Ethnic Minority Backgrounds Research Articles

Experiences of using Electronic Medical Records among Patients from Ethnic Minority Backgrounds: A Rapid Review

Experiences of using Electronic Medical Records among Patients from Ethnic Minority Backgrounds: A Rapid Review

Exploring patients’ views and experiences of side-effects and how they are reported, a focus group study

Abstract Introduction Adverse drug reactions (ADRs) are an increasing health concern, causing considerable physical, psychological and economic impacts1,2. The yellow card scheme (YCS) is the UK’s spontaneous reporting system, allowing patients and healthcare professionals to report ADRs (3). Research has shown that patient reports could provide a beneficial insight into real-world situations and are a key aspect of pharmacovigilance2. Despite this, under-reporting by patients remains a significant issue that needs to be addressed1. Aim This study aimed to explore views and experiences of the public regarding ADR reporting. Methods Following approval from Cardiff University School of Pharmacy and Pharmaceutical Sciences Research Ethics Committee, adult members of the South Wales public who had experienced an ADR (“side-effect”) were invited via social media outlets such as Facebook and WhatsApp to participate in an online (Zoom) focus group to discuss their ADR experience (including whether they reported) and knowledge and views on the YCS. Healthcare professionals were excluded from the study. Written informed consent and demographic information via a short online survey were obtained prior to the focus group. The focus groups were audio and video recorded via Zoom and discussions were transcribed verbatim. A thematic analysis was executed to identify fundamental themes. Results Four focus groups, involving 11 participants took place. The sample consisted mostly of females between 18-30 years of age from an ethnic minority background. Themes identified were lack of knowledge of ADRs and the YCS; support and barriers to reporting ADRs and strategies for improving YCS reporting. There was a lack of knowledge of ADRs with uncertainty over the concept of “side-effect” and varying degrees of understanding on the topic. All participants had suffered side-effects that were severe in nature, affecting them physically, psychologically or cosmetically. None of the participants had any concept of the YCS and side-effect reporting. Despite this, participants felt reporting of side-effects was vital to ensure the safety of medications and prevention of patient harm. The majority of participants sought support for side-effects from a General Practitioner (GP) or community pharmacist, although difficulties accessing GP appointments was a barrier. Strategies suggested for increasing awareness of YCS to increase ADR reporting were use of posters, social media, QR codes, online prompts, coffee mornings and letters sent home to parents from schools. Discussion / Conclusion If patients are unsure around the concept of a side-effect and don’t know about the YCS, reporting rates will continue to fall. Although it is recognised that the sample is not fully representative of the Welsh population, this small-scale exploratory study has nevertheless identified some possible concerns but also some opportunities to engage patients in ADR reporting. Patient education by healthcare professionals on side-effects, alongside increased promotion of the YCS via social media and advertisements in healthcare settings are key opportunities to increase patients’ awareness and understanding of ADRs and ADR reporting. Further research is essential to understand the extent of these issues and also to investigate how healthcare professionals can facilitate this process. Follow-up studies are planned.

Educational outcomes of children with major congenital anomalies: Study protocol for a population-based cohort study using linked hospital and education data from England

Background Major congenital anomalies (CAs) affect around 2% of live births and are a primary cause of infant mortality, childhood morbidity and long-term disability, often requiring hospitalisation and/or surgery. Children with CAs are at greater risk of lower educational attainment compared with their peers, which could be due to learning disabilities, higher rates of ill-health and school absences, or lack of adequate educational support. Our study will compare the educational attainment of children with CAs to those of their peers up to age 11 in England, using linked administrative health and education data. Methods We will analyse data from the ECHILD (Education and Child Health Insights from Linked Data) database. Children born in NHS-funded hospitals from 1st September 2003 to 31st August 2008 whose hospital records were linked to their educational records at three Key Stages (ages 4/5, 6/7 and 10/11 years) will be included. Children with different CAs, indicated by recorded hospital diagnosis codes, will be compared to children without CAs. We will compare the proportions of enrolled children who take the assessment, the proportions who reached national expected levels of attainment, and the mean standardised attainment scores for Maths and English at each Key Stage. We will describe variations in outcome by sex, ethnic minority background, region, and neighbourhood deprivation, and perform regression modelling to compare the attainment trajectories of children with and without CAs, controlling for sociodemographic factors. Ethics and dissemination Ethics approval has been obtained for the analyses of the ECHILD database. Our findings will provide information for parents regarding their children’s expected academic potential, and also enable the development of interventions to support those at risk of not doing well. We will disseminate our findings to academics, policy makers, service users and providers through seminars, peer-reviewed publications, conference abstracts and other media (lay summaries and infographics).

Barriers to and enablers of the early diagnosis of breast cancer among women from ethnic minority backgrounds in the UK: protocol for a qualitative evidence synthesis

IntroductionBreast cancer is the most commonly diagnosed cancer in women of all ethnic groups in the UK. The largest single ethnic groups in the UK are white, Indian, Pakistani, black...

Understanding the barriers and enablers to participation in vaccine trials in a pregnant population from diverse ethnic background in an inner-city UK hospital.

Vaccination during pregnancy is an important healthcare intervention for safeguarding the health of the mother and their infants. Ethnic disparities in recruitment to vaccine research studies during pregnancy potentially contribute to health inequalities. The aim of the current study was to explore the barriers and enablers influencing the willingness of pregnant women from ethnic minority backgrounds to participate in vaccine research studies. Semi-structured qualitative online interviews were conducted with 23 pregnant women from diverse ethnic backgrounds in the UK. Interviews were transcribed verbatim, and thematically analysed. Our findings suggest that participants perceived vaccines and vaccine research, in principle, to be beneficial to the individual and to society, and understood the value of vaccination in mitigating severity of disease and protecting the health of mothers and their infants. Apprehension over the safety of vaccination in pregnancy was common and reduced willingness to participate. For those that decided to participate in vaccine trials in pregnancy, this was seen as an act of solidarity, a way to contribute to a collective responsibility for the public health of the community. Personal and community connections and representation-seeing people from their own communities represented in in the recruitment process shapped decisions about vaccine trial participating. Trust and mistrust in health systems, shaped by past experiences of interacting with healthcare professionals were likely to inform whether they would consider participating. Practical considerations such as excessive time commitments related to study procedures, travel and organising childcare were barrier to participation. The level of invasiveness of trial procedures were also a concern, although increased monitoring during the trial was seen as a potential benefit, mitigating some safety concerns. Our study reinforcing previously identified barriers to vaccine participation among pregnant women from diverse ethnic communities. This study underlines the need to develop tailored interventions that focus on fostering trust with the aid of community engagement to understand cultural contexts, establishing authentic representation, and address practical considerations, to contribute to enhancing vaccine trial participation in pregnancy in those from diverse ethnic communities.

Ethnic minorities who complete cardiac rehabilitation achieve equivalent functional capacity outcomes after cardiac rehabilitation but only half complete

Abstract Background Cardiac rehabilitation (CR) reduces the risk of death and repeat cardiac events and improves multiple patient outcomes. Ethnic minority backgrounds experience significant health disparities, often due to lack of fluency in dominant language and higher rates of cardiovascular disease risk factors. Despite these issues, outcomes for ethnic minorities from CR are rarely differentiated and participation in CR programs infrequently reported. Purpose To compare participation in and exercise outcomes from CR programs for patients from ethnic minorities versus the majority. Methods A secondary analysis from a national CR audit including 2335 CR participants. Ethnic minority was defined as having poor English language fluency requiring an interpreter for CR assessment. Functional capacity was assessed using 6-minute walk test (6MWT) or metabolic equivalent of tasks (METs). Binary logistic regression model was created to identify independent predictors of completion, accounting for baseline variables. Multiple linear regression models were used to determine if ethnic minority status was an independent predictor of change in 6MWT and METs after adjusting for baseline characteristics. Results Of the 2335 participants, 326 (14%) were from ethnic minorities. The mean age was 66.3±12.4 years and 70% males. There were no differences between minority and majority groups in relation to baseline characteristics. The most common referral diagnosis was myocardial infarction (27%), angina (25%), other – arrhythmias, cardiac devices, valve diseases/procedures (24%), and cardiac surgery (24%). Ethnic minorities were half as likely to complete CR (OR 0.49, 95% CI 0.38, 0.65) adjusted for age, sex, diagnosis, minority status, smoking, referral site and wait time (Table 1). Other factors that increase completion likelihood included all other cardiac diagnoses (compared to myocardial infarction as reference) and non-smokers, whereas major referral centre and female sex negatively impacted completion. Patients from ethnic minority backgrounds had less functional capacity at CR entry compared to the majority (379.9±118 versus 430.7±103 metres, p<0.001), though METs were comparable (6.69±2.73 versus 6.46±2.28 mg/kg/min, p=0.69). However, improvements were equivalent for 6MWT: minority 71.03±58.57 versus majority 71.37±61.16 (p=0.96), and for METs: minority 3.01±1.66 versus majority 3.13±1.74 mg/kg/min (p=0.77). Ethnic minority status was not an independent predictor of change in 6MWT and METs after accounting for age, sex, diagnosis, smoking, referral site, and wait time. Conclusion For patients from ethnic minority groups who completed CR, exercise/functional capacity outcomes were equivalent to majority participants, however less than one-in-two completed. CR programs should consider the needs of ethnic minority groups, particularly in relation to language and tailor content and delivery to promote participation and ensure more equitable access.

Fairer Training in public health, the UK FPH example

Abstract Background Public Health (PH) advocates for health equity and social justice. The UK Faculty of Public Health (FPH) is committed to tackling inequalities across the public health career pathway. The Fair Training project is a multi-phased programme which focuses on fair recruitment into PH, reducing differential attainment during PH training and postgraduate examinations. Objectives • Analyse available data from various sources; • Identify gaps in fair training culture and any biases; • Identify where support or interventions may best be focussed to minimise disadvantages; • Identify improvements in data that could be used to monitor actions; • Identify areas of good practice. Variables explored were demographic characteristics e,g, age, sex, ethnicity, disability status, professional background, candidate status (UK or overseas), place of primary qualification. Results Results show that candidates from ethnic minority backgrounds, those who are older, from international medical graduate backgrounds and backgrounds other than medicine are under-represented at the end of recruitment. Multivariable analysis of the diplomate exam shows that an attainment gap exists across increase with age, and those from black, Asian or white other ethnicity, professional background other than medicine, and overseas candidates. For the membership exam, multivariable analysis shows the attainment gap persists across those of increasing age and black ethnicity. Conclusions Recognising differential attainment as a structural problem requires organisational and individual leadership. Recommendations include an action plan to ensure: • Equality of opportunity for learning and career progression; • Collaborative working to eliminate discrimination in the design of education; • Ensure that training and the working environment are inclusive and diverse; • Inform future PH workforce planning; • Share good practice. FPH will implement the recommendations and share with other organisations and countries. Key messages • Structural causes of differential attainment during recruitment and training in public health do exist and should be mitigated. • FPH aims to promote Fair Training and excellence in public health practice.

Co-producing COVID-19 health education resources with ethnic minority communities in the UK

Abstract Background Effective communication of relevant health information is challenging in elderly minority ethnic groups due to language barriers and cultural differences. During the COVID-19 pandemic, much of the public health guidance around COVID-19 was in dominant languages, lacking cultural nuance. This study aimed to co-produce culturally, linguistically, and age-appropriate health education resources in COVID-19, tailored to the needs of older adults from ethnic minority backgrounds. Methods This study involved three stages: 1) Semi-structured interviews with Indian and Nepalese older adults (≥65 years), their families (≥18 years) and healthcare professionals (HCPs) (≥18 years) engaging with these communities; 2) Co-production of COVID-19 information resource, and c) Implementation of co-produced resources among the communities. Results 24 participants took part in the study. There was wide variation in participants’ knowledge of COVID-19; some were knowledgeable, while others had limited information. Participants highlighted the need for information in multiple formats and languages and discussed the importance of culturally avenues for information dissemination. Drawing on these findings and two co-production workshops held with the stakeholders, culturally sensitive information leaflets (electronic and paper) were co-prodcued in Hindi and Nepalese using age-appropriate images and infographics. The leaflets were distributed widely to the Nepalese and Indian communities, healthcare trusts and local authorities using the networks of community members, HCPs, and religious leaders. Conclusions The project highlights the significance of participatory methods in the development of culturally relevant public health interventions applicable to the cultural practices of ethnic minority groups. The co-production approach in this study could influence information provision for future public health campaigns for other marginalised groups. Key messages • Health information should be co-produced with a representative sample of the community members and relevant stakeholders. • There is a need on an ongoing basis to identify and fill the information gaps, address misinformation and develop targeted messages.

“You really shouldn’t be here”: using social identity theory to explore under-represented ethnic minority (UREM) students experiences of belonging in a UK dental school

There is tacit acknowledgment that the psycho-social and educational challenges experienced by under-represented ethnic minorities in medical school are likely to be similar to those experienced by ethnic minorities in dental school. However, dental scholarship is not as expansive or comprehensive by comparison to confirm if this is the case. This paper addresses this research gap by presenting the findings of a small-scale exploratory study into the experiences of nine dental undergraduates from a variety of ethnic backgrounds studying at one UK dental school. A social identity theoretical framework was applied to the analysis of semi-structured interview data. The study reveals that dental school is a racialised educational space, where whiteness and white privilege are the norm and students from ethnic minority backgrounds occupy ‘out-group’ status through a process of depersonalisation and stereotyping. Their experiences reveal the existence of a climate of everyday racism perpetuated by students and faculty alike. This research calls on dental schools, and the dental profession more generally to address the lack of inclusivity as a pressing concern requiring immediate action.

Outcomes of Providing Children Aged 7-12 Years With Access to Evidence-Based Anxiety Treatment Via a Standalone Digital Intervention Using Immersive Gaming Technology: Real-World Evaluation.

Anxiety disorders are among the most common mental health conditions in childhood, but most children with anxiety disorders do not access evidence-based interventions. The delivery of therapeutic interventions via digital technologies has been proposed to significantly increase timely access to evidence-based treatment. Lumi Nova (BfB Labs Limited) is a digital therapeutic intervention designed to deliver evidence-based anxiety treatment for those aged 7-12 years through a mobile app incorporating immersive gaming technology. We aimed to evaluate the real-world impact of providing access to Lumi Nova through UK National Health Service-funded mental health services. We analyzed precollected anonymized data routinely captured through the implementation of Lumi Nova from children aged 7-12 years, who lived in the United Kingdom and had the opportunity to use the intervention for at least 1 week over an 18-month period. Engagement indices included whether the game key was activated, number of unique sessions, time spent engaging, and number of "challenges" completed. Clinical outcomes were assessed using the Goal-Based Outcomes measure and Child Outcome Rating Scale. Demographic data were analyzed to assess the health equality implications of Lumi Nova. Of 1029 eligible families invited to use Lumi Nova, 644 (62.5%) activated their game key, of whom 374 (58.1%) completed at least one in-game graded exposure challenge. The median number of unique sessions was 6 (IQR 3-12) and the median time spent engaging with the intervention was 42 (IQR 15-79) minutes. For the subset of young people with paired outcomes, there were statistically significant small to medium improvements in goal-based outcome scores (n=224; t223=5.78, P<.001; d=0.37, 95% CI 0.25-0.52) and Child Outcome Rating Scale scores (n=123; t122=5.10, P<.001; d=0.46, 95% CI 0.27-0.65) between the first and last data points. Two in 5 young people's scores reflected a change that would be considered reliable. Analysis of demographic characteristics tentatively suggested that children from ethnic minority backgrounds and those living in the most deprived neighbourhoods may be less likely to access Lumi Nova, but children from socioeconomically deprived areas were more likely to successfully complete a challenge once they accessed the intervention (P=.02). However, the level of missing data and small number of children in some demographic groups limited meaningful statistical comparisons. This study provides initial evidence that Lumi Nova may be associated with improved outcomes for those aged 7-12 years seeking anxiety treatment in real-world settings. However, the lack of a control comparator group and information about concurrent treatments accessed by the young people, in addition to substantial attrition, limited the analysis that could be conducted and confidence in the conclusions drawn.

Reducing research participant disparities through use of a co-developed video intervention: A cohort nested pre-post study

Background Evidence on effective approaches for the recruitment of diverse populations remains limited. This study aimed to assess whether a co-developed study information video would improve participant ethnic diversity within a paediatric study cohort. Methods Pre-post study nested within the Uveitis in childhood prospective national inception cohort study, UNICORNS. Intervention of interest: study information and recruitment video with format and content co-developed with a patient expert group. Outcome of interest: the proportion of families from ethnic minority groups, and of families with primary caregivers without a higher educational degree who were recruited to the study, and the proportion of families who engaged in study activities (returned patient reported outcome metrics following recruitment) pre and post intervention implementation. Results During the study period, 191 children were recruited to UNICORNS (110 pre-intervention era, 81 post-intervention era). A larger proportion of families recruited in the post-intervention era were of an ethnic minority background (36% versus 20%, Fisher’s exact test p=0.02). A larger proportion of families returned self-descriptions of their sociodemographic background (100% versus 87%, Fisher’s exact test p=0.0003) and a larger proportion returned study specific patient reported outcome measures (70% versus 55%, Fisher’s exact test p=0.003). Conclusion Co-created digital research information resources can be an effective tool for ensuring better representation in research studies and may also support participant engagement overall. Our reported methods and findings should support other researchers in developing patient-centred and patient co-developed strategies and tools for the purposes of equitable access to medical research.

Diversifying the teaching workforce: challenges and opportunities in initial teacher education (ITE)

ABSTRACT Globalisation and migration have led to increasingly diverse classrooms. Yet teachers from ethnic minority backgrounds continue to be disproportionally under-represented in the teaching workforce. While education policies often focus on addressing student differences and diversity, the attention is rarely extended to diversifying the traditionally homogenous teaching workforce. The result is the widening diversity gap between teachers and the students they teach. This has implications for social justice, equity and inclusive education. While the benefits of a diverse teaching workforce are widely recognised, efforts to increase teachers from ethnic minority backgrounds yielded limited results. This paper discusses the challenges that support the attraction and retention of teacher candidates in initial teacher education and their transition into teaching and recommends strategies addressing structural, institutional, and environmental factors that deter them from the teaching profession.

Routine outcomes to investigate differences between ethnic minorities and White British people presenting to emergency services for injury: the stakeholder consultation.

Research has found differences in processes and outcomes of care between people in ethnic minorities and White British populations in some clinical conditions, although findings have been mixed. The Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries study is investigating differences in presentation, experience and health outcomes between people from ethnic minorities and White British people who seek emergency health care for injury. Our aim was to consult with stakeholders to define measurable outcomes available in routine ambulance and emergency department data; to assess the appropriateness of existing outcome measures for ethnic minorities and White British people; and to identify any gaps. Clinicians, public contributors, researchers, people from the third sector, public health, healthcare inclusion were invited to join an online workshop to discuss routine outcomes. Twenty participants attended the stakeholder consultation, with only one being a public contributor, a limitation. Eleven were from a minority ethnic background and seven were female. The integrated list of outcomes included 25 items, combining routine outcomes from the Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries protocol and literature (n = 17) with additional outcomes (n = 8). Notably, the initial list lacked provisions for safeguarding referrals and cases of treatment refusal, which were new additions. Safety concerns arose due to the lack of safeguarding referrals, treatment refusal and self-discharge. Factors such as pre-existing health conditions, injury location and experiences of discrimination were identified as possible influences on care quality and waiting times for ethnic minority patients. Although the number of stakeholders taking part in our consultation was low, their participation identified outcomes not found in routine data, supporting the adoption of a mixed-methods approach to answer our research questions. A future consultation could look to include more public members and wider range of clinicians including those who work in safeguarding and rehabilitation services. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132744.

The impact of ethnicity on care and outcome after hip fracture in England and Wales.

To determine if patient ethnicity among patients with a hip fracture influences the type of fracture, surgical care, and outcome. This was an observational cohort study using a linked dataset combining data from the National Hip Fracture Database and Hospital Episode Statistics in England and Wales. Patients' odds of dying at one year were modelled using logistic regression with adjustment for ethnicity and clinically relevant covariates. A total of 563,640 patients were included between 1 April 2011 and 1 October 2020. Of these, 476,469 (85%) had a coded ethnicity for analysis. Non-white patients tended to be younger (mean 81.2 vs 83.0 years), and were more commonly male (34.9% vs 28.5%; p < 0.001). They were less likely to be admitted from institutional care (12.9% vs 21.8%; p < 0.001), to have normal cognition (53.3% vs 62.0%; p < 0.001), and to be free of comorbidities (22.0% vs 26.8%; p < 0.001), but were more likely to be from the most deprived areas (29.4% vs 17.3%; p < 0.001). Non-white patients were more likely to experience delay to surgery for medical reasons (14.8% vs 12.7%; p < 0.001), more likely to be treated with an intramedullary nail or a sliding hip screw (52.5% vs 45.1%; p < 0.001), and less likely to be mobilized by the day after surgery (74.3% vs 79.0%; p < 0.001). Mortality was higher among non-white inpatients (9.2% vs 8.4% for white), but was lower at one year after hip fracture (26.6% vs 30.3%). Our study identified serious problems with the quality of NHS ethnicity data. Despite this, we have shown that there is complex variation in case-mix and hip fracture morphology between ethnic groups. We have also identified variations in care received between ethnic groups, and that disparities in healthcare may contribute to poorer outcome. Inpatient mortality is higher in non-white patients, although this finding reverses after discharge, and one-year mortality is lower. Patients from ethnic minority backgrounds experience disparities in healthcare, however at one year postoperatively non-white patients have a statistically significant lower mortality after controlling for relevant clinical covariates.

Abstract B128: Underlying factors influencing kidney cancer surgical treatment disparities: Patients, non-patient community members and urologists’ perspectives

Abstract Background: Racial and ethnic minority patients often delay or forgo kidney cancer (KCa) surgical treatment and have an invasive surgical treatment. This study aimed to understand the underlying factors of KCa surgical treatment disparities through interviews with KCa patients and non-patients from racial and ethnic minority communities in Arizona and online surveys with urologists who practice in the U.S. Methods: We conducted phone interviews with KCa patients (n=13) and interviews at health events with community members without KCa (n=61). Online surveys were conducted with urologists (n=54). Results: Many interview participants had healthcare access issues with 22% reporting not having a primary care doctor and 12% reporting that there was a time when they could not see a doctor because of cost. Almost 50% reported that they had delayed care because they could not get an appointment soon enough. Among 10 patients who responded to a question about diagnosis delay, 4 answered that they waited over a year to see their doctor when they had health issues before their diagnosis. A quarter of community participants (25%) and about a third of patients (31%) reported that cultural values or religious beliefs influenced their choice of treatment. When community participants were asked what they knew about KCa symptoms and treatments, many did not provide relevant or correct information. Only 51% of non-patients reported that they trusted their doctor’s judgements about their medical care, but 92% of patients reported that they trusted their doctor’s judgement. About 30% of urologists reported that patients from racial and ethnic minority backgrounds often have healthcare access challenges, but only 9% responded that NHW patients often have challenges. They did not report that racial and ethnic differences in treatment exist. About 10% of urologists reported socioeconomic backgrounds of patients affect treatment decision and timeliness often or all the time. Only 46% reported that they refer patients to necessary services all the time, when patients express concerns of finance and healthcare access challenges. Many urologists strongly or slightly agreed that treatment decisions should be made by the treating clinicians (82%) and based on clinical information (87%). Many also strongly or slightly agreed that patients and their family members should contribute to decision-making (98%), while 46% strongly or slightly agreed that patients’ cultural and religious backgrounds often affect their treatment choices. In open-ended questions, urologists responded that work and family obligations, healthcare access, and health literacy rather than race and ethnicity are factors influencing treatment, while mistrust was identified as one of factors influencing treatment delay. Conclusions: Barriers to healthcare access, lack of knowledge, and mistrust before diagnosis may be underlying factors among patients, while urologists view healthcare access, social and economic factors, and mistrust influence KCa surgical treatment decision and delay. Citation Format: Ken Batai, Alex Cruz, Juan Adrover, Daphne Larose, D'Andre Gomez, Francine C. Gachupin, Jacquanette R. Slowtalker, Benjamin R. Lee, Juan Chipollini. Underlying factors influencing kidney cancer surgical treatment disparities: Patients, non-patient community members and urologists’ perspectives [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B128.

Using natural language processing approaches to characterize professional experiences of child welfare workers

High turnover rates among child welfare workers, including caseworkers and supervisors, are associated with negative attitudes and perceptions about work (NAPW). Our study aimed to (a) explore how child welfare workers’ demographic characteristics, professional attributes, and their work narratives are related to NAPW and (b) extract themes from these narratives to understand their professional needs and concerns. In 2022, a statewide online survey was administered to active child welfare caseworkers and supervisors in a large Midwestern state. This survey, combining standardized scales and an open-ended question about work experiences, yielded numeric (N = 551 survey respondents) and text data (N = 2,193 words). We analyzed the numeric data using general linear modeling and the text data using natural language processing (NLP) techniques. Results showed that workers associated with higher NAPW were female, younger, from racial and ethnic minority backgrounds, less tenured, and more likely to be employed in public agencies and to work longer hours. They are predominantly caseworkers rather than supervisors. Worker role and agency affiliation had the largest effect sizes. NLP analysis showed that workers with more NAPW frequently used third-person pronouns and emotionally negative language, suggesting a disconnection from colleagues and job dissatisfaction. Caseworkers often used first-person singular pronouns, indicating feelings of isolation. Two key themes emerged: a) the need for better agency support during home visits and b) concerns over traumatic experiences and ineffective trauma-informed practices. The findings suggest that future interventions should prioritize the well-being of caseworkers in public agencies and consider language patterns in workers’ narratives to understand their vulnerability to NAPW.

A qualitative study of research participation for parents from minority ethnic groups in the UK

Background/Aims Under-representation of pregnant women, their partners and parents from minority ethnic backgrounds has been reported in research involving the perinatal period. This study's aim was to explore the experiences of parents from minority ethnic groups who participated in research during the perinatal period, focusing on barriers and facilitators to participation. Methods In-depth qualitative interviews were conducted via Microsoft Teams by all three researchers with a purposive sample of 16 parents. Data were analysed using thematic analysis. Results Seven overarching themes were identified: motivating factors; unique contributions; language, understanding and access; cultural values, beliefs and practices; lack of time and other commitments; facilitators for participation; and experience of the current study. Conclusions Understanding motivation for participation is essential to developing recruitment strategies that promote involvement of parents from minority ethnic backgrounds. A clear understanding of research goals and perceived benefits, and maximising access to studies, is likely to result in improved recruitment. Implications for practice Ways to encourage research participation from parents in minority ethnic groups include using a range of advertising techniques and venues, offering a choice of time and place for activities and alternative methods of data collection, and disseminating information on available studies in early pregnancy.

The roles that students’ ethnicity and achievement levels play in teachers’ choice of learning materials in online teaching: evidence from two experimental studies

AbstractResearch has shown that, in general, students are treated differently on the basis of their achievement levels and ethnicity. Such differential treatment might also result in the administration of different learning materials, and so far, not much is known about how teachers choose these materials for different students. In two vignette studies, we investigated which student factors influence teachers’ choice of materials. In Study 1, preservice teachers were asked to choose between an easy or difficult instructional video with the same content in response to vignettes that differed by students’ ethnic minority or majority background. In Study 2, preservice teachers could choose between text or video materials with the same content. The student descriptions varied systematically in achievement (high vs. low) and ethnic background (minority vs. majority). The results of Study 1 showed that ethnic minority background students were significantly more often given the easy video than ethnic majority background students. In Study 2, the results showed that student achievement was the crucial factor. Low-achieving students were given the video significantly more often, whereas high-achieving students were more often given the text. Both studies provide initial insights into how teachers’ material choice might be influenced by student characteristics.

Experiences of ethnic minority personnel in the armed forces: A systematic review

LAY SUMMARY An armed forces consisting of personnel from diverse and ethnic minority backgrounds offers considerable benefits, not just in terms of reflecting society but for improving the effectiveness of military operations. Many ethnic minority individuals serve for long periods, during which they experience personal growth and benefit from military service. However, little research has explored the impact these experiences might have on ethnic minority communities within the Armed Forces, who report higher levels of bullying, harassment, and discrimination. Given the lack of empirical research into armed forces ethnic minority personnel, this systematic review aimed to provide insight into and understanding of existing international research, relevant reports, and policy. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and included articles written in English since 2010. The review identified three themes — cultural identity, health status and health utilization, and trauma and discrimination — and indicated that ethnic minority personnel experience greater disadvantage than their native counterparts, both during and after service.

'Picking up the pieces': primary care practitioners' experiences of cancer care reviews.

The number of people who are living with and beyond cancer is increasing in England. Primary care delivers cancer care via structured proactive conversations which are incentivised through the Quality and Outcomes Framework (QoF): 'cancer care reviews' (CCRs). Declining workforce numbers, increasing patient demand, CCR policy changes in 2020 and the onset of the coronavirus disease 2019 (COVID-19) pandemic, highlight a need to explore how staff deliver CCRs. To explore primary care staff experiences with CCRs, identify their view of CCRs, how they conduct CCRs and their perceived value of CCRs. Descriptive qualitative study in general practices in England. Semi-structured online interviews with 15 primary care staff; data analysis using reflexive thematic analysis. Four themes were identified: varied and evolving perception of cancer, the delivery and impact of CCRs, changes to CCR delivery during the COVID-19 pandemic, ways to complement CCRs. Primary care staff felt that the way that cancer was perceived by patients, including those from ethnic minority backgrounds, impacted how CCRs were delivered. Cancer care involved acknowledging the challenge of a cancer diagnosis, helping decode jargon, and addressing unmet care needs. The pandemic resulted in remote CCR delivery for some practices. Staff suggested community cancer teams to provide cancer care alongside existing services. Staff adopted the new 3- and 12-month format CCRs despite the COVID-19 pandemic. Clinical staff may benefit from better training on cancer as a long-term condition and how cancer is perceived by people from diverse ethnic backgrounds.