Enhancing community engagement, public involvement, and social capital through researchers' participation in community dance projects: unexpected outcomes in underserved communities.

BACKGROUND: The Dance and Health project aimed to promote public involvement in health research. Public involvement leads worked with project partner community groups, Aakash Odedra Dance Company and Moving Together, to develop a community engagement project with people living in low-socioeconomic areas/deprivation and diverse ethnic minority groups. Dance and Health included a weekly 60-min dance class and 30 min of facilitated health science discussion, that could either be a public involvement discussion for a research project, an activity about a particular biomedical research theme or ongoing discussions with a visiting researcher. The goal of this paper is to explore the impact of the Dance and Health project on the social capital of participants and provide key learnings on how to engage and build partnerships with people from underserved groups in health research contexts. METHODS: Qualitative interviews and focus groups were completed which explored participant and dance tutor experiences in community venues. Participants were aged between 22 and 90, most were female and were from Asian ethnic minority groups and White British groups living in deprived neighbourhoods in Leicester. Qualitative data were analysed using qualitative content analysis. RESULTS: The responses to the Dance and Health project were positive across all the focus groups. Central themes identified were Feedback on the Project, Motivation to Exercise, Criticism of the NHS, Mental Wellbeing, Engagement in a Post Pandemic New Normal, Accessibility and Inclusivity, Empowerment and Building Social Capital. DISCUSSION: The focus groups evidenced that the project had broad impact. Participants expressed empowerment and ownership and described a range of social capital enrichment generated through the project including networks and friendships, access to the institutional resource of health science, and the opportunity to engage with a health and leisure activity that was valued and meaningful.

A research team worked with community dance schools in Leicester to try to get more people from the Asian community and from poorer neighbourhoods involved in research and science. By taking part in the project, people benefitted from an opportunity to exercise and to learn about and influence health research taking place locally. However, the researchers also noticed that there were other benefits to the project. Dancing and learning about health science helped people bond and form new friendships. The researchers joined in, and this helped build friendships and trust between participants and people working in science and research. This is called bridging which is where we bring people together from different groups. The dance sessions made the researchers more approachable and less intimidating, so it was easier to trust them and build friendships. Bridging and bonding are ways of building social capital. Social capital describes the social resources that people can access in their neighbourhoods and communities e.g. facilities (village halls or clubs) and support networks. Researchers delivered focus groups in which participants talked about Feedback on the Project, Motivation to Exercise, Criticism of the NHS, Mental Wellbeing, Engagement in a Post Pandemic New Normal, Accessibility and Inclusivity, Empowerment and Social Capital. This supported the idea that projects where we try to engage with communities can build social capital. This is most likely when projects provide safety and accessibility, (1) and flexibility, a sense of belonging, commitment, communication, being genuine, relevance, sustainability (4).

Qualitative exploration of uterine cancer care for lesbian, gay, bisexual, trans and queer (LGBTQ+) patients in the UK: shifting from equality to equity.

OBJECTIVE: Patients identifying as lesbian, gay, bisexual, transgender and/or queer/questioning (LGBTQ+) report significant disparities in cancer care and are disproportionally affected by a cancer diagnosis on a number of health-related indicators. This study aimed to explore uterine cancer (UC) care from the perspectives of LGBTQ+ patients and stakeholders, to identify this population's care needs, which have been underprioritised thus far. METHODS AND ANALYSIS: Qualitative interview data were collected from three cohorts of participants: LGBTQ+ UC patients, partners of UC patients and stakeholders who provide advocacy and/or support within the UC care pathway, including healthcare professionals (HCPs). Semi-structured qualitative interviews were conducted and data were analysed using inductive reflexive thematic analysis. RESULTS: Fifteen participants (three patients, one partner, eight HCPs and three cancer support charity representatives) were recruited. Data analysis identified themes which represented participants' reflections on the relevance and opportunities for identity disclosure during the diagnostic pathway; feelings and implications of not fitting into the gynaecological cancer environment and, opportunities and challenges surrounding HCP education, and protocolled sexual and gender identity data collection. CONCLUSION: UC patients who identify as LGBTQ+ have specific care needs and considerations, particularly related to transvaginal procedures and survivorship. Opportunities for disclosure of patients' LGBTQ+ identity during the UC care pathway are essential for these needs to be recognised. Despite this, there are conflicting agendas between HCPs and stakeholders on the best approach to integrate disclosure processes. The current findings highlight the need for public health agendas and clinical services to address the needs of LGBTQ+ UC patients.

Cardiovascular disease prevention: Community Based Asset Mapping within religious networks in a rural Sub-Saharan African neighbourhood.

Prevalence of conditions which raise cardiovascular risk, such as hypertension and type 2 diabetes are seeing a dramatic rise in Sub Saharan Africa. A large proportion of these cases remain undiagnosed and there is limited resource to provide patients with self-management support and education once diagnosed. This study aimed to identify and catalogue community-based assets for the purposes of developing and deploying a screening and education programme for cardiometabolic risk factors (diabetes and hypertension) within religious organisations in a local community in a rural Ghanaian context. We utilised a community-based form of participatory research made up of a number of different components including community-based asset mapping and stakeholder consultation, supplemented by 18 in-depth interviews and 10 focus groups with n = 115 service users, to map existing assets with relevance to cardiometabolic health in this setting and context. Thematic analysis of interview and focus group data was performed to identify themes related to successful implementation of health screening. Two stakeholder workshops with local healthcare professionals, faith leaders and health policy makers were delivered to co-produced a prioritised list of recommendations and 'asset map' to aid deployment of mass screening within faith organisations in this context. The findings of this research highlight a number of 'hidden' community assets and motivational mechanisms at an individual, community and institutional levels; these have informed a list of recommendations which have been co-developed with the stakeholder group and local community to support the development of effective screening strategies for cardiometabolic conditions within faith organisations in this context. We have identified key mechanisms and assets which would support a sustainable screening approach designed to engage an underserved community at high CVD risk to promote general community health and well-being.

Examining Psychosocial and Economic Barriers to Green Space Access for Racialised Individuals and Families: A Narrative Literature Review of the Evidence to Date.

BACKGROUND: Social prescribing (such as green social prescribing), aims to address health disparities cross-culturally to improve well-being. However, evidence highlights racial disparities in relation to access to quality green space (including local/national parks and recreational spaces). This review aimed to identify the psycho-socioeconomic barriers to green space access for racialised individuals/families and Black Indigenous People of Colour (BIPOC), to understand what cultural adaptations might be made to help support them to access green social prescribing within the UK. METHOD: A narrative systematic review was conducted to identify barriers to green space access for racialised individuals/families and BIPOC. Searches of publication databases (APA PsycInfo, Cochrane Database of Systematic Reviews [CDSR], Cochrane Central Register of Controlled Trials [CENTRAL], Cumulated Index to Nursing and Allied Health Literature [CINAHL], and SCOPUS Preview) were undertaken from January to February 2022, to identify quantitative peer reviewed studies. Of the 4493 abstracts identified, ten studies met the inclusion criteria and were included for final review. RESULTS: The results suggest that interpersonal, practical (such as transportation costs, entrance fees and lodging costs) and environmental factors can act as barriers to green space access for racialised individuals/families. Most frequently reported barriers were perceptions of safety and costs associated with travel and accessing green spaces, particularly for families. CONCLUSION: Factors such as diversity-friendly schemes (e.g., multiple languages on signs and additional prayer spaces in parks), funding and strategies to improve safety should be considered in the design and commissioning of green space and green social prescribing initiatives in primary care. By mitigating these barriers green space can become more accessible and improve inclusivity for racialised individuals/families. Future research could explore the inter-racial differences between racialised populations and which mechanisms reduce barriers to access and in what contexts.

Qualitative evaluation of A Safer Ramadan, a structured education programme that addresses the safer observance of Ramadan for Muslims with Type 2 diabetes.

AIMS: Muslims can choose to fast during Ramadan. Guidelines exist for providing clinical support for this group, but there is a lack of culturally tailored diabetes management interventions to provide guidance. The study evaluates the implementation of a programme developed to meet this need. METHODS: A Safer Ramadan is a multi-faceted package comprising a self-management and community awareness programme, and healthcare professional training. Implementation of the programme took place in two cities in the UK, prior to Ramadan 2017. Uptake and attendance were determined, and qualitative interviews and focus groups were completed with people attending the programme, and with various stakeholders involved in implementation and delivery. RESULTS: Success of the implementation varied and engagement by primary care was limited. Three central themes emerged from the interviews highlighting barriers and facilitators of the programme implementation. These were the referral pathway, programme content and feedback on the delivery of the programme. CONCLUSIONS: Provision of interventions that provide support and education for Muslims during Ramadan was implemented in communities and valued by GPs and practice nurses. However, heavy workloads to support delivery made it difficult for practices to engage. Recommendations for future delivery of the programme indicate that greater attention should be given to marketing and its supporting practices. Furthermore, training for practice nurses to support patients prior to Ramadan and provision of funding is required.