing with health information, compared with existing studies, they do not have a lower health literacy than the population without a migration background. People with a migration background are therefore not to be regarded as vulnerable to low health literacy in general. Particularly socioeconomically disadvantaged subgroups display low health literacy. Interventions should therefore target these subgroups specifically and consider their living conditions. In addition, people with low literacy skills and German proficiency have greater difficulties in processing health information. This highlights the need for multilingual information, but also for multimedia materials in plain language. Structural measures are necessary for a health-literate health system and for reducing health inequalities.

Identity and Belonging: Emotional Assimilation in Two Immigrant Communities in Germany

In this article, we analyze emotional assimilation (host country identification) within Germany’s two largest immigrant communities—ethnic Germans from the former Soviet Union and those German citizens with an ethnic Turkish migration background. Specifically, we investigate the strength of emotional assimilation among these two communities and the differences that might exist between them. To what degree have these two large immigrant communities cultivated a sense of host country identification or German national identity? What factors shape emotional assimilation in these two communities? We find that ethnic German citizens with a background from the former Soviet Union have a stronger German identity than do citizens with a Turkish background. Nevertheless, the difference between these two groups is substantively small, perhaps because the transformation of immigration rules, citizenship laws, integration policies, and social norms in Germany over the last two decades has led to a greater identification with Germany and its emerging multicultural society.

Quality of Life and Sense of Coherence in Cancer Patients of German, Turkish and Polish Origin-A Cross-Sectional Study.

Due to a variety of symptoms and side-effects of cancer treatment, quality of life can be considerably impaired in cancer patients. Especially, cancer patients with a migration background seem to be at risk. The objective of our study is to investigate the quality of life and sense of coherence in adult cancer patients of German, Turkish and Polish origin. We assessed sociodemographic, migration-specific and cancer-related parameters. Quality of life was measured via the EORTC QLQ-C30, sense of coherence was measured with the SOC-13. We included 227 patients in the study (59.5% native Germans, 40.5% with migration background). Native Germans did not differ in quality of life compared to all migrants. However, more nausea and vomiting (NV) and higher appetite loss (AP) was found in Turkish migrants compared to Polish migrants and native Germans. For sense of coherence, we observed significantly higher scores for native Germans compared to all migrants. Turkish migrants had significantly lower scores compared to native Germans. A Turkish migration background seems to play an important role in the perception of symptoms, especially of nausea and vomiting and appetite loss. Culture-specific aspects should be considered in cancer care.

Digital health information and female adolescents with turkish migration background

Abstract Background Youth with Turkish migration background (TRMB) are repeatedly classified as a vulnerable group. Digital health information, which is prepared and made available by various providers in a variety of ways, may represent an opportunity to promote the health of these adolescents. Empirical findings on wheter young people have access to digital health information and what role digital health information plays in their everyday lives are hard to find. Methods In the project ELMi, a project of the HLCA Consortium, funded by the BMBF, female adolescents with TRMB were interviewed. Individual interviews as well as a focus group discussion were conducted and evaluated according to the Qualitative Content Analysis. Results Female adolescents with TRMB have technical access to digital health information. They use New Media to obtain health information. When searching for digital health information, it is important for the adolescents to be able to find factual and comprehensibly formulated information quickly. German-language homepages are preferred by them. Parallel to the digital platform they regard female persons from their own social network as contact persons for health questions. They draw on their health-related knowledge and experience in order to be able to obtain answers to their own questions. Conclusions Digital health information and the health-related knowledge and experience of the female social network are considered as a health related resource. German-language electronic information with low-threshold content can represent an opportunity to reach female adolescents with TRMB Key messages • Female adolescents with TRMB demonstrate technical and content access to digital health information. • Digital health information represents an opportunity to reach the target group.

Health System Barriers for HPV-vaccine uptake in females with a Turkish or Moroccan Migration background in the Netherlands

Abstract Background HPV vaccine uptake in female adolescents with a Turkish or Moroccan migration background in the Netherlands is lower as compared to the national average. This study aimed to study health system barriers for HPV vaccine uptake in these groups. Methods Semi-structured interviews with Turkish/Moroccan (2nd and 3rd degree migrants) female adolescents (12-18 years old), their parents and grandparents were conducted. In addition a focus group discussion with healthcare providers with particular experience with HPV immunization and the target groups was organized. Data was collected between November 2021-April 2022. Results 22 interviews were conducted among twenty-three individual participants. Sixteen participants with a Turkish migration background were recruited and seven participants were having a Moroccan migration background. In thirteen cases young women in the families did not receive an HPV vaccination. Health system barriers identified were: language barriers in the information provided, focus on HPV being a sexually transmitted disease in information campaigns, lack of knowledge and awareness on HPV among participants and healthcare providers and inability to reach the target groups with tailored immunization programs. Similar health system barriers were mentioned by the healthcare providers, but also included a lack of trust in the government and healthcare institutions, insufficient coordination and collaboration between different healthcare providers. National immunization programs with mass campaign vaccination is mentioned as a barrier to reach families with a Turkish/Moroccan migration background. Conclusions Various health system barriers were addressed to be related to HPV vaccine uptake in females with a Turkish/Moroccan migration background in the Netherlands. Despite similarities concerning health system barriers among community members and healthcare providers, different health system barriers were also mentioned.

Can I dismiss the stereotype – as my teacher did? Influence of stereotype activation and an immigrant teacher on student learning

Lower vocabulary in German is repeatedly reported for students with Turkish migration background attending school in Germany. We investigated whether in students of Turkish descent (a) learning vocabulary is impaired when the teacher activates the negative stereotype that students with Turkish family language learn less well and (b) whether a Turkish-origin teacher, as an ingroup expert model, can mitigate negative effects of the activation of the stereotype. In an experimental study, Turkish- and German-origin students (N = 182) living in Germany worked individually on a tablet on a vocabulary learning task instructed by a teacher in a video tutorial who introduced herself with either a Turkish or German name. Before the task, the teacher either mentioned that students in general (no stereotype activation) or students who speak Turkish in their families (stereotype activation) often have difficulties acquiring new vocabulary. A multiple-group regression analysis showed that Turkish-origin students learned significantly more under stereotype activation with the Turkish-origin teacher than in all other conditions. Results suggest that students are particularly motivated to learn when the teacher represents their ingroup targeted by negative stereotypes and openly addresses potential difficulties students of the stigmatized ingroup may encounter. We discuss the findings in light of the literature on stereotype threat and on the role of ingroup expert models.

The Impact of Perceived Discrimination on Cultural Identification, Psychological Stress, Emotion Regulation and Aggressive Tendencies in Individuals With Turkish Migration Background in Germany.

The following study considers correlates of the identification with the origin and host culture of German individuals with a Turkish migrant background. It examines how these two factors mediate the relationship between perceived discrimination, emotion regulation or psychological stress, and aggressive tendencies as the major dependent variable. For this purpose, the data of 229 people with Turkish migration background living in Germany was collected through an online survey. Findings depict that the identification with the Turkish (origin) and German (host) culture mediate the relationship between perceived discrimination and emotion regulation. The relationship between perceived discrimination and psychological stress is mediated by the identification with the German culture. The analysis shows that perceived discrimination is associated with a reduced identification with the German culture and with a high identification with the Turkish culture. Emotion regulation abilities are negatively related to perceived discrimination and identification with the Turkish culture. In contrary, the psychological stress level is positively related to perceived discrimination. The preparedness for aggressive behavior is also associated positively by psychological stress and negatively by emotion regulation abilities. The results are discussed against the background of the specific migration history and living conditions of Turkish immigrants in Germany.

When ethnic minority students are judged as more suitable for the highest school track: a shifting standards experiment

When students are grouped into school tracks, this has lasting consequences for their learning and later careers. In Germany to date, some groups of students (boys, ethnic minority students) are underrepresented in the highest track. Stereotypes about these groups exist that entail negative expectations about their suitability for the highest track. Based on the shifting standards model, the present research examines if and how stereotypes influence tracking recommendations. According to this theory, members of negatively stereotyped groups will be judged more leniently or more strictly depending on the framing of the judgment situation (by inducing minimum or confirmatory standards). N = 280 teacher students participated in a vignette study in which they had to choose the amount of positive evidence for suitability they wanted to see before deciding to recommend a fictitious student to the highest track. A 2 (judgment standard: minimum vs. confirmatory) × 2 (target student’s gender: male vs. female) × 2 (target student’s ethnicity: no migration background vs. Turkish migration background) between-subjects design was used. No effects of target gender occurred, but the expected interaction of target’s ethnicity and judgment standard emerged. In the minimum standard condition, less evidence was required for the ethnic minority student to be recommended for the highest track compared to the majority student. In the confirmatory standards condition, however, participants tended to require less evidence for the ethnic majority student. Our experiment underlines the importance of the framing of the recommendation situation, resulting in a more lenient or stricter assessment of negatively stereotyped groups.

Revisiting the Religious Openness Hypothesis in a Migration Context: The Case of Muslims with a Turkish Migration Background in Germany

Abstract The religious openness hypothesis, which states that religious traditions have the potential to integrate faith with intellect, is examined in this study within a migration context for the first time. Based on two lines of research, our central question is whether the sociological context or the Islamic tradition per se explains the (in)compatibility of faith and intellect orientation and their relation to psychological openness. Religious openness, psychological openness (ambiguity tolerance and acculturation strategies) and religiosity were measured among Muslims with a Turkish migration background in Germany. Our findings show a non-significant relationship between faith and intellect orientation and we therefore propose that the secular context is the crucial explaining factor. Religious reflection also moderates the link between different forms of religiosity and ambiguity tolerance. Finally, heterogeneous religious rationalities were uncovered that challenge the negative view of Muslims as fanatic, closed-minded people which prevails among the German majority society.

Gender-Related Particularities in the Identity of Young Muslims Living in Germany

Against the background of migration, globalization and nationalization, questions arise about the identity formation of young Muslims living in Germany. Gender-related characteristics of identity are of utmost relevance for the individual in order to be able to successfully locate oneself in modern society. In this article, we examine gender-specific differences between young Muslim women and Muslims with a Turkish migration background who grew up in Germany. We aim to answer the question of how the social, cultural, and ethnic identities of young Muslims growing up in Turkish immigrant families were formed, and to what extent gender differences between young men and women exist here. This question is particularly interesting as young Muslims with a migration background stand at the intersection of different ethnic, cultural, religious and political worlds and have to cope with the task of forming their own processual identity. In this qualitative study, 50 interviews were conducted with young Muslims aged 18-25 whose parents or grandparents migrated from Turkey to Germany. The interviews were audio-documented, transcribed, and imported into the qualitative software program <i>atlas.ti</i>. The analysis was structured by a codebook consisting of structural and open codes. Furthermore, co-occurrence analysis was used to examine the co-occurrence of open and structural codes verified through an interrater reliability calculated using the statistical measure Krippendorff's alpha. The results show that society and culture have a great influence on young Muslims. The development of identity shows significant gender-related characteristics: Young women describe a predominantly good, especially professional, integration into German society. In their Turkish family, however, they tend to encounter criticism, alienation and devaluation. The men are more likely to report discrimination and experiences of disintegration. On the other hand, they experience fewer conflicts in their Turkish family; as sons, they are held in higher esteem than the daughters. These findings reveal divergent expectations placed on men and women by Turkish and German society, which influence their identity formation, but also their inner-emotional conflicts. A hybrid migratory identity represents a valuable resource for shaping transnational and postmodern life-worlds.

Non-communicated judgements of, versus feedback on, students\u2019 essays: Is feedback inflation larger for students with a migration background?

When providing feedback, teachers are concerned not only with the simple transmission of information, but also with motivational and interpersonal dynamics. To mitigate these concerns, teachers may inflate feedback by reducing negative or increasing positive content. The resulting difference between initial judgments and feedback may be even more drastic for ethnic minority students: In non-communicated judgments, negative stereotypes may result in more negative judgments, whereas in feedback, concerns about being or appearing prejudiced may inflate feedback towards ethnic minority students. These hypotheses were tested in a sample of 132 German teacher students in a 2 (between subjects: feedback vs. non-communicated judgment) × 2 (within subjects: target student's migration background: Turkish vs. none) design in which participants read supposed student essays and provided their written impressions to the research team or the supposed student. Findings revealed that teacher students’ feedback was more positive than their non-communicated judgments on a multitude of dimensions. Contrary to expectations, these effects were not stronger when the student had a Turkish migration background. Instead, teacher students rated the essay of the student with a Turkish migration background more favorably both in the judgment and feedback conditions. Our results suggest that teachers adapt their initial judgments when giving feedback to account for interpersonal or motivational dynamics. Moreover, ethnic minority students may be especially likely to receive overly positive feedback. While the motivational/interpersonal dynamics may warrant some inflation in feedback, negative consequences of overly positive feedback, for which ethnic minority students may be especially vulnerable, are discussed.

Stigmatization and attitudes toward eating disorders: a comparison between native German adolescents, Turkish immigrant adolescents in Germany, and native Turkish adolescents

Background and aims The purpose of this study was to investigate the attitudes toward eating disorders in native German adolescents (Germans), adolescents with Turkish migration background in Germany (Immigrants), and native Turkish adolescents (Turks). Method A total of 507 adolescents (N = 139 Germans; N = 126 Immigrants; N = 242 Turks) read a vignette describing a 16-year-old female with bulimic symptoms. Participants completed questionnaires on mental health literacy, stigmatization, desirability of eating disorder-related behaviors and acquaintance with bulimic symptoms. Results Adolescents living in Germany were more likely to recognize the vignette as an eating disorder than Turks. Immigrants were more similar to Germans in mental health literacy of eating disorders than Turks. However, in terms of stigmatizing attitudes, immigrants blamed more than Germans, Turks being intermediate on this variable. In Turks, higher desirability of eating disorder-related behaviors was associated with an increased acquaintance with bulimic symptoms and decreased evaluations of impairment. Higher mental health literacy was associated with less blame in Germans. Conclusions Migration background was associated with increased mental health literacy of eating disorders but did not result in reduced stigma. Differences in attitudes toward eating disorders indicate the need for differential interventions across the groups.

Mothers and Parental Leave in Belgium: Social Inequalities in Eligibility and Uptake

In recent decades, many Western European countries introduced parental leave policies to support the work–family combination in families with young children. However, these parental leave schemes often exhibit employment‐based eligibility criteria, so the question arises to which extent social inequalities emerge in the access to parental leave, and as a result thereof also in the uptake of parental leave. Although research on parental leave increasingly addresses the issue of inclusiveness, only a limited number of studies has yet examined individual‐level differentials in parents’, and especially mothers’, eligibility. Using detailed register data, we develop an individual‐level indicator of eligibility in Belgium and deploy it to document differentiation in mothers’ eligibility by age at first birth, partnership status, migration background and education. In addition, we examine to what extent differential eligibility can explain inequalities in parental leave uptake. Our results show that a considerable share of mothers—specifically very young, single, low educated mothers and mothers with a migration background—do not meet the eligibility criteria and thus are structurally excluded from parental leave in Belgium. Furthermore, differential eligibility can account for a large part of the age and educational gradients in parental leave use, as well as differences by migration background. Eligibility cannot (fully) account for lower parental leave use by single mothers and mothers with a Moroccan or Turkish migration background. Our findings suggest that a reconsideration of eligibility criteria may be instrumental in increasing the inclusiveness of parental leave policies.

Medical decision making among patients with heart failure \u2013 does migration background matter?

BackgroundSome studies, mainly coming from the U.S., indicate disparities in heart failure (HF) treatment according to migration/ethnicity. However, respective results are inconsistent and cannot be transferred to other health care systems. Thus, we will address the following research question: Are there differences in the diagnosis and management of HF between patients with and without a Turkish migration background in Germany?MethodsA factorial experimental design with video vignettes was applied. In the filmed simulated initial encounters, professional actors played patients, who consulted a primary care physician because of typical HF symptoms. While the dialog was identical in all videos, patients differed in terms of Turkish migration history (no/yes), sex (male/female), and age (55 years/75 years). After viewing the video, primary care physicians (N = 128) were asked standardized and open ended questions concerning their decisions on diagnosis and therapy.ResultsAnalyses revealed no statistically significant differences (p < 0.05), but a consistent tendency: Primary care doctors more often asked lifestyle and psychosocial questions, they more often diagnosed HF, they gave more advice to rest and how to behave in case of deterioration, they more often auscultated the lung, and more often referred to a specialist when the patient has a Turkish migration history compared to a non-migrant patient. Differences in the medical decisions between the two groups ranged between 1.6 and 15.8%. In 10 out of 12 comparisons, differences were below 10%.ConclusionsOur results indicate that are no significant inequalities in diagnosis and management of HF according to a Turkish migration background in Germany. Primary care physicians’ behaviour and medical decision making do not seem to be influenced by the migration background of the patients. Future studies are needed to verify this result and to address inequalities in HF therapy in an advanced disease stage.

Own migration experience is not a risk factor for incident cardiovascular disease – a cohort study

Abstract Background Studies have shown differences regarding prevalence and incidence of chronic diseases among first (own migration experience) compared to second (born in host country) generation migrants. The aim of this study was therefore to investigate the incidence of cardiovascular diseases (CVD) among persons of Turkish descent with and without migration experience living in Berlin, Germany. Methods In 2012-2013, Berliners with a Turkish migration background were recruited, examined, and contacted again 5 years later via postal mail. Incidence of diagnosed CVD (myocardial infarction, stroke, coronary heart disease, heart failure, cardiac arrhythmia, intermittent claudicatio or transient ischaemic attack) was assessed via self-report. Incidence of any CVD is presented as number and percentages. Associations between the incidence of any CVD and having an own migration experience were investigated with uni- and multivariable regression analyses. Results are presented as odds ratios with a 95%-confidence interval (OR, 95%-CI). Results Data of 234 persons of Turkish descent (62.8% women) with a mean age±standard deviation of 44±12.4 years were included in the analyses. Out of these, 79.9% were first generation migrants. First compared to second generation participants differed regarding CVD incidence (any CVD 16.6% vs. 4.3%, respectively; p = 0.03), socio-demographic, and lifestyle factors. After adjusting for these factors, multivariable analysis showed that only BMI (OR 1.12 per BMI point, 95%CI [1.02;1.24], and having a diagnosis of dyslipidemia (OR 4.0, 95%CI [1.45;12.05]), were independently associated with CVD incidence. Conclusions In a cohort study with Berliners of Turkish descent, CVD incidence was associated with increasing BMI and dyslipidemia, but not with own migration experience. Future migration-related public health research needs to focus on the prevention of harmful health behaviours to avoid the progression of overweight/obesity and dyslipidemia. Key messages CVD incidence is higher in persons with migration experience compared to those without. Migration experience is not associated with CVD incidence after adjusting for confounders (e.g. age, BMI).

Similarities and intersections – A comprehensive view in three studies

Abstract Background Various groups face difficulties in access to, and usage of health care. Research on marginalization in health care, and programs aiming to reduce inequalities usually focus on one single group at a time. Regarding the heterogeneity of groups defined by a few social characteristics, our aim was to question the specificity of barriers, and similarities between different groups. Methods The results of a mixed methods study focusing on elderly people with Turkish migration background were compared to the interim results of a qualitative study focusing on transgender persons, and the interim results of a qualitative study focusing persons with trauma related psychiatric diagnoses. Results 1) While relevant barriers in access to, and usage of health care seem to be group-specific at the first view, their underlying mechanisms of emergence are analogous. 2) Beside more obvious similarities, 3) further barriers arise by the combination of more than the mainly addressed characteristics of the different groups. Conclusions Barriers analogous or similar among different groups lead to underlying structural or professionality-related issues. If different dimensions of marginalization intersect, they may be disguised by a concentration on single characteristics. To target health inequalities on the long term, a closer look on similarities between groups facing health inequalities could improve the development of programs for a broader range of persons. Key messages The comparison of different marginalized groups is useful to identify and target systematic inequalities in health care. Researchers and stakeholders should consider mechanisms of multiple marginalization.

Associations Between Acculturation, Depressive Symptoms, and Life Satisfaction Among Migrants of Turkish Origin in Germany: Gender- and Generation-Related Aspects

ObjectiveThe aim of the present study was to investigate the degree of depressive symptoms and life satisfaction (LS) as well as the association between acculturation and depressive symptoms among a large sample of persons with Turkish migration background in Germany, taking into account gender- and migration-related differences.MethodsThis study was part of a pretest for a large national epidemiological cohort study in Germany. Acculturation was measured using the Frankfurt Acculturation Scale (FRACC). Based on the median split of the two subscales, four acculturative styles according to Berry (integration, assimilation, separation and marginalization) were determined. Depressive symptoms were assessed with the depression module (PHQ-9) from the Patient Health Questionnaire. LS was assessed with a single item on a scale from 1 = bad to 5 = excellent. Differences in levels of depressive symptoms and LS in relation to gender and generation of migration were tested with analysis of covariance, controlling for age. Gender-stratified multiple linear regression analyses were also conducted for depressive symptoms as criterion variable.Results328 Turkish migrants participated (61.3% women). The cut-off-value of ≥10 for the PHQ-9 was achieved by 33.2% of the women and 26.4% of the men (p=0.209, φ=0.071). In female migrants, the age-adjusted mean score for depressive symptoms was 7.81 (SD=6.42), in males 6.70 (SD=6.41) (p=0.137, η2=0.007). After controlling for unemployment status, women showed a trend for being more frequently depressed than men (p=0.055, φ=0.117) and also demonstrated a trend for higher levels of depressive symptoms (p=0.072, η2=0.012). No significant gender-specific difference was found concerning age-adjusted mean score for LS (p=0.547, η2=0.001), also when controlled for unemployment status (p=0.322, η2=0.004). In both sexes, the second generation demonstrated a significantly higher age-adjusted mean score for LS of small/medium effect size than the first generation. In women, separation as acculturation style (linear regression coefficient (B=4.42, 95% CI=1.68, 7.17, p=0.002; reference: integration), having no partnership (B=2.56, 95% CI=0.26, 4.86, p=0.03) and lower education (B=-2.28, 95% CI=-4.54, -0.02, p=0.048) were associated with higher severity of depressive symptoms; in men, separation as acculturation style (B=4.01, 95% CI=0.70, 7.31, p=0.018; reference: integration) and employment status (B=-3.32, 95% CI=-5.71, -0.92, p=0.007) were related to depression levels.ConclusionsSeparation as acculturation style is associated with higher levels of depressive symptoms (for both genders). Gender-sensitive health promotion programs should target separated migrants to improve their integration into the German society.

Dementia in People with a Turkish Migration Background: Experiences and Utilization of Healthcare Services.

Background:As the proportion of older people with migration background (PwM) increases, the proportion of older PwM with dementia might also increase. Dementia is underdiagnosed in this group and a large proportion of PwM with dementia and family caregivers are not properly supported. Healthcare utilization is lower among older migrant populations. Thus, a better understanding of how PwM and family caregivers perceive their situation and how they experience healthcare services is needed to improve utilization of the healthcare system.Objective:Analyze how family caregivers of PwM with dementia experience their situation, why healthcare services are utilized less often, and what can be done to reverse this.Methods:Eight semi-structured interviews were conducted with people with Turkish migration background caring for PwM with dementia. Qualitative content analysis was used for data analysis.Results:Daily care was performed by one family member with the support of others. Healthcare services were used by most participants. Participants identified a need for better access to relevant information and incorporation of Turkish culture into healthcare services.Conclusion:PwM face similar challenges in taking care of persons with dementia as those without migration background. There is a willingness to use services, and services embracing Turkish culture would help to reduce hesitance and make affected people feel more comfortable, thereby increasing utilization and satisfaction. A limitation of this study is that participants were already connected to health services, which may not reflect the help-seeking behavior of those in the Turkish community who are not involved in healthcare.