A Qualitative Study Exploring Ethnic Minorities Experiences of Healthcare Interventions Delivered at Home or in Community Centres
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- Thematic analysis of qualitative data.
研究概览
简要总结
As ethnic diversity in Britain continues to grow, so do the health needs in a society with many different ethnic backgrounds, including the need for personalised healthcare. Studies show that people from ethnic minority groups are at a higher risk of illness and death compared to white people with the same health issues.
For example, ethnic minority individuals have strokes five years earlier than white people and are at greater risk of serious problems, including an increased risk of falling. These differences are made worse because people from ethnic minority communities are less likely to use or engage with healthcare interventions delivered in the community, which increases health inequalities.
Ethnic minorities have a greater susceptibility to falls because they are likely to have underlying health issues, such as high blood pressure and diabetes. We do not have enough evidence on what treatment can stop these falls. Older adults who fall can get hurt and may even die from their falls. Research hasn't found the best ways to prevent falls for ethnic minorities, because often, they are underrepresented in the study. The NHS wants to transform care delivery by providing more care in the community rather than in hospitals, by using more digital tools instead of paper methods and focusing more on keeping people healthy rather than just treating sickness. This means healthcare services need to be designed to meet the specific needs of different ethnic groups when they are provided at home or in community centres. This qualitative study is classified into two phases. The purpose of Phase 1 of the study is to understand how people from ethnic minority backgrounds feel about accessing healthcare delivered to them at home or in community centres, with the view to identifying how to help them participate in these services. Semi-structured interviews, focus groups or informal conversations will be conducted with adults from Asian, Black African, Black Caribbean, or Mixed ethnic backgrounds. The study aims to find out what changes can be made to better meet their needs. Phase 1 will explore broad areas of health due to health inequalities in diagnosis and treatment outcomes for the ethnic minority population. This will help understand the relevant factors to consider when delivering interventions. Phase 2 of the study will focus on falls prevention intervention due to the greater susceptibility to falls among ethnic minorities. A range of people deliver falls prevention in the community, for example, exercise instructors, personal trainers, support workers, nurses, AHPs, falls leads, community groups coordinators, etc. A semi-structured interview will be conducted with people delivering falls prevention interventions in the community to explore their experiences of providing tailored treatment to ethnic minorities.
详细描述
BACKGROUND AND RATIONALE
As the diversity of Britain continues to grow, so are the health challenges of a multi-diverse society, including the delivery of individualised healthcare (Blake 2024). With the NHS 10-year plan focusing on moving care "from hospital to community, from analogue to digital, and from a focus on sickness to a focus on prevention" (GOV.UK 2025), there is a need for healthcare interventions to be tailored to ethnic minorities needs to mitigate disparities in treatment outcomes (Khunti et al. 2023; Morales and Ali 2021; Tai et al. 2021; Kirby 2020; Gill et al. 2013) and inequity in the safety of healthcare (Wade 2023) as shown in the greater COVID-19 burden experienced by ethnic minorities and the limitation in the effectiveness of interventions for this population (Oskrochi et al. 2023). Despite this knowledge, ethnic minorities are underrepresented in health intervention research (Kayani et al. 2024). They are less likely to engage with healthcare interventions delivered in the community (Smart and Harrison 2016), exacerbating health inequalities that exist (The King's Fund 2024).
Evidence suggests people from ethnic minority backgrounds have a higher risk of morbidity and mortality than white people from cardiovascular diseases such as stroke, heart disease, peripheral arterial disease and aortic disease (Cousins 2024; Razieh et al. 2022). For example, the onset of stroke in ethnic minority individuals is five years earlier than their white counterparts and is twice as common in black populations (Stroke Association 2016) with higher risk of severe adverse outcomes (Fluck et al. 2023), leading to multiple long-term unmet needs (McKevitt et al. 2011), including increased risk of falling (Denissen et al. 2019; NICE 2025). According to Haagsma et al. (2020) report, there is an increased incidence of fall-related injuries requiring healthcare intervention for older adults and increased death rates due to falls. From the existing evidence, there are inconclusive findings to determine the optimum falls prevention interventions (Winter et al. 2013). These studies more often than not fail to report ethnicity data (Nanavati et al. 2024).
Ethnic minorities face higher fall risks (Wehner-Hewson et al. 2022) due to the prevalence of hypertension and diabetes (Freire et al. 2024). Koh et al. (2023) highlighted the interrelationship factors that enable and/or prevent implementation of falls prevention programs in the community. This aligns with World Falls Guidelines, which recommend a tailored multidomain approach to assessing falls risk and implementation of preventative measures (Montero-Odasso et al. 2022). There is an indication that effective implementation of falls prevention intervention requires a multifaceted approach, including collaboration between healthcare professionals, individuals and their support system (Ong et al. 2024), in addition to accessibility of the falls programme (Barmentloo et al. 2020).
This qualitative study is component two of the larger doctoral project exploring ' how falls prevention interventions could be adapted to provide tailored treatment to ethnic minority adults accessing healthcare interventions delivered at home or in community centres. This protocol only refers to this component of the overarching project. The overall doctoral study has three components, which include: a qualitative systematic review (https://www.crd.york.ac.uk/PROSPERO/view/CRD420251003414), a qualitative study and a co-design workshop with iterative and participative action research. Findings from one component will inform the other to help identify whether healthcare interventions delivered at home or in community centres need to be adapted to meet the needs of ethnic minorities.
研究设计
- 研究类型
- Observational
- 观察模型
- Ecologic Or Community
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Inclusion Criteria:
- •Ethnic minority individuals
- •Adults aged 18 and over
- •Never accessed or accessed or used or declined health intervention
- •Able to provide informed consent
- •Lives in their own home or living with family/ friend or supported living facilities
- •Lives in the United Kingdom at the time of study participation
排除标准
- •Patients in hospital admissions
- •Adults living in care homes
- •Inclusion criteria:
- •Individuals delivering falls prevention interventions in the community, for example, exercise instructors, personal trainers, support workers, nurses, AHPs, falls leads, community groups coordinators, etc.
- •From any ethnic background
- •Adults aged 18 and over
- •Able to provide informed consent
- •Exclusion criteria:
- •Provides falls prevention intervention only to inpatients, or in hospital settings, or in care homes
- •Lives outside of the United Kingdom at the time of study participation
研究组 & 干预措施
Phase 1: Asian, Black African, Black Caribbean, or Mixed ethnic background
To explore the views of ethnic minorities on accessing healthcare interventions delivered at home or in community centres and to understand how they could be supported to utilise these healthcare interventions.
干预措施: Qualitative study - Phase 1 (Other)
Phase 2: Individuals delivering falls prevention interventions in the community
In Phase 2, the population to be studied are individuals delivering falls prevention interventions in the community, for example, exercise instructors, personal trainers, support workers, nurses, AHPs, falls leads, community groups coordinators. An estimation of up to 15 participants will be recruited to explore how individuals delivering falls prevention interventions in the community provide tailored interventions to ethnic minorities at home or in community centres.
干预措施: Qualitative study - Phase 2 (Other)
结局指标
主要结局
Thematic analysis of qualitative data.
时间窗: 12 months
Interviews, focus groups and informal conversational interview data will be thematically analysed by coding the data into categories, identifying patterns and themes to gain insights into the cultural, social and behavioural nuances that may influence ethnic minorities participation in healthcare interventions delivered in their own homes or community centres.
次要结局
- Consolidated Framework for Implementation Research (CFIR) to measure or present facilitators to implementation of healthcare interventions.(12 months)
研究者
Katie Robinson
Principal Research Fellow
University of Nottingham