National Institute for Health and Social Care Research (NIHR), Applied Research Collaboration, East Midlands (ARC EM), Leicester, UK.
Diabetes Research Centre, University of Leicester, Leicester, UK.
Health Expect. 2024 Feb;27(1):e13944. doi: 10.1111/hex.13944.
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, transcribed and 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, Intersex and 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 relevance and 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 health and 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 relevance and cultural appropriateness.
Members of ethnic minority Patient and Public Involvement and Engagement group and Community Advisory Board supported the REPRESENT study design, conceptualisation and report development.
少数民族群体在医疗保健方面存在显著的差异和不平等;尽管他们承受着更大的疾病负担,但在医疗保健研究中,这些群体的代表性严重不足。因此,相关研究可能对这些人群的适用性较低。REPRESENT 研究旨在探索少数民族和其他少数群体的健康和社会保健体验、他们的研究兴趣以及合适的研究实践。
2022 年 5 月至 9 月,我们与英格兰的多个少数民族社区成员进行了焦点小组和半结构化访谈。使用 NVivo 12 对音频记录、转录和主题编码进行了分析。通过广泛的抽样、迭代数据收集和分析来确定严谨性。
52 名少数民族成员参加了小组访谈和一对一访谈。参与者包括以下群体的代表:非裔加勒比人、东欧人、吉普赛旅行者、女同性恋者、男同性恋者、双性恋者、跨性别者、酷儿、双性人或无性恋者、难民/寻求庇护者、索马里人和南亚社区。还对少数民族医疗保健提供者和研究人员进行了访谈。确定了三个总体类别:健康信息、医疗服务体验、健康和社会保健关注以及健康研究。健康和社会保健服务方面的挑战主要归因于歧视、服务延迟、文化相关性差以及语言和文化障碍。最有影响力的信息来源是当地社区组织和口口相传。主要的健康和社会保健关注点是慢性长期健康状况、心理健康、孕产妇健康和儿童发展。对研究的建议包括了解参与的动机、改善沟通和增强社区能力。研究的首要重点是长期健康状况、健康促进和教育、早期护理干预以及了解社区需求。
医疗保健服务提供中的歧视和偏见对加剧族裔健康不平等产生了严重影响。医疗保健委托机构和政策制定者可以利用少数民族群体对药店服务和社区组织的偏好,改善他们获得医疗保健的机会。提高研究兴趣和参与度需要了解个别社区的需求、社区敏感性、研究相关性和文化适宜性。
少数民族患者和公众参与和参与小组以及社区咨询委员会的成员支持了 REPRESENT 研究的设计、概念化和报告制定。