Representation Of Ethnic Minority Groups Research Articles

Reporting and representation of underserved groups in intervention studies for patients with multiple long-term conditions: a systematic review

Objectives Globally, there is a growing number of people who are living with multiple long-term conditions (MLTCs). Due to complex management needs, it is imperative that research consists of participants who may benefit most from interventions. It is well documented that ethnic minority groups and lower socioeconomic status (SES) groups are at an increased risk of developing MLTCs. Therefore, the aim of this systematic review was to determine the level of reporting and representation of underserved groups (ethnic minority and low SES) in intervention studies addressing MLTCs. Design Systematic review. Four databases including Cochrane Library, MEDLINE, CINAHL and Scopus were searched for intervention studies from North America or Europe published between January 1990 and July 2023. Setting Hospital and community-based interventions. We included interventional studies focusing on improving MLTC-related outcomes. Participants Patients with MLTCs. Main outcome measures Total number of studies reporting on ethnicity and SES. Number and proportion of studies reporting by ethnic/SES group. Results Thirteen studies met the inclusion criteria. Only 4 of 13 studies (31%) recorded and reported ethnicity information. Of these four studies that reported on ethnicity, three studies consisted of primarily White participants. Ethnic minority groups were underrepresented, but one study included a majority of African American participants. Moreover, 12 of 13 studies (92%) reported on SES with income and educational level being the primary measures used. SES representation of higher deprivation groups was varied due to limited data. Conclusions For ethnicity, there was a lack of reporting, and ethnic minority groups were underrepresented in intervention studies. For SES, there was a high level of reporting but the proportion of study samples from across the spectrum of SES varied due to the variety of SES measures used. Findings highlight a need to improve the reporting and representation of ethnic minority groups and provide more detailed information for SES through using consistent measures (e.g. education, income and employment) to accurately determine the distribution of SES groups in intervention studies of people with MLTCs.

Effective interventions to increase representation of under-served groups in randomised trials in UK and Ireland: a scoping literature review

Background Participants in clinical trials often do not reflect the populations that could benefit from the treatments being investigated. There are known barriers to trial participation for under-served groups, but limited evidence on strategies to alleviate these barriers to improve representation. This scoping review aimed to identify effective interventions and design features that improve the representation `of under-served groups in trials, focusing on the UK and Ireland. Methods We included methodological research studies that reported interventions to improve representation of ethnic minority groups, socioeconomically disadvantaged groups, older people, or those with impaired capacity to consent to randomised controlled trials, conducted in the UK and Ireland, published between 2000–2021. Systematic searches were conducted in November 2021 and data were independently extracted by two authors and narratively synthesised. Results Seven studies were included: one randomised controlled study embedded in five trials, one mixed-methods study, and five studies reporting ‘lessons learnt’ from one trial. We categorised the 47 reported interventions or strategies into nine broad themes: Recruitment sites, recruitment settings, community engagement, and communication with participants, incentives, inclusion criteria, flexibility, patient documentation, and the consent process. Only 28/47 interventions were evaluated, 23 of which were comparison of recruitment pathways. The randomised study found that a £100 incentive mentioned in the invitation letter increased positive responses overall across drug trials in cardiovascular disease and hypertension, but not for older people or those living in the most deprived areas. Invitation letters via GPs and working with communities were reported as successful recruitment pathways in recruiting different under-served populations. Conclusions Interventions aiming to improve the recruitment of under-served groups in the UK and Ireland were reported across seven papers, but their effectiveness was rarely rigorously evaluated. Included studies were context specific. Using a variety of recruitment methods is likely to help achieve a more diverse cohort.

Representation of ethnic and racial minority groups in European vaccine trials: a quantitative analysis of clinical trials registries

ObjectivesThe representation of ethnic minority groups in European vaccine trials is an important and hitherto unaddressed gap in the literature. The objectives of this study were to determine the proportion...

Theoretical discourse of the political representation of ethnic minority groups

Theoretical discourse of the political representation of ethnic minority groups

"As an ethnic minority, you just have to work twice as hard." Experiences and motivation of ethnic minority students in medical education.

IntroductionAdequate representation of ethnic minority groups in the medical workforce is crucial for ensuring equitable healthcare to diverse patient groups. This requires recruiting ethnic minority medical students and taking measures that enable them to complete their medical studies successfully. Grounded in self-determination theory and intersectionality, this paper explores the experiences of ethnic minority medical students across intersections with gender and other categories of difference and how these relate to students’ motivation.MethodsAn explorative, qualitative study was designed. Six focus groups were conducted with 26 ethnic minority students between December 2016 and May 2017. Thematic analysis was performed to identify, analyse and report themes within the data.ResultsThe findings were categorized into three main themes: the role of autonomy in the formation of motivation, including students’ own study choice and the role of their family; interactions/‘othering’ in the learning environment, including feelings of not belonging; and intersection of ethnic minority background and gender with being ‘the other’, based on ethnicity.DiscussionEthnic minority students generally do not have a prior medical network and need role models to whom they can relate. Ensuring or even appointing more ethnic minority role models throughout the medical educational continuum—for example, specialists from ethnic minorities in teaching and/or mentoring roles in the education—and making them more visible to students is recommended. Moreover, a culture needs to be created in the educational environment in which students and staff can discuss their ethnicity-related differences.Supplementary InformationThe online version of this article (10.1007/s40037-021-00679-4) contains supplementary material, which is available to authorized users.

Comparison of presentations to the emergency department during the COVID-19 pandemic (COPED-C).

BackgroundConcerns have been raised that patients requiring emergency care may not have accessed healthcare services during coronavirus disease 2019 (COVID-19) lockdown.MethodsThis case control study aimed to understand changes in characteristics and diagnosis of patients attending a large UK Emergency Department (ED) during the first wave of the COVID-19 pandemic (March–May 2020) compared with equivalent weeks in 2019.ResultsWe found a 50.7% drop in first attendances to the ED in 2020. Likelihood of attendance and admission decreased for paediatric patients and increased for patients ≥ 46 years, and for men. Likelihood of admission increased for all Black ethnic groups and for patients from the most deprived index of multiple deprivation quintiles. This shift to an older, male, more deprived patient population with greater representation of ethnic minority groups was amplified in the ‘Infections’ diagnostic category.ConclusionsCOVID-19 has dramatically impacted ED usage. Our analysis contributes to local resource planning and understanding of changes in healthcare-seeking behaviour during the pandemic. Future research to identify positive behaviour changes could help sustain a reduction in non-urgent visits in the longer term.

Comparative analysis of the political representation of ethnic minority groups in Slovak Republic and Ukraine (on the results of expert survey)

Comparative analysis of the political representation of ethnic minority groups in Slovak Republic and Ukraine (on the results of expert survey)

High rejection, low selection: How ‘punitive parties’ shape ethnic minority representation

Evidence suggests that as public opinion towards immigration becomes more negative, so the descriptive representation of ethnic minority groups is increasingly restricted. Recently, some initial research into the causal mechanism hinted that this effect is driven by patterns of candidacy. This suggests that political parties are creating an ‘ethnic penalty’ of their own in the selection stage. This paper investigates the relationship between patterns of candidacy, party strategy, and public opinion in Great Britain from 1997 to 2019, and proposes that ‘punitive parties’ are strongly responsible for shaping the representational outcomes of minority groups. I find support for earlier suggestions that parties are increasingly likely to place ethnic minority candidates away from ‘winnable’ contests as anti-immigrant hostility rises. These findings are important for our conceptions of ethnic penalties, of party behaviour in selection processes, and for the study and cause of improving political representation.

Biases at the Ballot Box: How Multiple Forms of Voter Discrimination Impede the Descriptive and Substantive Representation of Ethnic Minority Groups

Research shows that ethnic minority candidates often face an electoral penalty at the ballot box. In this study, we argue that this penalty depends on both candidate and voter characteristics, and that pro-minority policy positions incur a greater penalty than a candidate’s ethnic background itself. Using a conjoint experiment embedded in a panel study of British voters, we investigate the relative contributions of candidate ethnicity, policy positions, affirmative action, and voter attitudes to this electoral penalty. We find that although Pakistani (Muslim) candidates are penalized directly for their ethnicity, black Caribbean candidates receive on average the same levels of support as white British ones. However, black Caribbean candidates suffer conditional discrimination where they are penalized if they express support for pro-minority policies, and all candidates are penalized for having been selected through an affirmative action initiative. We also find that some white British voters are more inclined to support a black Caribbean candidate than a white British one, all else being equal. These voters (one quarter of our sample) have cosmopolitan views on immigration, and a strong commitment to anti-prejudice norms. However, despite efforts across parties to increase the ethnic diversity of candidates for office, many voters’ preferences continue to pose barriers toward descriptive and substantive representation of ethnic minority groups.

Visualizing minority: Images of ethnic minority groups in Chinese elementary social studies textbooks

This study investigates the visual representation of ethnic minority groups in Chinese elementary social studies textbooks. The author conducts a content analysis to examine the extent to which ethnic minority groups are visually represented and to explore the ways in which they are portrayed in some of the most popular social studies textbooks in China. A total of 6075 visuals drawn from 36 books were electronically coded and analyzed using SPSS. The findings reveal the dearth of ethnic minority-related visuals and show that ethnic minority individuals are visually represented in significantly different ways in many important aspects than non-minority people in these textbooks. The author concludes that the visual representations of ethnic minority groups in these textbooks contributes to a binary understanding of minority and majority by limiting the images of ethnic minority groups to selected cultural markers.

The electoral effects of the descriptive representation of ethnic minority groups in Australia and the UK

In this article we assess the electoral effects of the nomination of ethnic minority candidates. We argue that descriptive representation is an important factor in how parties in SMD systems establish their coalitions over multiple elections. We demonstrate this by showing that descriptive representation has a consistent effect on voting behavior, and thus that parties can rely on descriptive representation to win over specific segments of the voting population. Previous studies have been limited to single election years and single countries, but we collect original data from multiple election cycles in Australia and the UK to test our argument. We find that descriptive representation is consistently associated with a 10-percentage point bump in support from ethnic minority independents and Labour supporters. We conclude by highlighting the importance of this finding for party competition.

Stories From Intercultural Education in Serbia: Teacher Leadership and Parent Participation

This article explores the potential of teacher leadership as a strategy to promote intercultural education by empowering parents and members of ethnic minority groups to participate in the life of the school. It links the idea of participation for social justice with the goals of intercultural education within the context of the APREME (Advancing Participation and Representation of Ethnic Minority Groups in Education) project, which is located within a wider program of research, development, and advocacy designed to promote inclusion and social cohesion in the western Balkans. The outcomes of this action-based stage of the program are presented in the form of vignettes that portray teachers’ projects designed to enable parents and community members to participate more fully in the life of the school. Conclusions are drawn about the relationship between teacher leadership and a transformative approach to the intercultural education.

Tourism, Visual Culture, and the State in Northern Thailand

The progressive assimilation of Highlanders into lowland Thai society is matched by the simultaneous promotion of these groups to foreign and domestic tourists for their distinctive cultures and ways of life. Highlanders is a collective term representing more than 10 ethnic minority groups living in the mountainous regions of northern Thailand. This article addresses these contradictory discourses of assimilation and distinctiveness and argues that picture postcards of Highlanders serve as assemblage components of a broader political project as well as highlights how tourism discourses can intersect with local and state politics. Arguments in this article are based on a content analysis of 77 picture postcards of northern Thai highlanders. Beyond illustrating how these images echo institutionalized forms of representation of ethnic minority groups as feminized, living in harmony with nature, and timeless, this article attends to how these tourism imaginaries are implicated in the material realities of Highlanders living in northern Thailand.

Examining the Representation of Ethnic Minority Groups and Women in the Malaysian Civil Service

A retrospective view of the government's policies with respect to equal employment opportunity shows a transition from merely suggesting that government will integrate people from different gender and ethnicity into the workplace to taking proactive steps to increase the representation of women and minority groups in the civil service. However, ensuring a bureaucracy that mirrors the population it serves remains a daunting task.Some people have attributed at least some of the blame for the failure to achieve a fully representative civil service to inadequate support for such efforts by political leaders.Yet, in the context of Malaysia, it is the localization policy that is worthy of consideration that shows disproportionate numbers of women ana minorities in the civil senice as opposed to their number in the population.In addition, the unequal chances in recruitment and career advancement as well as the low pay discourage the minorities and women's application into the bureaucracy.The important issue raised is whether there exists a case of unequal opporhmities against wome and minority groups in the civil service in Malaysia.Building upon t$ls foundation, the paper argues that even if bureaucratic representativeness is an important tool for increasing government legitimacy, the structural, political and economic features of Malaysia have a bearing on the gender and minority representativeness of the civil service at the national and sub-national levels.The dearth of representative bureaucracy literature is then discussed within the historical context of Malaysia.In the conclnsion, it is noted that more strategies and policy action need to be taken to ensure representative bureaucracy, which requires more than just passive representation; active representation is essential.

The Electoral Effects of the Descriptive Representation of Ethnic Minority Groups in Australia and the United Kingdom

In this paper we assess the electoral effects of the nomination of ethnic minority candidates. We argue that descriptive representation is an important factor in how parties in SMD systems establish their coalitions over multiple elections. We demonstrate this by showing that descriptive representation has a consistent effect on voting behavior, and thus that parties can rely on descriptive representation to win over specific segments of the voting population. Previous studies have been limited to single election years and single countries, but we collect original data from multiple election cycles in Australia and the United Kingdom to test our argument. We find that descriptive representation is consistently associated with a 10-percentage point bump in support from ethnic minority independents and Labour supporters. We conclude by highlighting the importance of this finding for party competition.

Explaining Different Trajectories in Immigrant Political Integration: Moroccans and Turks in Amsterdam

This article examines why the political integration and representation of ethnic minority groups may develop along different paths. Taking Amsterdam as a case study, it compares two of the city’s most predominant immigrant groups: Turks, who have taken a group-based incorporation strategy – visible in this group’s dense organisational infrastructure – and Moroccans, who have followed a more individualist assimilation strategy. The distinct trajectories have produced a relatively high proportion of Turkish-origin elected officials, while individuals of Moroccan origin feature more prominently in executive office, exercising power over day-to-day decisions. The article proposes that whereas features of the electoral system determine which opportunities exist for immigrants to participate in the political process, it is the structure of an immigrant group that affects the ability of members to seize such opportunities. Furthermore, it shows how political parties and party elites act as gatekeepers and facilitators of immigrants’ political participation.

Factors that affect the food choices made by girls and young women, from minority ethnic groups, living in the UK

Lower birth weight, often found in infants from minority ethnic groups, may be partly because of the disproportionate representation of ethnic minority groups in low-income areas. To develop an intervention, to improve the nutritional intake of young women from populations at risk of low-birth-weight babies, which would be culturally sensitive and well received by the intended recipients, a community development approach was used to investigate factors that might influence food choice and the nutritional intake of girls and young women from ethnic minority groups. Focus group discussions were conducted across the UK, to explore factors that might affect the food choices of girls and young women of African and South Asian decent. The data was analysed using deductive content analysis (Qual. Soc. Res., 1, 2000, 1). Discussions were around the broad themes of buying and preparing food, eating food and dietary changes, and ideas for an intervention to improve diet. The focus group discussions indicated that all the communities took time, price, health and availability into consideration when making food purchases. The groups were also quite similar in their use of 'Western' foods which tended to be of the fast food variety. These foods were used when there was not enough time to prepare a 'traditional' meal. Many issues that affect the food choice of people who move to the UK are common within different ethnic groups. The idea of a practical intervention based on improving cooking skills was popular with all the groups.