Black, Asian And Minority Ethnic Backgrounds Research Articles

A qualitative study exploring experiences of racial minority stress in pharmacy education and practice

BackgroundDespite 49.1% of registered pharmacists in the UK being from a Black, Asian and Minority Ethnic (BAME) background, senior management roles within pharmacy are dominated by white males. People from BAME communities may experience minority stress which contributes to a professional attainment gap compared with non-BAME colleagues. Minority stress describes additional stressors, such as unconscious bias, micro-aggression and racial minority stress, experienced by minoritized people to adhere to the social norms of the majority. There is little evidence describing experiences of minority stress in pharmacy practice and education. The aim was to explore experiences of racial minority stress in pharmacy education and practice. MethodsA convenience sample of pharmacy students and pharmacists were recruited via email and social media posts to volunteer to take part in interviews and focus groups. A topic guide was used to explore experiences of unconscious bias, microaggressions and racial minority stress in education and practice. Interviews and focus groups were transcribed verbatim and inductively analysed using thematic analysis underpinned by a phenomenological approach. Ethical approval was granted from Newcastle University (5340/2020, 2430/2593). ResultsForty-five participants were recruited. Six focus groups and sixteen one-to-one semi-structured interviews were conducted. The sample was varied, with 56% (n = 25) students and 33% (n = 15) registered pharmacists from community, hospital, primary care, academia and an additional 11% (n = 5) still in foundation training in these sectors. The sample include diversity of racial identities, including 40% (n = 18) South Asian, 27% (n = 12) White, 15% (n = 7) Black, 7% (n = 3) Chinese and Arab mixed, 2% (n = 1) and 2% (n = 1) Not disclosed. Three themes were identified – Theme 1) Experiences of racial minority stress, Theme 2) Making sense of racial minority stress, and Theme 3) Responding to racial minority stress. Participants characteristics (for example skin colour, dialect, religious dress) made them feel susceptible to judgement, racist comments and microaggressions in education and practice. Participants required time to interpret, understand and make sense of incidents of racial minority stress. Responses to stressors included ‘ignoring ignorance’ and using a ‘professional identity’ to mask feelings. However, malicious comments and actions from other pharmacy staff were responded to differently to experiences from patients. Participants reported poor self-confidence to challenge racist behaviours in the workplace. ConclusionsThe aim of this study was to explore experiences of racial minority stress in pharmacy education and practice. This study shows dealing with microaggression, racial minority stress and judgement in pharmacy education and practice is a burden experienced by people from BAME backgrounds. These experiences could contribute to the professional attainment gap in pharmacy, as making sense of these experiences is an additional burden pharmacists and trainees must bear in comparison to people from non-BAME backgrounds. Further work is needed to explore interventions to reduce minority stress in pharmacy practice and education to reduce the attainment gap across the sector.

How counselling psychologists address issues of race with clients from black Asian and minority ethnic backgrounds: A discourse analysis

The prejudiced experiences that Black, Asian and Minority Ethnic (BAME) clients report when discussing culture, racial discrimination and race has been documented. However, research seldom investigates the practitioners’ interpretations when engaging with clients from non-White ethnic backgrounds. This raises questions about how professionals address individuals' needs in clinical and supervisory practice. Therefore, the present study shed light on the discourses counselling psychologists use to address and discuss issues of race and discrimination when talking with clients in clinical practice. Semi-structured interviews were conducted with a purposive sample of six counselling psychologists (mean age 40 years) who had engaged with clients or supervisees from a BAME background. A Discourse Analysis (DA) was employed to analyze dialogue used by participants in discussing race and discrimination in counselling psychology practice. This analysis yielded three main discourses when counselling psychologists described their therapeutic interactions with BAME clients and supervises. These were Systemic Institutional Racism; Legitimizing Racism; and Challenging Systemic Racism. The first two discourses alluded to similar repertoires present in the discussions of white counselling psychologist participants, whereas the discourse challenging systemic racism was constructed by BAME counselling psychologists. Findings indicate that becoming attuned and open to discussing race-related difficulties supports favorable outcomes in practice when engaging with BAME individuals. This research offers valuable implications for service provision across counselling and therapeutic practice.

The Uptake of Mediation from Black Asian and Minority Ethnic families in Edinburgh, Scotland.

Cyrenians Mediation and Support Service (CMSS) has been operating inScotlandsince 2006.Working in partnership, the Early Intervention Partnership (EIP) in Edinburgh is a collaborative project between Cyrenians and Rock Trust with the aim of tackling youth homelessness through early intervention and preventing relationship breakdown due to conflict and arguments within families. In recent years, anecdotal evidencehas suggestedthat the service may not be receiving referrals proportionate to the population of Black, Asian, and Minority Ethnic (BAME) communities in Edinburgh. This led to CMSS applying fora research grant to carry outresearch to determine the uptake of the mediation and support service fromthose ofBlack,Asian and Minority Ethnic (BAME) backgrounds living in Edinburgh, and to compare this against the percentage of the population living in Edinburgh from BAME backgrounds. We were also keento listen to professionals working with BAME communities about their perception of the mediation service, as well as what they would look for themselves in a mediation service. This paper describes the research and its findings. Following the research, steps weretaken to implement the recommendations of the research, which are described below. But, first,weprovide some context and background to CMSS and mediationservice. Then, wereview studies of BAME communities and their access to services, including mediation, in the UK. From this, we identifysome of the barriers that are particular to BAME communities accessing services, which could be relevant to a mediation service that seeks to break down barriers to its services.

Bridging the gap: Understanding the barriers and facilitators to performance for Black, Asian and Minority Ethnic medical students in the United Kingdom.

Differential attainment is a well-known phenomenon in medical education. Despite a strong impetus for institutions and researchers to move away from a 'student deficit model' when exploring the attainment gap, little attention has been given to understanding the experiences of Black, Asian and Minority Ethnic (BAME) medical students. Informed by the social construction of learning theory, this is the first national study to explore how multiple dimensions of the medical school environment impact academic performance of BAME undergraduate medical students across the UK. Using a sequential explanatory mixed-methods approach, the authors conducted a survey and facilitated three focus groups across medical schools in the UK between 2020-2021. Participants self-identified as being from BAME backgrounds. Quantitative analyses included descriptive statistics and bivariate analyses. Qualitative data were analysed using thematic analysis, subsequently identifying inductive themes. Three hundred sixty-two respondents completed the Phase 1 survey, and 17 participants participated in the Phase 2 focus groups. Although both survey and focus group participants identified facilitators to learning such as supportive relationships, students reported facing numerous barriers that they felt impeded their learning and performance. These barriers included limited access to educational resources, and undiversified curricula and medical school populations. Students also described both experiencing and witnessing various forms of racism throughout their educational journeys. Students encountered various difficulties throughout their medical training that they felt impacted their learning and performance. This study offers novel insights into the experiences of BAME students and builds upon previous research. It also reveals the pervasive nature of racism within medical schools, highlighting the urgent need for institutional changes. Educators and institutions must go beyond merely recognising these barriers and facilitators; they must proactively innovate and adapt. In doing so, they pave the way for inclusive learning environments that truly foster a sense of belonging for BAME students.

The impact of COVID-19 on the changes in health behaviours among Black, Asian and Minority Ethnic (BAME) communities in the United Kingdom (UK): a scoping review

BackgroundThe COVID-19 pandemic has led to changes in health behaviours, which include eating patterns and nutrition, smoking, alcohol consumption, sleeping patterns, physical activity and sedentary behaviour. There is a dearth of evidence reporting the impact of COVID-19 on the health behaviour of Black, Asian and minority ethnic (BAME) communities. This scoping review synthesises the available evidence on the impact of COVID-19 on the changes in health behaviours among BAME communities in the UK.MethodsFollowing a keyword strategy, 16 electronic databases were searched for articles that met the screening criteria. These articles were then reviewed in full text. Empirical studies that assessed COVID-19 related health behaviour changes among BAME communities in the UK, conducted during the COVID-19 pandemic between July 2020 and August 2021 and published in English language, were set as inclusion criteria. An initial 2160 studies were identified in the selected databases. After removing duplications and screening the title and abstracts of the 2154 studies, only 4 studies were selected to be reviewed as they met the inclusion criteria. The included studies employed different sample sizes which ranged from N = 47 to N = 30,375 and reported several health behaviour changes. Out of the 4 included studies, 3 studies included BAME groups within their sample as a subgroup while one study focused specifically on BAME groups.ResultsThe scoping review found that there were lower levels of physical activity among BAME groups compared to the White ethnic groups. About 41.7% of BAME groups reported drinking less alcohol than usual compared to their white counterparts who were, 34% of whom reported drinking less alcohol. Study participants from BAME backgrounds had the greatest effect of COVID-19 on decisions to purchase healthier food compared to people from white backgrounds whose decisions on purchasing healthier food were least affected. Similar to other ethnic groups the COVID-19 pandemic increased positive hygiene among BAME groups which is important in preventing other diseases and infections..ConclusionCOVID-19 had a significant impact on the health behaviours of BAME groups especially during the lockdowns as they reported changes to behaviour such as low levels of physical activities. Hence, it is important to promote health awareness among BAME groups to encourage healthy living. In addition, programmes such as physical fitness activities that favour BAME groups should be put in place, for example BAME women’s walking groups to encourage people from BAME backgrounds to engage more in physical activities. Furthermore, healthy food programmes such as food parcels can be given to people from BAME backgrounds who are not able to afford healthy food due to the impact of COVID-19. Similar to other ethnic groups, the COVID-19 pandemic has increased positive hygiene among BAME groups which is important in preventing other diseases and infections.

Mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic in Luton, England

BackgroundThe COVID-19 pandemic intensified the risk factors for poor mental health among care workers in the UK. However, there is inadequate evidence on the mental health impact of COVID-19 on Black, Asian, and minority ethnic (BAME) care workers in particular. This study seeks to explore mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic.MethodThis is a qualitative study conducted between February and May, 2021 in Luton, England. A sample of n = 15 care workers from BAME background working in nursing and residential care homes were recruited purposively using the snowball sampling technique. In-depth interviews were conducted around topics such as views on COVID-19, the impact of the COVID-19 pandemic on mental health and coping during the COVID-19 pandemic. Data from the interviews was analysed using the Framework Analysis Approach.ResultsThe COVID-19 pandemic had a negative impact on the participants’ mental health as they experienced stress, depression, anxiety, trauma and paranoia. The majority of the participants explained that they managed their mental health by belief in God and religious practices, by keeping themselves busy doing activities they were passionate about, following government guidelines on the prevention of COVID-19, seeing the service users happy and some participants managed through support that was offered by the government. However, some participants did not have any support for their mental health.ConclusionIssues such as increased workload associated with COVID-19 restrictions engendered mental health problems among BAME care workers, however, the workload only further increased during the pandemic, but the health and social care sector was already affected by heavy workload due to staff shortages and this needs to be addressed through increasing their wages to encourage more people to work in the health and social care sector. In addition, some BAME care workers never received any support for their mental health during the pandemic. Hence, integrating mental health services such as counselling, supportive psychotherapy and recreational therapies in care homes could help to support the mental health of care workers in the COVID-19 era.

Choosing Midwifery − The perceptions and experiences of Black, Asian and Minority Ethnic applicants to midwifery programmes: A mixed methods study

Aimto explore recruitment to UK midwifery programmes from the perspective of applicants from Black, Asian and Minority Ethnic (BAME) groups and describe the perceptions and experiences of the application process for these applicants and those from white backgrounds. BackgroundMidwifery in the Global North is an overwhelmingly white profession. This lack of diversity has been cited as a factor in the poorer outcomes experienced by women from non-white backgrounds. There is a need for midwifery programmes to recruit and support more ethnically and racially diverse cohorts if this situation is to be addressed. Very little is currently known about the recruitment experiences of midwifery applicants. DesignA mixed methods study comprising a survey and individual interview or focus group. The study was conducted between September 2020 and March 2021 in three universities in South East England. Participants comprised 440 applicants to midwifery programmes and 13 current or recently qualified BAME midwifery students. FindingsAlthough many survey findings in respect to choosing a midwifery programme were broadly similar between candidates from BAME and non-BAME backgrounds, some trends were noted. More BAME applicants cited school/college rather than family as encouraging. More BAME applicants also indicated that they would consider issues of diversity when selecting a place of study, and BAME respondents appeared less likely to consider location and university life. Survey and focus group findings combined may indicate deficits in social capital available to BAME midwifery applicants. Focus group findings in particular suggest multiple experiences of challenge and inequity at all stages of the application process, together with a perception that midwifery is a niche and white profession. Applicants value proactive support from universities and would appreciate increased diversity, opportunities for mentorship and an individualised approach to recruitment. ConclusionsBAME applicants to midwifery can face additional challenges which have an impact on their ability to secure a place. There is a need to reposition midwifery as an inclusive and welcoming option for people from all backgrounds and to develop equitable recruitment processes that value a range of skills and life experiences.

A mixed method evaluation of the North East Black, Asian & Minority Ethnic mentoring scheme launch: Reflections & actions

Black, Asian and Minority Ethnic (BAME) individuals are underrepresented in the UK clinical psychology workforce and in the wider psychological professions (Scior et al., 2016). An ethnically diverse and representative workforce within the psychological professions is imperative to addressing the well-documented inequity in access and disparities in the NHS (Kline, 2014). Diverse organisations also lead to safer, more effective, and culturally responsive service provision (Haigh et al., 2014), including better patient care (Kline, 2014).The lack of diversity in the qualified workforce is reflected on clinical psychology training programmes, including evidence that applicants from BAME backgrounds experience multiple barriers at several stages across recruitment and selection as well as during training itself (Ragavan, 2018). These disparities exist despite psychology being a popular choice of undergraduate degree for BAME students (Turpin & Fensom, 2004). Recently there have been calls to ‘even the playing field’ and to develop initiatives to increase equity of access for aspiring clinical psychologists from a BAME background (BPS, 2015).With this in mind the North East Clinical Psychology Training programmes collaborated to develop a regional BAME mentoring scheme to address evidenced disparities faced by BAME aspiring Clinical Psychologists. To initiate the mentoring scheme, a virtual Launch event was hosted by the Newcastle Clinical Psychology Doctorate in August 2020.Out of 120 attendees, 48 completed the pre-evaluation questionnaire and 28 attendees completed the post-evaluation questionnaire. Some questions were relevant to both North-East courses, relating, for example, to a general sense of belonging in the profession and confidence and hopefulness about securing a training place in future. Other questions were specific to the Newcastle Clinical Psychology Doctorate and assessed, for example, intention to apply to this course, belief that training at Newcastle would be positive, and understanding around what skills and experiences would support a strong application to Newcastle.For the Newcastle-specific questions, results indicated that post-event, participants reported that they were significantly more likely to understand the skills and experience required for admission to the course. Participants were also more likely to believe that the Newcastle DClinPsy training programme would support individuals from a BAME background, however this result was not statistically significant. For the cross-course questions, participants reported that they were more likely to feel inspired to be part of the profession following the event, however this finding was not statistically significant. Qualitative analysis found that participants felt the event was ‘insightful’, ‘inspiring’ and ‘informative’.Although the feedback from participants was generally positive, this paper additionally explores and critically reflects on the value of widening access schemes and highlights the need to address structural and institutional barriers and disparities in clinical psychology beyond ‘widening access schemes’.

Barriers and gaps within services which affect Black, Asian and Minority Ethnic access to community Forensic CAMHS

PurposeThis paper aims to determine any barriers and gaps within one community Forensic Child and Adolescent Mental Health Service (FCAMHS) provision for young people presenting with risk of harm to others or involvement with the youth justice system, from Black, Asian and Minority Ethnic (BAME) backgrounds.Design/methodology/approachThis study presents a systematic review of literature into the barriers and gaps within community FCAMHS, which showed little research in the area. Because of this, referral numbers for five major cities within the Yorkshire and Humber community FCAMHS region were compared to population statistics and youth justice caution and sentencing data.FindingsComparison suggests that BAME young people are under-represented across referrals to community FCAMHS. Also, there were differences in the representation of BAME young people when compared to youth justice data across the five major cities.Research limitations/implicationsThe lack of literature, combined with disparities in proportional representation of BAME young people within the Yorkshire and Humber FCAMHS, shows the need for a detailed study and analysis within national community FCAMHS.Practical implicationsMore needs to be done within community FCAMHS to ensure that services are meeting the needs of young people at risk of criminalisation.Originality/valueTo the best of the author’s knowledge, there is currently no published literature that explores ethnic representation and access to community-based FCAMH services. Exploration within one regional service suggests that young people from BAME backgrounds may be under-represented within such services, whilst at the same time being over-represented within formal criminal justice.

A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK.

Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe's first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) backgrounds. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of "Practice Pointers" posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME backgrounds, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.

Collaboration and co-production with Black, Asian and minority ethnic students: working in partnership with our students to inform and deliver access and participation practice

In recent years, the topic of UK-domiciled undergraduate students from Black, Asian and minority ethnic (BAME) backgrounds not accessing, succeeding and progressing as well as their White peers in Higher Education (HE) has gained increased policy and media attention. Institutions are required to address gaps amongst student groups that are underrepresented within HE, including students from BAME backgrounds, through their Office for Students' (OfS) regulated Access and Participation Plan (APP). This paper offers specific examples of how Edge Hill University, a university in North West England, has begun to approach this work in the new regulatory environment. APPs now place an increased emphasis upon research informed practice, student engagement, consultation, and evaluation. This innovative practice article provides a detailed example of genuine collaboration and coproduction with students to develop and deliver APP work, and extends an earlier presentation delivered at the March 2021 Open University Access Participation and Success International Biennial Conference. In this article, the authors outline the development of a new Diversity Access Programme and a BAME Student Advisory Panel. The paper offers a reflective account of how APP leads, Widening Participation (WP) practitioners, evaluators and students can work together effectively in partnership to design and deliver WP initiatives.

A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK

Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe’s first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) backgrounds. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of “Practice Pointers” posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME backgrounds, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.

A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK

Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe's first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) background. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of "Practice Pointers" posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME background, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.

FACTORS AFFECTING THE HELP-SEEKING BEHAVIOUR OF BLACK ASIAN MINORITY ETHNIC (BAME) GROUPS FOR MENTAL HEALTH SERVICES IN THE UK: A LITERATURE REVIEW

Background: There are numerous reports from government publications, mental health charities, the World Health Organisation and array of journal articles all writing about mental health issues in relation to Black, Asian, and Minority Ethnic (BAME). It appears to have become common knowledge that there are disparities in the treatment received by BAME individuals from mental health services. It also commonly reported that BAME individuals are more likely to access mental services via adverse routes, this prognosis is said to worsen in the case of Black males. Aims: This review aims to explore what factors influence BAME individuals’ help-seeking behaviour for mental health services in the UK. It also explores why BAME individuals access mental health services at certain entry points. Methodology: This is a systematic literature review of 16 peer-reviewed journal articles reporting on data from UK-based studies, with a critical analysis in a thematic style. Findings: The help-seeking behaviours of participants in the studies are strongly determined by the values and beliefs they hold, which are deeply steeped in their culture. BAME individuals report that mental health professionals do not understand nor seek to understand their religious and cultural views on mental illnesses. Also, the impact of internalised and external stigma instigates secrecy whereby individuals hide their symptoms from professional mental health services and even from their extended family members. Conclusion: Culture plays a major role and impacts directly on peoples’ help-seeking behaviours. Individuals from BAME background tend to seek support from extended family members for physical illnesses but often hide their mental symptoms.

Fit-testing of respiratory protective equipment in the UK during the initial response to the COVID-19 pandemic

BackgroundPublic Health England guidance stipulates the use of filtering facepiece (FFP3) masks for healthcare workers engaged in aerosol-generating procedures. Mask fit-testing of respiratory protective equipment is essential to protect healthcare workers from aerosolized particles.AimTo analyse the outcome of mask fit-testing across National Health Service (NHS) hospitals in the UK during the first wave of the coronavirus disease 2019 (COVID-19) pandemic.MethodsUsing the Freedom of Information Act, 137 NHS hospitals were approached on May 26th, 2020 by an independent researcher to provide data on the outcome of fit-testing at each site.FindingsNinety-six hospitals responded to the request between May 26th, 2020 to October 29th, 2020. There was a total of 86 mask types used across 56 hospitals, 13 of which were used in at least 10% of these hospitals; the most frequently used was the FFP3M1863, used by 92.86% of hospitals. Overall fit-testing pass rates were provided by 32 hospitals with mean pass rate of 80.74%. The most successful masks, in terms of fit-test failure rates, were the Alpha Solway 3030V and the Alpha Solway S–3V (both reporting mean fit-test failures of 2%). Male- and female-specific pass and failure rates were provided by seven hospitals. Across the seven hospitals, 20.1% of men tested failed the fit-test for all masks used, whereas 19.9% of women tested failed the fit-test for all masks used. Failure rates were significantly higher in staff from Black, Asian, and Minority Ethnic (BAME) backgrounds 644/2507 (25.69%) across four hospitals.ConclusionTwenty percent of healthcare workers tested during the first response to the pandemic failed fit-testing for masks. A small sample revealed that this was most prominent in staff from BAME backgrounds.

Exploration of the impact of the COVID-19 pandemic on people with dementia and carers from black and minority ethnic groups

IntroductionDespite community efforts to support and enable older and vulnerable people during the COVID-19 pandemic, many people with dementia and their family carers are still finding it difficult to adjust...

Learning from the experiences of Black, Asian and Minority Ethnic (BAME) university students who withdraw from their undergraduate degree

Students from a Black, Asian and Minority Ethnic (BAME) background are more likely to withdraw from their undergraduate degree in the United Kingdom (UK). It is therefore important to explore withdrawal experiences and perspectives that relate to this population of students to increase both student retention and success. Thirteen UK-domiciled, full-time undergraduate, first-degree entrants from a BAME background, who had withdrawn from a post-1992 university in the West Midlands, took part in a semi-structured interview. The present study explored BAME student experiences of withdrawal which covered personal, academic and social concerns. Using a thematic analysis approach, five themes were developed: (a) academic issues, (b) does anybody even care? (c) balancing part-time employment alongside HE, (d) family perception and pressure and (e) the importance of social integration. Participants often discussed withdrawal as a holistic experience whereby although certain aspects were more prominently spoken about, generally withdrawal was a materialisation of more than one problematic area. There is a need for institutions to further understand the challenges faced by BAME students in order to provide more localised support and intervention to improve BAME retention, success and experiences within higher education (HE).

A Smartphone App Designed to Empower Patients to Contribute Toward Safer Surgical Care: Qualitative Evaluation of Diverse Public and Patient Perceptions Using Focus Groups.

BackgroundMySurgery is a smartphone app designed to empower patients and their caregivers to contribute toward safer surgical care by following practical advice to help reduce susceptibility to errors and complications.ObjectiveThe aim of this study is to evaluate service users’ perceptions of MySurgery, including its perceived acceptability, the potential barriers and facilitators to accessing and using its content, and ideas about how to facilitate its effective implementation. The secondary aim is to analyze how the intended use of the app might differ for diverse patients, including seldom-heard groups.MethodsWe implemented a diversity approach to recruit participants from a range of backgrounds with previous experience of surgery. We aimed to achieve representation from seldom-heard groups, including those from a Black, Asian, and minority ethnic (BAME) background; those with a disability; and those from the lesbian, gay, bisexual, transgender, queer (LGBT+) community. A total of 3 focus groups were conducted across a 2-month period, during which a semistructured protocol was followed to elicit a rich discussion around the app. The focus groups were audio recorded, and thematic analysis was carried out.ResultsIn total, 22 individuals participated in the focus groups. A total of 50% (n=11) of the participants were from a BAME background, 59% (n=13) had a disability, and 36% (n=8) were from the LGBT+ community. There was a strong degree of support for the MySurgery app. The majority of participants agreed that it was acceptable and appropriate in terms of content and usability, and that it would help to educate patients about how to become involved in improving safety. The checklist-like format was popular. There was rich discussion around the accessibility and inclusivity of MySurgery. Specific user groups were identified who might face barriers in accessing the app or acting on its advice, such as those with visual impairments or learning difficulties and those who preferred to take a more passive role (eg, some individuals because of their cultural background or personality type). The app could be improved by signposting further specialty-specific information and incorporating a calendar and notes section. With regard to implementation, it was agreed that use of the app should be signposted before the preoperative appointment and that training and education should be provided for clinicians to increase awareness and buy-in. Communication about the app should clarify its scientific basis in plain English and should stress that its use is optional.ConclusionsMySurgery was endorsed as a powerful tool for enhancing patient empowerment and facilitating the direct involvement of patients and their caregivers in maintaining patient safety. The diversity approach allowed for a better understanding of the needs of different population groups and highlighted opportunities for increasing accessibility and involvement in the app.

Understanding patterns of adherence to COVID-19 mitigation measures: a qualitative interview study.

BackgroundEvidence highlights the disproportionate impact of measures that have been introduced to reduce the spread of coronavirus on individuals from Black, Asian and minority ethnic (BAME) communities, and among those on a low income. An understanding of barriers to adherence in these populations is needed. In this qualitative study, we examined the patterns of adherence to mitigation measures and reasons underpinning these behaviors.MethodsSemi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation during the pandemic and to explore the reasons underpinning this behavior.ResultsWe identified three categories of adherence to lockdown measures: (i) caution-motivated super-adherence (ii) risk-adapted partial-adherence and (iii) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures and perceived importance of/need for the behavior.ConclusionsThis research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.

The UK physician workforce: one-third at increased risk of death from COVID-19

21% of NHS staff are from Black, Asian and minority ethnic (BAME) backgrounds yet account for a disproportionately high number of medical-staff deaths from COVID-19. Using data from the published OpenSAFELY Collaborative, we analysed consultant physicians to determine those at increased risk of COVID-19 related death. Data from 13,500 consultant physicians collected by the Royal College of Physicians were analysed to determine those at an increased risk of death from COVID-19, assuming no comorbidities. The data reveal a picture in which a third of consultant physicians have a hazard ratio (HR) >1 for dying from COVID-19; one in five have HR >2; one in 11, HR >3; and one in 40, HR >4. Of concern are the risks to male physicians aged ≥60 with HR >3.8. Sub-specialties including cardiology, endocrine and diabetes, gastroenterology, haematology, neurology and rheumatology have a greater risk profile due to high proportion of men, physicians of older age, and proportion of BAME individuals. A third of consultant physicians have an increased risk of a COVID-19-related death, and one in five have a higher relative risk (HR >2). The risk is mainly driven by age, gender, and ethnicity, the risk is highest in male consultant physicians over 60, especially from BAME backgrounds.