First-generation Turkish immigrants' views and preferences on cardiovascular disease prevention in primary care - a qualitative study in the Netherlands

Objectives: First-generation Turkish migrants in the Netherlands face higher cardiovascular risk and are disproportionately affected by cardiovascular disease (CVD) compared to the Dutch host population. To improve prevention in primary care, we explored their views and preferences on cardiovascular prevention. Design: We conducted a qualitative study by interviewing first-generation Turkish migrants in The Netherlands. Semi-structured interviews and focus groups, conducted in Dutch or Turkish, were analyzed using thematic analysis. Results: We conducted 26 individual interviews and two sex-stratified focus group sessions. Participants were aware of CVD risk factors and related health hazards but struggled to adopt a healthy lifestyle, as family obligations, household responsibilities, and work often took precedence over personal health. All participants identified language barriers as a significant challenge, but opinions varied on whether it was necessary for GPs to understand Turkish culture. Some felt this was unnecessary, viewing GPs primarily as medical decision-makers or intermediaries for referrals to other (para)medics, with lifestyle advice outside their professional scope. They emphasized that GPs should ask openly about lifestyle rather than assuming that behaviours associated with a Turkish cultural background play a role. Conclusions: First-generation Turkish migrants in the Netherlands were aware of CVD risk, but personal responsibilities posed challenges in adopting a healthy lifestyle. Although views on the importance of GPs understanding Turkish culture varied, participants agreed that GPs should ask openly about lifestyle rather than assuming cultural relevance in cardiovascular prevention.