Suchergebnisse

Objective: To determine how to improve the cultural appropriateness and accept­ability of an extant evidence-based model of family intervention (FI), a form of 'talking treatment,' for use with African Caribbean service users diagnosed with schizophrenia and their families.Design: Community partnered participa­tory research (CPPR) using four focus groups comprising 31 key stakeholders.Setting: Community locations and National Health Service (NHS) mental health care settings in northwest England, UK.Participants: African Caribbean service us­ers (n=10), family members, caregivers and advocates (n=14) and health care profes­sionals (n=7).Results: According to participants, com­ponents of the extant model of FI were valid but required additional items (such as racism and discrimination and different models of mental health and illness) to im­prove cultural appropriateness. Additionally, emphasis was placed on developing a new ethos of delivery, which participants called 'shared learning.' This approach explicitly acknowledges that power imbalances are likely to be magnified where delivery of interventions involves White therapists and Black clients. In this context, therapists' cultural competence was regarded as funda­mental for successful therapeutic engage­ment and outcomes.Conclusions: Despite being labelled 'hard-to-reach' by mainstream mental health services and under-represented in research, our experience suggests that, given the opportunity, members of the African Carib­bean community were highly motivated to engage in all aspects of research. Participat­ing in research related to schizophrenia, a highly stigmatized condition, suggests CPPR approaches might prove fruitful in developing interventions to address other health conditions that disproportionately affect members of this community.Ethn Dis. 2018;28(Suppl 2): 485-492; doi:10.18865/ed.28.S2.485.

Background: We explore the roles of trust, distrust, and the prevailing socio-political context to better understand why people from ethnic minority communities are less likely to be blood donors compared to people from White communities. Recruiting more ethnic minority donors will enhance representativeness, reduce inequality, and help meet the clinical need to increase the proportion of blood with Ro Kell antigen to treat Sickle Cell Disease (SCD).Study Design and Methods: A 2 (Donor-Status: current vs non-donors) by 4 (Ethnicity: White vs, Asian, vs Mixed Race vs Black people) quasi-experiment (N = 981) was conducted to examine perceptions of trust/distrust and their influence on willingness to donate blood, within the socio-political context of the Windrush scandal and Brexit.Results: We identified five domains of trust ('National Health Service [NHS] and staff', 'NHS Blood and Transplant', 'outgroups', 'individuals', and 'politics'), and a single domain of conditional distrust domain. Trust across all the domains was lower, and 'conditional distrust' higher for ethnic minorities. Trust in 'individuals' and 'NHSBT' predicted willingness to donate in non-donors from ethnic minorities and White non-donors, respectively. Concerns about the Windrush scandal were related to lower political trust. Viewing Brexit as 'positive for the UK' was related to lower trust across domains and reduced willingness to donate in White non-donors through its influence on reduced trust in NHSBT.Conclusion: Distinct domains of trust and distrust are identified, and targeting 'trust in others' through conditional cooperation is recommended as a strategy to increase donor numbers from ethnic minority communities.