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Denford S, Holt L, Essery R, Kesten J, Cabral C, Weston D, Horwood J, Hickman M, Amlôt R, Yardley L. Engagement in rapid public health research among young people from underserved communities: maximising opportunities and overcoming barriers. BMC Public Health 2024; 24:2217. [PMID: 39143472 PMCID: PMC11325622 DOI: 10.1186/s12889-024-19762-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 08/12/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Inclusion in public health research of young people from low-income households and those from minority ethnic groups remains low. It is recognised that there is a need to change the way in which research is conducted so that it becomes more inclusive. The aim of this work was to identify novel and innovative ways to maximise recruitment and inclusion of diverse participants when doing co-production within very short time frames for emergency responses. METHOD We conducted interviews with young people from low-income and minority ethnic backgrounds, and members or leaders of groups or organisations supporting or representing young people from underserved communities. RESULTS A total of 42 participants took part in an interview. This included 30 young people from low income or minority ethnic backgrounds and 12 community leaders/service providers. Of the 30 young people, 26 participants identified as female and 12 participants identified as being from a minority ethnic background. Participants discussed a number of interrelated barriers to research involvement and identified ways in which barriers may be reduced. Prejudice and discrimination experienced by young people from underserved communities has led to substantial mistrust of educational and governmental establishments. Rigid and unfamiliar research practices further limit the involvement of young people. Four themes were identified as ways of supporting involvement, including: making opportunities available for young people, adaptations to research governance, understanding and acknowledging challenges faced by young people, and ensuring reciprocal benefits. CONCLUSION This research explored barriers to engagement in rapid public health co-production. Working with communities to co-produce rapid recruitment and research procedures to suit the needs and the context in which young people live is necessary.
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Affiliation(s)
- Sarah Denford
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK.
- School of Psychological Science, University of Bristol, Bristol, UK.
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK.
| | - Lydia Holt
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
| | - Rosie Essery
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Joanna Kesten
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Christie Cabral
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Dale Weston
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- Behavioural Science and Insights Unit, Health Security Agency, Porton Down, Salisbury, UK
| | - Jeremy Horwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Richard Amlôt
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- Behavioural Science and Insights Unit, Health Security Agency, Porton Down, Salisbury, UK
| | - Lucy Yardley
- School of Psychological Science, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- Academic Unit of Psychology, University of Southampton, Southampton, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Estupiñán Fdez de Mesa M, Marcu A, Ream E, Whitaker KL. Understanding and tackling cancer inequities: What opportunities does intersectionality offer researchers, policymakers, and providers? A scoping review. J Psychosoc Oncol 2024:1-28. [PMID: 39120128 DOI: 10.1080/07347332.2024.2361642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
PROBLEM IDENTIFICATION We summarised the international evidence relating to the role of intersectionality in patients' lived experience of inequities along the cancer care pathway. We produced guidance to use intersectionality in future research. LITERATURE SEARCH We included 42 articles published between 1989 to 2023 that used intersectionality to guide the study and interpretation of inequities in cancer care. DATA EVALUATION/SYNTHESIS Articles predominantly comprised North American (n = 37), followed by European (n = 4) and Asian (n = 1) studies. Similar compounding effects of racism, homophobia, and discrimination across countries exacerbated inequities in cancer care experience and cancer outcomes particularly for women of color and sexual/gender minority groups. Professionals' knowledge, attitudes, and behaviors toward minoritised groups affected patient-provider relationships and influenced cancer patients' psychosocial responses. CONCLUSION Intersectionality provides a framework to assess the personal, interpersonal, and structural processes through which cancer inequities manifest within and across countries.
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Affiliation(s)
| | - Afrodita Marcu
- School of Health Sciences, University of Surrey, Guildford, Surrey, UK
| | - Emma Ream
- School of Health Sciences, University of Surrey, Guildford, Surrey, UK
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Stevens M, Brimblecombe N, Gowen S, Skyer R, Moriarty J. Young carers' experiences of services and support: What is helpful and how can support be improved? PLoS One 2024; 19:e0300551. [PMID: 38551988 PMCID: PMC10980198 DOI: 10.1371/journal.pone.0300551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/28/2024] [Indexed: 04/01/2024] Open
Abstract
Globally, many children and young people provide support to family members who have poor physical or mental health, are disabled, or misuse drugs and alcohol. These young carers are at higher risk of poorer education, employment, health, and social participation outcomes compared to their peers without caring responsibilities. In the UK, awareness of the challenges faced by young carers, and a framework of their legal rights, are relatively well-developed. However, it is unclear how support can most effectively be provided. Taking a qualitative approach we explored experiences and views of young carers (aged 9-25), conducting focus groups or interviews with 133 young carers and 17 parent care recipients. We explored what aspects of services and support are seen as helpful, valued, and acceptable to young people, and what could be improved. A reflexive, thematic analysis was conducted. Valued support came from: young carers groups (including peer support), school-based and mental health support, and support for the care recipient. Helpful aspects of support included someone who listens and understands, and can be trusted not to break confidentiality; involving the young person in information, decision-making and planning (sometimes including regarding the care recipient); and finding and linking to other services. There was a difficult balance for practitioners between being perceived as proactive, persistent or intrusive when offering support to a young carer, but it was important to allow opportunities for young carers, and those they care for, to change their minds about when and whether to access support. Many interactions were perceived as unhelpful or threatening to the family, and there was often not enough of the type of support that was valued. Sharing of positive experiences can be beneficial for both people seeking support and those delivering it; key messages on what is helpful from the perspective of young carers can help support and shape practice approaches.
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Affiliation(s)
- Madeleine Stevens
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Nicola Brimblecombe
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Sara Gowen
- Sheffield Young Carers, Sheffield, South Yorkshire, United Kingdom
| | - Robin Skyer
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Jo Moriarty
- NIHR Health & Social Care Workforce Research Unit, King’s College London, London, United Kingdom
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Guerrero Z, Civišová D, Winkler P. Mental health and access to care among the Roma population in Europe: A scoping review. Transcult Psychiatry 2024; 61:118-130. [PMID: 37769608 DOI: 10.1177/13634615231200853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The Roma are Europe's largest ethnic minority group, and often face discrimination and social exclusion. Social strife and lack of access to healthcare are associated with increased symptoms of psychopathology. We aimed to review evidence on mental health outcomes and on access to mental healthcare among the Roma population in Europe. We systematically searched five databases (PsycINFO, Global Health, Social Policy and Practice, Web of Science and PubMed) and conducted a grey literature search in August 2020. We identified 133 studies, 26 of which were included for final analysis. We present the results using a narrative synthesis. The available literature indicates a relatively high prevalence of anxiety, depression and substance abuse among Roma, and females seem to be more affected than males. Roma children exhibit more externalizing and internalizing disorders when compared with non-Roma children. Mental health and perceived well-being among the Roma population are strongly linked to social determinants of health such as housing or economic income. Access to mental healthcare is limited for Roma people because of several barriers pertaining to language, lack of information regarding available services, and the insurance and economic status of Roma people. Roma people report mainly negative experiences with mental health services, including a lack of understanding from healthcare providers, and instances of racism and discrimination. There is a need for more research on mental health and access to healthcare in Roma people. Future studies should be participatory in order to provide guidelines for mental healthcare that addresses the needs of the Roma population.
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Affiliation(s)
- Zoe Guerrero
- National Institute of Mental Health, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development
| | - Dagmar Civišová
- National Institute of Mental Health, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development
| | - Petr Winkler
- National Institute of Mental Health, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development
- King's College London
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Hilário AP, Scavarda A, Numerato D, Mendonça J, Cardano M, Marhankova J, Gariglio L, Vuolanto P, Anderson A, Auvinen P, Bracke P, Douglass T, Hobson-West P, Lermytte E, Polak P, Rudek T. Recruiting a Hard-to-Reach, Hidden and Vulnerable Population: The Methodological and Practical Pitfalls of Researching Vaccine-Hesitant Parents. QUALITATIVE HEALTH RESEARCH 2023; 33:1189-1202. [PMID: 37671951 PMCID: PMC10626983 DOI: 10.1177/10497323231196439] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
While recruitment is an essential aspect of any research project, its challenges are rarely acknowledged. We intend to address this gap by discussing the challenges to the participation of vaccine-hesitant parents defined here as a hard-to-reach, hidden and vulnerable population drawing on extensive empirical qualitative evidence from seven European countries. The difficulties in reaching vaccine-hesitant parents were very much related to issues concerning trust, as there appears to be a growing distrust in experts, which is extended to the work developed by researchers and their funding bodies. These difficulties have been accentuated by the public debate around COVID-19 vaccination, as it seems to have increased parents' hesitancy to participate. Findings from recruiting 167 vaccine-hesitant parents in seven European countries suggest that reflexive and sensible recruitment approaches should be developed.
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Affiliation(s)
| | - Alice Scavarda
- Dipartimento di Culture Politica e Società, Universita Degli Studi Di Torino, Torino, Italy
| | - Dino Numerato
- Fakulta sociálních, Univerzita Karlova, Praha, Czech Republic
| | - Joana Mendonça
- Instituto de Ciências Sociais da Universidade de Lisboa, Lisboa, Portugal
| | - Mario Cardano
- Dipartimento di Culture Politica e Società, Universita Degli Studi Di Torino, Torino, Italy
| | | | - Luigi Gariglio
- Dipartimento di Culture Politica e Società, Universita Degli Studi Di Torino, Torino, Italy
| | - Pia Vuolanto
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Alistair Anderson
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Petra Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Piet Bracke
- Department of Sociology, Ghent University, Gent, Belgium
| | - Tom Douglass
- Department of Social Work & Social Care, University of Birmingham, Birmingham, UK
| | - Pru Hobson-West
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | | | - Paulina Polak
- Instytut Socjologii, Uniwersytet Jagiellonski, Krakow, Poland
| | - Tadeusz Rudek
- Instytut Socjologii, Uniwersytet Jagiellonski, Krakow, Poland
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O'Regan P, Walshe N, Jordaan G, Landers M, Condon C. Inequality in Health Care and the Experiences of Women From the Irish Traveller Community. Nurs Womens Health 2023; 27:362-371. [PMID: 37562461 DOI: 10.1016/j.nwh.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/28/2023] [Accepted: 06/15/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To explore the health care experiences of women from the Irish Traveller community, which is an indigenous ethnic minority group in Ireland and Great Britain. DESIGN A descriptive qualitative methodology underpinned by naturalistic inquiry was adopted. SETTING Halting sites where the participating Traveller women permanently reside. PARTICIPANTS The sample consisted of 24 women from the Traveller community in Ireland. INTERVENTION/MEASUREMENT Data were collected via two focus group interviews using semi-structured interviews. Inductive content analysis was used to analyze the data. RESULTS Three overarching themes emerged: Conceptualizing What It Means to Be in Receipt of Health Care; Respecting Ethnic Customs Around Death and Dying; and Strategies for Enhancing Cultural Competence. Women from the Traveller community experienced many challenges when requiring health care services. Some recalled a health care environment that lacked compassion and was discriminatory toward them. A lack of dignity and privacy afforded to women during the "passing" of a loved one was an important finding in this study. CONCLUSION Strategies to improve Traveller women's access to and engagement with health services are urgently required. These include cultural awareness training for health care providers and visual aids for Travellers accessing health services.
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Affiliation(s)
- Patricia O'Regan
- Brookfield Health Sciences Complex, University College Cork, Ireland
| | - Nuala Walshe
- Brookfield Health Sciences Complex, University College Cork, Ireland
| | - Gretchen Jordaan
- Brookfield Health Sciences Complex, University College Cork, Ireland
| | - Margaret Landers
- Brookfield Health Sciences Complex, University College Cork, Ireland.
| | - Carol Condon
- Brookfield Health Sciences Complex, University College Cork, Ireland
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Mahony LO, Shea EO, O'Connor EM, Tierney A, Harkin M, Harrington J, Kennelly S, Arendt E, O'Toole PW, Timmons S. 'Good, honest food': older adults' and healthcare professionals' perspectives of dietary influences and food preferences in older age in Ireland. J Hum Nutr Diet 2023; 36:1833-1844. [PMID: 37525412 DOI: 10.1111/jhn.13216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND This study aimed to explore older adults' and healthcare professionals' (HCPs) perceptions of dietary influences and food preferences in older age. METHODS The research design was phenomenological qualitative description. Semistructured one-to-one interviews and focus groups were held separately with community-dwelling older adults and HCPs involved in care of the older person in Ireland. Data were analysed using inductive thematic analysis. RESULTS A total of 47 adults aged 55+ years were recruited (50% male; 49% aged 60-69 years; 28% aged above 70 years), and 26 HCPs were involved, comprising dietitians (n = 8); geriatricians (n = 6); clinical therapists (n = 4); and nurses, pharmacists, catering managers and meal delivery service coordinators (n = 2 each). There are strong desires for 'good, honest food' within the diet for an older person; however, gaps in current nutrition priorities, dietary guidance and health promotion were perceived. There were differences in the perspectives held by HCPs and adults aged 55+ years, as some HCPs centred their discussion around nutrition for preventing sarcopenia, frailty or cognitive decline, whereas many adults aged 55+ years desired foods which promote cardiometabolic health and reflect wider personal health and environmental values. Other themes included the impact of health and lifestyle changes accompanying ageing on dietary priorities, the importance of personal and psychosocial values in determining food choice and the impact of the external food environment on accessibility and shopping experiences. CONCLUSIONS Influences on dietary choice for the older person are multifactorial, driven by a range of health, psychological, sociocultural and environmental perspectives. Future nutrition priorities for older adults should encourage health-promoting approaches and not just disease-mitigating efforts.
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Affiliation(s)
- Lauren O Mahony
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Emma O Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Eibhlís M O'Connor
- Department of Biological Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- APC Microbiome Ireland, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
| | - Audrey Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | - Sharon Kennelly
- National Primary Care Strategy and Planning, Health Service Executive, Cork, Ireland
| | - Elke Arendt
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Paul W O'Toole
- APC Microbiome Ireland, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
- School of Microbiology, University College Cork, Cork, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
- APC Microbiome Ireland, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
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Renedo A, Stuart R, Kühlbrandt C, Grenfell P, McGowan CR, Miles S, Farrow S, Marston C. Community-led responses to COVID-19 within Gypsy and Traveller communities in England: A participatory qualitative research study. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 3:100280. [PMID: 37200551 PMCID: PMC10156409 DOI: 10.1016/j.ssmqr.2023.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/31/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
Individuals were asked to play an active role in infection control in the COVID-19 pandemic. Yet while government messages emphasised taking responsibility for the public good (e.g. to protect the National Health Service), they appeared to overlook social, economic and political factors affecting the ways that people were able to respond. We co-produced participatory qualitative research with members of Gypsy and Traveller communities in England between October 2021 and February 2022 to explore how they had responded to COVID-19, its containment (test, trace, isolate) and the contextual factors affecting COVID-19 risks and responses within the communities. Gypsies and Travellers reported experiencing poor treatment from health services, police harassment, surveillance, and constrained living conditions. For these communities, claiming the right to health in an emergency required them to rely on community networks and resources. They organised collective actions to contain COVID-19 in the face of this ongoing marginalisation, such as using free government COVID-19 tests to support self-designed protective measures including community-facilitated testing and community-led contact tracing. This helped keep families and others safe while minimising engagement with formal institutions. In future emergencies, communities must be given better material, political and technical support to help them to design and implement effective community-led solutions, particularly where government institutions are untrusted or untrustworthy.
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Affiliation(s)
- Alicia Renedo
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Rachel Stuart
- College of Business, Arts and Social Sciences, Brunel University London, Kingston Lane, Middlesex, UB8 3PH, UK
| | - Charlotte Kühlbrandt
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Pippa Grenfell
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Catherine R. McGowan
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Sam Miles
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | | | - Cicely Marston
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Martyn E, Eisen S, Longley N, Harris P, Surey J, Norman J, Brown M, Sultan B, Maponga TG, Iwuji C, Flanagan S, Ghosh I, Story A, Matthews PC. The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda. eLife 2023; 12:e81070. [PMID: 36757862 PMCID: PMC9910830 DOI: 10.7554/elife.81070] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023] Open
Abstract
Hepatitis B virus (HBV) infection represents a significant global health threat, accounting for 300 million chronic infections and up to 1 million deaths each year. HBV disproportionately affects people who are under-served by health systems due to social exclusion, and can further amplify inequities through its impact on physical and mental health, relationship with stigma and discrimination, and economic costs. The 'inclusion health' agenda focuses on excluded and vulnerable populations, who often experience barriers to accessing healthcare, and are under-represented by research, resources, interventions, advocacy, and policy. In this article, we assimilate evidence to establish HBV on the inclusion health agenda, and consider how this view can inform provision of better approaches to diagnosis, treatment, and prevention. We suggest approaches to redress the unmet need for HBV interventions among excluded populations as an imperative to progress the global goal for the elimination of viral hepatitis as a public health threat.
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Affiliation(s)
- Emily Martyn
- The Francis Crick InstituteLondonUnited Kingdom
- London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Sarah Eisen
- Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Nicky Longley
- London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
- Department of Infectious Diseases, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Philippa Harris
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Julian Surey
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
- Institute of Global Health, University College LondonLondonUnited Kingdom
- Universidad Autonoma de Madrid, Ciudad Universitaria de CantoblancoMadridSpain
| | - James Norman
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Michael Brown
- London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Department of Infectious Diseases, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Binta Sultan
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
- Mortimer Market Centre, Central and North London NHS Foundation TrustLondonUnited Kingdom
| | - Tongai G Maponga
- Stellenbosch University, Faculty of Medicine and Health SciencesTygerbergSouth Africa
| | - Collins Iwuji
- Department of Global Health, Brighton and Sussex Medical School, University of SussexBrightonUnited Kingdom
- Africa Health Research InstituteDurban, KwaZulu-NatalSouth Africa
| | - Stuart Flanagan
- Mortimer Market Centre, Central and North London NHS Foundation TrustLondonUnited Kingdom
| | - Indrajit Ghosh
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
- Mortimer Market Centre, Central and North London NHS Foundation TrustLondonUnited Kingdom
| | - Alistair Story
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
- Collaborative Centre for Inclusion Health, University College LondonLondonUnited Kingdom
| | - Philippa C Matthews
- The Francis Crick InstituteLondonUnited Kingdom
- Department of Infectious Diseases, University College London Hospitals NHS Foundation TrustLondonUnited Kingdom
- Mortimer Market Centre, Central and North London NHS Foundation TrustLondonUnited Kingdom
- Division of Infection and Immunity, University College LondonLondonUnited Kingdom
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How Did the COVID-19 Pandemic and Digital Divide Impact Ciganos/Roma School Pathways? SOCIAL SCIENCES 2023. [DOI: 10.3390/socsci12020086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
The COVID-19 pandemic forced the Portuguese government to declare various lockdowns between 2020 and 2022. The first State of Emergency was enforced in March 2020, in which face-to-face classroom teaching was repeatedly interrupted. At that time, families were expected to provide the necessary supplies for digital learning, with some support from the government, municipalities, civil society, and local institutions. Nevertheless, many families already lived under precarious conditions before the pandemic, and so the lockdown measures increased their vulnerability, with a probable impact on student school attendance and conditions enabling academic success. Since Ciganos/Roma are part of this vulnerable population, we intend to explore how the COVID-19 pandemic impacts the school pathways of these students, namely in secondary education, where they represent a minority group. The data are derived from a variety of qualitative sources collected during research carried out in the two Metropolitan Areas in Portugal. The COVID-19 pandemic affected the youngsters’ access to classes and their motivation to attend school, and opens the discussion about how because of the government’s universal measures, by failing to consider social diversity, in particular Ciganos/Roma Ciganos/Roma families, this pandemic crisis may disproportionally affect the education of their children and youth. The findings highlight, firstly, that these impacts continue to be rendered invisible and naturalized in the public sphere and, secondly, that the measures and legislation underlying the pandemic effects continue not to include Ciganos in policymaking processes.
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O’Mahony L, O’Shea E, O’Connor EM, Tierney A, Harkin M, Harrington J, Kennelly S, Arendt E, O’Toole PW, Timmons S. Older adults and healthcare professionals have limited awareness of the link between the Mediterranean diet and the gut microbiome for healthy aging. Front Nutr 2023; 10:1104238. [PMID: 36776602 PMCID: PMC9911522 DOI: 10.3389/fnut.2023.1104238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives Strategies to improve the gut microbiome through consuming an improved diet, including adopting the Mediterranean Diet (MD), may promote healthy aging. We explored older adults' and healthcare professionals' (HCPs) perspectives of the MD, gut health, and microbiome for their role in healthy aging. Design Phenomenological qualitative. Setting Community-dwelling older adults and HCPs in primary and secondary care in Ireland. Participants Older adults (aged 55 + years), recruited through social, retirement and disease-support groups. HCPs recruited through researcher networks and professional associations. Measurements Semi-structured 1:1 interviews and focus groups (FGs) conducted remotely with older adults and HCPs separately. Interviews/FGs were recorded, transcribed, and coded using inductive thematic analysis. Results Forty-seven older adults were recruited (50% male; 49% aged 60-69 years; 28% 70 +), and 26 HCPs including dietitians (n = 8); geriatricians (n = 6); clinical therapists (n = 4); nurses, pharmacists, catering managers, and meal-delivery service coordinators (n = 2 each). Older adults considered the MD "a nice way to enjoy food," good for cardiovascular health and longevity, but with accessibility and acceptability challenges (increased salads/fish, different food environments, socio-cultural differences). HCPs felt the MD is included in healthy eating advice, but not overtly, mostly through the promotion of mixed-fiber intake. Older adults considered "live" yogurt and probiotics, and to a lesser extent fiber, to maintain a "healthy gut," suggesting the gut has "something to do with" cognitive and digestive health. Overall, microbiota-health effects were considered "not common knowledge" among most older adults, but becoming more topical among both professionals and the public with advancing scientific communication. Conclusion While "gut health" was considered important, specific effects of the MD on gut microbiota, and the significance of this for healthy aging, was under-recognized. Future efforts should explain the importance to older adults of maintaining the gut microbiota through diet, while appreciating perspectives of probiotic products and supplements.
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Affiliation(s)
- Lauren O’Mahony
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Emma O’Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Eibhlís M. O’Connor
- Department of Biological Sciences, University of Limerick, Limerick, Ireland,Health Research Institute, University of Limerick, Limerick, Ireland,APC Microbiome Ireland, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
| | - Audrey Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland,Health Implementation Science and Technology Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | - Sharon Kennelly
- National Primary Care Strategy and Planning, Health Service Executive, Dublin, Ireland
| | - Elke Arendt
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Paul W. O’Toole
- APC Microbiome Ireland, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland,School of Microbiology, University College Cork, Cork, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland,APC Microbiome Ireland, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland,*Correspondence: Suzanne Timmons,
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12
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Laranjeira C, Piaça I, Vinagre H, Vaz AR, Ferreira S, Cordeiro L, Querido A. Vulnerability through the Eyes of People Attended by a Portuguese Community-Based Association: A Thematic Analysis. Healthcare (Basel) 2022; 10:healthcare10101819. [PMID: 36292265 PMCID: PMC9601330 DOI: 10.3390/healthcare10101819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Vulnerability is associated with the individual’s social and biological conditions, but also the conditions of their enveloping environment and society, leading to terms such as vulnerable populations or risk groups. This study aimed to give a voice to people with experiences of vulnerability and explore their perspectives, using a descriptive qualitative design. Purportedly vulnerable adults were recruited and interviewed with semi-structured questions on vulnerability. Data were organized, using WebQDA software, and submitted to thematic content analysis, as proposed by Clark and Braun, which generated a thematic tree. The study included six men and six women with a mean age of 43.8 [SD = 14.17] years old. Thematic analysis generated three themes: (1) Conceptions about vulnerability, (2) Barriers imposed by vulnerability, and (3) Strategies for dealing with vulnerability. The results highlight that vulnerability is a highly dynamic process of openness to circumstances that influence individual outcomes. However, there is a lack of conceptual clarity. Although being vulnerable is perceived as something negative, we need to transform the social mindset, because vulnerability also has the potential to change priorities in life for the better.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André—66–68, 2410-541 Leiria, Portugal
- Research in Education and Community Intervention (RECI I&D), Piaget Institute, 3515-776 Viseu, Portugal
- Correspondence:
| | - Inês Piaça
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Henrique Vinagre
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Ana Rita Vaz
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Sofia Ferreira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Lisete Cordeiro
- InPulsar (Associação para o Desenvolvimento Comunitário), Rua José Gonçalves LT 55—LJ 3 PISO-1, 2410-121 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André—66–68, 2410-541 Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
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13
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Sobitan T. Understanding the experiences of school belonging amongst secondary school students with refugee backgrounds (UK). EDUCATIONAL PSYCHOLOGY IN PRACTICE 2022. [DOI: 10.1080/02667363.2022.2084042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Tunde Sobitan
- South Tyneside Educational Psychology Service (EPS), South Shields, UK
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14
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Lai C, Rossi LE, Scicchitano F, Ciacchella C, Valentini M, Longo G, Caroppo E. Motherhood in Alternative Detention Conditions: A Preliminary Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106000. [PMID: 35627538 PMCID: PMC9140378 DOI: 10.3390/ijerph19106000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022]
Abstract
Many women in detention are mothers and often the sole caregivers of their children. Italy, as most European countries, allows mothers to keep their children with them in detention, with the aim of preserving the fundamental bond between mother and child. Since prison does not seem to provide a good environment for the child’s growth, there are different alternative residential solutions, such as Group Homes. The aim of this preliminary study was to explore the differences between mothers living in detention through alternative measures with their children and mothers who are not detained regarding parenting stress, child behavior from the parent’s perspective, and maternal attachment. Twelve mothers were enrolled in this study, divided equally between the detained and the control groups. Both groups’ participants completed a three-questionnaire battery in order to assess parenting stress, child’s behavior, and maternal attachment. The analyses of variance showed significant differences between the two groups, with the detained group reporting higher scores than the control group in almost all the subscales of parenting stress. The results highlighted that imprisoned mothers might experience more stress than the general population. There is a need to design intervention programs to support parenting in detention.
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Affiliation(s)
- Carlo Lai
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, 00185 Rome, Italy; (L.E.R.); (F.S.); (C.C.)
- Correspondence:
| | - Linda Elisabetta Rossi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, 00185 Rome, Italy; (L.E.R.); (F.S.); (C.C.)
| | - Federica Scicchitano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, 00185 Rome, Italy; (L.E.R.); (F.S.); (C.C.)
| | - Chiara Ciacchella
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, 00185 Rome, Italy; (L.E.R.); (F.S.); (C.C.)
| | - Mariarita Valentini
- Research Center Health Human Care and Social Intercultural Assessment-He.R.A, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Satis-Centre for Clinical Psychology, 00198 Rome, Italy
| | - Giovanna Longo
- Associazione A Roma, Insieme Leda Colombini, 00186 Rome, Italy;
| | - Emanuele Caroppo
- Department of Mental Health, Local Health Unit Roma 2, 00159 Rome, Italy;
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O'Neill E, Abdul-Razak N, Anastasova Z, O'Callaghan C. Case series: Psychosocial challenges of female youth within the Irish Travelling community. Int J Soc Psychiatry 2022; 68:681-685. [PMID: 34806460 DOI: 10.1177/00207640211057795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Irish Travelling community are an ethnic minority group known for their distinct identity, traditions and language. Although this group has its roots in Ireland, they are marginalised and discriminated against by every part of Irish society. Irish Travellers are a group who are vulnerable to exclusion and experience health, economic and educational inequalities. Young female Irish Travellers in Ireland are highly susceptible to mental illnesses which makes the engagement of this ethnic group by healthcare services important. AIMS To review the cases of three female adolescents from the Irish Travelling community living in Ireland with a focus on their psycho-social difficulties. Complete a literature review, to complement and inform the three cases reviewed, on the socio-cultural and mental health challenges which effect adolescent females in the Irish Travelling community. METHODS Case series with literature search and review of relevant published articles using a keyword search of databases PubMed, PsycINFO and HSE protocols and reports. Hand searching of relevant references utilised. Informed signed consent obtained from each patient attending child and adolescent services in Ireland. Signed parental consent also obtained. Written consent obtained due to the use of patient history and assessments in the case series. RESULTS Adolescent females within the Irish Travelling community encounter particular difficulties within the moral constraints and expectations of this community. They encounter specific issues including mental illness, sexual stigma, domestic violence and limitations to the role of women. The three cases outlined give representative examples of the challenges faced by adolescent females within the Travelling community. CONCLUSIONS Psychiatric services need to be aware of this vulnerable group and focus on the recognition of their needs within the context of their community.
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Affiliation(s)
- Eimear O'Neill
- Eist Linn Child and Adolescent Unit, Bessborough, Blackrock, Cork, Ireland
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16
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Condon L, Curejova J, Leeanne Morgan D, Miles G, Barry D, Fenlon D. Public involvement in participatory research: the experiences of peer interviewers from Roma, Gypsy and Traveller communities. Nurse Res 2022; 30:17-23. [PMID: 35112515 DOI: 10.7748/nr.2022.e1818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND A vital component of research is patient and public involvement (PPI). The challenges of PPI increase when conducting cross-cultural research into sensitive subjects with marginalised ethnic minority groups. AIM To present the authors' reflections on conducting peer interviews with members of Roma, Gypsy and Traveller communities. DISCUSSION The authors provide examples of reflections on collecting data from a participatory research project that explored Gypsies, Roma and Travellers' experiences of cancer in their communities. They derived the reflections from audio-recorded, post-interview debriefs with co-researchers from the same ethnic backgrounds as interviewees ('peer researchers'). The main challenges for the peer researchers were cultural, linguistic and pragmatic, all fundamentally related to exploring a sensitive health topic through the lens of ethnicity. CONCLUSION Peer researchers recognised their role in building bridges between participants and the research team. They did this by establishing a relationship of trust, minimising distress, representing the views of their communities and obtaining data to meet the aims of the project. Peer researchers perform multiple roles to assist in cross-cultural data collection in participatory research. IMPLICATIONS FOR PRACTICE This article highlights underexplored aspects of peer researchers' work that have implications for the planning and conduct of cross-cultural research with marginalised groups.
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Affiliation(s)
- Louise Condon
- College of Human and Health Sciences, Swansea University, Swansea, Wales
| | | | | | | | | | - Deborah Fenlon
- College of Human and Health Sciences, Swansea University, Swansea, Wales
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17
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Pakai A, Mihály-Vajda R, Horváthné ZK, Gabara KS, Bogdánné EB, Oláh A, Zrínyi M, Újváriné AS. Predicting cervical screening and HPV vaccination attendance of Roma women in Hungary: community nurse contribution is key. BMC Nurs 2022; 21:36. [PMID: 35093051 PMCID: PMC8801086 DOI: 10.1186/s12912-022-00813-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 12/21/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND HPV screening/vaccination has been observed lower for ethic minorities. Understanding factors that predict and can improve attendance is therefore key. Hence, the aim was to identify causes, especially concerning the quality of the patient-provider relationship, that predict past HPV screening and vaccination turnout of Roma women in Hungary. METHODS Cross-sectional research design with self-developed, culturally sensitive questionnaire. A final, female Roma sample of 368 participants was randomly selected from census register. Community nurses contacted participants and distributed surveys. Surveys were mailed-in by participants. Bivariate logistic regression was used to predict former participation in HPV screening/vaccination. RESULTS Of the total sample, 17.4% of women attended at least one cervical screening and HPV vaccination in the past. Bad screening experience was positively associated with racially unfair behaviors of physicians. The odds of past attendance were 4.5 times greater if 'no negative earlier experience' occurred, 3.3 times likelier if community nurse performed screening/immunization and 1.6 times more probable if respondent felt 'no shame'. Evaluating the screening/vaccination process painful, being only financially motivated and attendance involving a lot of travel decreased the odds of 'no show' by 50%, 40% and 41%, respectively. CONCLUSIONS When considering the ratio of past cervical screening attendance, we conclude that our female Roma sample did not behave differently from the general population. We saw no evidence that racial mistreatment made any contribution to explaining cervical screening participation. Past positive screening experience and the quality of patient-provider relationship increased the odds of participation the most. Cancer of friends, pain, financial motivation and travel distance decreased odds of participation to a lesser extent. In order to improve future screening and immunization, community nurses should play more central and advanced role in the organization and implementation of such services specifically targeting Roma populations.
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Affiliation(s)
- Annamária Pakai
- grid.9679.10000 0001 0663 9479Szombathely University Campus, Faculty of Health, University of Pécs, Pécs, Hungary
| | - Réka Mihály-Vajda
- grid.9679.10000 0001 0663 9479Faculty of Health Sciences, Institute of Health Insurance, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Kívés Horváthné
- grid.9679.10000 0001 0663 9479Faculty of Health Sciences, Institute of Health Insurance, University of Pécs, Pécs, Hungary
| | | | - Eszter Basa Bogdánné
- grid.9679.10000 0001 0663 9479Kaposvár Campus, University of Pécs, Pécs, Hungary
| | - András Oláh
- grid.9679.10000 0001 0663 9479Living Lab Based Smart Care Research Center, University of Pécs, Pécs, Hungary
| | - Miklós Zrínyi
- Faculty of Health, University of Pécs, Vörösmarty utca 4, 7621, Pécs, Hungary.
| | - Adrienn Siket Újváriné
- grid.9679.10000 0001 0663 9479Faculty of Health, University of Pécs, Vörösmarty utca 4, 7621 Pécs, Hungary
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18
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O'Connell S, Ruane-McAteer E, Daly C, O’Connor C, Tuomey F, McDonnell L, Arensman E, Andriessen K, Griffin E. Exploring experiences of supports for suicide bereavement in Ireland: protocol for a national survey. HRB Open Res 2022; 4:114. [PMID: 34870092 PMCID: PMC8602958 DOI: 10.12688/hrbopenres.13437.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background A suicide death impacts upon the wellbeing of close family members and friends but has also been shown to affect many people outside of this immediate circle. This will be the first large-scale national study of adults bereaved or affected by suicide in Ireland, using a cross-sectional online survey. The overarching aim will be to gain insight into the experiences of supports received by people bereaved or affected by suicide and to identify the barriers to engagement following their loss. Methods A cross-sectional survey will be conducted among adults in Ireland who have been bereaved or affected by suicide. This project will seek to represent people with different demographics and backgrounds in the Irish population using a multifaceted approach to survey recruitment. A range of validated measures will be used to examine participants’ current wellbeing and grief experience. A combination of closed and open-ended questions will provide participants the opportunity to share their individual experiences, the services and supports available to them, and barriers and enablers to accessing supports. Results Quantitative data will be analysed using descriptive statistics. Chi-squared tests will be used to compare subgroups within categorical data items, and multivariable regression models will be used to examine differences in psychosocial and physical wellbeing across key groups. Qualitative content analysis will be used for qualitative responses to open-ended questions. Conclusions The survey will provide an in-depth understanding of the psychosocial and mental health impacts of suicide bereavement in Ireland; insight into the range of informal and formal supports accessed; and will identify unmet needs and challenges of accessing appropriate and timely supports. The findings will inform current national actions aimed at ensuring the standardisation and quality of the services and supports for those bereaved or affected by suicide.
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Affiliation(s)
- Selena O'Connell
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Eimear Ruane-McAteer
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Caroline Daly
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Clíodhna O’Connor
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Fiona Tuomey
- Healing Untold Grief Groups (HUGG), Dublin, Ireland
| | | | - Ella Arensman
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
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Pérez-Belloso AJ, Montaño-Jiménez P, Algaba-Del-Castillo J, Coheña-Jiménez M. Impact of foot health behavior among ethnic minority populations: A cross-sectional population-based study. Public Health Nurs 2022; 39:736-743. [PMID: 34981857 DOI: 10.1111/phn.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To analyze the impact of the foot health and health behavior and the characteristics of outdoor footwear among minority ethnic groups. DESIGN AND MEASURES A cross-sectional study design using the Foot Health Status Questionnaire: foot pain, foot function, shoe, general foot health, general health, physical activity, social capacity, and vigor. Outcomes included the self-reported type of outdoor footwear and clinical characteristics by sex were collected in 2019-2020. SAMPLE A total of 78 Roma participants self-identified as members of this ethnic minority and 72 participants non-Roma were assessed (n = 150). RESULTS The lower score values was recorded in the footwear and general foot health domains in Roma population. General population obtained higher scores in general health domains. The most common outdoor footwear types were running shoes and walking shoes in non-Roma population, versus flip flops and slippers in Roma population. Clinical characteristics did not show any statistically significant differences (p < .05). CONCLUSION Roma people wear flip flops and slippers and non-Roma people running shoes and walking shoes. These findings reveal cultural differences that make it easier for the Roma population to experience a greater burden of foot health problems. General foot health and foot pain dimensions show statistically significant differences among ethnicity.
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Affiliation(s)
| | - Pedro Montaño-Jiménez
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Seville, Spain
| | | | - Manuel Coheña-Jiménez
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Seville, Spain
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South E, Rodgers M, Wright K, Whitehead M, Sowden A. Reducing lifestyle risk behaviours in disadvantaged groups in high-income countries: A scoping review of systematic reviews. Prev Med 2022; 154:106916. [PMID: 34922995 PMCID: PMC8803546 DOI: 10.1016/j.ypmed.2021.106916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/06/2021] [Accepted: 12/12/2021] [Indexed: 11/20/2022]
Abstract
High prevalence of risk behaviours may exacerbate existing poor health in disadvantaged groups. We aimed to identify and bring together systematic reviews with a focus on reducing risk behaviours in disadvantaged groups and highlight where evidence is lacking. We searched MEDLINE and Embase up to October 2020, with supplementary searching in Epistemonikos and Health Systems Evidence. We included systematic reviews that reported behavioural outcomes and targeted smoking, excessive alcohol use, unhealthy diet, or physical inactivity in groups with the following characteristics: low income or low socio-economic status (SES), unemployed people, homeless people, care leavers, prisoners, refugees or asylum seeker, Gypsies, Travellers, or Roma, people with learning disabilities and people living in disadvantaged areas. Reviews that included primary studies from any high-income country were eligible. Reviews were mapped based on the disadvantaged group(s) and behaviour(s) targeted. Ninety-two reviews were included, with the majority (n = 63) focusing on people with low income or low SES. We identified gaps in the evidence for care leavers; Gypsies, Travellers, and Roma and limited evidence for refugees and unemployed people. Few reviews targeted alcohol use. There was limited evidence on barriers and facilitators to behaviour change. This suggests there is insufficient evidence to inform policy and practice and new reviews or primary studies may be required.
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Affiliation(s)
- Emily South
- Centre for Reviews and Dissemination, University of York, York, United Kingdom.
| | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Margaret Whitehead
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Amanda Sowden
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
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21
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Mytton J, Bedford H, Condon L, Jackson C. Improving immunization uptake rates among Gypsies, Roma and Travellers: a qualitative study of the views of service providers. J Public Health (Oxf) 2021; 43:e675-e683. [PMID: 32643752 PMCID: PMC8677431 DOI: 10.1093/pubmed/fdaa100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/13/2020] [Accepted: 06/09/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Gypsies, Roma and Travellers are at risk of low uptake of routine immunizations. Interventions to improve uptake in these communities are seldom evaluated. As part of a qualitative study exploring barriers and facilitators to immunization uptake in Travellers, we report service provider (SP) perspectives. METHODS We interviewed immunization SPs working with six Traveller communities across four UK cities. Participants included frontline staff and those with strategic or commissioning roles. Semi-structured interviews explored perceived attitudes of Travellers to vaccinations, local service delivery, and opportunities and challenges to improving uptake. Audio-recordings were transcribed, analyzed thematically and mapped to a socio-ecological model of health. RESULTS 39 SPs participated. Four overarching themes were identified: building trusting relationships between SPs and Travellers; facilitating attendance at appointments; improving record keeping and monitoring and responding to local and national policy change. Travellers were perceived as largely supportive of immunizations, though system and organizational processes were recognized barriers to accessing services. CONCLUSIONS Findings were broadly consistent across Traveller groups and settings. The barriers identified could often be addressed within existing infrastructure, though require system or policy change. Development of a culturally competent system appears important to enable equity in access to immunizations for Travellers.
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Affiliation(s)
- Julie Mytton
- Centre for Public Health and Wellbeing, University of the West of England, Coldharbour Lane, Bristol BS16 1QY UK
| | - Helen Bedford
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Louise Condon
- Swansea University, Singleton Park, Sketty, Swansea SA2 8PP, Wales, UK
| | - Cath Jackson
- Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
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O'Connell S, Ruane-McAteer E, Daly C, O'Connor C, Tuomey F, McDonnell L, Arensman E, Andriessen K, Griffin E. Exploring experiences of supports for suicide bereavement in Ireland: protocol for a national survey. HRB Open Res 2021; 4:114. [PMID: 34870092 DOI: 10.12688/hrbopenres.13437.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background A suicide death impacts upon the wellbeing of close family members and friends but has also been shown to affect many people outside of this immediate circle. This will be the first large-scale national study of adults bereaved or affected by suicide in Ireland, using a cross-sectional online survey. The overarching aim will be to gain insight into the experiences of supports received by people bereaved or affected by suicide and to identify the barriers to engagement following their loss. Methods A cross-sectional survey will be conducted among adults in Ireland who have been bereaved or affected by suicide. This project will seek to represent people with different demographics and backgrounds in the Irish population using a multifaceted approach to survey recruitment. A range of validated measures will be used to examine participants' current wellbeing and grief experience. A combination of closed and open-ended questions will provide participants the opportunity to share their individual experiences, the services and supports available to them, and barriers and enablers to accessing supports. Results Quantitative data will be analysed using descriptive statistics. Chi-squared tests will be used to compare subgroups within categorical data items, and multivariable regression models will be used to examine differences in psychosocial and physical wellbeing across key groups. Qualitative content analysis will be used for qualitative responses to open-ended questions. Conclusions The survey will provide an in-depth understanding of the psychosocial and mental health impacts of suicide bereavement in Ireland; insight into the range of informal and formal supports accessed; and will identify unmet needs and challenges of accessing appropriate and timely supports. The findings will inform current national actions aimed at ensuring the standardisation and quality of the services and supports for those bereaved or affected by suicide.
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Affiliation(s)
- Selena O'Connell
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Eimear Ruane-McAteer
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Caroline Daly
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Clíodhna O'Connor
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Fiona Tuomey
- Healing Untold Grief Groups (HUGG), Dublin, Ireland
| | | | - Ella Arensman
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
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Ellis N, Walker-Todd E, Heffernan C. Influences on childhood immunisation decision-making in London's Gypsy and Traveller communities. ACTA ACUST UNITED AC 2021; 29:822-826. [PMID: 32697638 DOI: 10.12968/bjon.2020.29.14.822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS Uptake of childhood immunisations is lower among Gypsy, Roma and Traveller (GRT) communities than in the general UK population. This small-scale study aimed to elicit insights from GRT mothers on their interaction with health services in London around childhood immunisations. The purpose was to inform a larger piece of work by the NHS England and Improvement (London) Public Health Commissioning Team to inform their planning to improve access to vaccination services for GRT communities in London. STUDY DESIGN An exploratory qualitative study using semi-structured interviews and a focus group. METHODS There was purposive sampling of mothers from any GRT background from south-west London using snowballing methods. One focus group and three interviews were conducted. A thematic analysis approach was used. RESULTS A total of nine women were recruited and seven participated between March and April 2018. Five themes were identified: adherence with antenatal care, self-declared parenting expertise, family support, childhood immunisations, keep children healthy but 'they say wait on the MMR until they are talking'. CONCLUSION Compliance with antenatal care, strong parenting beliefs and cohesive family support are strong influences on decision-making regarding immunisations. The women interviewed emphasised their own expertise in child rearing. This was occasionally at odds with the health advice provided by health professionals. The women widely shared their experiences of health professionals with other family and community members and this impacted on others' intention to vaccinate. These are key issues that should be considered when trying to improve uptake of immunisations in GRT families in a face-to-face manner. Equally, it warrants further exploration in a larger-scale study to see whether this reflects the wider community and in order to tailor supplementary immunisation activities to improve uptake.
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Affiliation(s)
| | - Ellie Walker-Todd
- Neighbourhood and Communities Manager-Public Health, London Borough of Kingston
| | - Catherine Heffernan
- Principal Advisor for Commissioning Early Years, Immunisations and Vaccination Services, Public Health England and NHS England (London Region)
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24
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Golenya R, Chloros GD, Panteli M, Giannoudis PV, Howard A. How to improve diversity in patient and public involvement. Br J Hosp Med (Lond) 2021; 82:1-8. [PMID: 34191561 DOI: 10.12968/hmed.2021.0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patient and public involvement involves ascertaining the opinions of and collaborating with patients and members of the public to holistically improve the quality of research. Patient and public involvement provides patients with a platform to use and share their lived experiences. This allows healthcare professionals to gain a deeper appreciation of the patient's perspective, which enables future research to be more patient centred and tailored to patients' requirements. Patient and public involvement aims to broadly encapsulate the opinions of the public, so ensuring diversity is recommended. This article provides a practical framework to increase diversity and engage hard-to-reach demographics in patient and public involvement. It highlights some common barriers to participation and methods for overcoming this, describes sampling frameworks and provides examples of how these have been adopted in practice.
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Affiliation(s)
- Rebecca Golenya
- Department of Medicine, St James Hospital, Leeds, UK.,School of Medicine, University of Leeds, Leeds, UK
| | - George D Chloros
- School of Medicine, University of Leeds, Leeds, UK.,Academic Department of Trauma and Orthopaedics, Leeds, UK
| | - Michalis Panteli
- School of Medicine, University of Leeds, Leeds, UK.,Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds University, Leeds, UK.,Leeds Orthopaedic Trauma Sciences, Leeds University, Leeds, UK
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, Leeds, UK.,Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds University, Leeds, UK.,Leeds Orthopaedic Trauma Sciences, Leeds University, Leeds, UK
| | - Anthony Howard
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds University, Leeds, UK.,Leeds Orthopaedic Trauma Sciences, Leeds University, Leeds, UK.,Department of Trauma and Orthopaedics, Leeds General Infirmary, Leeds, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK
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25
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Jayes M, Moulam L, Meredith S, Whittle H, Lynch Y, Goldbart J, Judge S, Webb E, Meads D, Hemsley B, Murray J. Making Public Involvement in Research More Inclusive of People With Complex Speech and Motor Disorders: The I-ASC Project. QUALITATIVE HEALTH RESEARCH 2021; 31:1260-1274. [PMID: 33645331 PMCID: PMC8182336 DOI: 10.1177/1049732321994791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
In this study, we aimed to identify processes that enabled the involvement of a person with complex speech and motor disorders and the parent of a young person with these disorders as co-researchers in a U.K. research project. Semi-structured individual and focus group interviews explored participants' experiences and perceptions of public involvement (PI). Sixteen participants were recruited, with representation from (a) the interdisciplinary project team; (b) academics engaged in discrete project activities; (c) individuals providing organizational and operational project support; and (d) the project's two advisory groups. Data were analyzed using Framework Analysis. Five themes were generated: (a) the challenge of defining the co-researcher role; (b) power relations in PI; (c) resources used to enable PI; (d) perceived benefits of PI; and (e) facilitators of successful PI. Our findings provide new evidence about how inclusive research teams can support people with complex speech and motor disorders to contribute meaningfully to co-produced research.
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Affiliation(s)
- Mark Jayes
- Manchester Metropolitan
University, Manchester, United Kingdom
| | - Liz Moulam
- Manchester Metropolitan
University, Manchester, United Kingdom
| | - Stuart Meredith
- Manchester Metropolitan
University, Manchester, United Kingdom
| | - Helen Whittle
- Manchester Metropolitan
University, Manchester, United Kingdom
| | - Yvonne Lynch
- Manchester Metropolitan
University, Manchester, United Kingdom
| | - Juliet Goldbart
- Manchester Metropolitan
University, Manchester, United Kingdom
| | - Simon Judge
- Barnsley Hospital NHS Foundation
Trust, Barnsley, United Kingdom
| | | | | | - Bronwyn Hemsley
- University of Technology Sydney,
Sydney, New South Wales, Australia
| | - Janice Murray
- Manchester Metropolitan
University, Manchester, United Kingdom
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26
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Condon L, Curejova J, Morgan DL, Miles G, Fenlon D. Knowledge and experience of cancer prevention and screening among Gypsies, Roma and Travellers: a participatory qualitative study. BMC Public Health 2021; 21:360. [PMID: 33593323 PMCID: PMC7885498 DOI: 10.1186/s12889-021-10390-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 02/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background The incidence of cancer is increasing worldwide, which has led to greater public health focus on primary prevention. Ethnic minorities have lower awareness of cancer risk factors and services, and are at greater risk of cancer mortality. While Gypsies, Roma and Travellers have poor health outcomes even in comparison with other ethnic minorities, little is known about how they view and enact primary prevention. This study takes a participatory approach to explore knowledge and experience of cancer prevention and screening in these communities. Methods Peer researchers conducted interviews (n = 37) and a focus group (n = 4) with a purposive sample of community members in Wales and South-West England. Participants self-identified as Roma (from Slovakia and Romania) or as Gypsies, Travellers or Showpeople (here described as Gypsy/Travellers). A third of the sample were Roma, and a quarter male, with ages ranging from 18 to 77 years. Data were collected from October 2018 to March 2019. Results Women and men knew that lifestyle factors, such as healthy diet, stopping smoking, drinking less alcohol and using sun protection, contribute to cancer risk reduction. However, there was a widespread lack of confidence in the effectiveness of these measures, particularly in relation to smoking. Traditional cultural beliefs were shared by Roma and Gypsy/Travellers, but did not necessarily affect the behaviour of individuals. Most women participated in cervical and breast screening but few Gypsy/Traveller men would engage with bowel screening, which conflicted with community ideals of stoical masculinity. Roma participants described language barriers to screening, with confusion about differences in timing and eligibility between the UK and Slovakian programmes; this led some to access screening abroad. Conclusion This study provides new knowledge about how Gypsies, Roma and Travellers keep healthy and prevent disease, giving insights into similarities and differences between ages, sexes and communities. These culturally distinct and high-need ethnic minorities have specific needs in relation to cancer prevention and screening, which merit targeted and acceptable health promotion to reduce health inequalities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10390-y.
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Affiliation(s)
- Louise Condon
- College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales, SA2 8PP, UK.
| | | | | | - Glenn Miles
- College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales, SA2 8PP, UK
| | - Deborah Fenlon
- College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales, SA2 8PP, UK
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27
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Villani J, Barry MM. A qualitative study of the perceptions of mental health among the Traveller community in Ireland. Health Promot Int 2021; 36:1450-1462. [PMID: 33582793 DOI: 10.1093/heapro/daab009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Irish Travellers are a minority ethnic group who experience a high prevalence of mental health problems and a rate of suicide six times higher compared to the general Irish population. This study explores Travellers' perceptions of mental health and its determinants. It also identifies the most relevant factors for promoting positive mental health and wellbeing among this socially excluded group. A descriptive qualitative approach was employed to explore participants' perceptions of mental health and mental health needs. Four focus groups were conducted with a total of 25 adult members of the Travelling community. Inductive thematic analysis was undertaken to identify and interpret the main themes emerging from the participants' responses. Travellers conceptualize mental health mostly in negative terms and showed a lack of awareness of the concept of positive mental health. Travellers showed a strong awareness of the social determinants of mental health identifying employment, better education, suitable accommodation, a reduction of discrimination and improved trust and social cohesion as important determinants that need to be addressed to improve their mental health status. The centrality of cultural identity and social-emotional skills emerged as key factors in promoting positive mental health among Travellers. The findings suggest that Travellers' mental health is multidimensional and requires a socio-ecological approach that addresses the wider determinants of health. Community mental health promotion initiatives should focus on reducing discrimination, enhancing social and emotional wellbeing and self-esteem, improvement of living conditions, reduced mental health stigma, and the promotion of Traveller culture and positive self-identity.
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Affiliation(s)
- Jacopo Villani
- Mental Health Services, Health Service Executive, 2-3 Sherwood House, Sherwood Avenue, H91 TR22, Galway, Ireland
| | - Margaret M Barry
- World Health Organization Collaborating Centre for Health Promotion Research, National University of Ireland Galway, Galway, Ireland
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28
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Dyson L, Bedford H, Condon L, Emslie C, Ireland L, Mytton J, Overend K, Redsell S, Richardson Z, Jackson C. Identifying interventions with Gypsies, Roma and Travellers to promote immunisation uptake: methodological approach and findings. BMC Public Health 2020; 20:1574. [PMID: 33081730 PMCID: PMC7574499 DOI: 10.1186/s12889-020-09614-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 09/27/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND In the UK, Gypsy, Roma and Traveller (GRT) communities are generally considered to be at risk of low or variable immunisation uptake. Many strategies to increase uptake for the general population are relevant for GRT communities, however additional approaches may also be required, and importantly one cannot assume that "one size fits all". Robust methods are needed to identify content and methods of delivery that are likely to be acceptable, feasible, effective and cost effective. In this paper, we describe the approach taken to identify potential interventions to increase uptake of immunisations in six GRT communities in four UK cities; and present the list of prioritised interventions that emerged. METHODS This work was conducted in three stages: (1) a modified intervention mapping process to identify ideas for potential interventions; (2) a two-step prioritisation activity at workshops with 51 GRTs and 25 Service Providers to agree a prioritised list of potentially feasible and acceptable interventions for each community; (3) cross-community synthesis to produce a final list of interventions. The theoretical framework underpinning the study was the Social Ecological Model. RESULTS Five priority interventions were agreed across communities and Service Providers to improve the uptake of immunisation amongst GRTs who are housed or settled on an authorised site. These interventions are all at the Institutional (e.g. cultural competence training) and Policy (e.g. protected funding) levels of the Social Ecological Model. CONCLUSIONS The "upstream" nature of the five interventions reinforces the key role of GP practices, frontline workers and wider NHS systems on improving immunisation uptake. All five interventions have potentially broader applicability than GRTs. We believe that their impact would be enhanced if delivered as a combined package. The robust intervention development and co-production methods described could usefully be applied to other communities where poor uptake of immunisation is a concern. STUDY REGISTRATION Current Controlled Trials ISRCTN20019630, Date of registration 01-08-2013, Prospectively registered.
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Affiliation(s)
- Lisa Dyson
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
| | - Helen Bedford
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH UK
| | - Louise Condon
- College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP UK
| | - Carol Emslie
- School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Lana Ireland
- School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA UK
| | - Julie Mytton
- University of the West of England, Centre for Child and Adolescent Health, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Karen Overend
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
| | - Sarah Redsell
- Faculty of Health, Social Care and Education, Anglia Ruskin University East Road Campus, Cambridge, CB1 1PT UK
| | - Zoe Richardson
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
| | - Cath Jackson
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
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29
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Luna Puerta L, Smith HE. The "PPI Hawker": an innovative method for patient and public involvement (PPI) in health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:31. [PMID: 32551135 PMCID: PMC7298814 DOI: 10.1186/s40900-020-00205-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Patient and Public Involvement (PPI) in health research entails doing research 'with' the public. Successful PPI requires a diversity of patients' perspectives and experiences. In Singapore, including the public's voice in research is still in its infancy and different ways of involving the public have to be explored.Our aims were to describe a PPI initiative that enables members of the public to share their ideas and opinions about health research, and to assess the feasibility, accessibility and utility of the initiative. METHODS Building on the concept of the PPI Café used in the west we designed a "PPI Hawker" for Singapore. Here Hawker Centres rather than cafes are used frequently for eating and socialising, providing a one-stop destination for a wide section of society. The PPI facilitators approached people sitting at tables and joined them to discuss questions of relevance to a local research study. Observations and reflexive field notes were used to evaluate the "PPI Hawker's" feasibility, acceptability and utility in the Singaporean community. RESULTS In three "PPI Hawkers" we approached 96 people and 72 (75%) engaged in discussions about the design of a population-based research study. The majority (75%) of participants willingly discussed all of the questions posed to them by the researchers, indicating the feasibility of PPI. The PPI participants came from the three major ethnic groups in Singapore and appeared to be broad in age, suggesting "PPI Hawkers" are easily accessible. Both participants and researchers recognised the utility of the "PPI Hawker", reflecting on people's willingness to talk about the research issues, engaging in informative conversations and posing relevant questions. CONCLUSION The "PPI Hawkers" succeeded in engaging the public in conversations about a local population-based study. The public brought to the researchers' attention a variety of previously unheard perspectives about the research. Each event fostered connectivity between professionals and the public, generating among researchers a more positive perception of the power of public involvement."PPI Hawkers" provide an opportunity for co-informed conduct of research studies with diverse members of the public. They create a focus within a community setting for researchers to engage with the public. The resources needed (costs and preparatory time) are relatively few. Not only do "PPI Hawkers" have potential in Singapore, but also for the rest of Asia.
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Affiliation(s)
- L. Luna Puerta
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232 Singapore
| | - H. E. Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232 Singapore
- Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, BN1 9PH UK
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30
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Luna Puerta L, Bartlam B, Sun HLS, Smith HE. Perspectives on public involvement in health research from Singapore: The potential of a supported group model of involvement. Health Expect 2020; 23:1074-1085. [PMID: 32520434 PMCID: PMC7696133 DOI: 10.1111/hex.13058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 11/28/2022] Open
Abstract
Background Singapore is an international research hub, with an emphasis on translational clinical research. Despite growing evidence of the positive impact of public involvement (PPI) in research, it remains rare in Singapore. Aims To investigate Singaporean public perspectives around the rationale, role and scope for being involved in health research To identify the potential, challenges, facilitators and strategies for implementing PPI in Singapore.
Design Semi‐structured qualitative interviews with members of the public, analysed using thematic framework analysis. Results Twenty people participated. Four main themes emerged: potential benefits; challenges; facilitators; and strategies for implementation. Whilst initially unfamiliar with the concept, all interviewees recognized potential benefits for the research itself and those involved, including researchers. PPI was seen to offer opportunities for public empowerment and strengthening of relationships and understanding between the public, academics and health professionals, resulting in more impactful research. Challenges included a Singaporean culture of passive citizenship and an education system that inculcates deferential attitudes. Facilitators comprised demographic and cultural changes, including trends towards greater individual openness and community engagement. Implementation strategies included formal government policies promoting involvement and informal community‐based collaborative approaches. Conclusion Given the socio‐political framework in Singapore, a community‐based approach has potential to address challenges to PPI and maximize impact. Careful consideration needs to be given to issues of resource and support to enable members of the public to engage in culturally sensitive and meaningful ways that will deliver research best placed to effectively address patient needs.
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Affiliation(s)
- Lidia Luna Puerta
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Bernadette Bartlam
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Hsiao-Li Shirley Sun
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.,School of Social Sciences, Nanyang Technological University Singapore, Singapore, Singapore
| | - Helen E Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.,Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, UK
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Pavlikova B, Freel L, van Dijk JP. To Comply or Not to Comply: Roma Approach to Health Laws. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3087. [PMID: 32365484 PMCID: PMC7246461 DOI: 10.3390/ijerph17093087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/20/2020] [Accepted: 04/26/2020] [Indexed: 11/18/2022]
Abstract
According to the general public in Slovakia, compliance with the law is problematic when it comes to Roma and health. Roma compliance with laws has not yet been studied. The aim of this is study was to explore the determinants of Roma behavior in the field of health laws. We used the concept of a semi-autonomous field proposed by Moore (1973) and the theory of planned behavior by Ajzen (1985). We found that Roma (non-)compliance with health laws was influenced by many different factors, such as beliefs, traditions, living conditions and culture. Group beliefs overrule national laws and also individual preferences, which tend to be subordinate to the group view. The less contact Roma from settlements have with non-Roma, the stronger their own rules are in the field of health. Roma health status is influenced by many factors: group beliefs and community traditions are stronger and overrule individual and state behavioral influence. A community-based participatory approach together with improvement of living conditions in cooperation with Roma is desirable.
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Affiliation(s)
- Barbara Pavlikova
- Research Agency, 831 02 Bratislava, Slovakia
- Department of Labor Law and Social Welfare Law, Faculty of Law, Comenius University, 810 00 Bratislava, Slovakia
| | - Lenka Freel
- Department of Labor Law and Social Welfare Law, Faculty of Law, Comenius University, 810 00 Bratislava, Slovakia
| | - Jitse P. van Dijk
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia
- Theological Faculty, Olomouc University Social Health Institute, Palacky University, 771 11 Olomouc, Czech Republic
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Coheña-Jiménez M, Chicharro-Luna E, Algaba-Del-Castillo J, Páez-Tudela A. Foot health among the Roma population of southern Spain according to the foot health status questionnaire. BMC Public Health 2020; 20:462. [PMID: 32252719 PMCID: PMC7137201 DOI: 10.1186/s12889-020-08571-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foot health of the Roma population is a challenge for the health professionals where this minority is significant, as is the case in Spain. At present, little is known about foot health of the Roma population and their knowledge would promote the training of these professionals at the community level. Foot pain is common and a reason for consulting podiatry services. The purpose of this study was to determine foot health among the Roma population according to the Foot Health Status Questionnaire. METHOD An observational, cross-sectional and quantitative study conducted at the Roma population living in Spain in 2018. Self-reported data and the Foot Health Status Questionnaire were recorded. Examining the general health and foot health (foot pain, foot function, footwear and general health) and general (general health, social capacity, physical activity and vigour). This questionnaire is recommended as a valid and reliable patient-reported outcome. The obtained scores were compared. RESULTS A sample made up of 624 men and women from the Roma population took part in this study. 45% were Roma men and 55% Roma women. In the first section of the FHSQ, a lower score of values was recorded in the footwear domain (62.5) and in the general foot health domain (60). Gypsy women obtained lower scores in all the domains. In the second section, lower scores were obtained in the vigour (56) domain and in the general health (60) domain. A large effect size (r-Rosenthal) was found by gender in the footwear domain (0.334) and in the vigour domain (0.195). Roma women showed higher values in cardiac disorders, serious illnesses, doctor visits and foot problems. 67.8% reported that they had never been assisted by a podiatrist. CONCLUSIONS The studied Roma population has foot health problems, and these are more pronounced among women. They show lower values in the footwear and vigour domains. More professional training is required for health workers in this field to avoid cultural diversity stereotypes.
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Affiliation(s)
- Manuel Coheña-Jiménez
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Avicena st, 41009 Sevilla, Spain
| | - Esther Chicharro-Luna
- Department of Behavioral Sciences and Health, Faculty of Medicine, University Miguel Hernández, San Juan de Alicante, Spain
| | - José Algaba-Del-Castillo
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Avicena st, 41009 Sevilla, Spain
| | - Amanda Páez-Tudela
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Avicena st, 41009 Sevilla, Spain
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Luna Puerta L, Bartlam B, Smith HE. Researchers' perspectives on public involvement in health research in Singapore: The argument for a community-based approach. Health Expect 2019; 22:666-675. [PMID: 31322811 PMCID: PMC6737771 DOI: 10.1111/hex.12915] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 11/30/2022] Open
Abstract
Background Singapore is becoming a world‐class research hub, promoting the advancement of patient care through translational clinical research. Despite growing evidence internationally of the positive impact of public involvement (PPI), in Singapore PPI remains unusual beyond patient participation as subjects in studies. Objective To explore health researchers' understandings of the principles, role and scope of PPI, and to identify barriers and opportunities for implementation in Singapore. Design Semi‐structured qualitative interviews between April and July 2018. Data were analysed using thematic framework analysis. Results Whilst most participants (n = 20) expressed a lack of experience of PPI, the interview process provided an opportunity for reflection through which it emerged as a beneficial strategy. Interviewees highlighted both utilitarian and ethical reasons for implementing PPI, particularly around increasing the relevance and efficiency of research. In addition to those challenges to PPI documented in the existing literature, participants highlighted others specific to the Singaporean context that make PPI at an individual level unlikely to be successful, including the socio‐political environment and prevailing social and professional hierarchies. They also identified asset‐based strategies to overcome these, in particular, a more community‐oriented approach. Conclusion The cultural reluctance of individuals to question perceived authority figures such as researchers may be overcome by adopting an approach to PPI that is closer to family and local community values, and which facilitates patients and the public collectively engaging in research. Further work is needed to explore the views of patients and the public in Singapore, and the implications for other Asian communities.
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Affiliation(s)
- Lidia Luna Puerta
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Bernadette Bartlam
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.,Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Helen E Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.,Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, UK
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Cardoso GKA, Bonomo M. Infância Calin: Socialização Étnica e Identidade Social entre Crianças Ciganas. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2019. [DOI: 10.1590/1982-3703003222651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Compreendendo fases sucessivas do momento de proteção, aprendizagem e preparação para se tornarem adultas, na infância, as crianças ciganas vão sendo formadas para uma vida em grupo e voltada para o núcleo familiar. A partir dos conceitos de socialização étnica e de identidade social, o estudo foi desenvolvido com o objetivo de analisar o universo psicossocial da infância calin entre crianças de etnia calon no estado do Espírito Santo. Participaram do estudo sete crianças, com idades entre 4 e 12 anos, que compõem a terceira geração da comunidade, a primeira após processo de fixação territorial. As entrevistas foram orientadas por um roteiro semiestruturado explorando os universos da lei cigana, tradições do grupo e vivências cotidianas, bem como técnicas de desenho a fim de conhecer as imagens de si, da família e de futuro. Todas as entrevistas foram realizadas no acampamento cigano e os dados foram analisados por meio da análise de conteúdo temática. Os principais resultados demonstraram que as crianças calin destacam em suas narrativas a vivência da lei cigana e das tradições por meio do uso de vestimentas típicas e da língua caló, moradia em tendas e obediência às normas para o matrimônio, bem como relatam rotinas envolvendo brincadeiras, escolarização e atividades de mediação para o universo adulto. Nesse contexto, manifestam-se movimentos de resistência do grupo, em que a nova geração teria como tarefa manter os elementos identitários essenciais da cultura cigana e criar recursos para manutenção de sua sociabilidade em trânsito nas fronteiras com o mundo não cigano.
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