Minority Ethnic Communities Research Articles

Alexithymia, life satisfaction, depression and anxiety in black and ethnic minority communities in the UK

AbstractAlexithymia is the inability to express and recognise emotions and can be expressed in non-clinical populations. Alexithymia is typically experienced alongside depression, anxiety, and burnout. However, research in this area has not explored the extent to which alexithymia is experienced in Black, Asian and Minority Ethnic group. Access to treatment for this community are limited. The aim of the current research is to explore high vs. low scores of alexithymia on anxiety, depression, life satisfaction among British black and ethnic minority communities. A total of 94 participants had filled in questionnaires. Results indicated high levels of alexithymia resulted in increased anxiety, thus a decreased in life satisfaction. However the hypothesis of high alexithymia resulted in high depressive symptoms were not found. Additionally, there were no gender difference in alexithymia level.

Health and Comorbidities in Minority Ethnic Adults Living with Visual Impairment in the UK

Visual impairment has been associated with mental and physical comorbidities in older adults. Research into comorbidities within minority ethnic communities (MEC) with visual impairment is yet to be explored, despite the increase in numbers. A secondary analysis of survey data collected by UK-based sight loss charities provides the first insight into comorbid conditions in a matched control sample of 77 MEC and 77 White adults aged 18–85 years. Participants were matched based on age, gender, UK region, and urban/rural setting. Group differences were explored, and subgroup analysis was also carried out for the two largest subgroups within the MEC group: Asian (n = 46) and Black (n = 22). Response frequencies (n) and proportions (%) were calculated for all variables including eye conditions, vision difficulties, comorbid conditions, and exercise. The sample was predominantly young, and few significant differences were found. Sub-group analysis showed that Asian participants were more likely to report not doing any exercise, having bad health, and comorbidities including high blood pressure, dexterity, hearing and communication difficulties, and a recent emotional/psychological/mental health condition. Black participants, however, were more likely to report comorbidity, in particular physical conditions and mobility difficulties.

Social Media, Newsworthiness, and Missing White Woman Syndrome: A Criminological Analysis

Missing White Woman Syndrome has been widely acknowledged within traditional mainstream media, resulting in a heavy focus on missing white women and a simultaneous underrepresentation of missing women from minority ethnic communities. However, less is known about whether this has carried through to social media, wherein users play a key role in determining what becomes widespread news. This review seeks to examine this issue with reference to existing research. It begins by exploring the concept of newsworthiness and the ways in which social media influences the distribution of news. It will then review the concept of the ‘ideal victim’, and its continued association with ethnicity. Finally, the review will examine Missing White Woman Syndrome and the ways in which it has historically manifested within traditional media and continues to manifest on social media. The review will conclude with a discussion on findings and avenues for future research in Ireland and internationally.

Access to eye care and support services among adults from minority ethnic communities living with visual impairment in the United Kingdom.

Despite an increased risk of certain eye conditions which can lead to visual impairment (V.I.), there is evidence of a greater delay to treatment-seeking among adults from minority ethnic communities (MEC). MEC adults may also be underrepresented on V.I. registers, within early intervention services, and among the beneficiaries of national V.I. charities. However, much of this evidence is outdated or anecdotal. This secondary analysis of V.I. Lives survey data explored use of eye health and support services and mobility aids among a matched control sample of 77 MEC and 77 adults aged 18 and over from white communities (WC). Participants were matched on age, gender, UK region and urban/rural setting. Additional subgroup analysis was conducted for Asian (n = 46) and black participants (n = 22). There were no significant group differences in areas such as eye health service use, registration status, contact with charities, and level of practical support received. But MEC participants were significantly more likely than WC participants to have received direct payments from social services to cover their care needs, Χ2 (1, 154) = 8.27, p = 0.004, and to use apps on their mobile for mobility, Χ2 (1, 154) = 5.75, p = 0.017. In contrast, WC participants were significantly more likely to agree that they were getting the level of emotional support to get on with their life, U = 3,638, p = 0.010, to feel confident to ask their friends for support, U = 2,416, p = 0.040, and to have a guide dog for mobility, Χ2 (1, 154) = 3.62, p = 0.057, although the latter did not reach statistical significance. Within the MEC group, Asian participants were significantly more likely than black participants to use a long cane, Χ2 (1, 68) = 7.24, p = 0.007, but they were significantly less likely to agree that they had received the right level of support when they started to experience V.I., U = 236.5, p = 0.040. The preliminary findings suggests that there is scope to increase support provided by V.I. charities and the V.I. register, although, contrary to existing evidence, there were no statistically significant differences in eye health service use, registration status and use of wider support services. Further research is required to confirm these findings and explore reasons for differences.

Detention of children and adolescents under mental health legislation: a scoping review of prevalence, risk factors, and legal frameworks

BackgroundFor individuals with severe mental illness, involuntary assessment and/or treatment (hereafter detention) can be a necessary intervention to support recovery and may even be lifesaving. Despite this, little is known about how often these interventions are used for children and adolescents.MethodsThis global scoping review set out to: (1) map the current evidence around mental health detentions of children and adolescents (< 18 years); (2) identify the clinical, sociodemographic, and behavioural factors associated with detention; and (3) document the views of professionals and young people on the implementation of mental health legislation.ResultsAfter searching databases of peer-reviewed literature and citation chaining, 42 articles from 15 jurisdictions were included. About one fifth of psychiatric admissions in national register data were detentions, however trends were only available for a few high-income Western countries. The circumstances justifying detention and the criteria authorising detention varied between studies, with a mix of clinical factors and observed behaviours reported as the reason(s) warranting/precipitating a detention. Particular groups were more likely to experience detention, such as children and adolescents from minority ethnic communities and those with a documented history of abuse. There was a notable absence of qualitative research exploring the views of professionals or children and adolescents on detention.ConclusionFurther research is needed to explore the impact of detention on those aged < 18 years, including national register-based studies and qualitative studies. This is particularly relevant in nations currently undergoing legislative reform.

Misaligned or misheard? Physical activity and healthy eating messaging to ethnic minority communities during the COVID-19 pandemic: A qualitative study and scoping review.

This mixed-methods study identified physical activity (PA) and healthy eating messages produced during the COVID-19 pandemic and explored how they were received by UK ethnic minority communities. A scoping review of research and grey literature identified categories of PA and healthy eating messaging targeted at ethnic minorities. Individual and group interviews were conducted, audio-recorded, transcribed and analysed using inductive thematic analysis. There was active community engagement in all study phases to ensure relevance and co-production of findings. Interviews were held with 41 study participants aged 18-86 years (20 men) residing in England and Wales using digital conferencing and in person. The scoping review identified 24 records containing messages grouped into three categories: 1) PA messages; 2) healthy eating messages; 3) risk messages. Five themes described participants' views of these messages: 1) lack of awareness of messaging; 2) responses to PA messaging; 3) responses to healthy eating messaging; 4) perceptions of risk messaging and 5) perceptions of conflict in messages. The review revealed that physical activity and healthy eating messaging specifically targeting ethnic minority communities is limited. This limited messaging was almost entirely missed by these communities. When received, the messaging was not interpreted as intended, perceived to be conflicting and risk messaging was perceived as blaming. More work with ethnic minority communities needs to be done to co-produce meaningful and appropriate PA and healthy eating messaging in a timely manner.

Improving Pathways to Care for Ethnic Minority Communities.

It is well established that the COVID-19 pandemic has had a substantial impact on ethnic minority communities and has worsened existing health inequalities experienced bythese populations globally. Individuals from ethnic minority backgrounds have not only been more likely to become infected with COVID-19 throughout the pandemic, but they have also higher risk of adverse symptoms and death following infection. Factors responsible for these discrepancies are wide reaching and encompass all aspects of the social determinants of health (SDoH). Although always an area of concern among healthcare professionals, barriers to health care experienced by ethnic minority populations became a more pertinent issue during the COVID-19 pandemic when all individuals required sufficient and sustained access to a healthcare system (whether this be for COVID-19 testing, vaccination or treatment). These healthcare barriers exacerbated the increased COVID-19 burden experienced by minority populations and will continue to detrimentally impact the health of these populations during future COVID-19 waves or indeed, future novel pandemics. This chapter aims to summarise the major healthcare barriers experienced by minority populations throughout the COVID-19 pandemic, includingCOVID-19prevention, vaccine rollout, care during hospitalisation and post-COVID care for long COVID patients. To end, this chapter will summarise lessons learned and future directions that need to be taken to improve health disparities and healthcare access for minority populations in relation to the COVID pandemic and beyond.

Carers’ and therapists’ views of internet-delivered guided self-help acceptance and commitment therapy for family carers of people with dementia (iACT4CARERS): a qualitative study in the context of ethnic minority families

Abstract This study aimed to explore the views of family carers of people living with dementia from ethnic minority groups and their therapists on internet-delivered, self-help acceptance and commitment therapy for family carers (iACT4CARERS), enhanced with additional therapist guidance. To achieve this, a qualitative approach with semi-structured interviews was employed with ethnic minority carers who completed Enhanced iACT4CARERS (n=9) and therapists who supported them throughout the programme (n=5). The interviews were audio-recorded, transcribed and analysed using framework analysis. Four over-arching themes were identified: (1) Value of the programme to ethnic minority carers, (2) Barriers for ethnic minority carers, (3) Sense of connectedness through written feedback, and (4) Sense of connectedness through one-to-one sessions. Theme 1 reflected that ethnic minority carers valued ACT techniques, highlighting their usefulness and simplicity, leading to perceived benefits. Theme 2 revealed the irrelevance of examples provided of carer experiences throughout the programme due to differences in family carers’ experiences of providing care within ethnic minority communities. Theme 3 highlighted that carers’ engagement with the programme was facilitated by feelings of validation and encouragement received from their therapist via weekly written feedback. Finally, Theme 4 highlighted that additional one-to-one support sessions allowed both carers and therapists to develop strong therapeutic relationships. This enhanced subsequent text-based online interactions, allowing carers to be more open and engaged. Also, therapists reported that a strong sense of connectedness helped them to tailor their feedback. Enhanced iACT4CARERS that uses carers’ experiences more relevant to ethnic minority communities may be more acceptable. Key learning aims (1) To understand the views of family carers of people living with dementia from ethnic minority groups and their therapists on internet-delivered, self-help acceptance and commitment therapy (ACT), which has been found to be feasible and acceptable with White British carers. (2) To understand whether additional one-to-one support can help develop effective therapeutic relationships and thus improve the experiences of carers in completing the programme. (3) To learn whether any cultural adaptations are needed to improve the acceptability of internet-delivered self-help ACT among this population.

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.

Research following trauma in minority ethnic and faith communities: lessons from a study of the psychosocial sequelae of the Christchurch mosque terror attacks.

Recruiting participants for research from highly traumatised ethnic and faith communities requires a participatory and trauma-informed approach that considers logistic barriers, as well as trauma-related and culture-specific issues. Active community engagement through every stage of the project and employing community members in research roles can help build trust, identify and mitigate concerns early, prevent re-traumatization, and ensure that findings will be of value to the community. Some of these research challenges are discussed in the context of the Christchurch mosque terror attacks. These insights may be helpful for researchers and clinicians working in similarly challenging environments.

Supporting People With Musculoskeletal Conditions From Underserved Communities in the United Kingdom to Engage With Physical Activity: A Realist Synthesis and Q-Methodology Study.

In the United Kingdom, 20 million individuals suffer from a musculoskeletal condition, for which physical activity (PA) is a core treatment. Minority ethnic communities experience a disproportionate impact, experiencing higher levels of pain and engaging in less PA. Research has identified various factors that affect their participation in PA, including lack of access to support, limited knowledge of resources, language barriers, fear of racial harassment while exercising, and insufficient communication/information from healthcare professionals. This project adopted a realist perspective, aiming to understand "what works, in which circumstances, and for whom?" The project had 4 steps: (1) defining review scope with stakeholders; (2) searching and extracting literature, creation of initial program theories; (3) refining/validating initial program theories with stakeholders; and (4) adopting Q-methodology to highlight priority areas. 17 papers were included. Three program theories were identified: (1) Lack of initial access to health service support; (2) Nature of musculoskeletal self-management support-the importance of the therapeutic relationship and value of shared conversations; and (3) Accessible long-term support for PA engagement. The Q-sort exercise highlighted priority areas: (1) complex booking procedures and inadequate translation services, (2) time constraints impact effective patient-centered care, (3) dismissive attitudes/mismatched expectations impact shared decision making, (4) rebuilding trust to strengthen therapeutic relationships, (5) cultural relevance in developing therapeutic relationships, and (6) clinician recommended PA opportunities increase knowledge of PA. Our findings shed light on inequities across the UK's musculoskeletal pathways, specifically in relation to PA engagement. This points toward priority areas for future research and interventions.

Spiritual Forests—A Nature Conservation Model of Ethnic Minority Communities in Central Viet Nam

Spiritual Forests—A Nature Conservation Model of Ethnic Minority Communities in Central Viet Nam

Sustainable tourism governance: A study of the impact of culture

This study meticulously explores the intricate interplay between sustainable tourism and the preservation of cultural heritage, focusing on how tourism practices can foster the protection and revitalization of cultural and ethnic traditions within diverse communities in Thanh Hoa province, Vietnam (Pan et al., 2018). The research problem centers on understanding how sustainable tourism contributes to cultural preservation and the economic upliftment of ethnic minority groups. The research aims to unveil how sustainable tourism can act as a catalyst for cultural exchange, economic development, and the safeguarding of natural and cultural assets, with a particular emphasis on the involvement and empowerment of ethnic minority communities in the tourism development process (Datta et al., 2015). Employing multivariate linear regression as its primary research method, the study rigorously analyzes case studies to draw correlations between sustainable tourism activities and their impacts on cultural preservation. The main findings reveal that sustainable tourism practices significantly contribute to protecting cultural heritage, enhancing community participation, and fostering responsible tourism policies. These practices not only support the economic sustainability of ethnic minority groups but also ensure the conservation of their unique cultural identities. The implications of this research are profound, offering valuable insights for policymakers and tourism practitioners aiming to harmonize cultural heritage conservation with community well-being. By advocating for the integration of community perspectives into tourism planning and policy formulation, this study underscores the potential of sustainable tourism to serve as a powerful tool for cultural and economic revitalization, highlighting its importance in the broader context of cultural heritage management and sustainable development (Gould, 2018).

The Burden of Obesity and Hypertension Among a Vegetarian Ethnic Minority Community: A Study Among Jain's of Madhya Pradesh, India

Introduction: The prevalence of obesity is increasing among children and adults worldwide. Obesity is one of the major risk factors for hypertension. Thus, the study aimed to document the prevalence of obesity, hypertension and their association with each other among the Jain community of Khurai town, Sagar District (Madhya Pradesh), India. Methods: Data was collected on 175 participants belonging to the age group of 20-59 years. Anthropometric measurements were taken and indices were calculated such as Body mass index, waist-hip ratio, and waist-height ratio to assess general and abdominal obesity. Blood pressure was recorded using a sphygmomanometer. Results: The prevalence of overweight and obesity was found 25.71 percent and 9.71 percent. Whereas, 54.28 percent and 48.14 percent of participants were at risk for central obesity. The prevalence of hypertension was 41.14 percent. Obesity and hypertension were more prevalent among males, females were more overweight. Hypertension had a significant (p-value &lt;0.01) positive correlation with anthropometric indices. Body Mass Index imposed highest significant increase risk (p-value &lt;0.05) on hypertension. Conclusion: Jain adults had a high prevalence of overweight/obesity and hypertension despite of being vegetarian community. Therefore, more attention should be directed towards this community for the prevention, management, and treatment of non-communicable diseases.

Informal Islamic Education for Minority Muslims: Lessons from Chinese Ethnic Minority Muslims in Yogyakarta

The Chinese ethnic minority Muslim community is a cultural entity that represents two social crisis poles. This fact motivates them to practice the informal Islamic education method while keeping their religious, social, and cultural backgrounds in mind. This article aims to comprehend and investigate the method of informal Islamic education in Yogyakarta's Chinese ethnic minority Muslim community. This study is a type of field research using a descriptive-analytical case study method. The primary data sources were the DIY (Daerah Istimewa Yogyakarta) Chinese Muslim Association of Indonesia's board of directors, members, and the community. Scientific literature and organizational documents are examples of secondary data sources. This study's data collection uses in-depth interviews, observation, and documentation techniques. According to the findings of this study, education with the vision of Islam as raḥmah li al-‘ālamīn takes place in informal environment settings such as the family, community, and society. This vision is translated into various methods behind informal Islamic education in Yogyakarta's ethnic Chinese Muslim minority community.

Sport as a Medium for Multidimensional Social Inclusion: The Role of Rugby in the (Re-)construction of the Identity of New Zealanders of Croatian Origin

There are two general approaches to the role of sport in the development of minority ethnic communities. One focuses on the process of assimilation, while the other focuses on maintaining ethnic identity. This paper uses the example of Croats in New Zealand and their descendants to analyse the role of rugby in terms of both approaches. According to the main thesis, rugby played an important role in the process of integrating many members of the Croatian diaspora into New Zealand society, while simultaneously preserving identity elements of their country of origin and finally renewing their ties to Croatia after decades of being relatively poorly connected.

Development, Implementation, and Evaluation of Three Outreach Events to Improve COVID-19 Vaccine Uptake Among Racial and Ethnic Minority Communities in Houston, Texas, 2022.

Lack of access to timely, accurate, and linguistically appropriate COVID-19 information has complicated the dissemination of evidence-based information and contributed to vaccine hesitancy among racial and ethnic minority groups in the United States. We developed community events that provided outreach, education, and access to COVID-19 vaccination to overcome vaccine hesitancy in these communities. Using spatial analysis techniques, we identified 3 communities with low vaccine uptake in Houston, Texas, in fall 2021; engaged 20 stakeholders from these communities via 4 focus groups to understand barriers to vaccination; and developed and implemented 3 COVID-19 vaccine education and outreach events tailored to the needs of these communities in January-March 2022. We used program evaluation surveys to assess attendee characteristics and satisfaction with the events. Vaccinated attendees also completed surveys on what motivated them to get vaccinated. Two communities were predominantly Hispanic, and the third had an equal number of Black and Hispanic residents. Based on community stakeholder input, the study team organized 2 health fairs and 1 community festival featuring dialogue-based COVID-19 vaccine engagement in January and March 2022. Across the 3 events, a total of 865 attendees received COVID-19 education and 205 (24.0%) attendees received a COVID-19 vaccine or booster. Of 90 attendees who completed program evaluation surveys, 81 (90%) rated the outreach event as good or excellent. Of 145 attendees who completed postvaccination surveys, 132 (91%) endorsed ≥1 key program feature as motivating them to either get vaccinated or vaccinate their child that day. Community outreach events are important strategies for disseminating information, building trust, and facilitating COVID-19 vaccine uptake.

LONELINESS AMONG UNDER-REPRESENTED OLDER ADULTS IN THE UK: A STUDY OF MINORITY ETHNIC AND LGBTQ+ POPULATIONS

Abstract Internationally loneliness has been identified as a major public health problem. Although there is a substantial body of research about loneliness in older adults in the UK, there is a significant evidence gap reporting experiences of loneliness of older people from ethnic minorities and those who identify as lesbian, gay, or bisexual and transgender (LGBT). These two groups, under-represented in UK gerontological research, are included in our recently funded project, Socially Inclusive Ageing across the Lifecourse. In this poster we explicitly focus upon the experiences of loneliness for older adults, aged 50+, from the LGBTQ+ and minority ethnic communities. Using wave 9 data from the UK Household Longitudinal Study (UKHLS/Understanding Society) we measured loneliness using the three-item UCLA scale with a score of 6+ out of 9 defining loneliness. Of our total sample of 16,805 who completed the loneliness measure, 1.5% of respondents identified as LGB and 5.4% as Asian, 2.9% as black and 1.5% as other or mixed ethnicity. Overall, 21.7% of the population aged 50+ were lonely. Participants from a black, Asian or other ethnic minority reported higher loneliness than white respondents: 25.8%, 29.6%, 31.0% and 21.0% respectively. Respondents identifying as gay or lesbian (29.1%) or as bisexual (35.2%) reported greater loneliness in comparison to those who identified as heterosexual (21.3%). Our study is novel and timely in demonstrating the higher prevalence of loneliness in two under-represented groups of older adults with the potential consequences this may have for their health and wellbeing in later life.

INITIAL EFFICACY OF THE SAVVY CAREGIVER PROGRAM IN KOREAN AMERICAN DEMENTIA CAREGIVERS

Abstract Dementia caregivers in ethnic minority communities have often been excluded from access to caregiver interventions and their benefits because of linguistic and cultural barriers. In pursuit of equal treatments for all, it is imperative to make evidence-based interventions available and accessible to ethnic minority dementia caregivers, and linguistic and cultural adaptation is indispensable for reaching out to them. In the present study, we adapted the Savvy Caregiver Program for Korean American dementia caregivers and tested its initial efficacy for reducing depressive symptoms. This pilot intervention was delivered to 13 Korean American dementia caregivers by two Savvy-certified Korean-speaking trainers. Over the 6-week period of program implementation, there was no attrition (session completion rate = 98%). All participants’ depressive symptoms were reduced at completion of the program, and the level of reduction was statistically significant, with a large effect size (t = 8.64, p &amp;lt; .001, Cohen’s d = .89). Although patterns of change did vary among participants, the score difference between post-intervention and 6-month follow-up was not statistically significant (t = .74, p = .47). The program played a significant role in reducing depressive symptoms in this pilot sample of Korean American dementia caregivers, and this benefit was sustained at the 6-month follow-up. Along with the program’s notably high retention rate, its efficacy suggests strong unmet needs for psychoeducational programs among Korean American dementia caregivers. The study offers promise for sharing the therapeutic benefit of the Savvy program with linguistic minorities when delivered in a linguistically, culturally appropriate manner.

Health and social care experience and research perception of different ethnic minority populations in the East Midlands, United Kingdom (REPRESENT study).

Ethnic minority populations experience significant health and social care disparities; despite experiencing a greater burden of diseases, these groups are underrepresented in health and social care research. Consequently, related research can be less applicable to these population groups. The REPRESENT study aims to explore the health and social care experiences of ethnic minorities and other minoritised populations, their research interests and appropriate research practices. Focus groups and semistructured interviews were conducted between May and September 2022 with members of a number of ethnic minority communities in England. Data were audio recorded, transcribedand thematically coded using NVivo 12. Rigour was determined through extensive sampling, iterative data collection and analysis. Fifty-two ethnic minority members were engaged in group interviews and one-to-one interviews. Participants included representatives of the following groups: African Caribbean, Eastern European, Gypsy Travellers, Lesbian, Gay, Bisexual, Transgender, Queer, Intersexand Asexual+, Refugee/Asylum Seekers, Somali and South Asian communities. Interviews were also conducted with ethnic minority healthcare providers and researchers. Three overarching categories were identified: health information, medical service experiences, health and social care concerns and health research. Health and social care services challenges were mostly attributed to discrimination, delayed services, poor cultural relevanceand language and cultural barriers. The most influential information sources were local community organisations and word-of-mouth. The main health and social care concerns were chronic long-term health conditions, mental health, maternal healthand child development. Recommendations for research involved understanding the motivations for participation, improving communication and empowering communities. Top research priorities were long-term health conditions, health promotion and education, early care interventions and understanding community needs. Discrimination and bias in health and social care provision have severe implications for worsening ethnic health inequalities. Healthcare commissioning authorities and policymakers can leverage the preference of ethnic minority groups for pharmacy services and community organisations to improve access to care. Improving research interest and engagement requires understanding individual community needs, community sensitivity, research relevanceand cultural appropriateness. Members of ethnic minority Patient and Public Involvement and Engagementgroup and Community Advisory Boardsupported the REPRESENT study design, conceptualisation and report development.