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Crossing cultures: health promotion for senior migrants in the Netherlands.

A health promotion programme focusing on the meaning of everyday activities was implemented and evaluated to test its usefulness for community-dwelling seniors in the Netherlands. To evaluate how senior migrants with a Surinamese-Hindustani background and professionals received the programme, and how it could be contextualized and improved in line with their values and expectations. A responsive evaluation methodology was followed to foster reflexive learning in and among stakeholders as the basis for programme contextualization. The evaluation consisted of three phases. Outcomes of former phases served as input for subsequent phases. Methods included interviews and focus groups with seniors and professionals. Open and selective coding techniques were used to analyse the interactively derived data. A. small group of women was interested and followed the programme. It was not individual concerns or daily life problems that dominated, but the wish to become well informed, to maintain functional capacities and to continue their roles in the family and community. Striking differences in perspectives between professionals and migrants related to conflict between the underlying Western values of the programme (independence, personal control and autonomy) and the values of the migrants (interdependence, predestination, rebirth and destiny). Awareness among professionals of their own cultural background and the values of the migrant seniors was enhanced, but adapting the programme to the local context and values appeared far more complicated than originally expected. Adaptation requires intensive collaboration with participants and cultural brokers in the community.