Purpose -Evidence, though limited, suggests that UK minority ethnic individuals have lower referral rates for eating disorders than their White British counterparts. Missed or delayed diagnosis may be an important contributory factor. This paper seeks to identify key areas that require attention for early detection and treatment of eating disorders in minority ethnic people.Design/methodology/approach -The approach taken was a community-based qualitative study in Sheffield, England: interviews with relatives of people with eating disorders (n ¼ 3); key informant interviews (n ¼ 15); group discussions with community members aged 18-24 (n ¼ 4, 24 participants).Findings -Several factors appear to influence the recognition of, and response to, eating disorders among minority ethnic people with potential implications for timely diagnosis and treatment. Low public awareness was an important barrier to seeking medical attention. Norms and ideals relating to food and body image, as well as some religious practices, can also discourage prompt recognition of illness, though there is much diversity within and between families and communities. Some service providers can be slow to consider the possibility of eating disorders among minority ethnic individuals, while others lack confidence to deal with the needs of minority ethnic people. Poor past experiences with services also undermine people's willingness to engage with services.Originality/value -The paper provides insights into socio-cultural influences on the experiences of people living with eating disorders that require greater attention by services. Healthcare practitioners need enhanced awareness that eating disorders do affect minority ethnic people and greater confidence to engage with these patients to gain the information needed for prompt diagnosis and effective treatment.
This article investigates women's experiences of domestic violence, in two contexts rated as fragile and stable in global indices: Pakistan, and the UK. The research shows the importance of understanding how intersectional disadvantages, based on gender and ethnic minority status among others, can lead to some groups of women experiencing life as inhabitants of a 'fragile context within a stable state'.
BackgroundPublic health researchers are increasingly encouraged to establish international collaborations and to undertake cross-national comparative studies. To-date relatively few such studies have addressed migration, ethnicity and health, but their number is growing. While it is clear that divergent approaches to such comparative research are emerging, public health researchers have not so far given considered attention to the opportunities and challenges presented by such work. This paper contributes to this debate by drawing on the experience of a recent study focused on maternal health in Canada, Germany and the UK.DiscussionThe paper highlights various ways in which cross-national comparative research can potentially enhance the rigour and utility of research into migration, ethnicity and health, including by: forcing researchers to engage in both ideological and methodological critical reflexivity; raising awareness of the socially and historically embedded nature of concepts, methods and generated 'knowledge'; increasing appreciation of the need to situate analyses of health within the wider socio-political setting; helping researchers (and research users) to see familiar issues from new perspectives and find innovative solutions; encouraging researchers to move beyond fixed 'groups' and 'categories' to look at processes of identification, inclusion and exclusion; promoting a multi-level analysis of local, national and global influences on migrant/minority health; and enabling conceptual and methodological development through the exchange of ideas and experience between diverse research teams. At the same time, the paper alerts researchers to potential downsides, including: significant challenges to developing conceptual frameworks that are meaningful across contexts; a tendency to reify concepts and essentialise migrant/minority 'groups' in an effort to harmonize across countries; a danger that analyses are superficial, being restricted to independent country descriptions rather than generating integrated insights; difficulties of balancing the need for meaningful findings at country level and more holistic products; and increased logistical complexity and costs.SummaryIn view of these pros and cons, the paper encourages researchers to reflect more on the rationale for, feasibility and likely contribution of proposed cross-national comparative research that engages with migration, ethnicity and health and suggests some principles that could support such reflection.
Plain English summaryPublic health research sometimes uses members of communities as researchers. These are called Community Researchers. The advantage of using Community Researchers is that it enables people who live in communities to participate in research by designing the research, gathering data and being involved in analysis. This ‘participatory’ approach also has the potential to reach communities that might otherwise not be included in research. There are few studies that report the experiences of Community Researchers who take part in such research. This study helps fill this gap by exploring the issues and challenges faced by Community Researchers involved in a study of health and poverty in ethnically mixed areas of east London, UK. Through the accounts of 12 researchers, the study reveals that being a community ‘insider’ had advantages: many felt they had been able to gain the trust of respondents and access people for the research that would have otherwise been missed. The role of Community Researcher was, however, difficult to manage with some researchers feeling burdened by their role and the increased knowledge they had about the lives of those in their community. In addition to the personal challenges for the Community Researchers, the findings raise various ethical and methodological issues that need consideration in participatory research.Abstract Background Inclusive research approaches are increasingly employed by public health researchers. Recent methodological development includes the engagement of Community Researchers (CRs), who use their knowledge and networks to facilitate research with the community with which they identify. Few studies have explored the experiences of CRs in the research process, an important element of any comprehensive assessment of the pros and cons of such research endeavours. We report here on the experiences of CRs engaged in a study of health inequalities and poverty in ethnically diverse and disadvantaged areas of London, UK. Methods We draw on the experiences of 12 CRs. Two sets of data were generated, analysed and integrated: debriefing/active reflection exercises throughout the 18-month research process and individual qualitative interviews with CRs, conducted at the end of the project (n = 9). Data were organised using NVivo10 and coded line-by-line using a framework developed iteratively. Synthesis and interpretation were achieved through a series of reflective team exercises involving input from 4 of the CRs. Final consolidation of key themes was conducted by SS and ES. Results Being an ‘insider’ to the communities brought distinct advantages to the research process but also generated complexities. CRs highlighted how ‘something would be lost’ without their involvement but still faced challenges in gathering and analysing data. Some CRs found it difficult to practice reflexivity, and problems of ethnic stereotyping were revealed. Conflict between roles as community members and investigators was at times problematic. The approach promoted some aspects of ...
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