British South Asian Communities Research Articles

British South Asian and Muslim Community's Perceptions and Experiences of Addiction and Traditional Drug and Alcohol Treatment Services.

Within traditional drug and alcohol (D&A) treatment services, the majority of those accessing support are of white ethnicity, with only a small percentage of people from the British South Asian (BSA) and Muslim community engaging in treatment services. This paper aims to explore perceived barriers to accessing traditional D&A services within the British South Asian and Muslim communities, based on qualitative data from interviews with family members and a practitioner. Qualitative data were obtained via 11 semi-structured interviews involving a practitioner (n = 1), and family and friends (n = 10) of those with historic and current D&A use in the community. Reflexive thematic analysis revealed four themes: (1) awareness of drug and alcohol use in the community, (2) drug and alcohol use as a taboo topic and the impact of admitting use, (3) knowledge of services for treatment, (4) how to increase awareness and accessibility of treatment. There was an increasing awareness of D&A use in the BSA and Muslim community. Despite this, limited conversations and misconceptions around D&A use and recovery led to those using D&A and their family members feeling stigmatised within their community and unable to seek support. This paper concludes by recommending increased communication between the BSA and Muslim communities and D&A treatment services to ensure accessibility of treatment by improving cultural competency.

Exploring the Multidimensional Characteristics of Selected and Non-Selected White British and British South Asian Youth Cricketers: An Exploratory Machine Learning Approach

Selection into a County Age Group (CAG; under 10–18) programme is the first step for young aspiring cricketers on their journey to achieving professional status. Recognising that the British South Asian (BSA) community represents 30% of those who play recreational cricket compared to less than 5% of those who are selected to play at the professional level in England and Wales, it is important to better understand the characteristics of selected and non-selected players based on ethnicity to identify potential sociocultural differences during selection. Thus, the purpose of this study was to investigate the multidimensional factors that differentiated between selected and non-selected adolescent male cricketers as well as between White British (WB) and BSA selected players into a CAG programme. A total of 82 male participants aged between 14 and 17 years were included (mean = 15.3 ± 1.1 years: selected n = 33 and non-selected n = 49: WB n = 34, BSA n = 44, Other n = 4). In total, 104 characteristics were measured over nine tests, which were subsequently placed into five overarching factors: (a) physiological and anthropometrical, (b) perceptual–cognitive expertise, (c) psychological, (d) participation history, and (e) socio-cultural influences. A Bayesian binomial regression was performed in rSTAN using a weak normal prior to highlight differentiators in selection as well as differences between WB and BSA selected players. The results highlighted that athleticism, wellbeing and cohesion, the number of older brothers, and being born in birth quarters two and three were positively correlated with player selection into a CAG. Conversely, increases in psychological scores, a greater number of younger brothers and older sisters, as well as antisocial behaviour resulted in a reduced chance of player selection. Finally, several developmental factors (i.e., athleticism, wellbeing and cohesion, psychological distress, and levels of anti-social behaviour) differed based on ethnicity. These exploratory findings serve as a useful opening to highlight there are important differences to consider based on selection and ethnicity in CAG cricket.

Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford: a qualitative interview study

BackgroundPain is a significant problem for many people with advanced disease or a serious illness. Culture and ethnicity can affect the experience and management of pain. However, there is limited research in South Asian communities in the UK on their experiences of pain. The aim of this study is to explore the experiences and attitudes of patients and family carers from South Asian communities about pain and its management within advanced disease or serious illness.MethodsQualitative thematic analysis based on descriptive phenomenology (Sundler et al. 2019). Qualitative semi-structured interviews with patients or family carers from South Asian communities (N = 15). Interviews were recorded, transcribed and analysed using an inductive approach. Public and Patient Involvement representatives from British South Asian communities were consulted for guidance.ResultsThere were five key themes from the interviews: The importance of communication about pain with healthcare professionals; Concerns about taking pain medication; Personal resilience, privacy and self-management; Gender, culture and pain; Home pain management as struggle and frustration.ConclusionTo improve pain management for people from South Asian communities with advanced disease or a serious illness, there are a number of important issues for healthcare professionals from palliative and primary care services to address. These include: greater awareness around people’s fears and concerns about pain medication; their potential use of alternative pain management strategies; and cultural issues such as resilience, privacy, dignity and gender roles. Effective communication between doctors, patients and family members could be improved by using a ‘cultural humility’ model; providing clear and accessible pain medication information; understanding and taking account of people with both low, and medium levels, of English language proficiency; and improving patient trust. Additionally, improvements to out of hours services could improve pain management for all patients managing their pain at home.

‘They Wouldn’t Believe Me’: Giving a Voice to British South Asian Male Survivors of Child Sexual Abuse

AbstractBritish South Asian male child sexual abuse (CSA) survivors face a twofold problem: lack of research on this phenomenon and limited service provision. First, male CSA survivors have traditionally been marginalized in favour of female CSA survivors, a group that forms the basis of most academic research and to whom the majority of counselling and support services in the UK cater (Rapsey et al. 2020). The centrality of these female experiences, although crucial to understanding CSA survivor experiences in general, has eclipsed the specific narratives of male survivors. Second, despite the UK’s incredibly multicultural population, people from minoritized backgrounds still experience institutional forms of racism that are entrenched in service provision and research and that lead to racialized and Eurocentric perspectives and practices (Singh 2019). This article thus seeks to expand on the existing body of literature on male CSA in minoritized groups. It illuminates the experiences of male survivors from British South Asian communities, creating space for the much-needed voices of a critically under-researched group.

British South Asian male nurses' views on the barriers and enablers to entering and progressing in nursing careers.

To ascertain British South Asian male nurses' views on the barriers and enablers to entering and progressing in nursing education and careers. There is a shortage of men from Black, Asian and Minority Ethnic groups in the National Health Service nursing workforce. There is a dearth of evidence on the views of British south Asian men on this subject. A qualitative interpretative intersectional approach was used to carry out one-to-one interviews (n=5) with British South Asian male nurses using a semi-structured topic guide. Interviews took place between July 2018 and February 2019, across England. A framework analysis approach was used to analyse the interview transcripts. The main themes emerging as barriers were as follows: poor pay and conditions; negative immediate, extended family, community views; and a lack of knowledge and awareness of the nursing profession. The main themes emerging as enablers were as follows: personal circumstances (including role models) and ethnicity (including the role of religion and masculinity). Findings suggest that the intersection between ethnicity and gender presents as an important enabler, as well as inhibitor, for British South Asian men. Nursing careers and salient barriers exist at a systemic level and include institutional racism. Managers review policies and practice on unconscious bias and institutional racism in the recruitment, retention and progression of British South Asian men. Employers provide continuous professional development including mentoring support to help career progression for these men. Human resources colleagues develop culturally specific interventions to reduce the stigma associated with the nursing profession in the British South Asian community. Nurse recruitment colleagues consider places of worship as venues for delivery of these interventions when promoting nursing.

779 Dietary Practices and Beliefs of British South Asian Patients With Inflammatory Bowel Disease: A Prospective Study From the United Kingdom

INTRODUCTION: The increasing incidence of inflammatory bowel disease (IBD) in developing countries and immigrant populations appears to outpace that which genetic influences alone could instigate and implicates “westernisation” and diet in the aetiopathogenesis of IBD. 1 Limited data exist on the dietary practices of the migrant South Asian population with IBD. We aim to describe the dietary practices of British South Asian patients with IBD and the information resources which guide these beliefs. METHODS: A prospective, cross-sectional, questionnaire-based study is being conducted in the UK. Two-hundred South Asian patients with IBD will complete a questionnaire regarding demographics and dietary practices. Here we provide an interim analysis of the data collected from the first 27 patients. RESULTS: Mean patient age was 36.1 years (59% male). 56% had UC and 44% Crohn's. 62% identified themselves as Pakistani, 19% as Indian and 19% as Bangladeshi. 74% of patients were born in the UK to parents born outside of the UK, the remaining 26% were born outside of the UK. Mean disease duration was 10.2 years. 48% considered diet to be an initiating factor in their IBD, based on their own experience (100%) and internet resources (31%). 63% of patients felt that diet had triggered a relapse of their disease, the most commonly reported foods being spicy (65%), fatty foods (53%), milk products (35%) and red meat (35%). 81% of patients avoided certain foods in an attempt to prevent an IBD “flare.” Most frequently avoided foods were spicy foods (91%), fatty foods (86%), coffee and carbonated drinks (55%) and red meat (50%). Just over a third of patients reported being able to find specific dietary advice for IBD, most commonly on the internet. Around half of patients avoided eating the same meal as their family or eating out to prevent relapse of their IBD. CONCLUSION: Dietary restriction may be highly prevalent amongst the British South Asian community with IBD with a high proportion reporting diet as an initiating factor and trigger for IBD. Studies on immigrant populations may hold valuable clues for IBD pathogenesis or related symptoms. A larger dataset will be presented at conference proceedings.

‘I Am Talking About It Because I Want to Stop It’: Child Sexual Abuse and Sexual Violence Against Women in British South Asian Communities

This article explores the role of socio-cultural factors in violence against women and girls, focusing on child sexual abuse (CSA) and sexual violence (SV) in British South Asian communities. Using examples from 13 in-depth interviews with survivors, the researchers examine (1) how abusers gain access to their victims, (2) family and community responses and (3) the role of cultural factors in concealing CSA/SV. The interviews demonstrate that British South Asian survivors are extremely reluctant to disclose SV/CSA due to factors that other groups of victims usually do not face, including a general taboo about discussing sex and strong cultural norms around notions of shame. These findings are contextualized in relation to a larger study that also involved community focus groups and interviews with professionals in relevant fields. Moving forward, new culturally specific support pathways for British South Asian victims must be developed that take account of the role that victims and their communities must play if CSA and SV are to be effectively combatted.

“Honour”-based violence in a British South Asian community

PurposeThe purpose of this paper is to explore attitudes towards, and victimisation experiences of, “honour”-based violence (HBV) in a reportedly vulnerable population in the UK.Design/methodology/approachA convenience sample of 216 participants were recruited from a local community in England; the majority were young (mean age=21.93), Indian or Pakistani (85 per cent), Muslim (96 per cent), females (67 per cent).FindingsAlthough gender differences were found for attitudes towards one aspect of HBV (namely, forced marriage), these were not significant. While HBV victimisation affected only a small proportion of this sample, when it was reported, the effects were serious and included anxiety, attempted suicides and running away from home. This highlights the need to identify and safeguard vulnerable groups without stigmatising whole communities.Originality/valueThese findings contribute to the scarce literature available on HBV in British communities, and highlight a need for culturally aware emergency and health service provision.

Policing the culture of silence: strategies to increase the reporting of sexual abuse in British South Asian communities

ABSTRACTThe policing of black and minority ethnic communities have a chequered history, with institutional racism, over policing and under protection being rife. While there have been several studies completed on policing and race, very little has looked at the intersectionality of race, gender and policing. Taking into account relevant literature which suggests that aspects of community policing may still suffer from institutional racism and based on original empirical research, this article attempts to contribute to a small literature base by concentrating on the low level of sexual abuse reporting from South Asian women and in particular on how four British police force areas currently respond to sexual abuse incidents where the victim is a member of the British South Asian community. In addition to evaluating these police responses we explore what more can be done by the police and other organisations to help increase the sexual abuse reporting rates from this and other ethnic groupings.

Explaining electoral fraud in an advanced democracy: Fraud vulnerabilities, opportunities and facilitating mechanisms in British elections

Explanatory theories of electoral fraud are usually developed for new and failing democracies. However, while rarer, electoral fraud does happen in advanced democracies. Because data on fraud in advanced democracies are scarce, single instances of fraud are studied in isolation and offer very little generalisability. This study uses a unique comparative dataset of 35 in-depth, semi-structured interviews from eight locations, only half of which experienced allegations of fraud. We show that theories of why and how fraud happens in developing democracies can be extended to an advanced democracy. We also provide a detailed description of two micro-mechanisms, which facilitate fraud taking place and thus provide a causal link between the structural vulnerability to fraud and the direct opportunities for fraud to take place. The case study of Britain focuses mostly on the biraderi structures within the British South Asian communities, but we offer ways in which these structures generalise more broadly.

Breaking Down Barriers: Recommendations for Improving Sexual Abuse Reporting Rates in British South Asian Communities

Sexual abuse reporting rates, which are low in general, are thought to be even worse for those living within British South Asian communities. After brief consideration of why British South Asian women and children do not report sexual abuse, this article focuses on the working practices of the non-governmental agencies that support such women. It reflects on existing legislation and policy and makes several key recommendations with reference to how this, along with practice, should change. The findings indicate an urgent need for a national training programme; the implementation of mandatory healthy relationship programmes; enhanced community involvement; outreach work; and the creation of victim groups and mentor schemes.

An exploratory study of image and performance enhancement drug use in a male British South Asian community

BackgroundConsumerism of image and performance enhancement drugs (IPEDs) is a world-wide public health concern. Given anecdotal reporting of increased normalisation of IPED use and uptake of British South Asian male IPED users at UK needle and syringe exchange services, the study aimed to explore use of IPEDs among this under-researched ethnic group. Methods20 in depth interviews were conducted with a purposive sample of British South Asian males attending harm reduction outreach in the North East of England. The interviews explored motives for use of IPEDs, sourcing routes, information seeking, injecting behaviours and cultural and community sensitivities around IPED use among this group. The data was collected and analysed using the Interpretative Phenomenological Analysis approach (IPA). ResultsMotives for use centred on the achievement of enhanced definition and density of muscle, and improved recovery from training and injuries. All participants reported initial stimulation of interest and triggers to seek information on IPEDs due to social media, community and peer messages. Diverse forms of IPED use were described, with rational and moderated use common among older participants. In contrast younger participants adopted more excessive use in seeking short cuts to attaining muscle size. Sourcing of androgenic–anabolic steroids (AAS) and growth hormones from originating countries (Pakistan, India) was reported, along with diversification of entrepreneurial activity into IPED dealing networks. Sellers were generally reported to provide effective and reliable products and mentoring to inexperienced users. Group injecting practices were common. IPED use was observed by some as health promotion medium within religious contexts. Crime deterrence and drug abstinence occurred for some while involved in AAS cycles. ConclusionsThe study is intended to contribute to health policy and practice debate around the targeting of dedicated education, outreach and harm reduction for ethnic groups engaged in IPED use.

The use of a collaborative structured methodology for the development of a multifaceted intervention programme for the management of asthma (the MIA project), tailored to the needs of children and families of South Asian origin: a community-based, participatory study

BackgroundAsthma is one of the most common chronic childhood illnesses in the UK. South Asian children are more likely to suffer from their asthma and be admitted to hospital. While this inequality needs to be addressed, standard behaviour-change interventions are known to be less successful in minority ethnic groups. Evidence suggests a need to enhance services provided to ethnic minority communities by developing culturally sensitive tailored interventions.ObjectivesThe Management and Interventions for Asthma (MIA) project aimed to test an iterative multiphase participatory approach to intervention development underpinned by the socioecological model of health, producing an intervention-planning framework and enhancing an evidence-based understanding of asthma management in South Asian and White British children.DesignInterviews and focus groups facilitated by community facilitators (CFs) were used to explore knowledge and perceptions of asthma among South Asian communities, children, families and healthcare professionals (HCPs). A smaller comparison group of White British families was recruited to identify aspects of asthma management that could be addressed either by generic interventions or by a tailored approach. Collaborative workshops were held to develop an intervention planning framework and to prioritise an aspect of asthma management that would be used as an exemplar for the development of the tailored, multifaceted asthma intervention programme.SettingThe community study was based in a largely urban environment in Leicester, UK.ParticipantsParticipants were recruited directly from the South Asian (Indian, Pakistani and Bangladeshi) and White British communities, and through the NHS. Children were aged between 4 and 12 years, with a range of asthma severity.Intervention developmentThe study had four phases. Phase 1 consisted of an evidence review of barriers and facilitators to asthma management in South Asian children. Phase 2 explored lay understandings of childhood asthma and its management among South Asian community members (n = 63). Phase 3 explored perceptions and experiences of asthma management among South Asian (n = 82) and White British families (n = 31) and HCP perspectives (n = 37). Using a modified intervention mapping approach incorporating psychological theory, phase 4 developed an intervention planning framework addressing the whole asthma pathway leading to the development of an exemplar multifaceted, integrated intervention programme called ‘ACT [Awareness, Context (cultural and organisational) and Training] on Asthma’.ResultsData on the social patterning of perceptions of asthma and a lack of alignment between the organisation of health services, and the priorities and competencies of British South Asian communities and families were produced. Eleven key problem areas along the asthma pathway were identified. A four-arm multifaceted tailored programme, ‘ACT on Asthma’, was developed, focusing on the theme ‘getting a diagnosis’. This theme was chosen following prioritisation by families during the collaborative workshops, demonstrating the participatory, iterative, phased approach used for the intervention design.ConclusionsThe MIA study demonstrated barriers to optimal asthma management in children at the family, provider and healthcare system levels and across the whole asthma pathway. Interventions need to address each of these levels to be effective. Minority ethnic communities can be successfully engaged in collaborative intervention development with a community-focused and culturally sensitive methodology.Future workFurther research is required to (1) assess the feasibility and effectiveness of the proposed ‘ACT on Asthma’ programme, (2) develop methods to increase active participation of children in research and service development, (3) develop and test strategies to enhance public understanding of asthma in South Asian communities and (4) identify effective means of engaging the wider family in optimising asthma management.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Speaking about sexual abuse in British South Asian communities: offenders, victims and the challenges of shame and reintegration

Cultural dynamics have a significant impact on how sexual matters, including sexual abuse, are discussed in British South Asian communities. The ways in which these communities talk about sexual violence often reinforce patriarchal norms and values, especially those concerned with honour and shame. As a result, victims are either silenced or the blame for the sexual violence they have suffered is laid at their own feet. Addressing the fact that these problems are rooted in patriarchal norms and values is key to understanding how to tackle sexual offending effectively in such communities. Both retributive and restorative justice are necessary in responding to sex crimes; retributive approaches help to recognise victims’ suffering, while restorative approaches offer promising avenues for encouraging victims and offenders alike to speak about their experiences. Both approaches are essential components to reintegrating victims and offenders into their communities.

Targeted case finding for hepatitis B using dry blood spot testing in the British–Chinese and South Asian populations of the North‐East of England

Chronic infection with the hepatitis B virus (HBV) is a frequent cause of cirrhosis and liver cancer. Targeted HBV screening is recommended by the Centre for Disease Control (CDC) and Prevention for subjects born in countries with >2% HBV prevalence. However, there are no UK guidelines. Here, we applied the (CDC) recommendations to the British-Chinese and British-South Asian community of North-East (NE) England. British-Chinese and South Asian subjects were invited to attend for HBV education and screening sessions held in community centres. Hepatitis B surface antigen (HBsAg) and hepatitis B core total antibody (HBcAb) were tested with dry blood spot tests. South Asians were also tested for hepatitis C antibody (HCVAb). A total of 1126 subjects (606 Chinese and 520 South Asian) were screened. Sixty-two (5.5%) were HBsAg positive. Ten of these reported a previous diagnosis of HBV. The prevalence of HBsAg positivity was 4.6% when previously diagnosed individuals were excluded. The HBsAg prevalence was significantly higher in the Chinese subjects compared with South Asians (8.7% VS. 1.7% P < 0.001). In Chinese subjects, HBsAg positivity was highest in subjects born in Vietnam (17.4%), followed by China (11%), Hong Kong (7.8%) and the UK (6.7%). Subjects from Pakistan had the highest HBsAg and HCV Ab prevalence in the South Asians (3.1% and 1.8%, respectively). Ten percentage of HBsAg positive patients who had follow-up assessment had active disease requiring antiviral treatment. Undiagnosed HBV infection was above the 2% threshold for screening suggested by the CDC in the British-Chinese and Pakistani community of NE England, which provides evidence for a UK HBV-targeted screening programme.

Assisted Conception and South Asian communities in the UK: public perceptions of the use of donor gametes in infertility treatment

This paper explores ‘public’ attitudes to the use of donated gametes in infertility treatment amongst members of British South Asian communities in the UK. The study included 14 single-sex focus groups with a total of 100 participants of Indian, Pakistani and Bangladeshi origins in three English cities and 20 individual semi-structured interviews with key informants. It explores five themes from the data: childlessness and stigma; using sperm and using eggs; cultural connections; choosing gametes; religion and the use of donated gametes; and disclosure and the management of information. The paper demonstrates that the socio-cultural context of fertility treatment is highly relevant and those delivering services and those consulting the public need to be aware of cultural and gender differences. Third party assisted conception represents a challenge to received ideas of identity and has implications for social reproduction and kinship which go well beyond immediate conjugal relationships.

The politics of performance and the creation of South Asian music in Britain: Identities, transnational cosmopolitanism and the public sphere

The identities of the various South Asian communities are shaped and recognized not only by their place of origin and their specific contexts of migratory history, but also by very diverse post-migratory adaptive strategies and practices taken up by these South Asians. The complexities and debates that surround the roles and positions of music in British South Asian communities and their specific contexts are indicative of these adaptations and re-appropriation of South Asian transnational cultures in the British context. Using the Liverpool-based South Asian arts promoter Milapfest as a case study, this article critically examines the significances and implications of the development of new forms of South Asian music in Britain and how they relate to the broader issues of production and reproduction of South Asian cultures and identities in transnational and global contexts. It also argues that their musical practice and the associated politics of participation is necessarily located in the dialogic nexus between religious and secular, public and private, homeland and diasporas.

PMO-171 A pilot of targeted case finding for hepatitis B virus (HBV) and hepatitis C (HCV) in the British South Asian community

IntroductionChronic HBV (cHBV) and HCV (cHCV) are frequent causes of cirrhosis and liver cancer. cHBV and cHCV are prevalent in subjects from South Asian countries and many infected individuals are...

Constructing Relatedness

This article explores how conceptual frameworks around new reproductive technologies may be influenced by religious and cultural contexts. Using data derived from an Economic and Social Research Council (ESRC) funded project on the public perceptions of gamete donation in British South Asian communities, the article discusses women's narratives of third-party assisted conception in infertility treatment, as constructed in focus group discussions. The analysis suggests a strong contrast in perceptions of egg donation and sperm donation. Embodied motherhood had the effect of naturalizing the use of donated eggs for women. Fatherhood, however, was seen as constituted by genetic relatedness in a patrilineal cultural context. Using donated eggs, then, was considered less problematic than using donated sperm. However, the embodiment of motherhood, the attachment of women to their biological material and the emotional ties of even `detached' reproduction, meant that women simultaneously had difficulty in imagining themselves becoming egg donors.

Voter Turnout in British South Asian Communities at the 2001 General Election

The turnout of 59.4 per cent at the 2001 general election was the lowest since 1918. It has been widely assumed that ethnic or religious minority electors are less likely to vote in general elections than white electors. Furthermore, electoral participation is regarded as both an indicator of the integration of minority communities and the quality of the democratic system. However, existing research that attempts to provide ethnic or religious specific estimates relies heavily on survey data or aggregate data. Most surveys do not overcome the problems of misreporting, non-response bias and a small sample size. Ecological estimates for minority groups are based on potentially spurious inferences from aggregate to individual data. In short, evidence of lower turnout among ethnic and religious minority electors remains inconclusive. Here we use an alternative method to gauge the level of participation among South Asian electors at the 2001 general election. This article uses evidence from complete sets of marked electoral registers from a random sample of 97 wards at the 2001 general election, analysed using names recognition software. This allows a unique analysis of electoral turnout among Britain's South Asian communities. Using religious origin to aid comparisons with other data sources, the results show turnout is as high or higher for South Asian electors than the rest of the population, but this varies by religious groups. For Hindus, turnout was significantly higher than the overall rate. Also using a multi-level logistic regression model, we find that South Asian turnout is statistically significantly higher in areas where there are more South Asians in the electorate, which is where overall turnout rates are much lower.