BACKGROUND: Persistent inequalities in palliative and end-of-life care continue to affect ethnically diverse populations in the UK, with disparities in access, engagement, and quality of care. This study explored the perspectives of health professionals and service providers on barriers and facilitators to equitable palliative and end-of-life care in England (Bedfordshire, Hertfordshire, and Milton Keynes). The research was embedded within the KEEPNET initiative, a Research Partnership Network aimed at co-producing solutions to local healthcare inequalities. METHODS: A qualitative design was employed using semi-structured interviews with six purposively sampled professionals across statutory and third sector palliative and end-of-life care services in Bedfordshire, Hertfordshire, and Milton Keynes. Participants included clinicians, service managers, and hospice-based practitioners. Data were collected in March 2023 and analysed thematically using an inductive approach to identify key patterns in professional experiences and perceptions of delivering care to ethnically diverse communities. RESULTS: Three overarching themes were identified: (1) access to services (2), uptake of services, and (3) experiences of engaging with services. Barriers included language differences, mistrust of statutory services, cultural misconceptions around palliative and end-of-life care and limited outreach effectiveness. Facilitators included compassionate, individualised care; trust-building through culturally sensitive communication; and community engagement through faith and local leaders. Structural challenges such as workforce shortages and limited weekend provision were also reported. The Research Partnership Network model supported dialogue and capacity building between professionals and communities. CONCLUSION: Culturally competent, community-embedded approaches are essential to addressing disparities in palliative and end-of-life care. Research Partnership Networks offer a collaborative framework for developing responsive and inclusive care models that align with the lived realities of ethnically diverse populations. To ensure equitable care at the end of life, investment in cultural training, community partnerships, and co-produced service development is required.

PurposeGlobal adoption of integrated care provides opportunities for enhancing life outcomes and personalised services and addressing health and social inequality, with the attainment of these aspirations requiring specific educational interventions. This project sought to address the paucity of available interventions within the literature by presenting an effective curriculum framework for training pre-registration health and social care students to provide integrated care within the primary context of English integrated care systems. Design/methodology/approachAn action research approach developed the curriculum framework in four stages: (1) a literature review identified existing evidence available for educating students around integrated care; (2) thematic mapping of professional standards and health and social care course learning outcomes confirmed the elements required for successful practice; (3) student evaluation of the mapping outputs and perspectives on integrated care confirmed applicability to programmes and (4) conceptualisation of the final framework. FindingsThe curriculum framework comprises eight domains, each containing competency requirements to achieve the overall outcome aligned to successful practice in integrated care and within integrated care systems. The presented framework provides the overall thematic outcome for the domain and the learning outcomes required. The framework is centralised by person-centred care as a hallmark of effective practice and commitment within integrated care. Research limitations/implicationsThe framework offers a tailored approach to educating undergraduate health and social care students around integrated care and working within integrated care systems. Practical implicationsThe framework offers a new and novel mechanism for training the future workforce in integrated care and for working in integrated care systems. Originality/valueThe integrated care curriculum framework offers an opportunity to address the current evidence gap of interventions designed to train students for future practice in integrated care and within integrated care systems and the requirements of professional education for enhancing knowledge in the field.

BackgroundLuton, a super-diverse town in the East of England, is home to one of the largest Roma populations in the UK. Roma communities experience significant health inequalities, particularly in accessing healthcare services, contributing to poorer health outcomes. However, there is limited research on effective ways to engage Roma communities and address these disparities. This study aimed to explore the views of the Luton Roma community on accessing healthcare services and to co-develop solutions.MethodsA qualitative study was conducted using eleven focus groups with 64 participants. Discussions were transcribed verbatim and analysed using Thematic Framework Analysis.FindingsThree main themes emerged. First, key health concerns included maternity and child healthcare, dissatisfaction with emergency care, long waiting times, and perceived quality of care. Second, barriers to access comprised limited knowledge of services, language difficulties, the need to travel to Romania for care, and perceived discrimination from providers. Third, suggested improvements focused on raising awareness of services, providing language support, and ensuring culturally competent, compassionate care. Gender and age shaped healthcare experiences. Women emphasised caregiving responsibilities and communication challenges, while men highlighted work-related pressures and system-level issues. Younger participants faced digital literacy challenges, middle-aged adults navigated caregiving demands, and older participants reported cumulative discrimination and distrust.ConclusionImproving healthcare access for Roma communities requires systemic, rights-based interventions addressing language, discrimination, and structural obstacles, rather than expecting individuals to adapt. Policy actions should include professional interpretation, culturally competent care, anti-discrimination mechanisms, and active Roma involvement in service design. Improving health-seeking behaviours among Roma communities requires attention to age and gender dynamics, as socially constructed gender roles and life-course experiences shape health perceptions, caregiving responsibilities, and engagement with healthcare services. Community-led models, such as Roma health mediators, are essential for building trust, bridging communication gaps, and promoting equitable health outcomes.

Background:Musculoskeletal disorders (MSDs) significantly impact quality of life, particularly among Black, Asian, and Minority Ethnic communities in the UK, who face disproportionate burdens and barriers to care. Despite growing recognition of ethnic health disparities, there is limited understanding of interventions tailored to these populations. This scoping review aimed to map the existing literature on interventions for MSDs among Black, Asian, and Minority Ethnic groups in the UK, identifying key approaches, gaps, and opportunities for culturally appropriate healthcare delivery. Method:A scoping review was conducted following the Population-Concept-Context (PCC) framework. Seven databases (PubMed Central, CINAHL, Scopus, Medline Full-text, Web of Science, PsycInfo, and Cochrane) were systematically searched up to April 2025. Studies were included if they assessed MSD interventions among Black, Asian and Minority Ethnic individuals in the UK. Both qualitative and quantitative studies were considered. Data were synthesised narratively using thematic analysis supported by NVivo v.11 software. Findings:Nine studies met the inclusion criteria. Three primary themes emerged: (1) language and communication initiatives, such as multilingual resources and telephone helplines; (2) pharmacological and dietary interventions, particularly addressing vitamin D deficiency and rheumatoid arthritis management; and (3) peer-support and educational initiatives, including community-based and culturally tailored programmes. A significant underrepresentation of Black African and Black Caribbean populations was identified alongside a noticeable lack of participatory or qualitative research approaches. Conclusion:There is a critical need for ethnically inclusive, culturally tailored MSD interventions in the UK. Future research should prioritise holistic, community-based approaches and actively address structural inequalities to improve health outcomes and ensure equitable care across all ethnic groups.

Objective To identify the barriers and facilitators to accessing services for neurodevelopmental disorders (NDDs) among the carers of individuals from Black, Asian and minority ethnic groups in the UK.Design A scoping review.Data sources Seven databases: PubMed, Cochrane, MEDLINE Full Text, APA PsycINFO, Scopus, CINAHL and Web of Science were searched for relevant studies up to the end of March 2025. Titles and abstracts and, where appropriate, full-text articles were screened based on predefined inclusion and exclusion criteria. Two reviewers independently screened the 6454 studies, with data extraction carried out by two reviewers. A narrative synthesis of the findings was undertaken.Findings A total of 15 studies were included in the review, the majority of which were qualitative (n=9; 60%). Among the Black, Asian and minority ethnic populations represented, South Asians comprised the predominant group. The review underscores that the barriers faced by Black, Asian and minority ethnic communities are multifactorial, which includes: (1) language and communication barriers, (2) cultural and religious influences, (3) stigma, (4) formal and informal support systems and (5) experience with healthcare services.Conclusion Access to neurodevelopmental care for carers from Black, Asian and minority ethnic groups in the UK is shaped by complex, multifactorial barriers. These communities are not homogeneous, and evidence gaps make it unclear whether challenges are shared or distinct. Greater understanding is needed to inform culturally appropriate, evidence-based policy and practice. Further research is essential to address disparities and improve equitable access across all groups.

Urban greenspaces are considered an important health asset associated with improved population health and well-being. However, inequalities in access to and use of the outdoors continue to exist, particularly among low-income and minority ethnic populations. Following a socio-ecological approach, this study aimed to investigate the individual, interpersonal, and environmental factors that influence the use of greenspaces among an ethnically diverse community in the UK and explore strategies to increase use. A mixed-methods cross-sectional community survey was conducted between March and June 2022 with residents of two ethnically diverse towns situated in Southeast England, UK. Data were collected on factors that influence greenspace use alongside demographic information on age, ethnicity, and social deprivation. An open-ended question explored respondents’ views on strategies to increase engagement with greenspaces. The survey was completed by 906 participants aged between 16 and 94 (60.7% female; 94.5% non-white British). The findings revealed that age, gender, perceived importance of using greenspaces, awareness of greenspaces, and the natural environment were all significant predictors of greenspace use. Qualitative evidence supported these findings and provided useful strategies for increasing access. The findings have provided an increased understanding of the factors that influence greenspace use and suggest that to improve access. There is a clear need to improve the quality of the available green spaces, making them safe and visually appealing to the local communities they serve. Increasing awareness and providing more opportunities for social and intergenerational interaction were also considered important strategies for increasing use.

Background: The Community Connectors programme is a UK pilot initiative designed to bridge gaps between cancer, palliative, and end-of-life care services and diverse ethnic and faith communities. Community Connectors are local individuals with strong cultural insight who enhance two-way communication, increase awareness of care services, and address the unique needs of seldom-heard groups, including South Asian, Black African-Caribbean, and Eastern European communities. By engaging trusted community members, the programme aims to foster relationships, empower communities, and improve understanding of cancer and palliative care pathways among underserved populations. Objective: To explore the experiences and perspectives of Community Connectors implementing this model, with a focus on feasibility, acceptability, and perceived impact within target communities. Methods: A qualitative longitudinal design was employed using linked interviews and reflective diaries. A qualitative descriptive approach was used to explore evolving perceptions of the role, community engagement, and barriers to care access. Semi-structured interviews ( N = 3) were conducted between July 2023 and April 2024, focusing on emerging themes and changes in perceptions. In addition, Community Connectors ( N = 4) kept diaries and activity logs to document their community interactions, challenges, and key observations throughout their involvement in the project. Results: Community Connectors reported success in building trust and relationships within the community, emphasising that trust, integrity, and passion for the role were more important than financial reward. Initially, there was confusion about the role, with expectations of marketing work evolving into a focus on research and engagement. They faced several challenges, including time constraints linked to the part-time nature of the role, as well as cultural sensitivities, language barriers, and stigma around cancer. Despite difficulties in measuring impact, Connectors reported personal growth, strong community relationships, and a sense of reward from their involvement. Conclusion: The Community Connector model is a feasible and culturally responsive approach to improving access to cancer and palliative care in underserved communities. Future programmes should provide clearer role definitions, sustained funding, and training in emotional resilience and cultural competence. Further research is needed to assess the long-term impact of this model on health outcomes and its integration into mainstream health services.

Cardiovascular disease (CVD) is one of the leading causes of premature death globally. CVD is expensive to treat and therefore carries a significant cost for public healthcare systems and the people in them. Those most likely to develop CVD often report co-occurring mental health concerns such as depression and anxiety, in addition to behavioural factors (e.g. physical inactivity) and physical health conditions (e.g. hypertension, high cholesterol, obesity and diabetes). Due to these inter-connecting issues, healthcare provision for CVD patients necessitates a joined-up care pathway providing holistic, person-centred support. Despite the rapid emergence and growth in attempts to deliver such care, evidence concerning how it is experienced and how to promote engagement is fragmented. This review aims to capture the experiences and factors that influence integrated care engagement, reported by adults with CVD risk factors and mild-to-moderate mental health concerns. This systematic review protocol will be reported according to the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-P) guidelines. Proposed database searches will include Emcare, MEDLINE, PsycINFO (via OVID), CINAHL and preprint databases for grey literature. Articles of interest will include adults’ experiences of and factors that influence engagement with integrated care in the UK, specifically for support with CVD risk and mild-to-moderate mental health concerns. Any study design reporting qualitative primary data will be included (excluding conference abstracts). Data on study population (actors/targets), what they do (behaviours) care setting (context), care format (time) and participant experiences and perspectives will be extracted. Where appropriate, thematic synthesis of extracted data will be coded to the Theoretical Domains Framework (TDF), updated Consolidated Framework for Implementation Research (CFIR) and Action, Actor, Context, Target and Time (AACTT) framework. Findings from this review will provide foundation evidence for a behavioural systems map and recommendations for policymakers, commissioners and those involved or interested in integrated care for people at risk of CVD with mental health concerns. Such evidence can be used to develop future intervention strategies to assist the optimisation of integrated care. Systematic review registration: PROSPERO (CRD42024554282.

Abstract Background Inequalities in cancer, palliative, and end-of-life care services remain a significant challenge, particularly for ethnic minorities who face systemic barriers such as limited awareness, cultural stigmas, and language differences. These disparities hinder equitable access to essential services and contribute to poorer health outcomes for affected communities. Addressing these challenges requires targeted, culturally sensitive initiatives that promote both awareness and uptake of care. Community readiness is a critical factor in the success of such interventions, as it reflects the willingness and capacity of a community to engage with and support change. Methods A mixed-methods approach was used, combining individual interviews and two focus groups with key informants (N = 14). This study, conducted in the ethnically and geographically diverse region of Bedfordshire, Luton, and Milton Keynes in southeast England, aimed to assess community readiness to embrace initiatives designed to reduce health inequalities in cancer, palliative, and end-of-life care. The key informants, including faith leaders and professional stakeholders, rated community readiness on five anchored scales: Knowledge of efforts, Leadership, Knowledge of the issue, Community Climate, and Resources. The focus groups facilitated a discussion of the ratings, providing deeper insights into community dynamics and barriers. Results Overall, the community was identified as being at the pre-planning stage of readiness to address disparities in cancer, palliative, and end-of-life care for ethnic minorities. Quantitatively, faith and religious leaders assessed readiness at the vague awareness stage (mean: 3.88), while professional stakeholders rated it at the pre-planning stage (mean: 4.87). Qualitative findings highlighted limited community knowledge, passive leadership with potential for ‘community champions’ to foster openness, a positive climate influenced by younger generations, widespread misconceptions, language barriers, and resource constraints affecting service accessibility. Conclusions The Community Readiness Model provides an insight into the community’s position regarding disparities in access to cancer, palliative and end-of-life services. In order to ensure that continuing efforts are successful in addressing existing inequalities rather than exacerbating them, this study emphasises how critical it is to evaluate the readiness of the community in order to avoid widening inequalities in access and use of services.

Background:Minority ethnic patients are less likely to access timely and effective palliative and end-of-life care and, as a consequence, more likely to experience poorer symptom management and receive more intensive treatments at the end of life. Research activity has the potential to address the aforementioned barriers to improve access. However, there is a need to develop capacity and capability, particularly within underserved communities, to provide an infrastructure that can drive research activity informed by the community to benefit the community. Objective:To build and develop a robust, inclusive and representative research partnership to facilitate improved research activity committed to addressing inequity in access to palliative and end-of-life care among ethnically diverse communities. Design:An inclusive and representative KEEch research Partnership NETwork was established, comprised over 80 partner organisations that represent the local diverse and multifaith communities. Interviews (n = 11) with service providers and face-to-face roundtable workshops with community stakeholders, service providers, informal carers and faith leaders were conducted to understand needs, challenges and research priorities. Setting:Bedfordshire, Hertfordshire and Milton Keynes, United Kingdom. Results:Developing KEEch research Partnership NETwork required a flexible and agile approach to engage effectively with institutionalised and non-institutionalised stakeholders. Sharing a joint purpose of learning, managing partners' expectations and providing transparency and accountability within the network were all essential in building trust and equity within the research partnership. The overarching findings revealed a range of sociocultural and structural barriers that negatively impact access and experience among minority ethnic groups. Discussions centred on the disconnect between informal care and support within the community, which many ethnic minority communities rely upon, and 'institutional' medical services. KEEch research Partnership NETwork uncovered that while service providers and communities acknowledge they need to engage with each other more, they remain uncertain of the best way to achieve this. There was also consensus that services need to deliver more effective, culturally competent, person-centric care that promotes compassion and gives weight to non-medical needs to better meet the needs of the diverse population. These findings and priorities have informed the submission of a co-produced research funding proposal. Beyond that, KEEch research Partnership NETwork has also provided a platform for further unplanned spin-off research projects and collaboration, including the implementation of an innovative 'community connector' role to facilitate better integration of community and voluntary services in palliative and end-of-life care. Conclusions:KEEch research Partnership NETwork has provided valuable insight into factors that can facilitate the successful collaboration between multifaith and diverse community stakeholders. Through KEEch research Partnership NETwork, we offer our observations as an opportunity for shared learning for others who want to adopt a similar approach when in the planning stages of establishing a research partnership network. The mutual benefit of developing this partnership and working collectively with communities to address inequalities in accessing palliative and end-of-life care could provide a useful approach and way of solving other important priorities to reduce wider health inequalities. Funding:This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research as award number NIHR135381.

In the UK, there are disparities in the use of urban greenspaces, particularly among low-income, ethnically diverse communities. Determining how populations interact with greenspaces and the barriers and facilitators that influence use remains pertinent to improve access. This study aimed to examine how people who reside in an ethnically diverse community use and engage with urban greenspaces and, drawing on the COM-B model (capability, opportunity, motivation, and behaviour), aimed to assess the potential barriers and facilitators that influence use. A cross-sectional survey, conducted across two ethnically diverse towns in southeast England investigated greenspace usage, including activities and reasons for using greenspaces and included the Brief Measure of Behavior Change (COM-B). The survey was shared online via Qualtrics and widely disseminated in the local community via bilingual fieldworkers and community networks. The sample comprised 906 participants (60.7 % female; mean age 38 +/- 16.37 years). The findings revealed that the use of greenspaces was low with around 33 % visiting greenspaces frequently (at least once a week). Older people, those with higher levels of deprivation and/or those from a minority ethnic background were all shown to be the lowest users of greenspaces. The findings also confirmed that the types of activities and reasons for visiting greenspaces were shown to vary by a range of socio-demographic characteristics. The COM-B model was shown to be a useful explanatory framework with physical capability and motivation identified as significant predictors of frequency of greenspace use. We now encourage future research to consider what factors underpin motivation and the opportunities to use greenspaces, and how these vary across the wider population.

Background Minority ethnic groups are at increased risk of COVID-19 related mortality or morbidity yet continue to have a disproportionally lower uptake of the vaccine. The importance of adherence to prevention and control measures to keep vulnerable populations and their families safe therefore remains crucial. This research sought to examine the knowledge, perceived risk, and attitudes toward COVID-19 among an ethnically diverse community. Methods A cross-sectional self-administered questionnaire was implemented to survey ethnic minority participants purposefully recruited from Luton, an ethnically diverse town in the southeast of England. The questionnaire was structured to assess participants knowledge, perceived risk, attitudes toward protective measures as well as the sources of information about COVID-19. The questionnaire was administered online via Qualtrics with the link shared through social media platforms such as Facebook, Twitter, and WhatsApp. Questionnaires were also printed into brochures and disseminated via community researchers and community links to individuals alongside religious, community and outreach organisations. Data were analysed using appropriate statistical techniques, with the significance threshold for all analyses assumed at p = 0.05. Findings 1,058 participants (634; 60% females) with a median age of 38 (IQR, 22) completed the survey. National TV and social networks were the most frequently accessed sources of COVID-19 related information; however, healthcare professionals, whilst not widely accessed, were viewed as the most trusted. Knowledge of transmission routes and perceived susceptibility were significant predictors of attitudes toward health-protective practises. Conclusion/recommendation Improving the local information provision, including using tailored communication strategies that draw on trusted sources, including healthcare professionals, could facilitate understanding of risk and promote adherence to health-protective actions.

Background The COVID-19 pandemic has led to changes in health behaviours, which include eating patterns and nutrition, smoking, alcohol consumption, sleeping patterns, physical activity and sedentary behaviour. There is a dearth of evidence reporting the impact of COVID-19 on the health behaviour of Black, Asian and minority ethnic (BAME) communities. This scoping review synthesises the available evidence on the impact of COVID-19 on the changes in health behaviours among BAME communities in the UK. Methods Following a keyword strategy, 16 electronic databases were searched for articles that met the screening criteria. These articles were then reviewed in full text. Empirical studies that assessed COVID-19 related health behaviour changes among BAME communities in the UK, conducted during the COVID-19 pandemic between July 2020 and August 2021 and published in English language, were set as inclusion criteria. An initial 2160 studies were identified in the selected databases. After removing duplications and screening the title and abstracts of the 2154 studies, only 4 studies were selected to be reviewed as they met the inclusion criteria. The included studies employed different sample sizes which ranged from N = 47 to N = 30,375 and reported several health behaviour changes. Out of the 4 included studies, 3 studies included BAME groups within their sample as a subgroup while one study focused specifically on BAME groups. Results The scoping review found that there were lower levels of physical activity among BAME groups compared to the White ethnic groups. About 41.7% of BAME groups reported drinking less alcohol than usual compared to their white counterparts who were, 34% of whom reported drinking less alcohol. Study participants from BAME backgrounds had the greatest effect of COVID-19 on decisions to purchase healthier food compared to people from white backgrounds whose decisions on purchasing healthier food were least affected. Similar to other ethnic groups the COVID-19 pandemic increased positive hygiene among BAME groups which is important in preventing other diseases and infections. . Conclusion COVID-19 had a significant impact on the health behaviours of BAME groups especially during the lockdowns as they reported changes to behaviour such as low levels of physical activities. Hence, it is important to promote health awareness among BAME groups to encourage healthy living. In addition, programmes such as physical fitness activities that favour BAME groups should be put in place, for example BAME women’s walking groups to encourage people from BAME backgrounds to engage more in physical activities. Furthermore, healthy food programmes such as food parcels can be given to people from BAME backgrounds who are not able to afford healthy food due to the impact of COVID-19. Similar to other ethnic groups, the COVID-19 pandemic has increased positive hygiene among BAME groups which is important in preventing other diseases and infections.

BackgroundObstetric fistula continues to affect the social and mental wellbeing of women living in Nigeria giving rise to poor maternal health outcome. While the World Health Organisation (WHO) has recommended the introduction of psycho-social interventions in the management of obstetric fistula women, psycho-social support for women living with obstetric fistula in Nigeria, are limited. This systematic review aimed to synthesise the psycho-social impact of obstetric fistula on women living in Nigeria as well as the available psycho-social support for these affected women.MethodsFollowing a keyword strategy, Medline, CINAHL, Google scholar, ScienceDirect, Cochrane library, PsychINFO, AMED, British Nursing database, Pubmed central, TRIP database, UK Pubmed central, socINDEX, Annual reviews, ISI Web of Science, Academic search complete, Credo reference, Sage premier and Scopus databases were searched alongside hand searching of articles. The inclusion criteria were set as articles published between 2000 and 2020, on the psychosocial consequences of obstetric fistula in Nigeria. The Critical Appraisal Skills Program (CASP) tool was used to appraise the quality of the included studies. The data was extracted and then analysed using narrative synthesis.Results620 relevant citations were identified, and 8 studies were included. Women with obstetric fistula, living in Nigeria were found to be ostracised, abandoned by families and friends, stigmatised and discriminated against, which led to depression, loneliness, loss of self-esteem, self-worth and identity. Psycho-social interventions for women who experienced obstetric fistula are not widely available.ConclusionThere is a need for the introduction of more rehabilitation and reintegration programs across the country. The psychosocial effect of obstetric fistula is significant and should be considered when developing interventions. Further, more research is needed to evaluate the sustainability of psychosocial interventions in Nigeria.

Background The COVID-19 pandemic intensified the risk factors for poor mental health among care workers in the UK. However, there is inadequate evidence on the mental health impact of COVID-19 on Black, Asian, and minority ethnic (BAME) care workers in particular. This study seeks to explore mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic. Method This is a qualitative study conducted between February and May, 2021 in Luton, England. A sample of n = 15 care workers from BAME background working in nursing and residential care homes were recruited purposively using the snowball sampling technique. In-depth interviews were conducted around topics such as views on COVID-19, the impact of the COVID-19 pandemic on mental health and coping during the COVID-19 pandemic. Data from the interviews was analysed using the Framework Analysis Approach. Results The COVID-19 pandemic had a negative impact on the participants’ mental health as they experienced stress, depression, anxiety, trauma and paranoia. The majority of the participants explained that they managed their mental health by belief in God and religious practices, by keeping themselves busy doing activities they were passionate about, following government guidelines on the prevention of COVID-19, seeing the service users happy and some participants managed through support that was offered by the government. However, some participants did not have any support for their mental health. Conclusion Issues such as increased workload associated with COVID-19 restrictions engendered mental health problems among BAME care workers, however, the workload only further increased during the pandemic, but the health and social care sector was already affected by heavy workload due to staff shortages and this needs to be addressed through increasing their wages to encourage more people to work in the health and social care sector. In addition, some BAME care workers never received any support for their mental health during the pandemic. Hence, integrating mental health services such as counselling, supportive psychotherapy and recreational therapies in care homes could help to support the mental health of care workers in the COVID-19 era.

The UK’s minority ethnic population, despite being at higher risk of COVID-19 and experiencing poorer health outcomes, continue to have lower uptake of the COVID-19 vaccine compared with their white British counterparts. Given the importance of the vaccination programme in improving health outcomes, this research sought to examine the influential factors that impact the decision to accept the COVID-19 vaccination among an ethnically diverse community. A total of 1058 residents from Luton, UK, a large town with an ethnically diverse population, completed a community survey. Questions centred around uptake or individuals’ intentions to accept the offer of COVID-19 vaccination alongside demographics, knowledge, and views on the vaccine. A binary logistic regression analysis was conducted to determine the most significant predictors of vaccine hesitancy, while respondents’ reasons for not getting vaccinated were identified using qualitative content analysis. Findings revealed that age and ethnicity were the only sociodemographic factors to predict vaccine hesitancy. Knowledge of symptoms and transmission routes, alongside ensuring information about COVID-19 was objectively sourced, were all identified as protective factors against vaccine hesitancy. Qualitative analysis revealed that ‘lack of trust in government/authorities’ and ‘concern of the speed of vaccine development’ were the most common reasons for non-uptake. This research reinforces the importance of age, ethnicity, and knowledge as influential factors in predicting vaccine hesitancy. Further, this study uncovers some of the barriers of uptake that can be utilised in developing promotional campaigns to reduce vaccine hesitancy in certain sections of the diverse UK population.

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Background The United Kingdom has one of the lowest breastfeeding rates in Europe, with the initiation and continuation of breastfeeding shown to be closely related to the mothers’ age, ethnicity and social class. Whilst the barriers that influence a woman’s decision to breastfeed are well documented, less is known how these barriers vary by the UK’s diverse population. As such, this study aimed to explore mothers’ experiences of breastfeeding and accessing breastfeeding services offered locally amongst a deprived and culturally diverse community. Methods A qualitative interpretive study comprising of 63 mothers (white British n = 8, Pakistani n = 13, Bangladeshi n = 10, black African n = 15 and Polish n = 17) who took part in single-sex focus groups, conducted in local community centres across the most deprived and ethnically diverse wards in Luton, UK. The focus groups were audio-recorded, transcribed and analysed thematically using Framework Analysis. Results The most common barriers to breastfeeding irrespective of ethnicity were perceptions surrounding pain and lack of milk. Confidence and motivation were found to be crucial facilitators of breastfeeding; whereby mothers felt that interventions should seek to reassure and support mothers not only during the early stages but throughout the breastfeeding journey. Mothers particularly valued the practical support provided by health care professions particularly surrounding positioning and attachment techniques. However, many mothers felt that the support from health care professionals was not always followed through. Conclusions The findings presented inform important recommendations for the design and implementation of future programs and interventions targeted at reducing breastfeeding inequalities. Interventions should focus on providing mothers practical support and reassurance not only during the early stages but throughout their breastfeeding journey. The findings also highlight the need for tailoring services to support diverse communities which acknowledge different traditional and familial practices.

In the UK, ethnic minority children are at greater risk of obesity and weight-related ill health compared to the wider national population. The factors that influence the provision of a healthy diet among these populations remain less understood. An interpretive qualitative study with a phenomenological perspective comprised of 24 single sex semi-structured focus groups was conducted with 110 parents (63 mothers and 47 fathers) of young children (aged 0–5 years). The participants were recruited from deprived and ethnically diverse wards in Luton, UK and self-identified as being white British, Pakistani, Bangladeshi, black African–Caribbean or Polish. The findings highlighted a wide range of inter-relating psychological and sociocultural factors that underpin parental beliefs and practices in providing children with a healthy diet. Parents, whilst aware of the importance of providing children with a healthy diet, faced challenges such as lack of time and balancing competing responsibilities, which were clear barriers to providing children with a healthy diet. Access to and affordability of healthy food and the overexposure of cheap, convenient, and unhealthy processed foods made it increasingly difficult for parents to provide a healthy diet for their growing families. Household food practices were also found to be situated within the wider context of sociocultural and religious norms around cooking and eating, along with cultural identity and upbringing.