Black And Minority Ethnic Backgrounds Research Articles

Differential perceptions regarding personal protective equipment use during the COVID-19 pandemic by NHS healthcare professionals based on ethnicity, sex and professional experience

SummaryObjectivesTo capture perceptions regarding personal protective equipment (PPE) among healthcare professionals during the COVID-19 pandemic, including staff subgroups at high risk for severe COVID-19, such as black and minority ethnic (BAME) groups.DesignElectronically distributed survey with semi-quantitative analysis. Survey distributed at a major academic NHS tertiary referral centre in the West Midlands with a diverse medical workforce to medically qualified staff who completed COVID-19 redeployment training. (N=121; 47% female; 49% of BAME background; 26% international medical graduates).ResultsAll demographic groups reported overall good awareness of when and how to use PPE during COVID-19 pandemic. Statistically significant differences in the perceptions regarding PPE use during COVID-19 were noted between BAME vs non-BAME staff, international vs UK medical graduates, and male vs female participants, as well as between professionals at different stages of their career. The differences related to perceptions around availability, degree of protection provided, perceived inconvenience, ability to raise concerns about availability, confidence in sharing underlying health conditions with managers and the impact of full PPE in emergency situations causing delay patient care.ConclusionsAmongst medically qualified staff, significant differences exist in the perceptions relating to the, availability and effectiveness of PPE during the COVID-19 pandemic depending on country of training, ethnic background and sex.GAFREC Study ApprovalStudy ID GF0392.

COVID-19 and fertility services in the United Kingdom: a biphasic qualitative study.

SummaryRecently, fertility services have started resuming since COVID-19 was declared a pandemic, but there remains significant uncertainty in the way this care will be delivered in the United Kingdom. The objective of our study was to explore the impact of COVID-19 on individuals using fertility services in the United Kingdom. The study was conducted in two phases between May 2020 and July 2020: an online questionnaire involving 1212 participants and subsequent individual semi-structured telephone interviews with 15 participants. Through thematic analysis, we learned from the questionnaire findings that 74% of individuals identified as White British, 21% as Black and Minority Ethnic (BAME) and 2.6% as male. Ninety-six per cent of individuals from the questionnaire explained that COVID-19 had a ‘negative impact’ on their fertility treatment, namely ‘delay in care’. Eighty-two per cent of participants discussed concerns about the ‘uncertainty’ they felt about fertility services; these included the ‘unknown impact of COVID-19 on pregnancy outcomes’, the ‘unknown impact on general gynaecology services’ and the ‘unknown impact of COVID-19 on fertility success’. Through semi-structured telephone interviews with 15 participants, we learned about the ‘cultural pressures’ individuals from BAME backgrounds faced in relation to care. Participants were mindful about the ‘pressures on the service’ when reopening, and therefore ‘advancing maternal age’, ‘socio-economic background’ and ‘previous unsuccessful fertility treatment’ were the main factors individuals considered important when ‘prioritising’ fertility care. Our findings can be used by fertility service providers to appreciate the patient perspective when considering the reopening of fertility services nationally and internationally.Lay summaryThe impact of COVID-19 on patients seeking or undergoing fertility treatment is not entirely known. Many patients have had their treatment postponed during the pandemic. As fertility services begin to recommence, it is important to understand how the pandemic has affected this group of patients. In addition, it is vital to appreciate and understand the patient’s voice in order to ensure services take into account the patients’ concerns as they begin to offer certain fertility treatments. Our study was conducted in two phases and involved an online questionnaire and individual interviews with people. We found that people were worried about services restarting and how care would be prioritised. People also discussed some of the perceived barriers to seeking fertility healthcare. Our findings highlight the importance of understanding the patient’s voice when recommencing fertility services.

Partha Kar: Covid-19 and ethnicity-why are all our angels white?

The higher covid-19 mortality rate among people from black and minority ethnic (BME) backgrounds—both in healthcare workers and the general population—has shone a spotlight on an important matter. For those unfamiliar with the issue it may be a shock to realise that people from BME backgrounds, as a whole, have poorer outcomes than other groups. There’s a well established link between mortality rates and socioeconomic deprivation, and there’s been enough of a hint that people from BME backgrounds sometimes experience carer apathy too, whether it’s down to language barriers or downright racism. The NHS’s general response has been to produce lots of platitudes, a few glossy documents, and lots of verbal commitments to improve. Anyone looking for a previous example need …

The association between ethnic background and prostate cancer.

Prostate cancer is a complex disease which is more prevalent among men of black and minority ethnic (BME) background than their Caucasian counterparts, with men of African-Caribbean background experiencing higher levels of incidence and mortality than any other ethnic group. The reasons behind this health inequality are poorly understood and likely to be multifactorial. Several theories have been posited, including genetic disposition, poorer access to health care, a lack of understanding of the risks posed by prostate cancer and an unwillingness to access mainstream health care. There is, however, a notable disparity between the amount of literature focusing on prostate cancer as it affects those with a BME background and on prostate cancer in general. This further compounds the difficulties encountered by BME men, who rely on health professionals being aware of the greater risk they face. More knowledge and understanding is required by both the general population and medical practitioners to address this health inequality.

Barriers and facilitators of physical activity among adults and older adults from Black and Minority Ethnic groups in the UK: A systematic review of qualitative studies.

Older adults from Black and Minority Ethnic (BME) groups experience a relatively higher burden of physical inactivity compared with their counterparts from non-BME groups. Despite the increasing number of qualitative studies investigating the barriers and facilitators of physical activity among older adults from BME backgrounds in the UK, there is very limited review-level evidence. The aim of this review is to undertake a synthesis of existing qualitative studies, using a meta-ethnographic approach, to explore the barriers and opportunities for physical activity among adults and older adults from BME communities in the UK.Studies conducted between January 2007 and July 2017 were eligible if they met the following criteria: employed any qualitative method; included participants identified as being BME, aged 50 and above, and living in the UK. In total, 1036 studies were identified from a structured search of six electronic databases combined with hand searching of reference bibliographies. Ten studies met the inclusion criteria for the review and were included.Six key themes emerged from the data: awareness of the links between physical activity and health, interaction and engagement with health professionals, cultural expectations and social responsibilities, suitable environment for physical activity, religious fatalism and practical challenges. There was a substantial gap in research among Black African groups.Interventions aimed at improving physical activity participation among older adults should be acceptable and accessible to minority groups. Further research is needed to investigate the barriers and facilitators of physical activity among older adults from African backgrounds.

Counselling for young people and young adults in the voluntary and community sector: An overview of the demographic profile of clients and outcomes.

ObjectivesTo determine the demographic profile of clients accessing voluntary and community sector (VCS) counselling services for young people and young adults, and to undertake the first systematic evaluation of outcomes.DesignNaturalistic, non‐experimental study design.MethodsA total of 2,144 clients were recruited from nine services in England. Data on gender, age, ethnicity, number of sessions, problem descriptions, and initial levels of psychological distress were collected from clients. Calculations of reliable and clinically significant change, repeated measures t‐tests, effect size estimates, and moderation analyses were undertaken to determine whether pre–post change, over an average of 5.1 (SD = 5.3) sessions, was significant and which variables predicted outcomes. Levels of service satisfaction were also recorded.ResultsThe demographic profile of clients accessing VCS services was distinct to those accessing statutory and school‐based counselling services, with a greater representation of females, ‘older’ clients, and clients from Black and Minority Ethnic (BME) groups. Clients accessing VCS counselling services presented with multiple and complex needs. Statistically significant reductions in psychological distress were observed with effect sizes ranging from .64 to .80. High levels of service satisfaction were expressed by clients.ConclusionsThis study establishes that clinical outcomes in the VCS are comparable to those reported in school‐based and statutory mental health services in the United Kingdom. VCS services were perceived as being highly accessible and appear able to reach marginalized groups who may not be accessing other services.Practitioner points VCS services in the United Kingdom may be more accessible to young people from marginalized groups, such as those from BME backgrounds, compared to statutory and school‐based counselling services.Counselling in VCS services is associated with significant short‐term reductions in psychological distress, at a level comparable with the statutory and educational sectors.Clients accessing counselling in VCS services report relatively high levels of service satisfaction.

Perceived inequalities in care and support for older women from Black and minority ethnic backgrounds in Wales: findings from a survey exploring dignity from service providers’ perspectives

ABSTRACTObjective: As part of a large mixed-method study aimed at capturing understandings of dignity, and care expectations of community dwelling older women from Black and minority ethnic (BME) backgrounds living in Wales, the aim of this paper is to compare service providers’ perceptions of their care and support provided to older people in general, and to older women from BME backgrounds in particular, with a focus on two dignity indicators: care and support needs, and effective communication.Design: A survey design was used.Results: A total of 124 responses from service providers in Wales were received. Perceived inequalities in care and support were found. Although most respondents reported that care and support provision was generally acceptable, more respondents believed that compared to older people in general, older women from BME backgrounds were seldom or never offered opportunities and support to express their needs, were involved in their own care, were provided appropriate information, had their key needs especially less visible needs (psychological and religious needs) been taken into account, or were communicated with effectively (all p < 0.05). In some cases, respondents tended to report more positively in areas related to their own practice.Conclusion: We suggest that learning from the views and perceptions of service providers, as well as older people and their families, remains key to developing services for the UK's increasingly diverse and ageing population. A better understanding of how inequalities may occur, their impact on older people and their families, and how they may be minimised can inform the development of high quality care for older people regardless of their ethnic and cultural backgrounds in Wales, other parts of the UK and beyond.

Exploring the feasibility and acceptability of a school-based self-referral intervention for emotional difficulties in older adolescents: qualitative perspectives from students and school staff.

BackgroundAdolescents with emotional difficulties need accessible, acceptable and evidence‐based mental health interventions. Self‐referral workshops (DISCOVER workshops) were offered to stressed 16‐ to 19‐year olds in 10 Inner London schools.MethodSemistructured interviews were conducted with three groups of participants: students who attended a 1‐day workshop (n = 15); students who initially showed interest in the DISCOVER workshop programme, but decided not to take part (n = 9); and school staff who helped organise the programme in their schools (n = 10). Students were purposively sampled to ensure that those from Black and minority ethnic (BME) backgrounds were represented. Data were analysed using thematic analysis.ResultsThe accounts generally indicate that the delivery and evaluation of this intervention is perceived as feasible and acceptable. Students, including those from BME backgrounds, described the setting as suitable and reported that the workshop helped them develop new understandings of stress and how to handle it. They expressed a preference for engaging and interactive activities, and valued a personalised approach to workshop provision. School staff felt that the workshop was in line with school values. They described some logistical barriers to providing the workshops in school settings, and expressed a desire for more information about the workshop in order to provide follow‐up support. The main reason students gave for nonparticipation was limited time.ConclusionsFindings are discussed in relation to increasing the feasibility of implementing school‐based psychological interventions and the value of providing access to mental health support in schools.

Improving leadership skills and health outcomes.

The Mary Seacole awards provide an opportunity for individuals to be recognised for their outstanding work in black and minority ethnic (BME) communities. Set up in 2004, the awards are funded by Health Education England and made in association with the Royal College of Nursing, Royal College of Midwives, Unison and Unite, with the support of NHS Employers. They are open to nurses, midwives and health visitors in England, and recipients need not come from a BME background.

'To get to the top you must be prepared to take risks'.

Black and minority ethnic (BME) nurses have been a mainstay of the NHS since it was founded, but only a handful of directors of nursing are from a BME background.

Rates of criminal victimization in an early intervention for psychosis service - a cross sectional survey.

There is a growing body of research looking into the high rates of victimization amongst people with severe mental illness. Studies to date have tended to look at victimization rates in people with chronic mental illness over a wide age range. However, national crime surveys indicate that younger people are more likely to be the victim of crime than older people. There is also evidence that people from ethnic minorities are more likely to experience and less likely to report criminal victimization. This study therefore aimed to look at victimization rates specifically in young people with first episode psychosis (FEP) in Birmingham, one of the most youthful and ethnically diverse cities in the UK. Patients with FEP under the South Birmingham Early Intervention Service were asked to complete a modified version of the Crime Survey for England and Wales (CSEW). Data was compared to control-group data from the CSEW 2014. Patients with FEP were significantly more likely to be victims of crime, in particular violent crime, than their age-matched counterparts. The overall victimization rate was 39%. Black and Minority Ethnic (BME) groups were more likely to be victims of personal and violent crime than the white FEP population. Victimization rates were broadly in keeping with other UK and international studies. Young people with FEP, particularly those from BME backgrounds, are at significantly greater risk of victimhood than the general population of the West Midlands.

Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England

ObjectiveIn most developed countries, substantial disparities exist in access to mental health services for black and minority ethnic (BME) populations. We sought to determine perceived barriers to accessing mental health...

Chronic fatigue syndrome: Comparing outcomes in White British and Black and minority ethnic patients after cognitive–behavioural therapy

Cognitive-behavioural therapy (CBT) is one of the most promising treatments for chronic fatigue syndrome (CFS). It is unclear whether CBT is effective for Black and minority ethnic (BME) groups. To assess the effectiveness of CBT in BME patients compared with White British patients presenting to a specialist CFS service. Data from 67 (19.0%) BME participants and 285 (81.0%) White British participants referred to a specialist CFS service in the UK were collected at baseline and after CBT treatment. Pairwise comparisons revealed that both BME participants and White British participants significantly improved on measures of fatigue severity (P<0.001), physical functioning (P<0.001) and work/social adjustment (P<0.001). Independent samples t-tests showed that BME participants improved despite exhibiting significantly higher baseline damage beliefs (P = 0.009), catastrophising (P = 0.024), all-or-nothing behaviour (P = 0.036) and avoidance/resting behaviour (P = 0.001), compared with White British participants. To our knowledge, this study is the first to indicate that CBT is effective for treating CFS in a group of patients from diverse BME backgrounds.

Addressing social care needs and wellbeing of older migrants and ethnic minorities in the UK

Population ageing is a phenomena happening all over the world. In the UK, all groups of the population are growing older. These include people from different background, migration history, life experience and culture. Many studies highlight the relationship between the experience of people during various stages of their life, including childhood and adulthood working lives, on their health at older age. It is not a surprise then to observe an increasing policy and practice interest in migrants ageing in the UK. The latest UK census (2011) shows that more than half of London’s population identified their ethnicity not to be ‘White British’ and one in six people in the UK aged 65 or over. However, older people from Black and Minority Ethnic (BME) groups vary considerably between themselves and cannot be viewed as a homogenous group. How people migrated, their level of involvement in the labour market, their education and their participation in various activities are some of the factors that impact on their experience of ageing. Additionally, culture norms and perceptions are directly related to expectations from family, community and the wider health and social care system in providing care support. In this presentation I will draw on various studies related to ageing among different groups of older people from BME background, reflecting on some strengths and challenges that different groups may encounter. The paper aims to provide a more sympathetic understanding of subjective and structural barriers that some groups may face when accessing and receiving health and care services. It will conclude by a discussion of various strategies that materialise on various cultural norms to facilitate more effective communications and service acceptance.

Improving access to primary mental health services: are link workers the answer?

Background The incidences of common mental disorders such as anxiety, depression and low-level post-traumatic stress are associated with deprivation. Since 2007, the Improving Access to Psychological Therapy (IAPT) programme in Ealing has made it easier for primary care practitioners to refer patients with common mental disorders for treatment. However, fewer patients of a black and minority ethnic (BME) background were referred than expected. Setting Southall, Ealing, is a diverse ethnic community; over 70% of the population is classified as having a BME background. Aim To evaluate the effect of locating mental health link workers in general practitioners' (GP) surgeries on referral of BME patients to IAPT services. Methods In 2009, an initiative in Southall helped practitioners and managers that served geographic areas to work with many different agencies to improve whole systems of care. One strand of this work led to mental health link workers being placed in 6 of the 23 GP practices. They provided psychological therapy and raised awareness of common mental disorders in BME groups and what mental health services can do to improve these. Referrals to the service were monitored and assessed using statistical process control. Results The mean referral rate of BME patients for GP practices without a link worker was 0.35 per week per 10 000 patients and was unchanged throughout the period of the study. The referral rates for the six practices with a link worker increased from 0.65 to 1.37 referrals per week per 10 000 patients. Conclusions Link workers located in GP practices, as part of a collaborative network of healthcare, show promise as one way to improve the care of patients with anxiety and depression from BME communities.

Perinatal mental health services for black and ethnic minority women in prison

Objective: To provide a synthesis of published research concerning the perinatal mental health needs of black and minority ethnic (BME) women in prison. Methods: This integrative review utilised a narrative overview design to explore available literature. Results: The search strategy identified 13 relevant papers. Out of these, six met the inclusion criteria. The results found that imprisoned women are more likely to be from a BME background. As a group, pregnant women in prison present a vulnerable obstetric risk. In addition to the universal obstacles, BME women face further challenges of overcoming ethno-cultural barriers when trying to access appropriate perinatal mental health care while in prison. Clinical implications: BME imprisoned pregnant women are clearly a high-risk obstetric group, and their numbers are increasing. Deciphering and meeting the unique perinatal mental health needs of this group of women presents a challenge to both the health-care and prison systems. Becoming aware and sensitive to these needs is the first step towards policy makers and service providers addressing them. This research will add to the limited academic field on the perinatal mental health needs of BME women in prison. These findings demonstrate that more research and attention needs to be paid to this highly vulnerable group of women.

Factors associated with breastfeeding in England: an analysis by primary care trust

ObjectivesTo identify the sociodemographic factors associated with variation in area-based breastfeeding in England; to calculate the predicted breastfeeding rates adjusted for sociodemographic variations.DesignEcological analysis of routine data using random effects...

Supporting black and minority ethnic students in practice learning

The paper highlights the need of black and minority ethnic (BME) students in England to access support systems to help them overcome the challenges that they face as minority students when undertaking placement learning as part of their social work qualifying programme. It also considers the wider issue of developing supportive anti- oppressive practice with regard to all students undertaking the social work degree; i.e. ‘walking the talk’ of the values that underpin Social Work practice. Research shows that progression and retention rates for students from marginalised groups is lower than the sector averages and that specific support systems can improve the likelihood of course completion, as well as increasing student confidence.The paper evaluates a project undertaken to investigate and pilot how a mentoring support scheme and other good practice initiatives can increase the successful completion of practice learning for students from a BME background (and those with English as an additional language).

Can managed care networks improve perinatal mental healthcare for Black and minority ethnic (BME) women?

PurposePerinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and chronic mental health problems. Maternal mental illness can also adversely impact the cognitive, physical, and psychological health and development of children. In light of known psychosocial risks, there is concern that fewer than expected women from black and minority ethnic (BME) backgrounds access care and treatment. This paper aims to address this issue.Design/methodology/approachResponding to persistent reports of patchy service provision across the UK more generally and particular concerns about potentially unmet needs among BME women, mixed‐method research was undertaken between September 2009 and March 2010. Using survey questionnaires and telephone interviews, the study sought to explore professional stakeholders' perspectives on current perinatal mental health provision and the extent to which it meets the needs of BME women. Findings from the study were intended to inform policy and plans to improve provision by establishing managed care networks (MCNs) for perinatal mental healthcare.FindingsIn total, 45 questionnaires were returned from the national survey. One‐third of respondents (n=14) consented to follow‐up telephone interviews. There was evidence of multi‐agency working among the 27 professional groups which respondents reported as being directly involved in delivering perinatal mental healthcare across the country. However, there was also evidence of disjuncture and poor communication – particularly between statutory and voluntary sectors and NHS primary and secondary care. Some respondents had difficulty defining “BME” or identifying the women to whom the acronym might be applied. They also questioned the validity of providing “BME‐specific” services. Instead, they endorsed more ethnically “inclusive models” of provision and “signposting” women to appropriate “community” services.Practical implicationsTaken together, these findings suggests that whilst there might be a theoretical argument for perinatal mental health MCNs, considerable effort is required if policy‐makers' aspirations for more “joined‐up” services capable of meeting the needs of all women are to be fully realised. Furthermore, current proposals for public sector reform coupled with reduction in voluntary sector provision is likely to disproportionately affect women from BME and other marginalised communities as they provide significant amounts of “below the radar” care and support.Originality/valueThis paper is of particular relevance to policy makers and practitioners. Findings suggest that women from BME backgrounds might be particularly vulnerable to perinatal mental illness. Contraction of voluntary sector provision increases the likelihood that the needs of BME women will remain unmet with deleterious consequences for their health and wellbeing of their families. This has potentially serious public health implications. MCNs/clinical networks have the potential to reduce inequalities by providing more “joined up” care for all women. However, the evidence base for levels of need and appropriate service response to perinatal mental illness among BME women is weak. Further research is required to bridge the evidence gap and to evaluate the impact of health and social care reform on vulnerable groups.

Black and minority ethnic older people and mental well‐being: possibilities for practice

There is a shortage of examples of arrangements and practice approaches that focus on mental wellbeing in black and minority ethnic (BME) older people. This article draws on our practice enquiry1, which brought together accounts of social care practice across different types of social care settings from four parts of the UK, away from the areas of high demographic concentration that have been the focus of most previous research. Over 80 practitioners, managers, older people and carers were interviewed over 2009‐2010. They described and reflected on the support for older people from BME backgrounds, particularly focusing on how they might promote mental well‐being.