• Addressing obesity in Roma communities: a community readiness approach

      Islam, Shahid; Small, Neil A.; Bryant, M.; Yang, T.; Cronin de Chavez, A.; Saville, F.; Dickerson, J. (2019)
      Participation in community programmes by the Roma community is low whilst this community presents with high risk of poor health and low levels of wellbeing. To improve rates of participation in programmes compatibility must be achieved between implementation efforts and levels of readiness in the community. The Community Readiness Model (CRM) is a widely used toolkit which provides an indication of how prepared and willing a community is to take action on specific issues. We present findings from a CRM assessment for the Eastern European Roma community in Bradford, UK on issues related to nutrition and obesity. We interviewed key respondents identified as knowledgeable about the Roma community using the CRM. This approach applies a mixed methodology incorporating readiness scores and qualitative data. A mean community readiness score was calculated enabling researchers to place the community in one of nine possible stages of readiness. Interview transcripts were analysed using a qualitative framework analysis to generate contextual information. An overall score consistent with vague awareness was achieved, which indicates a low level of community readiness. This score suggests there will be a low likelihood of participation in currently available nutrition and obesity programmes. To our knowledge this is the first study to apply the CRM in the Roma community for any issue. We present the findings for each of the six dimensions that make up the CRM together with salient qualitative findings.
    • An annotated and critical glossary of the terminology of inclusion in healthcare and health research

      Islam, Shahid; Small, Neil A. (2020-04)
      The importance of including members of the public has been accorded a significant position in health planning, service delivery and research. But this position masks a lack of clarity about terms that are used. This paper identifies terms that are in common use in the lexicon of community based involvement and engagement in health with the intention of clarifying meaning and thus reducing ambiguity. We define and distinguish between key terms related to inclusion, we consider the terminology attached to community processes and to the challenges of inclusion and we engage with the strengths and weaknesses of the commonly used metaphor of "a ladder of participation". We wish to contribute to the clear communication of intentions, challenges and achievements in pursuing varied forms of inclusion in health.
    • Assessing community readiness for early intervention programmes to promote social and emotional health in children

      Islam, Shahid; Small, Neil A.; Bryant, M.; Bridges, S.; Hancock, N.; Dickerson, J. (2019-06)
      Evidence for early intervention and prevention-based approaches for im-proving social and emotional health in young children is robust. However, rates of participation in programmes are low. We explored the dynamics which affect levels of community readiness to address the issues of social and emotional health for preg-nant women, young children (0-4 years) and their mothers.Setting:A deprived inner‐city housing estate in the north of England. The estate falls within the catchment area of a project that has been awarded long-term funding to address social and emotional health during pregnancy and early childhood.Methods:We interviewed key respondents using the Community Readiness Model. This approach applies a mixed methodology, incorporating readiness scores and qualitative data. A mean community readiness score was calculated enabling the placement of the community in one of nine possible stages of readiness. Interview transcripts were analysed using a qualitative framework approach to generate con-textual information to augment the numerical scores.Results:An overall score consistent with vague awareness was achieved, indicating a low level of community readiness for social and emotional health interventions. This score suggests that there will be a low likelihood of participation in programmes that address these issues.Conclusion:Gauging community readiness offers a way of predicting how willing and prepared a community is to address an issue. Modifying implementation plans so that they first address community readiness may improve participation rates.
    • The journey effect: how travel affects the experiences of mental health in-patient service-users and their families

      Heyman, B.; Lavendar, E.; Islam, Shahid; Adey, A.; Ramsey, T.; Taffs, N.; Xplore Service-user and Carer Research Group (2015-07)
      The qualitative study presented in this paper explored the perspectives of serviceusers, family members and staff about the impact of travel issues on the lives of mental health in-patients and carers. This topic was chosen because it was prioritised by members of Xplore, a service-user and carer research group, and has received little research attention. Travel problems were a significant issue for many service-users and carers, bound-up with mental health issues and the recovery experience. Travel facilitation through the funding of taxis and the provision of guides was greatly appreciated. A few service-users and carers positively valued distancing from their previous home environment. The meaning of travel issues could only be understood in the context of individuals’ wider lives and relationships. The significance of the findings is discussed in relation to the social model of disability.
    • Not a level playing field: a qualitative study exploring structural, community and individual determinants of greenspace use amongst low-income multi-ethnic families

      Cronin de Chavez, A.; Islam, Shahid; McEachan, Rosemary (2019-03)
      Greenspace is important for physical and mental health. Low-income, multi-ethnic populations in deprived urban areas experience several barriers to using greenspace. This may exacerbate health inequalities. The current study explored structural and individual determinants of greenspace use amongst parents of young children in an urban, deprived, multi-cultural area situated in the North of England, UK. Semi-structured in-depth interviews and focus group discussions were conducted with 30 parents of children aged 0–3 between December 2016 and May 2017 from a range of ethnic groups. Thematic analyses were informed by the Human Health Habitat Map and the Theoretical Domains Framework. The results show that whilst all families recognised the benefits of greenspaces, use was bounded by a variety of structural, community, and individual determinants. Individual determinants preventing use included lack of knowledge about where to go, or how to get there and confidence in managing young children whilst outdoors. Fear of crime, antisocial behaviour and accidents were the overriding barriers to use, even in high quality spaces. Social and community influences both positively encouraged use (for example, positive social interactions, and practical support by others) and prevented use (antisocial or inappropriate behaviours experienced in greenspace). The built environment was a key barrier to use. Problems related to unsuitable or unsafe playgrounds, no gardens or safe areas for children's play, poor accessibility, and lack of toilets were identified. However, the value that parents and children placed on natural blue and green features was an enabler to use. Contextual influences included external time pressures, difficulties of transporting and caring for young children and poor weather. Multi-sectoral efforts are needed to tackle the uneven playing field experienced by multi-ethnic, urban, deprived communities. Initiatives to increase use should tackle structural quality issues, addressing fears about safety, whilst simultaneously encouraging communities to reclaim their local greenspaces.
    • Square pegs in round holes: the mental health needs of young adults and how well these are met by services – an explorative study

      Islam, Shahid (2011)
      Purpose – This research paper aims to examine the mental health needs of young adults and to discuss how well these are met from the vantage‐point of the patients. Young adulthood is identified as an epidemiological risk for developing mental health problems and so the care provided during these developmental years is investigated to assess efficacy and experience. Design/methodology/approach – After interviewing 35 young adults, it was found most people are aware of the genesis to their problems and have strong views about the level of support and types of treatments offered. Findings – Like other writings, this research finds that many of the needs presented by young adults are unique to this transitional phase in life and administratively determined age structures on which current mental health care is configured do not adequately meet these needs. Research limitations/implications – The small sample size (35) and the geographical region covered means caution should be exercised in drawing any generalisations. Further research on outcomes after the mid‐20s by reflecting on service experience during the 18‐25 transformational years would be a useful area for exploration. Practical implications – This paper makes some powerful recommendations on why service provision must meet service user needs and how the recent equality legislation may provide impetus to this. All of this needs to start with examining the age boundaries on which mental healthcare is designed.