Addi van Bergen

Cross-cultural validity of the Dutch version of the SEI-HS 99 5 Figure 1. Flowchart study design. I Quantitative phase Data collection The quantitative data were collected by the Public Health Services of the four largest cities in the Netherlands, as part of the Public Health Monitor (PHM) 2012. The PHM is a nationwide self-report survey of non-institutionalised adults aged 19 years or older, conducted every four years. To ensure that elderly and people living in neighbourhoods with a low socioeconomic status were well represented, stratified samples were drawn by Statistics Netherlands, based on age and neighbourhood. In total 71,627 residents of Amsterdam, Rotterdam, The Hague and Utrecht were invited to participate. Non-responders received two written reminders, and in the case of non- Western immigrants, an extra telephone call or home visit. Questionnaires in Turkish, Moroccan Arabic and English translation could be used and trained interviewers were available to assist respondents face-to-face or by phone in their preferred language (Dutch, Arabic, Berber, Turkish or English). The response rate was 40% (Surinamese 28%, Moroccan 26%, Turkish 26%, Dutch 48%). Statistics Netherlands enriched the PHM data with information on zip code, migration background and standardised household income [35]. Participation in the research was anonymous and voluntary. In accordance with the Dutch Law, participants were informed by letter that by completing the questionnaire they consent with anonymous use of data for research. Measurement Social exclusion. The SEI-HS consists of 17 items which measure four dimensions and an overall index of SE [24]. The four dimensions are: 1) lack of social participation, 2) material deprivation, 3) inadequate access to basic social rights and 4) lack of normative integration. Scores on the index and the four dimensions are categorised into ‘little or no’, ‘some’ and ‘moderate to strong’ exclusion. The SEI-HS was validated in the general Dutch population. The items were derived from various validated questionnaires such as the Loneliness scale of De Jong