Ethnic Minorities Experiences of Healthcare Intervention

Not yet recruiting

• Conditions: Healthcare Inequities; Health Intervention; Study Focus is Healthcare Interventions and Health Inequalities

• Registration Number: NCT07211698
• Lead Sponsor: University of Nottingham

Brief Summary

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. They also face a higher chance of severe issues after a stroke, leading to long-term needs that are not met. In 2016, the Stroke Association report showed that black and Afro-Caribbean people are twice as likely to have a stroke compared to white people. 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.

The purpose 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 identify how to help them participate in these services. Semi-structured interviews, focus groups or informal conversations will be conducted with people from Asian, Black African, Black Caribbean, Mixed ethnic or non-white ethnic backgrounds. The study aims to find out what changes can be made to meet their needs better.

Detailed Description

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. There is a need for ethnic diversity in clinical research participants to mitigate disparities in treatment outcomes and inequity in the safety of healthcare as shown in the greater COVID-19 burden experienced by ethnic minorities and the limitation in the effectiveness of interventions for this population. Despite this knowledge, ethnic minorities are underrepresented in health intervention research. They are less likely to engage with healthcare interventions delivered in the community exacerbating health inequalities that exist.

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. 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 with higher risk of severe adverse outcomes, leading to multiple long-term unmet needs.

This qualitative study is component two of the larger doctoral project exploring adaptation of the Action Falls Programme for ethnic minority stroke survivors. This protocol only refers to this component of the overarching project. The overall doctoral study has three components which include: a qualitative systematic review, a qualitative study and 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.

The aim of the qualitative study is to explore the views and lived experiences from the perspectives of ethnic minority population on accessing healthcare interventions delivered at home or in community centres and how their participation in healthcare interventions in their own homes or community centres could be supported.

The data collection methods are semi-structured interviews, focus groups and informal conversational interviews. Undertaking semi-structured interviews, focus groups and having informal conversations provides an opportunity for different cultural and religious requirements to be explored surfacing ways to improve cultural competence. These qualitative methods can help capture differences in opinion and experiences providing essential deeper insights into real-world situations. It will help drill into the multi-faceted and complex nature of healthcare interventions research delivered in the community, its benefits, challenges, and implementation.

Furthermore, a qualitative study is an ideal method for developing partnerships, gaining trust, and building concepts that work for the community. It will provide an understanding of the support required by ethnic minorities to engage in healthcare interventions and assess the inequalities in accessing healthcare interventions delivered in the community. It will help probe into the social, cultural and behavioural nuances. A narrative approach will be used to present the perspectives of the participants.

The potential risk for this study could be participants sharing sensitive, embarrassing or upsetting information or other disclosures requiring safeguarding action. Another possible risk is focus group participants disclosing personal information or what has been said in the focus group once the study is over. The researcher(s) will remind participants to respect each other's privacy and maintain confidentiality and that it is prohibited to repeat anything that has been discussed during the study conversations outside of the study.

It is recognised that findings from this study may not be generalizable to all populations. However, contextual depth will provide rich and valuable insights for healthcare interventions delivered in people's homes or community centres.

The population to be studied are ethnic minorities; this refers to all ethnic groups except white British group in the UK. In the context of this study, ethnic minorities include Asian ethnic groups, Black African, Black Caribbean, people with a Mixed ethnic background and other non-white ethnic groups. This study will focus on this population because of ethnic inequality in diagnosed illness among this group. The study will seek a diverse group of participants, including individuals from both genders and various ethnic minority groups. Participants information will be provided to all potential participants in easy read format to make it accessible to people with language barriers or learning disabilities. The study summary videos are in English and Urdu languages to facilitate inclusion. A University of Nottingham approved interpreter will be used if required.

Study Timeline

• Status Verified: 2025-07
• Study First Submitted: 2025-09-12
• Study Start: 2025-09-30
• Study First Submitted QC: 2025-09-30
• Last Update Submitted: 2025-09-30
• Study First Posted: 2025-10-08
• Last Update Posted: 2025-10-08
• Primary Completion: 2026-07-31
• Study Completion: 2026-12-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 30

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

Exclusion Criteria

• Patients in hospital admissions
• Adults living in care homes

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Thematic analysis of qualitative data.	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.

Secondary Outcome Measures

Name	Time	Method
Consolidated Framework for Implementation Research (CFIR) to measure or present facilitators to implementation of healthcare interventions.	12 months	CFIR will be used to present barriers and enablers to participation in healthcare interventions delivered in peoples' homes or community centres with a view to identifying where targeted adaptation could be made to provide an intervention that led to effective change. This approach will help build the theory for exploring opinions and experiences that can inform how ethnic minority stroke survivors will be supported to take part in healthcare interventions delivered in their own homes or community centres.

Trial Locations

Locations (1)

Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham; 🇬🇧 Nottingham, United Kingdom