Developing a toolkit for increasing the participation of black, Asian and minority ethnic communities in health and social care research

Background It is recognised that Black, Asian and Minority Ethnic (BAME) populations are generally underrepresented in research studies. The key objective of this work was to develop an evidence based, practical toolkit to help researchers maximise recruitment of BAME groups in research. Methods Development of the toolkit was an iterative process overseen by an expert steering group. Key steps included a detailed literature review, feedback from focus groups (including researchers and BAME community members) and further workshops and communication with participants to review the draft and final versions. Results Poor recruitment of BAME populations in research is due to complex reasons, these include factors such as inadequate attention to recruitment strategies and planning, poor engagement with communities and individuals due to issues such as cultural competency of researchers, historical poor experience of participating in research, and lack of links with community networks. Other factors include language issues, relevant expertise in research team and a lack of adequate resources that might be required in recruitment of BAME populations. Conclusions A toolkit was developed with key sections providing guidance on planning research and ensuring adequate engagement of communities and individuals. Together with sections suggesting how the research team can address training needs and adopt best practice. Researchers highlighted the issue of funding and how best to address BAME recruitment in grant applications, so a section on preparing a grant application was also included. The final toolkit document is practical, and includes examples of best practice and ‘top tips’ for researchers.

Intersectionality & Sexual harassment as a Minority Ethnic Female Surgeon

As a trainer, I have even taught women from certain cultures (who may find this level of contact difficult), that this is ‘normal’ in surgery. After reading the editorial and letter of response, in the Royal College of Surgeon’s Bulletin, [1] I have to think again about what I teach. I have taken for granted that surgeons have some sort of moral standing. Maybe I should be explaining also what they should not be tolerating. Even as a female surgeon, often at cultural gatherings, I feel I am perceived differently by women from my cultural or ethnic background, even if they are medical professionals themselves. I feel ostracised as being the woman who is playing with the men at their game. The younger generations however do applaud it, and I see more and more young women have a fervour for surgery. I feel now I want to protect them from this misogyny and sexual harassment more than ever.

Notes on policing, racism and the Covid-19 pandemic in the UK

This commentary excerpts from the research report ‘A threat to public safety: policing, racism and the Covid-19 pandemic’, carried out by the Centre on the Dynamics of Ethnicity (CoDE) and published by the Institute of Race Relations in September 2021. One of the only pieces of research based on the experiences of the policed and their testimonies, the report suggests that policing during the Covid-19 pandemic undermines public health measures whilst disproportionately targeting Black and Minority Ethnic communities in the UK. The authors raise concerns about the policing of the pandemic and show that racially minoritised communities have been most harshly affected – being more likely to be stopped by the police, threatened or subject to police violence and falsely accused of rule-breaking and wrong-doing. The report argues that lockdown conditions, new police powers, and histories of institutionally racist policing have combined to pose a threat to already over-policed communities and the most marginalised and vulnerable sections of society.

Przełamywanie barier komunikacyjnych (na przykładzie wieloetnicznej i wielojęzycznej sytuacji społecznej Zaolzia)

Breaking Communication Barriers (on the Example of the Multiethnic and Multilingual Situation of the Society in the Zaolzie Region)The present paper describes the language situation in several parts of Cieszyn Silesia (the Zaolzie region) in the Czech Republic. The research is based on authentic language material from two music (art) schools in Český Těšín and Třinec. The Třinec school has the official status of a bilingual Czech-Polish educational institution. These two establishments share several common features: both students and teachers come from either majority Czech or minority ethnic Polish communities; Polish children study in both institutions, although a larger group of these "foreign" students attends the school in Český Těšín. The authors analyze not only the spoken language itself but also the competence and language awareness of the respondents. They have come to the conclusion that interactions between the users of two (different) languages can be successful regardless of the fact whether each participant uses their own native tongue or that of their interlocutor, although they speak this language only at a basic level. Przełamywanie barier komunikacyjnych (na przykładzie wieloetnicznej i wielojęzycznej sytuacji społecznej Zaolzia)W artykule została opisana sytuacja językowa w czeskiej części Śląska Cieszyńskiego w Republice Czeskiej na podstawie autentycznego materiału językowego pochodzącego z dwóch szkół muzycznych (artystycznych) – jednej z Czeskiego Cieszyna, drugiej – z Trzyńca. Szkoła trzyniecka ma oficjalny status czesko-polskiej szkoły dwujęzycznej. Obie placówki łączy kilka cech wspólnych: zarówno uczniowie, jak i nauczyciele wywodzą się bądź z większościowego środowiska czeskiego, bądź należą do polskiej etnicznej wspólnoty mniejszościowej. W obu placówkach uczą się także dzieci z Polski, choć o wiele więcej takich „zagranicznych” uczniów uczęszcza do szkoły w Czeskim Cieszynie. Autorzy zajmują się nie tylko analizą samego języka mówionego, ale również kompetencją i świadomością językową badanych osób, dochodząc do wniosku, że interakcja między użytkownikami dwu (różnych) języków może przebiegać pomyślnie nawet wtedy, gdy każdy z nich używa własnego języka ojczystego (względnie gwary ojczystej) lub języka partnera komunikacji, chociaż język ten opanował tylko na poziomie podstawowym.

Comparative effectiveness of ChAdOx1 versus BNT162b2 vaccines against SARS-CoV-2 infections in England and Wales: A cohort analysis using trial emulation in the Virus Watch community data

Introduction: Infections of SARS-CoV-2 in vaccinated individuals have been increasing globally. Understanding the associations between vaccine type and a post-vaccination infection could help prevent further COVID-19 waves. In this paper, we use trial emulation to understand the impact of a phased introduction of the vaccine in the UK driven by vulnerability and exposure status. We estimate the comparative effectiveness of COVID-19 vaccines (ChAdOx1 versus BNT162b2) against post-vaccination infections of SARS-CoV-2 in a community setting in England and Wales. Method: Trial emulation was conducted by pooling results from six cohorts whose recruitment was staggered between 1st January 2021 and 31st March 2021 and followed until 12th November 2021. Eligibility for each trial was based upon age (18+ at the time of vaccination), without prior signs of infection or an infection within the first 14 days of the first dose. Time from vaccination of ChAdOx1 or BNT162b2 until SARS-CoV-2 infection (positive polymerase chain reaction or lateral flow test after 14 of the vaccination) was modelled using Cox proportional hazards model for each cohort and adjusted for age at vaccination, gender, minority ethnic status, clinically vulnerable status and index of multiple deprivation quintile. For those without SARS-CoV-2 infection during the study period, follow-up was until loss-of-follow-up or end of study (12th November 2021). Pooled hazard ratios were generated using random-effects meta-analysis. Results: Across six cohorts, there were a total of 21,283 participants who were eligible and vaccinated with either ChAdOx1 (n = 13,813) or BNT162b2 (n = 7,470) with a median follow-up time of 266 days (IQR: 235 - 282). By November 12th 2021, 750 (5.4%) adults who had ChAdOx1 as their vaccine experienced a SARS-CoV-2 infection, compared to 296 (4.0%) who had BNT162b2. We found that people who received ChAdOx1 vaccinations had 10.54 per 1000 people higher cumulative incidence for SARS-CoV-2 infection compared to BNT162b2 for infections during a maximum of 315 days of follow-up. When adjusted for age at vaccination, sex, minority ethnic status, index of multiple deprivation, and clinical vulnerability status, we found a pooled adjusted hazard ratio of 1.35 [HR: 1.35, 95%CI: 1.15 - 1.58], demonstrating a 35% increase in SARS-CoV-2 infections in people who received ChAdOx1 compared to BNT162b2. Discussion: We found evidence of greater effectiveness of receiving BNT162b2 compared to ChAdOx1 vaccines against SARS-CoV-2 infection in England and Wales during a time period when Delta became the most prevalent variant of concern. Our findings demonstrate the importance of booster (third) doses to maintain protection and suggest that these should be prioritised to those who received ChAdOx1 as their primary course.

The Chechens and Kurds of Kazakhstan between Historical and Second Homelands

Almost all minority ethnic groups in Kazakhstan are immigrants. This means that in addition to their current place of residence, Kazakhstan (their “Second Homeland”), they also have a place of origin (their “Historical Homeland”). The leadership of the country has approached this situation, which offers opportunities as well as dangers, by explicitly exhorting the official ethnic representations of minorities to nurture contacts with their Historical Homelands. In this article the examples of the Chechens and Kurds will be used to show how the representations of both ethnicities actively and politically pursued this task. For both groups, representing a nation without an independent state, a fourth actor must be added to the “triangle nexus” familiar from diaspora studies, respectively Russia and Turkey, whose positions the Kazakhstani government cannot simply disregard. What emerges from the study is the strong emotional link of both minorities’ representatives with Kazakhstan as their Second Homeland.

COVID-19 vaccine hesitancy in diverse groups in the UK - is the driver economic or cultural in student populations?

Studies have identified a greater reluctance for members of the Black, Asian, and minority ethnic communities to be vaccinated against COVID-19 despite a higher probability of greater harm from COVID-19. We conducted an anonymised questionnaire-based study of students (recruiting primarily before first reports of embolic events) at two London universities to identify whether economic or educational levels were primarily responsible for this reluctance: a postgraduate core group (PGCC) n=860 and a pilot study of undergraduate medical and nursing students (n=103). Asian and Black students were 2.0 and 3.2 times (PGCC) less likely to accept the COVID vaccine than White British students. Similar findings were noted in the pilot study students. As students were studying for Masters or PhD degrees and voluntarily paying high fees, educational and economic reasons were unlikely to be the underlying cause, and wider cultural reservations were more likely. Politicians exerted a strong negative influence, suggesting that campaigns should omit politicians.

Inside, Outside, Upside Down: Power, Positionality, and Limits of Ethnic Identity in the Ethnographies of the Far-Right

Methodological literature on ethnographies of the far-right has largely centered around the ethical and political implications of such studies. Discussions on researcher’s positionality with regard to his/her insider–outsider positioning, ethnic-racial characteristics and concomitant power relations in the field remain relatively undertheorized. What occurs, for example, when the researcher studying anti-minority, ethnic nationalist right-wing groups is from a minority ethnic community? To what extent s(he) can gain access and develop rapport with the respondents? In this article, I seek to answer these questions by providing insights from my fieldwork experiences. I reflect upon my own position as a non-White, minority ethnic, and female ethnographer who conducted extensive fieldwork among grassroot activists of “Alternative für Deutschland,” a German right-wing political party. The article demonstrates that even in face of an apparent noncongruence between an immigrant ethnographer and right-wing, pro-majority respondents, researcher’s position is not static but fluid, intersectional and deeply situational. Ethnographer’s long term sustained proximity to the respondents, exposure to the everyday contexts of their lives create zones of congruence for an apparent outsider and can at times undermine the dominant category of ethnicity as primary social signifier.

Exploring the ‘unexplained’ awarding gap through understanding BAME students' experiences

A narrative method of enquiry was used to investigate the university experiences of Black, Asian and minority ethnic (BAME) students studying in a south-eastern UK business school. Participants were self-selecting undergraduates and postgraduates and academic and professional staff. The three facilitators were all academic staff from the Business School: two who identify as Black, one who identifies as white. Using a ‘Thinking Group’ (Kline, 1999) narrative methodology, it was found that issues relating to belonging, isolation, inclusive curriculum, and employability are all impacting Black, Asian and minority ethnic students' success in the Business School currently. The research resulted in the co-creation of 30 recommendations for action in the following academic year.