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Objectives Uptake of the COVID-19 vaccine continues to be lower in ethnically diverse communities in the UK even though they are disproportionally affected by the negative effects of the virus. To better understand why uptake is lower, we explored factors that may underpin vaccine hesitancy and intention to vaccinate in these communities with an emphasis on medical mistrust and feelings of mattering. Design One hundred and sixty-one adults from ethnically diverse backgrounds who had not had a COVID-19 vaccination completed an online questionnaire that contained closed (quantitative) and open (qualitative) questions. Results Analyses of quantitative questions revealed that medical mistrust, but not feelings of mattering, was related to COVID-19 hesitancy and likelihood of getting a COVID-19 vaccination. Of the three components of medical mistrust, suspicion was the only unique predictor and was related to higher hesitancy towards the COVID-19 vaccine and lower likelihood of getting a COVID-19 vaccine. Analyses of the responses to the qualitative questions were organised into four themes: (1) Beliefs that taking the vaccine is an important social responsibility; (2) Experiences of pressure to take the vaccine and limited choice; (3) General mistrust linked to personal experiences and the health system; (4) Being concerned about social/medical restrictions if not vaccinated. Conclusion The findings suggest that medical mistrust may partly explain why uptake of the COVID-19 vaccine is lower in ethnically diverse communities in the UK and appears to play a role in how people weigh a sense of responsibility and pressure against health and social concerns in making the decision to be vaccinated.

Background and aims: Self-mutilation (self-harm) is a phenomenon that is increasingly being seen in patients presenting in mental health services in the United Kingdom. This present study aimed to explore the lived experience of South Asian women raised in the United Kingdom and their perspective of 'Izzat', which refers to honour.Method: Semi-structured interviews were conducted with 12 women of 'South Asian' heritage. Their accounts were analysed using interpretative phenomenological analysis (IPA). Findings and discussion:The findings suggest that the concept of Izzat and Asian cultural identity permeated the narratives of all the participants. The results position Izzat as central to cultural discord felt by the women and as a base for some of the discontent that led to self-mutilating. The analysis revealed five over-arching themes as the most common factors to self-harm among South Asian women, which include:(1) The struggle to maintain cultural identity, (2) Experience of loss of control and trauma, (3) Focus on self-mutilation as a distraction process, (4) Psychological angst as metacommunication of pain, and (5) Enactment of perceived deserved punishment. Our conclusions argue for the importance of understanding the complexity of cultural diversity, introjected cultural expectations, and its impact on the development of trauma and implications for clinical practice.Future research and practice should focus on exploring trauma-informed methodologies and culturally sensitive approaches in working with those impacted by Izzat and the cultural responsibility of maintaining family honour.

Background This article aimed to advance the understanding of ‘what works’ in visual art interventions from the perspective of key stakeholders, including people with dementia, their family members and visual art professionals. Method Semi-structured interviews were conducted with 22 participants, exploring their perceptions on barriers, facilitators, perceived benefits, experiences of delivering/attending a visual art intervention and any recommendations for implementation. Results Five factors were identified within the interviews that indicated important considerations for intervention structure and implementation, including benefits of group work, a skilled facilitator, participant choice, artistic ability and activity content. While art therapists expressed a clear protection of professional boundaries, the success of all of the visual art interventions was largely attributed to the supportive facilitator who possessed certain core values such as empathy and compassion and had knowledge in both artistic practice and the impact of living with dementia. It was clear the group dynamic was valued, and it was important to provide enjoyable, failure-free activity content with a strong focus on the creative process. Conclusion These findings offer a direction for evidence-based practice when implementing visual art interventions.

Acceptability and feasibility study of a six-week person-centred, therapeutic visual art intervention for people with dementia. Arts & Health. pp. 1-19.