Does stimulating self-care increase self-care behaviour for minor illnesses of Dutch and Turkish inhabitants of a deprived area?

A large number of interventions have been applied to stimulate medical self-care in an attempt to reduce medical care-seeking behaviour. It is not clear why some interventions led to success, whereas others failed. Moreover, it is not known whether success was due to an increase of self-care behaviour, because self-care behaviour in itself was practically never used as an outcome measure. AIM: The aim of the present study was to examine whether self-care behaviour increases after an intervention aimed to reduce care-seeking behaviour by stimulating self-care behaviour for minor illnesses of Turkish and Dutch inhabitants of a deprived area in the government city of the Netherlands, and to see whether there are cultural differences. Design: This longitudinal study was based on a "pre-test/post-test one group" design. Method: Data were collected during three structured face-to-face interviews: before, six months and one year after the intervention, in which participants were asked to report their self-care actions during the six months preceding each interview. Also, the TpB was applied. Intervention: GPs personally handed out booklets to their patients containing guidelines on the management of 12 minor illnesses. Each guideline consisted of a description of the minor illness, advice on when to seek help, and suggestions for self-treatment. Results: The number of self-reported self-care actions did not increase. The number of consultations for minor illnesses however, decreased. The Turkish participants showed the strongest reduction of formal health care utilisation, but they also reported a decrease in number of self-care actions. Furthermore their attitude towards self-care became more negative and they perceived less control. The number of self-reported self-care actions of the Dutch increased, their attitude and their perception of control over self-care increased, but they only reported less consultations for minor illnesses during the first six months of the study. Conclusion: The intervention was most effective to the Turkish participants, but its consequences were reverse to what was expected: their self-care behaviour decreased! Obvious stimulating self-care in itself does not lead to a reduction in formal health care utilisation, there must be other factors responsible for the effectiveness of self-care stimulating interventions.