Background Adolescence and transition into adulthood are periods shaping life-long mental health, cardiometabolic risk, and inequalities. However, they are poorly studied and understood. By extending and expanding the Born in Bradford (BiB) cohort study through this period using innovative, co-produced approaches to collect and analyse data, we aim to understand better the interplay of factors that influence health and wellbeing, and inform/evaluate interventions to improve them and reduce inequalities. Protocol BiB Age of Wonder (AoW) is a large, whole city cohort that will capture the contemporary lived experience amongst multi-ethnic adolescents progressing into young adulthood. We will collect repeated data from existing BiB participants and their peers (N~30,000 adolescents). The protocol for the first phase of the quantitative methods, involving survey measurements and health assessments in mainstream secondary schools is described here. We describe the co-production behind these methods, and lessons learned from the first year of data collection.

Background Black, Asian and Minority Ethnic nurses and midwives are under-represented in higher and managerial roles. Aims This study explored the presence and nature of career progression delays for Black, Asian and Minority Ethnic nurses and midwives and investigated where the barriers to progression were. Design A secondary analysis of data from a wider cross-sectional survey investigating workplace experiences, burnout and patient safety in nurses and midwives. Methods 538 nurses and midwives were recruited from four UK hospitals between February and March 2017. A career progression delay was viewed as being present if Black, Asian and Minority Ethnic nurses and midwives had spent longer on the entry level nursing grade and less time on higher grades in the previous 10 years. The analysis included items pertaining to: receipt of professional training, perceived managerial support for progression, likelihood of submitting applications and application success rates. Data were analysed using linear regression, odds ratios and t-tests. Results were reported using the STROBE Checklist. Results Black, Asian and Minority Ethnic nurses and midwives (n = 104; 19.4%) had spent more months working at the entry-level grade (M = 75.75, SD = 44.90) than White nurses and midwives (n = 428; 79.7%; M = 41.85, SD = 44.02, p < 0.001) and fewer months at higher grades (M = 15.29, SD = 30.94 v 29.33, SD = 39.78, p = 0.006 at Band 6; M = 6.54, SD = 22.59 v M = 19.68, SD = 37.83, p = 0.001 at Band 7) over the previous 10 years. Black, Asian and Minority Ethnic nurses and midwives were less likely to have received professional training in the previous year (N = 53; 53.0% v N = 274; 66.0%, p = 0.015) and had to apply for significantly more posts than White nurses and midwives before gaining their first post on their current band (M = 1.22, SD = 1.51 v M = 0.81, SD = 1.55, p = 0.026). Conclusions Interventions are needed to improve racial equality regarding career progression in nurses and midwives. Increasing access to professional training and reducing discriminatory practice in job recruitment procedures may be beneficial. Impact statement Black, Asian and Minority Ethnic nurses and midwives experience career progression inequalities. Interventions should improve transparency in recruitment procedures and enhance training opportunities.

Background Bullying and discrimination may be indirectly associated with patient safety via their contribution to burnout, but research has yet to establish this. Aims The aims of this study were to investigate the relationships between workplace bullying, perceived discrimination, levels of burnout and patient safety perceptions in nurses and midwives and to assess whether bullying and discrimination were more frequently experienced by Black, Asian and minority ethnic than White nurses and midwives. Methods In total, 528 nurses and midwives were recruited from four hospitals in the United Kingdom to complete a cross-sectional survey between February and March 2017. The survey included items on bullying, discrimination, burnout and individual level and ward level patient safety perceptions. Data were analysed using path analysis. Results The results were reported according to the STROBE checklist. Bullying and discrimination were significantly associated with higher burnout. Higher burnout was in turn associated with poorer individual- and ward-level patient safety perceptions. Experiences of discrimination were three times more common among Black, Asian and minority ethnic than White nurses and midwives, but there was no significant difference in experiences of bullying. Conclusions Bullying and discrimination are indirectly associated with patient safety perceptions via their influence on burnout. Healthcare organisations seeking to improve patient care should implement strategies to reduce workplace bullying and discrimination.