1
|
Gibson K, Robinson L, Bains M, Samsi K, Cîrstea AM, Brittain K. Intersecting social relations of care: a protocol for an ethnographic and interview study with South Asian people ageing in place with dementia. BMJ Open 2024; 14:e092946. [PMID: 39653559 PMCID: PMC11628994 DOI: 10.1136/bmjopen-2024-092946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 10/22/2024] [Indexed: 12/12/2024] Open
Abstract
INTRODUCTION People living at home with dementia are often cared for by family members, especially those from minority ethnic groups. Many people living with dementia from minority ethnic communities face barriers to accessing formal care. However, there is a paucity of dementia research, which foregrounds diversity within minority ethnic populations. This study, conducted between July 2024 and August 2026, will explore the diverse care experiences of South Asian people living with dementia. Conducted across four sites (Newcastle, Nottingham, Birmingham and London), it aims to understand how inequalities related to ethnicity intersect with other factors (eg, gender, age and class) to shape the dementia care experiences of people living in South Asian communities and apply this learning to explore how public policy and care systems could be improved to reduce health and social inequalities. METHODS AND ANALYSIS In Newcastle, ethnographic research will be undertaken with up to 20 people living with dementia (or with memory concerns) in South Asian communities for a period of 12 months. The lengthy research period will enable a deep understanding about how experiences change as dementia progresses over time. In Nottingham and Birmingham, semi-structured interviews and/or focus groups will be conducted with up to 30 people living with dementia (or with memory concerns) in South Asian communities. This will enhance the data generated via the ethnographic research. Analysis will follow the principles of reflexive thematic analysis and will involve identifying themes and synthesising and theorising the data. Following this, findings will be reflected upon in 4-6 task groups convened in London, Nottingham and Newcastle with practitioners from health and social care, voluntary organisations or faith groups involved in dementia care. Task groups will focus on developing practical goals based on the research findings. ETHICS AND DISSEMINATION Ethical approval for this study has been granted by Newcastle University Faculty of Medical Sciences Ethics Committee (Reference: 2773/43721). Findings will be disseminated to academics, practitioners, policymakers and members of the public via a range of channels including conferences, peer-reviewed publications, lay reports, leaflets and non-written formats such as animated videos.
Collapse
Affiliation(s)
- Kate Gibson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Manpreet Bains
- Centre for Academic Primary Care, University of Nottingham, Nottingham, UK
| | - Kritika Samsi
- The Policy Institute, King's College London, London, UK
| | - Ana-Maria Cîrstea
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katie Brittain
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
2
|
Youssef E, Calvert A, Greening V, Pearce D, Wright S, Eccleston E, Oshodi L, Heath P, Vandrevala T. Understanding the barriers and enablers to participation in vaccine trials in a pregnant population from diverse ethnic background in an inner-city UK hospital. PLoS One 2024; 19:e0312799. [PMID: 39475877 PMCID: PMC11524452 DOI: 10.1371/journal.pone.0312799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 10/11/2024] [Indexed: 11/02/2024] Open
Abstract
BACKGROUND 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. METHODS AND FINDINGS 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. CONCLUSIONS 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.
Collapse
Affiliation(s)
- Essra Youssef
- School of Nursing, Allied and Public Health, Faculty of Health, Science, Social Care and Education, Kingston University London, London, United Kingdom
| | - Anna Calvert
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, St George’s, University of London, London, United Kingdom
| | - Vanessa Greening
- Women’s Health Research, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Dominique Pearce
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, St George’s, University of London, London, United Kingdom
| | - Suzannah Wright
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, St George’s, University of London, London, United Kingdom
| | - Emma Eccleston
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, St George’s, University of London, London, United Kingdom
| | - Lolade Oshodi
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, St George’s, University of London, London, United Kingdom
| | - Paul Heath
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, St George’s, University of London, London, United Kingdom
| | - Tushna Vandrevala
- School of Nursing, Allied and Public Health, Faculty of Health, Science, Social Care and Education, Kingston University London, London, United Kingdom
| |
Collapse
|
3
|
Matheson L, Greaves C, Duda JL, Wells M, Secher D, Rhodes P, Lorenc A, Jepson M, Ozakinci G, Watson E, Fulton-Lieuw T, Mittal S, Main B, Nankivell P, Mehanna H, Brett J. Development of the 'ACT now & check-it-out' intervention to support patient-initiated follow up for Head and Neck cancer patients. PATIENT EDUCATION AND COUNSELING 2024; 119:108033. [PMID: 37988772 DOI: 10.1016/j.pec.2023.108033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE Current Head and Neck cancer (HNC) follow-up models are considered sub-optimal at detecting recurrences. We describe the development of a patient-initiated follow up (PIFU) trial intervention support package, to support HNC patients to engage in PIFU self-care behaviors. METHODS An intervention mapping approach, informed by evidence synthesis, theory and stakeholder consultation, guided intervention development. Data sources included a patient survey (n = 144), patient interviews (n = 30), 7 workshops with patients (n = 25) and caregivers (n = 3) and 5 workshops with health professionals (n = 21). RESULTS The intervention ('ACT now & check-it-out') comprises an education and support session with a health professional and an app and/or a booklet for patients. The main targets for change in patient self-care behaviors were: assessing what is normal for them; regularly checking for symptom changes; prompt help-seeking for persistent/new symptoms; self-management of fear of recurrence; engaging with the intervention over time. CONCLUSIONS We have developed an evidence, person and theory-based intervention to support PIFU self-care behaviors in HNC patients. PRACTICE IMPLICATIONS A trial is underway to assess the effectiveness and cost-effectiveness of the intervention. If successful, this intervention could be adapted for patients with other cancers or diseases, which is important given the recent shift towards PIFU pathways.
Collapse
Affiliation(s)
- Lauren Matheson
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, OX3 0FL Oxford, UK.
| | - Colin Greaves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Mary Wells
- Nursing Directorate, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK.
| | | | | | - Ava Lorenc
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK.
| | - Marcus Jepson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK.
| | - Gozde Ozakinci
- Division of Psychology, University of Stirling, Stirling FK9 4LA, UK.
| | - Eila Watson
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, OX3 0FL Oxford, UK.
| | - Tessa Fulton-Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Saloni Mittal
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Barry Main
- Bristol Dental School, University of Bristol, BS1 2LY, UK.
| | - Paul Nankivell
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Hisham Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Jo Brett
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, OX3 0FL Oxford, UK.
| |
Collapse
|
4
|
Optimising patient-initiated follow-up care – A qualitative analysis of women with breast cancer in the UK. Eur J Oncol Nurs 2022; 60:102183. [DOI: 10.1016/j.ejon.2022.102183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 06/01/2022] [Accepted: 07/17/2022] [Indexed: 11/17/2022]
|