ethnic minorities

少数民族
  • 文章类型: Journal Article
    尽管越南在孕产妇健康指标方面取得了总体进展,与Kinh(多数族裔群体)相比,偏远地区的边缘化少数民族获得产前护理的机会较少,孕产妇死亡率较高。去年,我们对2个定性研究项目进行了实地考察,旨在解决越南北部农村地区少数族裔孕妇的孕产妇健康不平等问题.虽然不是我们研究的重点,在营利性私人诊所中,超声检查服务的使用在参与者寻求医疗服务的账户中普遍存在.营利性诊所的超声扫描是少数民族妇女产前保健的主要组成部分:许多人在怀孕期间购买了8到10次扫描,每次扫描6.15美元,尽管他们每月的农业收入有限,只有120至205美元。妇女不知道推荐了多少次扫描以及他们的医学指示的时间表,但购买了频繁的扫描,以缓解怀孕焦虑,并获得他们体验到的最高质量的产前服务。串联,营利性超声检查提供商提供了更广泛的开放时间,立竿见影的结果,和丰富的技术扫描,这似乎为贫困家庭提供了他们辛苦赚来的钱最切实的“价值”。以前的文献记录了越南城市Kinh妇女过度使用超声检查的情况:这种趋势的影响是什么?经济边缘化,孕产妇死亡率高4倍?我们的发现引起了人们对安全的担忧,金融脆弱性和提供者诱导的需求,以及关于低资源环境中医疗保健商品的更广泛的卫生政策问题。严重的,没有证据表明产科超声对降低低收入和中等收入国家的孕产妇死亡率有影响,其过度使用可能会给可用资源带来负担,并减损循证服务。我们的研究结果表明,卫生系统的差距正在促使贫困妇女经常购买一种不足的孕产妇保健商品:这不会改善她们的怀孕结局或边缘化少数民族的健康公平性。我们认为,解决由于提供者引起的需求而导致的超声检查过度使用需要多管齐下的反应,以满足女性日益增长的期望。我们的发现强调了投资健康教育的必要性,健康促进,为越南少数民族社区提供可靠的高质量公共孕产妇保健。
    Despite Vietnam\'s overall progress on maternal health indicators, marginalized ethnic minorities in remote areas face lower access to antenatal care and higher maternal mortality rates relative to the Kinh (majority ethnic group). Last year, we conducted fieldwork for 2 qualitative research projects that aimed to address maternal health inequities among pregnant ethnic minority women in rural Northern Vietnam. Although not the focus of our research, the use of ultrasonography services at for-profit private clinics was ubiquitous in participants\' healthcare-seeking accounts. Ultrasound scans from for-profit clinics were a major component of ethnic minority women\'s antenatal care: many purchased 8 to 10 scans during pregnancy at $6.15 US dollars per scan, despite their limited agricultural income of $120 to $205 per month. Women were unaware of how many scans were recommended and their medically indicated scheduling, but purchased frequent scans to assuage pregnancy anxieties and access what they experienced as the highest-quality antenatal service. In tandem, for-profit ultrasonography providers offered broader opening hours, immediate results, and rich technological scans, which seemed to deliver poor families the most tangible \"value\" for their hard-earned money. Previous literature documented the concerning overuse of ultrasonography among Kinh women in urban Vietnam: What are the implications of this trend extending to affect rural-dwelling ethnic minority women who face lower education, economic marginalization, and a 4-fold higher maternal mortality rate? Our findings raise concerns related to safety, financial vulnerability and provider-induced demand, and broader health policy questions regarding healthcare commodities in low-resource settings. Critically, there is no evidence of the effect of obstetrical ultrasound on reducing maternal mortality in low- and middle-income countries, and its excess use could burden available resources and detract from evidence-based services. Our findings suggest that health system gaps are driving poor women toward frequent purchases of a single insufficient maternal health commodity: this will not improve their pregnancy outcomes or health equity for marginalized ethnic minorities. We argue that addressing this overuse of ultrasonography due to provider-induced demand requires a multipronged response that meets women\'s growing expectations. Our findings highlight the need for investment in health education, health promotion, and reliable high-quality public maternal healthcare for ethnic minority communities in Vietnam.
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  • 文章类型: Journal Article
    真正的中国舞蹈治疗是在方兴未艾和精神病学的方法,涉及广泛的原则,如本体论身份,社会包容和集体支持,审美化和表现性宣泄,象征性的驱魔,恍惚和佛教正念。它的模型基于源自各个朝代的丰富的中国舞蹈流派以及少数民族的文化传统。由于西方诊断手册的认识论背景和中国传统的精神疾病观点不同,需要对病理和治疗动力学的复杂理解。因此,这篇观点文章提出了一个理论框架,鼓励跨学科方法以及包容性的跨文化精神病学和相关的科学哲学。
    Genuine Chinese dance therapy is in the ascendant and psychiatric approaches that involve a broad spectrum of principles such as ontological identity, social inclusion and collective support, aestheticisation and expressive catharsis, symbolic exorcism, trance and Buddhist mindfulness. Its models are based on a wealth of Chinese dance genres originating from various dynasties as well as cultural traditions of ethnic minorities. Due to different epistemological backgrounds of Western diagnostic manuals and traditional Chinese views of mental diseases, complex understanding of pathologies and therapeutic dynamics is needed. Therefore, this opinion piece suggests a theoretical framework that encourages interdisciplinary approaches as well as inclusive transcultural psychiatry and related philosophy of science.
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  • 文章类型: Journal Article
    一项名为Hap-pas-Hapi的治疗抑郁症的在线自助计划在瑞士和德国的阿尔巴尼亚语移民中进行了测试,比较了两种不同水平的文化适应。尽管进行了大规模的招募工作,可以招募的参与者人数不足,辍学率超过90%。
    我们进行了一项定性研究,以更好地了解不使用Hap-pas-Hapi的原因。
    对17名19-59岁的阿尔巴尼亚语参与者进行了11次访谈。为了本研究的目的招募了参与者,而不是试验的参与者。他们浏览了招聘材料和Hap-pas-Hapi介绍模块,评论了平面设计,可用性,内容,并分享了他们对心理健康和自助的看法。
    与会者批评缺乏“设计系统”(即,Hap-pas-Hapi在社交媒体上的清晰可识别且一致的图形设计),招聘信息不清楚。该计划本身被认为对整个社区很重要和有帮助,但是大多数参与者表示他们不会自己使用它。年轻一代更喜欢德语或法语的申请,而老一辈人认为使用在线自助计划来管理他们的心理困扰没有好处。在该目标群体中,对精神障碍和心理干预的负面信念被认为是常见的。
    专业的招聘策略,更仔细地选择目标人群(例如,年龄组)和不同类型的适应可能会导致对干预的更好接受度。同时,需要反污名运动和心理教育来增强治疗动机。
    UNASSIGNED: An online self-help programme for the treatment of depression called Hap-pas-Hapi was tested among Albanian-speaking immigrants in Switzerland and Germany, and two different levels of cultural adaptation were compared. Despite a massive recruitment effort, an insufficient number of participants could be recruited, and the drop-out rate was over 90%.
    UNASSIGNED: We conducted a qualitative study to better understand the reasons for the non-use of Hap-pas-Hapi.
    UNASSIGNED: Eleven interviews were conducted with 17 Albanian-speaking participants aged 19-59. Participants were recruited for the purpose of this study and were not participants from the trial. They went through the recruitment material and the Hap-pas-Hapi introduction module, commented on the graphic design, usability, content, and shared their views about mental health and self-help.
    UNASSIGNED: Participants criticised the lack of a \"design system\" (i.e., a clearly identifiable and consistent graphic design) on social media for Hap-pas-Hapi, and the recruitment messages were unclear. The programme itself was perceived to be important and helpful for the community at large, but most participants said that they would not use it for themselves. The younger generation would have preferred an application in German or French, while the older generation did not see a benefit in using an online self-help programme to manage their psychological distress. Negative beliefs about mental disorders and psychological interventions were perceived to be common in this target group.
    UNASSIGNED: A professional recruitment strategy, a more careful selection of the target population (e.g., age groups) and different kinds of adaptations might have resulted in a better acceptance of the intervention. At the same time, anti-stigma campaigns and psychoeducation are needed to enhance treatment motivation.
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  • 文章类型: Journal Article
    背景:少数民族人口经历了巨大的健康和社会护理差距;尽管经历了更大的疾病负担,这些群体在健康和社会护理研究中的代表性不足。因此,相关研究可能不太适用于这些人群。REPRESENT研究旨在探索少数民族和其他人口的健康和社会护理经验,他们的研究兴趣和适当的研究实践。
    方法:2022年5月至9月,对英格兰一些少数民族社区的成员进行了焦点小组和半结构化访谈。数据是音频记录的,使用NVivo12进行转录和主题编码。严谨是通过广泛取样确定的,迭代数据收集和分析。
    结果:52名少数民族成员进行了集体访谈和一对一访谈。与会者包括以下小组的代表:非洲加勒比,东欧,吉普赛旅行者,女同性恋,同性恋,双性恋,变性人,酷儿,双性恋和无性系+,难民/寻求庇护者,索马里和南亚社区。还对少数民族医疗保健提供者和研究人员进行了采访。确定了三个总体类别:健康信息,医疗服务经验,健康和社会护理问题以及健康研究。卫生和社会护理服务挑战主要归因于歧视,延迟服务,文化相关性差,语言和文化障碍。最有影响力的信息来源是当地社区组织和口碑。主要的健康和社会护理问题是慢性长期健康状况,心理健康,孕产妇健康和儿童发育。研究建议涉及了解参与的动机,改善沟通和赋予社区权力。最重要的研究重点是长期的健康状况,健康促进和教育,早期护理干预和了解社区需求。
    结论:健康和社会护理提供中的歧视和偏见对种族健康不平等的恶化具有严重影响。医疗保健委托当局和政策制定者可以利用少数族裔群体对药房服务和社区组织的偏好,以改善获得护理的机会。提高研究兴趣和参与度需要了解个人社区需求,社区敏感性,研究的相关性和文化适宜性。
    少数民族患者和公众参与和参与小组以及社区咨询委员会的成员支持REPRESENT研究设计,概念化和报告开发。
    BACKGROUND: Ethnic minority populations experience significant health and social care disparities; despite experiencing a greater burden of diseases, these groups are underrepresented in health and social care research. Consequently, related research can be less applicable to these population groups. The REPRESENT study aims to explore the health and social care experiences of ethnic minorities and other minoritised populations, their research interests and appropriate research practices.
    METHODS: Focus groups and semistructured interviews were conducted between May and September 2022 with members of a number of ethnic minority communities in England. Data were audio recorded, transcribed and thematically coded using NVivo 12. Rigour was determined through extensive sampling, iterative data collection and analysis.
    RESULTS: Fifty-two ethnic minority members were engaged in group interviews and one-to-one interviews. Participants included representatives of the following groups: African Caribbean, Eastern European, Gypsy Travellers, Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual+, Refugee/Asylum Seekers, Somali and South Asian communities. Interviews were also conducted with ethnic minority healthcare providers and researchers. Three overarching categories were identified: health information, medical service experiences, health and social care concerns and health research. Health and social care services challenges were mostly attributed to discrimination, delayed services, poor cultural relevance and language and cultural barriers. The most influential information sources were local community organisations and word-of-mouth. The main health and social care concerns were chronic long-term health conditions, mental health, maternal health and child development. Recommendations for research involved understanding the motivations for participation, improving communication and empowering communities. Top research priorities were long-term health conditions, health promotion and education, early care interventions and understanding community needs.
    CONCLUSIONS: Discrimination and bias in health and social care provision have severe implications for worsening ethnic health inequalities. Healthcare commissioning authorities and policymakers can leverage the preference of ethnic minority groups for pharmacy services and community organisations to improve access to care. Improving research interest and engagement requires understanding individual community needs, community sensitivity, research relevance and cultural appropriateness.
    UNASSIGNED: Members of ethnic minority Patient and Public Involvement and Engagement group and Community Advisory Board supported the REPRESENT study design, conceptualisation and report development.
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  • 文章类型: Systematic Review
    对降低痴呆风险和早期发现阿尔茨海默病和相关疾病的认识提高了对痴呆风险识别的兴趣,潜在的推定生物学,或者痴呆症本身。实施这些方法需要公众的接受。2012年之前的研究表明,人群痴呆筛查的可接受性有限。痴呆症预防研究的变化可能会影响最近的看法。此外,来自服务不足的人群的观点,如少数民族和低社会经济群体,缺乏。
    在这篇系统综述中,我们寻求自2012年以来发表的关于痴呆症患者态度和偏好的研究,照顾者和来自少数民族和低社会经济群体的公众对痴呆症筛查。
    此评论已在PROSPERO(CRD42023384115)上进行了预注册,并遵循了PRISMA指南。关键搜索项被输入到五个数据库中。如果文章侧重于人群或通过基于初级/社区护理的评估进行痴呆症的风险筛查,其中包括多数少数民族或低社会经济群体,或在数据分析中离散地考虑了这些群体。数据是叙述式合成的。
    七项研究报道了少数民族对痴呆症筛查的看法;一项研究包括来自低社会经济群体的人。结果表明,来自少数民族的参与者愿意接受痴呆症筛查。意愿的预测因素包括对福利的信念,渴望促进多样性,并实施生活方式的改变。不愿意与对结果的焦虑有关。
    尽管在研究组中似乎对筛查具有很高的可接受性,需要更多的研究来探索诸如文化和经济障碍之类的筛查的实际考虑因素,信任,和筛查后的行动。
    UNASSIGNED: Increased understanding of dementia risk-reduction and early detection of Alzheimer\'s disease and related disorders has spurred interest in the identification of risks for dementia, underlying putative biologies, or dementia itself. Implementation of such approaches require acceptability to the public. Research prior to 2012 indicated limited acceptability for population dementia screening. The changing landscape of dementia prevention research may influence recent perceptions. Additionally, perspectives from underserved populations, such as ethnic minorities and low socio-economic groups, are lacking.
    UNASSIGNED: In this systematic review, we sought published studies since 2012 on attitudes and preferences of people with dementia, carers and the general public from ethnic minorities and low socio-economic groups regarding dementia screening.
    UNASSIGNED: This review was preregistered on PROSPERO (CRD42023384115) and followed PRISMA guidelines. Key search terms were entered into five databases. Articles were included if they focused on population or risk screening for dementia via primary/community care-based assessments, and which included majority ethnic minority or low socio-economic groups or discretely considered these groups in data analysis. Data were synthesized narratively.
    UNASSIGNED: Seven studies reported perspectives of ethnic minorities regarding dementia screening; one study included people from low socio-economic groups. Results indicated that participants from ethnic minorities were willing to undergo dementia screening. Predictors of willingness included belief in benefits, desire to boost diversity, and to implement lifestyle changes. Unwillingness was associated with anxiety regarding results.
    UNASSIGNED: Although there seems to be high acceptability for screening in the studied groups, more research is necessary to explore the practical considerations for screening such as cultural and economic barriers, trust, and post-screening actions.
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  • 文章类型: Journal Article
    背景:文化和语言上不同的人群在其祖先国家以外的医疗机构中经历了更高的体重和其他与体重无关的歧视。对具有阿拉伯遗产的个人的经历知之甚少。这项研究旨在定性地探索澳大利亚体重较高的阿拉伯遗产个体的交叉体重相关医疗保健经验。
    方法:采用一般归纳法。Purposive,便利和滚雪球采样被用来招募居住在澳大利亚的阿拉伯遗产。邀请个人参加在线半结构化面试。采访被记录下来,转录和主题分析。
    结果:15名参与者参与了这项研究。在这些参与者中,93%为女性(n=14),80%的年龄在18至44岁之间(n=12),73%受过大学教育(n=11),53%出生在澳大利亚以外(n=8),都是穆斯林(n=15)。确定了四个主要主题:(1)基于外观的判断,(2)一般性建议和假设,(3)文化响应性和(4)医疗体系约束。
    结论:在澳大利亚体重较高的阿拉伯遗产的个人,即,女性,经常认为他们的医疗保健经验是对他们的文化和宗教需求不屑一顾,并受到围绕体重的因果关系假设的驱动。至关重要的是,提供的护理包括文化谦逊,包含权重,并承认系统性约束。文化安全培训基准,建议医疗管理改革和体重包容性医疗方法,以协助医疗服务提供者提供有效的,整体和文化安全的护理。
    从与阿拉伯遗产社区成员的对话中获得的见解,以及与体重相关的医疗保健遭遇的真实经历,为研究设计和方法提供了信息。
    BACKGROUND: Culturally and linguistically diverse population groups disproportionately experience higher weight and other non-weight-related discrimination in healthcare settings outside of their ancestral country. Little is known about the experiences of individuals with Arab heritage. This study aimed to qualitatively explore the intersectional weight-related healthcare experiences of individuals of Arab heritage with higher weight in Australia.
    METHODS: A general inductive enquiry approach was used. Purposive, convenience and snowball sampling was used to recruit individuals of Arab heritage residing in Australia. Individuals were invited to participate in an online semistructured interview. Interviews were recorded, transcribed and thematically analysed.
    RESULTS: Fifteen participants took part in the study. Of these participants, 93% were female (n = 14), 80% were aged between 18 and 44 years (n = 12), 73% were university educated (n = 11), 53% were born outside of Australia (n = 8) and all were Muslim (n = 15). Four main themes were identified: (1) appearance-based judgement, (2) generalised advice and assumptions, (3) cultural responsiveness and (4) healthcare system constraints.
    CONCLUSIONS: Individuals of Arab heritage with higher weight in Australia, namely, females, often perceive their healthcare experiences as dismissive of their cultural and religious needs and driven by causality assumptions around weight. It is crucial that care delivered encompasses cultural humility, is weight-inclusive and acknowledges systemic constraints. Cultural safety training benchmarks, healthcare management reform and weight-inclusive healthcare approaches are recommended to assist healthcare providers in delivering effective, holistic and culturally safe care.
    UNASSIGNED: Insights gained from conversations with Arab heritage community members with lived experiences regarding weight-related healthcare encounters informed the study design and approach.
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  • 文章类型: Journal Article
    少数民族经历的健康不平等一直是一个持续的全球现象。诊断不同类型的皮肤状况,例如,黑色素瘤,有色人种是可能发生误诊的健康领域之一,可能导致危及生命的后果。尽管高加索人更有可能被诊断为黑色素瘤,由于延迟诊断,非洲裔美国人出现IV期黑色素瘤的可能性要高出四倍。必须认识到,社会经济地位和获得医疗保健服务的机会有限等其他因素可能是促成因素。非洲裔美国人死于黑色素瘤的可能性也是白种人的1.5倍,非洲裔美国人的5年生存率明显低于高加索人(72.2%vs.89.6%)。这是一个复杂的问题,加上几个因素:准备不足的医生,有色人种缺乏对黑色素瘤和其他皮肤病的认识,缺乏信息和医疗资源,为从业者的不断发展,有色人种在研究中代表性不足,POC是一个出了名的难以接触的群体,和“粉刷的”医学院课程。虽然数字技术可以为减少健康不平等带来新的希望,人工智能在医疗保健中的部署会带来风险,可能会放大有色人种所经历的健康差距,而数字技术可能会提供一种虚假的参与感。例如,真皮辅助,正在开发的皮肤诊断电话应用程序,已经因为依赖少数有色人种的数据而受到批评。本文着重了解有色人种皮肤状况的误诊问题,并探索已尝试的进展和创新,为大数据分析的可能应用铺平道路,人工智能,和以用户为中心的技术,以减少有色人种之间的健康不平等。
    The health inequalities experienced by ethnic minorities have been a persistent and global phenomenon. The diagnosis of different types of skin conditions, e.g., melanoma, among people of color is one of such health domains where misdiagnosis can take place, potentially leading to life-threatening consequences. Although Caucasians are more likely to be diagnosed with melanoma, African Americans are four times more likely to present stage IV melanoma due to delayed diagnosis. It is essential to recognize that additional factors such as socioeconomic status and limited access to healthcare services can be contributing factors. African Americans are also 1.5 times more likely to die from melanoma than Caucasians, with 5-year survival rates for African Americans significantly lower than for Caucasians (72.2% vs. 89.6%). This is a complex problem compounded by several factors: ill-prepared medical practitioners, lack of awareness of melanoma and other skin conditions among people of colour, lack of information and medical resources for practitioners\' continuous development, under-representation of people of colour in research, POC being a notoriously hard to reach group, and \'whitewashed\' medical school curricula. Whilst digital technology can bring new hope for the reduction of health inequality, the deployment of artificial intelligence in healthcare carries risks that may amplify the health disparities experienced by people of color, whilst digital technology may provide a false sense of participation. For instance, Derm Assist, a skin diagnosis phone application which is under development, has already been criticized for relying on data from a limited number of people of color. This paper focuses on understanding the problem of misdiagnosing skin conditions in people of color and exploring the progress and innovations that have been experimented with, to pave the way to the possible application of big data analytics, artificial intelligence, and user-centred technology to reduce health inequalities among people of color.
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  • 文章类型: Journal Article
    背景:对增强教育机会的日益追求导致各个领域的国际学生入学率显着上升,包括护理。护理目前处于早期阶段,面临着与种族微侵略有关的挑战。了解种族微观侵略的动态在土耳其这样的国家至关重要,那里有来自不同种族背景的学生。
    目的:探索并更深刻地了解少数民族护理专业学生面临种族微侵略的生活遭遇。
    方法:本研究采用描述性现象学方法。数据收集涉及从2023年2月1日至2023年6月1日进行深入访谈。利用Colaizzi的分析方法进行分析。
    结果:研究中的每个参与者都遇到了至少一种类型的微攻击。分析确定了三个明确的主题:“社会互动中的挑战,\"\"不利的学习氛围,“和”对未来的渴望。
    结论:这项研究强调了建立安全和包容的环境以促进学术环境中的真实讨论的关键需求。教师和教育工作者应加强他们在各种情况下考虑不同观点的能力。此外,整合最新和全面的课程,随着包容性语言的采用,纳入护理计划对于有效解决这些问题至关重要。
    The increasing pursuit of enhanced educational opportunities has led to a significant rise in international student enrollment in various fields, including nursing. Nursing is currently in its early stages and faces challenges related to racial microaggression. Understanding the dynamics of racial microaggression is crucial in countries like Turkey, where students from diverse ethnic backgrounds are accommodated.
    To explore and achieve a more profound insight into the lived encounters of ethnic minority nursing students confronting racial microaggression.
    The study employed a descriptive phenomenological approach. Data collection involved conducting in-depth interviews from February 1, 2023, to June 1, 2023. Analysis was performed utilizing Colaizzi\'s analysis method.
    Each participant in the study encountered at least one type of microaggression. The analysis identified three clear themes: \"challenges in social interactions,\" \"unfavorable learning atmosphere,\" and \"aspirations for the future.\"
    This study highlights the crucial need to establish secure and inclusive environments that foster authentic discussions within academic settings. Faculty and educators should strengthen their ability to consider diverse perspectives in various scenarios. Moreover, integrating an up-to-date and comprehensive curriculum, along with the adoption of inclusive language, into the nursing program is essential for effectively addressing these concerns.
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  • 文章类型: Journal Article
    患者和公众的参与和参与(PPIE)对于改善研究成果和减少研究浪费至关重要。为了有效,PPIE应为不同的群体提供机会,为所有研究阶段做出贡献。然而,英国少数民族社区在研究中的代表性仍然不足。本文介绍了公共卫生研究项目中采用的策略,这些策略有效地建立了信任并增加了少数民族社区的包容性。由研究人员和PPIE合作伙伴组成的研究团队反映了项目期间的经验教训,并描述了建立有意义的信任和包容水平的六个主要策略:1)尽早开始招募PPIE合作伙伴;2)以关系为重点的参与;3)联合制作和咨询活动;4)公开沟通和迭代反馈;5)项目结束活动的联合制作,和;6)多样化的研究团队。对社区有意义的成果包括少数民族作为研究参与者和PPIE合作伙伴的参与,社区福祉,共同制作在英国议会大厦共同提出的公共卫生建议,51个活跃的PPIE合作伙伴的注册证明了整个联盟的影响。PPIE合作伙伴反思他们的研究参与,向研究人员提供建议,并鼓励少数民族社区的人们参与研究。PPIE合作伙伴的一个重要信息是,参与不应限于少数民族特有的项目,而应成为一般人口研究的常规部分,承认少数民族是英国社会不可分割的一部分。总之,这篇文章表明,通过适当的策略,在公共卫生研究中可以实现包容性和多样性。我们推荐研究人员,从业者和决策者在规划公共卫生项目时采用这些策略。
    Patient and public involvement and engagement (PPIE) is essential for improved research outcomes and reduced research waste. To be effective, PPIE should provide opportunities for diverse groups to contribute to all research stages. However, UK ethnic minority communities remain underrepresented in research. This article describes strategies adopted in a public health research project that were effective in building trust and increasing inclusion of ethnic minority communities. The study team of researchers and PPIE partners reflects lessons learnt during the project and describe six main strategies that built meaningful levels of trust and inclusion: 1) early start to recruitment of PPIE partners; 2) relationship-focused engagement; 3) co-production and consultation activities; 4) open communication and iterative feedback; 5) co-production of project closure activities, and; 6) diverse research team. Meaningful outcomes for the community included the involvement of people from ethnic minorities as research participants and PPIE partners, community wellbeing, co-production of public health recommendations co-presented at the UK Houses of Parliament, and consortium-wide impact evidenced by the enrolment of 51 active PPIE partners. PPIE partners reflect on their research involvement, offering advice to researchers and encouraging people from ethnic minority communities to take part in research. An important message from PPIE partners is that involvement should not be restricted to projects specific to ethnic minorities but become a routine part of general population research, recognising ethnic minorities as an integral part of UK society. In conclusion, this article demonstrates that with appropriate strategies, inclusion and diversity can be achieved in public health research. We recommend researchers, practitioners and policy makers adopt these strategies when planning their public health projects.
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  • 文章类型: Journal Article
    北美高收入国家的少数民族,欧洲,和其他地方不成比例地受到T2DM的影响,死亡率和发病率的风险更高。社区卫生工作者和同伴支持者的使用提供了一种方法,可以确保在普通人群中观察到的自我管理支持的好处由少数民族社区的人分享。
    在主要数据库中搜索现有的定性证据,证明社区卫生工作者和同伴支持者(CHWP)在少数民族人群中提供2型糖尿病自我管理支持的参与者的经验和观点。使用Sekhon的“可接受性理论框架”对数据进行了分析。
    出于清晰和简洁的原因,在可接受性框架的五个领域中描述了结果,从七个领域崩溃了:情感态度描述了参与者对CHWP提供干预的满意度,包括开放,与与临床提供者形成对比的信任关系。在考虑负担和机会成本时,参与者反映了健康的影响,运输,以及工作和育儿对他们出勤的责任,缺乏维持健康饮食和积极生活方式所必需的资源。关于文化敏感性,与会者赞赏CHWPs对特定文化需求和挑战的更多理解。与干预一致性相关的证据表明,参与者对实际和应用内容做出了积极的回应,教材的范围,和互动实践会议。最后,在检查有效性和自我效能的影响时,参与者描述了他们如何改变一系列与健康相关的行为,在处理他们的病情和与高级临床医生互动方面更有信心,并受益于其他参与者和CHWP的社会支持。
    观察到许多相同的障碍,围绕出勤和参与通常向一般人群提供的自我管理支持干预措施,包括缺乏时间和资源。然而,CHWP的洞察力,他们对文化敏感和具体的自我管理策略以及信任关系的发展具有相当大的优势。
    UNASSIGNED: Ethnic minority groups in high income countries in North America, Europe, and elsewhere are disproportionately affected by T2DM with a higher risk of mortality and morbidity. The use of community health workers and peer supporters offer a way of ensuring the benefits of self-management support observed in the general population are shared by those in minoritized communities.
    UNASSIGNED: The major databases were searched for existing qualitative evidence of participants\' experiences and perspectives of self-management support for type 2 diabetes delivered by community health workers and peer supporters (CHWPs) in ethnically minoritized populations. The data were analysed using Sekhon\'s Theoretical Framework of Acceptability.
    UNASSIGNED: The results are described within five domains of the framework of acceptability collapsed from seven for reasons of clarity and concision: Affective attitude described participants\' satisfaction with CHWPs delivering the intervention including the open, trusting relationships that developed in contrast to those with clinical providers. In considering Burden and Opportunity Costs, participants reflected on the impact of health, transport, and the responsibilities of work and childcare on their attendance, alongside a lack of resources necessary to maintain healthy diets and active lifestyles. In relation to Cultural Sensitivity participants appreciated the greater understanding of the specific cultural needs and challenges exhibited by CHWPs. The evidence related to Intervention Coherence indicated that participants responded positively to the practical and applied content, the range of teaching materials, and interactive practical sessions. Finally, in examining the impact of Effectiveness and Self-efficacy participants described how they changed a range of health-related behaviours, had more confidence in dealing with their condition and interacting with senior clinicians and benefitted from the social support of fellow participants and CHWPs.
    UNASSIGNED: Many of the same barriers around attendance and engagement with usual self-management support interventions delivered to general populations were observed, including lack of time and resource. However, the insight of CHWPs, their culturally-sensitive and specific strategies for self-management and their development of trusting relationships presented considerable advantages.
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