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Hinton L, Dakin FH, Kuberska K, Boydell N, Willars J, Draycott T, Winter C, McManus RJ, Chappell LC, Chakrabarti S, Howland E, George J, Leach B, Dixon-Woods M. Quality framework for remote antenatal care: qualitative study with women, healthcare professionals and system-level stakeholders. BMJ Qual Saf 2024; 33:301-313. [PMID: 35552252 PMCID: PMC11041557 DOI: 10.1136/bmjqs-2021-014329] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/15/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND High-quality antenatal care is important for ensuring optimal birth outcomes and reducing risks of maternal and fetal mortality and morbidity. The COVID-19 pandemic disrupted the usual provision of antenatal care, with much care shifting to remote forms of provision. We aimed to characterise what quality would look like for remote antenatal care from the perspectives of those who use, provide and organise it. METHODS This UK-wide study involved interviews and an online survey inviting free-text responses with: those who were or had been pregnant since March 2020; maternity professionals and managers of maternity services and system-level stakeholders. Recruitment used network-based approaches, professional and community networks and purposively selected hospitals. Analysis of interview transcripts was based on the constant comparative method. Free-text survey responses were analysed using a coding framework developed by researchers. FINDINGS Participants included 106 pregnant women and 105 healthcare professionals and managers/stakeholders. Analysis enabled generation of a framework of the domains of quality that appear to be most relevant to stakeholders in remote antenatal care: efficiency and timeliness; effectiveness; safety; accessibility; equity and inclusion; person-centredness and choice and continuity. Participants reported that remote care was not straightforwardly positive or negative across these domains. Care that was more transactional in nature was identified as more suitable for remote modalities, but remote care was also seen as having potential to undermine important aspects of trusting relationships and continuity, to amplify or create new forms of structural inequality and to create possible risks to safety. CONCLUSIONS This study offers a provisional framework that can help in structuring thinking, policy and practice. By outlining the range of domains relevant to remote antenatal care, this framework is likely to be of value in guiding policy, practice and research.
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Affiliation(s)
- Lisa Hinton
- THIS Institute (The Healthcare Improvement Studies), Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Francesca H Dakin
- Nuffield Department of Primary Health Care Sciences, Oxford University, Oxford, UK
| | - Karolina Kuberska
- THIS Institute (The Healthcare Improvement Studies), Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Janet Willars
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Tim Draycott
- Royal College of Obstetricians and Gynaecologists, London, UK
| | | | - Richard J McManus
- Nuffield Department of Primary Health Care Sciences, Oxford University, Oxford, UK
| | - Lucy C Chappell
- Maternal and Fetal Research Unit Division of Women's Health, St Thomas' Hospital, London, UK
| | | | - Elizabeth Howland
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | | | - Mary Dixon-Woods
- THIS Institute (The Healthcare Improvement Studies), Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Lai PHL, Halvorsen CJ, Chang K, Nguyen LHT, Howard EP, Lyons KS. Unemployed, Immigrant, and Older Asian Workers in a U.S.-Based Job-Training Program: Their Experiences and Well-Being, and Strategies for Reaching This Important Population. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-17. [PMID: 38598561 DOI: 10.1080/01634372.2024.2339980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
The Senior Community Service Employment Program (SCSEP) is a U.S.-based job-training program that serves unemployed workers aged 55 and older with incomes at or below 125% of the federal poverty level. While federal funds are set aside to serve Asian workers in SCSEP, little is known about their characteristics and experiences. In response, this pilot study aimed to document the health, well-being, and experiences of older Asian SCSEP participants in Massachusetts through the completion of a survey. Respondents (N = 39) ranged in age from 58 to 73 and identified as either Chinese (72%) or Vietnamese (28%). All were immigrants, and almost all spoke a language other than English at home. Most reported "good" health as well as financial difficulties. They also stated that their supervisors in their placements were supportive. On average, respondents noted moderate interest in searching for a paid job after exiting SCSEP, although more reported interest in searching for a volunteer role. Key to the success of this study was a robust collaboration with a local human services organization with strong ties to the Chinese and Vietnamese communities. The findings highlight the importance of this growing group of older workers.
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Affiliation(s)
| | - Cal J Halvorsen
- School of Social Work, Boston College, Chestnut Hill, MA, USA
- Center on Aging & Work at Boston College, Chestnut Hill, MA, USA
| | - Kun Chang
- Greater Boston Chinese Golden Age Center, Boston, MA, USA
| | | | | | - Karen S Lyons
- Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
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Ryan CG, Karran EL, Wallwork SB, Pate JW, O'Keeffe M, Fullen BM, Livadas N, Jones N, Toumbourou JW, Gilchrist P, Cameron PA, Fatoye F, Ravindran D, Lorimer Moseley G. We Are All in This Together-Whole of Community Pain Science Education Campaigns to Promote Better Management of Persistent Pain. THE JOURNAL OF PAIN 2024; 25:902-917. [PMID: 37918470 DOI: 10.1016/j.jpain.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/02/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
Persistent pain is a major public health issue-estimated to affect a quarter of the world's population. Public understanding of persistent pain is based on outdated biomedical models, laden with misconceptions that are contrary to best evidence. This understanding is a barrier to effective pain management. Thus, there have been calls for public health-based interventions to address these misconceptions. Previous pain-focussed public education campaigns have targeted pain beliefs and behaviours that are thought to promote recovery, such as staying active. However, prevailing pain-related misconceptions render many of these approaches counter-intuitive, at best. Pain Science Education improves understanding of 'how pain works' and has been demonstrated to improve pain and disability outcomes. Extending Pain Science Education beyond the clinic to the wider community seems warranted. Learning from previous back pain-focussed and other public health educational campaigns could optimise the potential benefit of such a Pain Science Education campaign. Pain Science Education-grounded campaigns have been delivered in Australia and the UK and show promise, but robust evaluations are needed before any firm conclusions on their population impact can be made. Several challenges exist going forward. Not least is the need to ensure all stakeholders are involved in the development and implementation of Pain Science Education public messaging campaigns. Furthermore, it is crucial that campaigns are undertaken through a health equity lens, incorporating underrepresented communities to ensure that any intervention does not widen existing health inequalities associated with persistent pain. PERSPECTIVE: Public misconceptions about pain are a significant public health challenge and a viable intervention target to reduce the personal, social, and economic burden of persistent pain. Adaptation of Pain Science Education, which improves misconceptions in a clinical setting, into the public health setting seems a promising approach to explore.
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Affiliation(s)
- Cormac G Ryan
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - Emma L Karran
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Sarah B Wallwork
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Joshua W Pate
- Pain Education Team to Advance Learning (PETAL) Collaboration; Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Mary O'Keeffe
- Pain Education Team to Advance Learning (PETAL) Collaboration; Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, University of Sydney, Australia
| | - Brona M Fullen
- Pain Education Team to Advance Learning (PETAL) Collaboration; UCD School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
| | - Nick Livadas
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - Niki Jones
- Pain Education Team to Advance Learning (PETAL) Collaboration
| | - John W Toumbourou
- Pain Education Team to Advance Learning (PETAL) Collaboration; Deakin University, School of Psychology and Centre for Social and Early Emotional Development, Geelong, Australia
| | - Peter Gilchrist
- Pain Education Team to Advance Learning (PETAL) Collaboration; The University of Adelaide Rural Clinical School, Rural Generalist Program, South Australia
| | - Paul A Cameron
- Pain Education Team to Advance Learning (PETAL) Collaboration; Fife Health & Social Care Partnership, Scotland, UK; School of Medicine, Cardiff University, UK
| | - Francis Fatoye
- Pain Education Team to Advance Learning (PETAL) Collaboration; Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, UK; Lifestyle Disease Entity, North-West University, South Africa
| | - Deepak Ravindran
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Department of Pain Medicine, Royal Berkshire NHS Foundation Trust, UK
| | - G Lorimer Moseley
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
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Yuan J, Wang J, Wang Y, Wu H, Jia Y, Zhao C, Zhu B, Fritschi C. Information Needs and Its Association With Depressive Symptoms in People With Type 2 Diabetes. Sci Diabetes Self Manag Care 2024; 50:65-73. [PMID: 38158816 DOI: 10.1177/26350106231215788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
PURPOSE The purpose of this study was to describe the information needs and examine its association with depressive symptoms in people with type 2 diabetes (T2D). METHODS A descriptive, correlational design was used. People with T2D (N = 358) were recruited from 12 communities in Shanghai, China. Self-reported information needs and depressive symptoms were measured using the Information Needs in Diabetes Questionnaire and Patient Health Questionnaire-9 (PHQ-9), respectively. Multivariate linear regression analysis was performed. RESULTS The participants were 64.8 years on average, and 46.6% were men. One hundred fifty-one (42.2%) had depressive symptoms (PHQ-9 ≥ 5). Participants had the least knowledge about "diabetes research," "acute complications," and "lifestyle adjustment." The sample had the highest levels of information needs about topics including "mental strain," "treatment/therapy," and "diabetes in everyday life." Compared to those without depressive symptoms, those experiencing depressive symptoms were less informed and had higher levels of need for further information. Controlling for covariates, higher levels of need for further information were significantly associated with greater depressive symptoms (B = 0.368, 95% CI, 0.155-0.582, P = .001). CONCLUSIONS This study demonstrated areas that should be prioritized when meeting patients' information needs. It also showed the potential negative effect of unmet information needs on depression. These findings may help develop a more tailored intervention for people with T2D.
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Affiliation(s)
- Jinjin Yuan
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jinle Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yueying Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Huihui Wu
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yun Jia
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunyan Zhao
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Cynthia Fritschi
- College of Nursing, University of Illinois Chicago, Chicago, Illinois
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Small N, Masood Y, Stevenson F, Brown BC, Sanders C, McMillan B, Atherton H, Mazumdar T, Ara N, Haqqani H, Cheraghi‐Sohi S. Exploring the experiences and preferences of South Asian patients' of primary care in England since COVID-19. Health Expect 2024; 27:e13982. [PMID: 39102699 PMCID: PMC10844758 DOI: 10.1111/hex.13982] [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: 10/09/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Remote (digital and/or telephone) access and consultation models are being driven by national policy with the goal being that the National Health Service operate on a remote-first (digital-first) basis by 2029. Previous research has suggested that remote methods of access to care and consulting may act to widen health inequalities for certain patients and/or groups such as those from ethnic minorities. South Asian (SA) patients comprise the largest ethnic minority group in England. Understanding the experiences and needs of this group is critical to ensuring that general practice can deliver equitable, quality health care. METHODS Qualitative study. 37 participants (from Indian, Pakistani and/or Bangladeshi background) were recruited to take part in either in-person preferred language focus groups or remote semistructured interviews in the English language. Thematic analysis was conducted to identify themes in the qualitative data. FINDINGS Three major interlinked themes were identified: (1) reduced access, (2) reduced patient choice and (3) quality and safety concerns. The findings highlight access issues split by (i) general issues with appointment access via any remote means and (ii) specific issues related to language barriers creating additional barriers to access and care. Some patients valued the convenience of remote access but also raised concerns regarding appointment availability and reduced patient choice. Face-to-face consultations were preferable but less available. The findings underscore how participants perceived remote care to be of lesser quality and less safe. Concerns were greatest for those with limited English proficiency (LEP), with the removal of non-verbal aspects of communication and 'hands-on' care leading to perceptions of reduced psycho-social safety. CONCLUSION SA patients' experiences of remote-led primary care access and care delivery were negative with only a minority viewing it positively and for certain limited scenarios. Face-to-face models of care remain the preferred mode of consultation, particularly for those with LEP. Hybrid models of access offer patients the greatest choice, and are likely to meet the varying needs of the South-Asian patient population going forwards. The remote first approach to primary care may be achievable as a service ideal, but its limitations need to be recognised and accounted for to ensure that primary care can be an equitable service, both now and in the future. PUBLIC CONTRIBUTION Members of the public were involved in all phases of research in the study. This included co-working in partnership throughout the study including, reviewing patient-facing documents, recruiting participants, data facilitation, translation work, interpretation of the data and co-authors on this manuscript. The key to the success of our study was collaborative teamwork, which involved experienced members of the public with SA cultural knowledge working together with and integral to the research team for all components.
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Affiliation(s)
- Nicola Small
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, Faculty of Biology, Medicine, and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Yumna Masood
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, Faculty of Biology, Medicine, and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Fiona Stevenson
- Research Department of Primary Care and Population Health, Institute of Epidemiology and Health CareUniversity College LondonLondonUK
| | - Benjamin C. Brown
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, Faculty of Biology, Medicine, and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Caroline Sanders
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, Faculty of Biology, Medicine, and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Brian McMillan
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, Faculty of Biology, Medicine, and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Helen Atherton
- Unit of Academic Primary Care, Warwick Medical SchoolUniversity of WarwickCoventryUK
| | | | | | | | - Sudeh Cheraghi‐Sohi
- Division of Psychology and Mental Health, Faculty of Biology, Medicine, and Health, School of Health SciencesUniversity of ManchesterManchesterUK
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Krasuska M, Davidson EM, Beune E, Jenum AK, Gill JM, Stronks K, van Valkengoed IG, Diaz E, Sheikh A. A Culturally Adapted Diet and Physical Activity Text Message Intervention to Prevent Type 2 Diabetes Mellitus for Women of Pakistani Origin Living in Scotland: Formative Study. JMIR Form Res 2023; 7:e33810. [PMID: 37713245 PMCID: PMC10541642 DOI: 10.2196/33810] [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: 09/24/2021] [Revised: 12/20/2022] [Accepted: 01/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Individuals of South Asian origin are at an increased risk of developing type 2 diabetes mellitus (T2DM) compared with other ethnic minority groups. Therefore, there is a need to develop interventions to address, and reduce, this heightened risk. OBJECTIVE We undertook formative work to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. METHODS We used a stepwise approach that was informed by the Six Steps in Quality Intervention Development framework, which consisted of gathering evidence through literature review and focus groups (step 1), developing a program theory for the intervention (step 2), and finally developing the content of the text messages and an accompanying delivery plan (step 3). RESULTS In step 1, we reviewed 12 articles and identified 3 key themes describing factors impacting on diet and physical activity in the context of T2DM prevention: knowledge on ways to prevent T2DM through diet and physical activity; cultural, social, and gender norms; and perceived level of control and sense of inevitability over developing T2DM. The key themes that emerged from the 3 focus groups with a total of 25 women were the need for interventions to provide "friendly encouragement," "companionship," and a "focus on the individual" and also for the text messages to "set achievable goals" and include "information on cooking healthy meals." We combined the findings of the focus groups and literature review to create 13 guiding principles for culturally adapting the text messages. In step 2, we developed a program theory, which specified the main determinants of change that our text messages should aim to enhance: knowledge and skills, sense of control, goal setting and planning behavior, peer support, and norms and beliefs guiding behavior. In step 3, we used both the intervention program theory and guiding principles to develop a set of 73 text messages aimed at supporting a healthy diet and 65 text messages supporting increasing physical activity. CONCLUSIONS We present a theory-based approach to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. This study outlines an approach that may also be applicable to the development of interventions for other ethnic minority populations in diverse settings. There is now a need to build on this formative work and undertake a feasibility trial of a text message-based diet and physical activity intervention to prevent T2DM for women of Pakistani origin living in Scotland.
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Affiliation(s)
- Marta Krasuska
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma M Davidson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Erik Beune
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jason Mr Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Irene Gm van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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Ojo AS, Nnyanzi LA, Giles EL, Ells LJ, Awolaran O, Okeke SR, Afaya A, Bolarinwa OA. Perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries: a systematic review of qualitative literature. BMC Nutr 2023; 9:85. [PMID: 37443077 DOI: 10.1186/s40795-023-00743-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Minority ethnic groups are a fast-growing population in many high-income countries, partly due to the increasing population of immigrants and second-generation migrants. The dietary practices of some of these minority ethnic groups might make them to be disproportionately affected by obesity and increase their risks of developing non-communicable diseases. Population-specific interventions and strategies are vital to addressing poor nutritional practices among this population. Thus, this study systematically reviewed the perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries. METHODS This systematic review was conducted in line with the guidelines of the Joanna Briggs Institute (JBI) methodology for systematic reviews, using a meta-aggregative design. This systematic review identified and synthesised qualitative literature on the perceptions of dietary intake amongst BlackAsian and other minority ethnic groups in high-income countries. An extensive and comprehensive database search was conducted between January 2000 - May 2022 and included twenty (20) studies that met the eligibility criteria from six countries. The included studies were assessed for quality using the JBI qualitative assessment and review instrument. The JBI data extraction tools were used to retrieve relevant data from included articles, and the data were thematically analysed. RESULTS We identified eight major themes across this database: (1) "Social and Cultural Factors," (2) "Availability and Accessibility," (3) "Family and Community Influences," (4) "Food Preferences", (5) "Home Country Food Versus Host Country Food" (6) "Dietary Acculturation" (7) "Health and Healthy Eating" (8) "Perception of Nutritional Information." CONCLUSION Overall, Black, Asian, and other minority ethnic groups individuals were found to be aware of the effects of unhealthy eating on their health, and some of them have nutritional knowledge, but social and cultural factors, including structural factors, were deterrents to their healthy eating behaviours. An important finding from this review is that some participants believed that nutritional information, based on bio-medical science, was intended for only White population groups and that it was antagonistic to their cultural and community well-being.
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Affiliation(s)
- Abimbola S Ojo
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Lawrence A Nnyanzi
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Emma L Giles
- Centre for Public Health, School of Health & Life Sciences, University of Teesside, Teeside, UK
| | - Louisa J Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Olusegun Awolaran
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Sylvester R Okeke
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Agani Afaya
- Mo-Im Kin Nursing Research Institute, College of Nursing, Yonsei University, 50‑1, Yonsei‑ro, Seodaemun‑gu, Seoul, Seoul, 03722, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St John University, London, UK.
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
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Teodorowski P, Rodgers SE, Fleming K, Tahir N, Ahmed S, Frith L. 'To me, it's ones and zeros, but in reality that one is death': A qualitative study exploring researchers' experience of involving and engaging seldom-heard communities in big data research. Health Expect 2023; 26:882-891. [PMID: 36691930 PMCID: PMC10010102 DOI: 10.1111/hex.13713] [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: 10/06/2022] [Revised: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom-heard voices, to ensure that a range of voices are heard and that research is meaningful to them. OBJECTIVE We explored how researchers involve and engage seldom-heard communities around big data research. METHODS This is a qualitative study. Researchers who had experience of involving or engaging seldom-heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio-recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. RESULTS The analysis highlighted the complexity of involving and engaging seldom-heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. CONCLUSION The study offers researchers a better understanding of how to involve and engage seldom-heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project-specific and dependent on the public contributors, researchers' needs, resources and time available. PATIENT AND PUBLIC INVOLVEMENT Two public contributors are authors of the paper and they were involved in the study design, analysis and writing.
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Affiliation(s)
- Piotr Teodorowski
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Sarah E Rodgers
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Kate Fleming
- National Disease Registration Service, NHS Digital, Liverpool, UK
| | | | | | - Lucy Frith
- Department of Law, University of Manchester, Manchester, UK
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Gbinigie OA, Boylan AM, Butler CC, Heneghan CJ, Tonkin-Crine S. Enhancing opportunistic recruitment and retention in primary care trials: lessons learned from a qualitative study embedded in the Cranberry for Urinary Tract Infection (CUTI) feasibility trial. BMC PRIMARY CARE 2022; 23:184. [PMID: 35883016 PMCID: PMC9315325 DOI: 10.1186/s12875-022-01796-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022]
Abstract
Background Opportunistic recruitment in primary care is challenging due to the inherent unpredictability of incident conditions, and workload and time pressures. Many clinical trials do not recruit to target, leading to equivocal answers to research questions. Learning from the experiences of patients and recruiters to trials of incident conditions has the potential to improve recruitment and retention to future trials, thereby enhancing the quality and impact of research findings. The aim of this research was to learn from the trial experiences of UTI patients and recruiters to the Cranberry for UTI (CUTI) trial, to help plan an adequately powered trial of similar design. Methods One-to-one semi-structured interviews were embedded within the CUTI feasibility trial, an open-label, randomised feasibility trial of cranberry extract for symptoms of acute, uncomplicated Urinary Tract Infection (UTI) in primary care. Interviews were conducted with a sample of: CUTI trial participants; non-CUTI trial UTI patients; and, recruiters to the CUTI trial. Verbatim transcripts were analysed thematically. Results Twenty-six patients with UTI and eight recruiters (nurses and GPs) to the CUTI trial were interviewed. Three themes were developed around: reasons for participating in research; barriers to opportunistic recruitment; and, UTI patients’ experiences of trial procedures. Recruiters found that targeted electronic prompts directed at healthcare practitioners based in clinics where patients with incident conditions were likely to present (e.g. minor illness clinic) were more effective than generic prompts (e.g. desk prompts) at filtering patients from their usual clinical pathway to research clinics. Using a script to explain the delayed antibiotic trial group to patients was found to be helpful, and may have served to boost recruitment. For UTI patients, using an electronic diary to rate their symptoms was considered an acceptable medium, and often preferable to using a paper diary or mobile phone application. Conclusions The use of targeted prompts directed at clinicians, a script to explain trial groups that may be deemed less desirable, and an appropriate diary format for patient-reported outcomes, may help to improve trial recruitment and retention. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01796-7.
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Gilchrist K, Iqbal S, Vindrola-Padros C. The role of patient and public involvement in rapid qualitative studies: Can we carry out meaningful PPIE with time pressures? RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:67. [PMID: 36451246 PMCID: PMC9713187 DOI: 10.1186/s40900-022-00402-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Rapid qualitative studies conducted with patient and public involvement can help promote policy-relevant and efficient research. There is a need to understand the experiences of researchers, patients, and members of the public to guide the development of good practice and to determine the extent to which rapid qualitative research can be implemented in PPIE projects. METHODS We conducted a qualitative study to explore the experiences of research teams that carried out studies using rapid techniques with patient and public involvement. We carried out 26 interviews with researchers, coordinators, patients, carers, service users and members of the public. RESULTS This study identified needs which related to practical and time constraints. Rapid qualitative research tends to be limited to certain PPIE groups, and particular phases of the research process. Study findings are rarely discussed with PPIE members. The educational needs of rapid qualitative research were also identified. Researchers and PPIE members considered three main issues: a lack of training on patient involvement for researchers, rapid qualitative research training for PPIE members, and the diversity of PPIE members. CONCLUSION We found that rapid researchers were able to involve patients and members of the public in research despite time pressures. The challenges identified in this study can be used to plan future training programmes for researchers and PPIE panel members and develop strategies to recruit PPIE panel members from a wide range of backgrounds. PUBLIC CONTRIBUTION The research aim was to explore the experiences of those carrying out rapid qualitative studies with PPIE. As such, the participants of this study included patients, carers, service users and members of the public, who were interviewed individually. A lived experienced researcher and PPIE member for a hospital conducted the design, data collection and analysis of the study. The study brief was to interview researchers only. The lived-experience researcher initiated the inclusion of PPIE members as participants, therefore strengthening the study design. We shared the draft report with the PPIE participants for participant validation and to maintain a continuous feedback relationship. This led to addressing key issues in designing and involving PPIE members in more meaningful and equal ways. Whilst there is agreement on activities which centre on PPIE, there is no consensus on how to achieve these in high quality rapid qualitative studies.
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Affiliation(s)
- Katie Gilchrist
- Department of Targeted Intervention, University College London, London, UK
| | - Syka Iqbal
- Department of Psychology, University of Bradford, Bradford, UK
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Synnot A, Hill S, Jauré A, Merner B, Hill K, Bates P, Liacos A, Turner T. Broadening the diversity of consumers engaged in guidelines: a scoping review. BMJ Open 2022; 12:e058326. [PMID: 35710237 PMCID: PMC9204430 DOI: 10.1136/bmjopen-2021-058326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Guideline developers are encouraged to engage patients, carers and their representatives ('consumers') from diverse backgrounds in guideline development to produce more widely applicable guidelines. However, consumers from diverse backgrounds are infrequently included in guidelines and there is scant research to support guideline developers to do this. OBJECTIVES To identify principles and approaches to broaden the diversity of consumers engaged in guideline development. DESIGN Scoping review and semi-structured interviews. METHODS We conducted comprehensive searches to March 2020 for studies, reports and guidance documents. Inclusion criteria included the terms 'consumer' (patients, carers and their representatives), 'diversity' (defined using the PROGRESS-PLUS mnemonic) and 'consumer engagement' (the active involvement of consumers at any stage of guideline development). We also conducted four interviews with consumers and guideline developers. We used descriptive synthesis to identify themes, and summarised information about implemented approaches used to broaden diversity of consumers in guidelines. RESULTS From 10 included documents, we identified eight themes. Themes covered general engagement concepts (Respectful partnerships; Recruitment; Expectations, process and review); specific concepts about guideline development group (GDG) engagement (Characteristics of guideline personnel; Consumers' role, characteristics and prominence; Preparing and supporting consumers); and other (non-GDG) approaches (Online methods; Consultations and research-based approaches). The most commonly included PROGRESS-PLUS categories were Disability, Race/culture/ethnicity/language, Place of residence and Other vulnerable (eg, 'disadvantaged groups'). Each theme included the views of both consumers and guideline developers. We found descriptions of 12 implemented engagement approaches to broaden diversity of consumers in guidelines. CONCLUSIONS Relationship-building, mitigating power imbalances and meeting consumers where they are at underpin our findings. Engaging with diverse groups may require greater attention to building formal, respectful partnerships and employing inclusive engagement methods.
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Affiliation(s)
- Anneliese Synnot
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Allison Jauré
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kelvin Hill
- Stroke Foundation, Melbourne, Victoria, Australia
| | - Peta Bates
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | | | - Tari Turner
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Abraham S, Foreman N, Sidat Z, Sandhu P, Marrone D, Headley C, Akroyd C, Nicholson S, Brown K, Thomas A, Howells LM, Walter HS. Inequalities in cancer screening, prevention and service engagement between UK ethnic minority groups. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S14-S24. [PMID: 35648663 DOI: 10.12968/bjon.2022.31.10.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
More people in the UK are living with cancer than ever before. With an increasingly ethnically diverse population, greater emphasis must be placed on understanding factors influencing cancer outcomes. This review seeks to explore UK-specific variations in engagement with cancer services in minority ethnic groups and describe successful interventions. The authors wish to highlight that, despite improvement to engagement and education strategies, inequalities still persist and work to improve cancer outcomes across our communities still needs to be prioritised. There are many reasons why cancer healthcare inequities exist for minority communities, reported on a spectrum ranging from cultural beliefs and awareness, through to racism. Strategies that successfully enhanced engagement included language support; culturally-sensitive reminders; community-based health workers and targeted outreach. Focusing on the diverse city of Leicester the authors describe how healthcare providers, researchers and community champions have worked collectively, delivering targeted community-based strategies to improve awareness and access to cancer services.
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Affiliation(s)
- Shalin Abraham
- F2 Academic Foundation Doctor, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Nalini Foreman
- Quality Assistant, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Zahirah Sidat
- Senior Research Practitioner, Hope Clinical Trials Facility, University Hospitals of Leicester NHS Trust, Leicester
| | - Pavandeep Sandhu
- Research Technician, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Domenic Marrone
- Research Technician, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Catherine Headley
- Senior Cancer Services Manager, Leicester City Clinical Commissioning Group, Leicester
| | - Carol Akroyd
- Collaboration for Leadership in Applied Health Research and Care Equality and Diversity Theme Manager, Centre for Ethnic Health Research, University of Leicester, Leicester
| | - Sarah Nicholson
- Hope Clinical Trials Facility Manager/Cancer, Haematology, Urology, Gastroenterology, General Surgery Research Lead, Hope Clinical Trials Facility, University Hospitals of Leicester NHS Trust, Leicester
| | - Karen Brown
- Professor in Translational Cancer Research, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Anne Thomas
- Professor of Cancer Therapeutics, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Lynne M Howells
- Experimental Cancer Medicine Centre Translational Research Manager, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Harriet S Walter
- Associate Professor of Medical Oncology, Leicester Cancer Research Centre, University of Leicester, Leicester
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Iqbal H, West J, McEachan RRC, Haith-Cooper M. Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study. Health Expect 2022; 25:1821-1831. [PMID: 35514272 PMCID: PMC9327845 DOI: 10.1111/hex.13527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner‐city areas of Bradford. Methods Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. Results This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women‐only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. Conclusion These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. Patient or Public Contribution Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis.
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Affiliation(s)
- Halima Iqbal
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK.,Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Jane West
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | | | - Melanie Haith-Cooper
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK
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Having a Say in Research Directions: The Role of Community Researchers in Participatory Research with Communities of Refugee and Migrant Background. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084844. [PMID: 35457711 PMCID: PMC9024418 DOI: 10.3390/ijerph19084844] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 12/10/2022]
Abstract
Research teams in high-income countries often fail to acknowledge the capacity and contributions of Community Researchers. This qualitative exploratory study used decolonising methodology and the Foundation House ‘Refugee Recovery Framework’ to understand Community Researchers’ perceptions and experiences of their role, and how research teams can integrate the knowledge they bring into research. Purposive sampling was used to facilitate the recruitment of eight Community Researchers from five different community groups working in Melbourne, Victoria. Semi-structured interviews lasting forty to sixty minutes occurred between December 2020 and January 2021. Data were analysed using reflexive thematic analysis. Findings reported in this paper include eight themes: ‘nothing about us without us’; ‘open the door’; a safe space to share; every step of the way; this does not translate; finding the right way to ask; a trauma-informed approach; and support within the workplace. The knowledge obtained demonstrates that Community Researchers facilitate meaningful participation in research for women, families, and communities of refugee or migrant background. Community Researchers’ presence, knowledge, and skills are vital in establishing culturally safe research practices and developing accessible language to facilitate conversations about sensitive research topics across multiple languages. Community Researchers can make important contributions at all stages of research, including data collection and interpretation.
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Howcutt SJ, Saini P, Henshall C, Brett J, Watson E, Smith L. Visualizing community networks to recruit South Asian participants for interviews about bowel cancer screening. J Cancer Policy 2022; 32:100333. [DOI: 10.1016/j.jcpo.2022.100333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/10/2022] [Accepted: 04/18/2022] [Indexed: 12/28/2022]
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Iqbal H, West J, Haith-Cooper M, McEachan RRC. A systematic review to identify research priority setting in Black and minority ethnic health and evaluate their processes. PLoS One 2021; 16:e0251685. [PMID: 34048459 PMCID: PMC8162667 DOI: 10.1371/journal.pone.0251685] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 05/01/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Black, Asian and minority ethnic communities suffer from disproportionately poorer health than the general population. This issue has been recently exemplified by the large numbers of infection rates and deaths caused by covid-19 in BAME populations. Future research has the potential to improve health outcomes for these groups. High quality research priority setting is crucial to effectively consider the needs of the most vulnerable groups of the population. OBJECTIVE The purpose of this systematic review is to identify existing research priority studies conducted for BAME health and to determine the extent to which they followed good practice principles for research priority setting. METHOD Included studies were identified by searching Medline, Cinnahl, PsychINFO, Psychology and Behavioral Sciences Collection, as well as searches in grey literature. Search terms included "research priority setting", "research prioritisation", "research agenda", "Black and minority ethnic", "ethnic group". Studies were included if they identified or elicited research priorities for BAME health and if they outlined a process of conducting a research prioritisation exercise. A checklist of Nine Common Themes of Good Practice in research priority setting was used as a methodological framework to evaluate the research priority processes of each study. RESULTS Out of 1514 citations initially obtained, 17 studies were included in the final synthesis. Topic areas for their research prioritisation exercise included suicide prevention, knee surgery, mental health, preterm birth, and child obesity. Public and patient involvement was included in eleven studies. Methods of research prioritisation included workshops, Delphi techniques, surveys, focus groups and interviews. The quality of empirical evidence was diverse. None of the exercises followed all good practice principles as outlined in the checklist. Areas that were lacking in particular were: the lack of a comprehensive approach to guide the process; limited use of criteria to guide discussion around priorities; unequal or no representation from ethnic minorities, and poor evaluation of their own processes. CONCLUSIONS Research priority setting practices were found to mostly not follow good practice guidelines which aim to ensure rigour in priority setting activities and support the inclusion of BAME communities in establishing the research agenda. Research is unlikely to deliver useful findings that can support relevant research and positive change for BAME communities unless they fulfil areas of good practice such as inclusivity of key stakeholders' input, planning for implementation of identified priorities, criteria for deciding on priorities, and evaluation of their processes in research priority setting.
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Affiliation(s)
- Halima Iqbal
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
- * E-mail:
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
| | | | - Rosemary R. C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
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