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In reply to the news article by J. Wise about building on the success of the Covid-19 vaccination programme (1), we are encouraged to see that recommendations from a recent government progress report include tackling longer-standing health inequalities using learning from the pandemic (2). Lessons include using community partnerships, and local and celebrity ethnic minority voices, to build trust and help tackle misinformation; taking interventions into the heart of communities; and increasing ethnic minority participation in health research.
One government recommendation of particular interest is to develop and disseminate culturally appropriate health information for future campaigns. Developing culturally relevant information on long-term conditions that disproportionately impact ethnic minority groups would also help tackle longer-standing health inequalities seen prior to the pandemic and exacerbated during it.
The far-reaching impact of short educational videos in multiple languages has been demonstrated throughout the pandemic and is highlighted in the government report. Research published pre-pandemic also shows statistically significant improvement in knowledge, and improvement in consultations between patients and health professionals, when culturally sensitive educational videos are used with South Asian groups (3). The benefits of using community partners to co-create content, and of communicating health messages through local partners and specialist media channels, cannot be underestimated.
These points echo findings from our own community engagement work on developing health information for South Asian communities (4). In five community engagement workshops, 50 Bangladeshi, Indian and Pakistani patient and public contributors discussed their views on the need for multilingual educational videos on long-term conditions that disproportionately affect South Asian groups, the preferred length of videos, content, languages and subtitles, use of infographics and other images, and dissemination.
Our participants felt that educational videos on common conditions is vital because culturally appropriate information can help fill in gaps in knowledge; improve communication with health professionals; help break taboos and barriers; and promote discussion of sensitive health topics (e.g. depression). Evidence-based information from healthcare professionals and examples of patients’ lived experiences was seen as essential, as well as information about the mental health impacts of long-term conditions, and sources of support.
Every group is unique, and needs and preferences vary. Conducting similar workshops with Black and other ethnic minority groups is critical before developing educational resources to ensure that content is relevant, acceptable, and does not stereotype or stigmatise particular groups. Disseminated widely, educational videos can help counter misinformation. Social media, including WhatsApp, YouTube, Instagram and TiKTok, can be used to maximise reach. Research teams with established relationships with community partners can be commissioned to carry out this work in a timely manner.
The report highlights the important role of the National Institute for Health Research and the NHS Race and Health Observatory in helping to increase ethnic minority participation in clinical trials. These organisations can also play a significant role in commissioning research into ethnic minority experiences of long-term conditions that disproportionately affect them. This includes lived experience of accessing health services, views on service improvement, impacts of a long-term condition on people’s daily lives, and information-seeking and support. The umbrella term ‘ethnic minority’, as the government report notes, does not enable in-depth understanding of the differential impacts of covid-19 on different groups, nor of the varying impacts of long-term conditions. In-depth research with specific ethnic minority groups is urgently needed.
Building on lessons learnt from the COVID-19 vaccination programme is crucial. This also includes valuable lessons in developing culturally appropriate health information that is co-designed with community partners.
References
1. Wise J. Covid-19: Build on success of vaccination programme in reaching ethnic minority groups, report recommends. BMJ 2021;375:n3003.
3. Patel N, Stone MA, Hadjiconstantinou M, Hiles S, Troughton J, Martin-Stacey L, Daly H, Carey M, Khulpateea, A, Davies MJ, Khunti K. Using an interactive DVD about type 2 diabetes and insulin therapy in a UK South Asian community and in patient education and healthcare provider training. Patient Education and Counseling 2015; 98:1123–1130.
Competing interests:
KK is a member of SAGE, Chair of Ethnicity subgroup of SAGE, Director of the Centre for Ethnic Health Research, University of Leicester, and a trustee of the charity South Asian Health Foundation. KK is supported by the NIHR Applied Research Collaborations, East Midlands (NIHR ARC-EM).
19 January 2022
Suman Prinjha
Senior Research Advisor
Professor Kamlesh Khunti
University of Leicester
Centre for Ethnic Health Research, Diabetes Research Centre, University of Leicester, Leicester General Hospital
Applying lessons from the covid-19 vaccination programme to improve health information for ethnic minority populations Re: Covid-19: Build on success of vaccination programme in reaching ethnic minority groups, report recommends
Dear Editor,
In reply to the news article by J. Wise about building on the success of the Covid-19 vaccination programme (1), we are encouraged to see that recommendations from a recent government progress report include tackling longer-standing health inequalities using learning from the pandemic (2). Lessons include using community partnerships, and local and celebrity ethnic minority voices, to build trust and help tackle misinformation; taking interventions into the heart of communities; and increasing ethnic minority participation in health research.
One government recommendation of particular interest is to develop and disseminate culturally appropriate health information for future campaigns. Developing culturally relevant information on long-term conditions that disproportionately impact ethnic minority groups would also help tackle longer-standing health inequalities seen prior to the pandemic and exacerbated during it.
The far-reaching impact of short educational videos in multiple languages has been demonstrated throughout the pandemic and is highlighted in the government report. Research published pre-pandemic also shows statistically significant improvement in knowledge, and improvement in consultations between patients and health professionals, when culturally sensitive educational videos are used with South Asian groups (3). The benefits of using community partners to co-create content, and of communicating health messages through local partners and specialist media channels, cannot be underestimated.
These points echo findings from our own community engagement work on developing health information for South Asian communities (4). In five community engagement workshops, 50 Bangladeshi, Indian and Pakistani patient and public contributors discussed their views on the need for multilingual educational videos on long-term conditions that disproportionately affect South Asian groups, the preferred length of videos, content, languages and subtitles, use of infographics and other images, and dissemination.
Our participants felt that educational videos on common conditions is vital because culturally appropriate information can help fill in gaps in knowledge; improve communication with health professionals; help break taboos and barriers; and promote discussion of sensitive health topics (e.g. depression). Evidence-based information from healthcare professionals and examples of patients’ lived experiences was seen as essential, as well as information about the mental health impacts of long-term conditions, and sources of support.
Every group is unique, and needs and preferences vary. Conducting similar workshops with Black and other ethnic minority groups is critical before developing educational resources to ensure that content is relevant, acceptable, and does not stereotype or stigmatise particular groups. Disseminated widely, educational videos can help counter misinformation. Social media, including WhatsApp, YouTube, Instagram and TiKTok, can be used to maximise reach. Research teams with established relationships with community partners can be commissioned to carry out this work in a timely manner.
The report highlights the important role of the National Institute for Health Research and the NHS Race and Health Observatory in helping to increase ethnic minority participation in clinical trials. These organisations can also play a significant role in commissioning research into ethnic minority experiences of long-term conditions that disproportionately affect them. This includes lived experience of accessing health services, views on service improvement, impacts of a long-term condition on people’s daily lives, and information-seeking and support. The umbrella term ‘ethnic minority’, as the government report notes, does not enable in-depth understanding of the differential impacts of covid-19 on different groups, nor of the varying impacts of long-term conditions. In-depth research with specific ethnic minority groups is urgently needed.
Building on lessons learnt from the COVID-19 vaccination programme is crucial. This also includes valuable lessons in developing culturally appropriate health information that is co-designed with community partners.
References
1. Wise J. Covid-19: Build on success of vaccination programme in reaching ethnic minority groups, report recommends. BMJ 2021;375:n3003.
2. Final report on progress to address covid-19 health inequalities. December 2021. www.gov.uk/government/organisations/race-disparity-unit.
3. Patel N, Stone MA, Hadjiconstantinou M, Hiles S, Troughton J, Martin-Stacey L, Daly H, Carey M, Khulpateea, A, Davies MJ, Khunti K. Using an interactive DVD about type 2 diabetes and insulin therapy in a UK South Asian community and in patient education and healthcare provider training. Patient Education and Counseling 2015; 98:1123–1130.
4. Prinjha S, Miah N, Ali E, Bhavsar S, Grewal-Santorini G, Farmer A, Khunti K. (2021). Learning from COVID-19: British South Asian perspectives on developing culturally appropriate health information resources. https://dipexcharity.org/wp-content/uploads/2021/05/Co-producing-health-...
Competing interests: KK is a member of SAGE, Chair of Ethnicity subgroup of SAGE, Director of the Centre for Ethnic Health Research, University of Leicester, and a trustee of the charity South Asian Health Foundation. KK is supported by the NIHR Applied Research Collaborations, East Midlands (NIHR ARC-EM).