Structural racism remains a primary public health risk amidst COVID and beyond in the United Kingdom

Clementi, Rebecca

doi:10.1093/pubmed/fdaa102

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…This indicates that government slogans like “protect the NHS” may not have the intended effect on BAME communities and should be rethought to be more inclusive. However, reasons for a lack of trust on the part of BAME people in the governments and institutions in the United Kingdom are likely linked to persistent issues of structural racism [ 37 ] and, thus, are unlikely to be changed through singular measures alone, such as government messaging.…”

Section: Discussionmentioning

confidence: 99%

Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study

Dowthwaite¹,

Fischer²,

Vallejos³

et al. 2021

J Med Internet Res

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Background Digital contact tracing is employed to monitor and manage the spread of COVID-19. However, to be effective the system must be adopted by a substantial proportion of the population. Studies of mostly hypothetical contact tracing apps show generally high acceptance, but little is known about the drivers and barriers to adoption of deployed systems. Objective The aim of this study was to investigate adoption of and attitudes toward the NHS (National Health Service) COVID-19 smartphone app, the digital contact tracing solution in the United Kingdom. Methods An online survey based on the extended Technology Acceptance Model with the added factor of trust was carried out with a representative sample of the UK population. Statistical analysis showed adoption rates, attitudes toward and trust in the app, and compliance with self-isolation advice and highlighted differences for vulnerable populations (ie, older adults aged 65 years and over and members of Black, Asian, and minority ethnic [BAME] communities). Results A total of 1001 participants took part in the study. Around half of the participants who had heard of the NHS COVID-19 mobile phone app (490/963, 50.9%; 95% CI 47.8%-54.0%) had downloaded and kept the app, but more than one-third (345/963, 35.8%; 95% CI 32.8%-38.8%) either did not intend to download it or had deleted it. Significantly more BAME respondents than White respondents had deleted the app (16/115, 13.9%; 95% CI 11.8%-16.0%, vs 65/876, 7.4%; 95% CI 5.8%-9.0%), and significantly more older adults 65 years and over than those under 65 years did not intend to download it (44/127, 34.6%; 95% CI 31.7%-37.5%, vs 220/874, 25.2%; 95% CI 22.5%-27.9%). Broadly, one of the reasons for uptake was to help the NHS and other people, especially among older adults, although significantly fewer BAME participants agreed that they did so to help the NHS. Reported compliance with received notifications to self-isolate was high but was significantly lower than reported intended compliance without received notifications. Only one-fifth (136/699, 19.5%; 95% CI 17.0%-22.0%) of participants understood that the decision to send self-isolation notifications was automated by the app. There were a range of significantly more negative views among BAME participants, including lower trust in the NHS, while older adults were often significantly more positive. Respondents without the app reported significantly lower trust and more negative views toward the app and were less likely to report that they understood how the app works. Conclusions While compliance on the part of the approximately 50% of participants who had the app was fairly high, there were issues surrounding trust and understanding that hindered adoption and, therefore, the effectiveness of digital contact tracing, particularly among BAME communities. This study highlights that more needs to be done to improve adoption among groups who are more vulnerable to the effects of the virus in order to enhance uptake and acceptance of contact tracing apps.

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Section: Discussionmentioning

confidence: 99%

Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study

Dowthwaite¹,

Fischer²,

Vallejos³

et al. 2021

J Med Internet Res

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Access to Chronic Pain Services for Adults from Minority Ethnic Groups in the United Kingdom (UK): a Scoping Review

Leach,

Ndosi,

Jones

et al. 2023

J. Racial and Ethnic Health Disparities

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Background Chronic pain services in the UK are required to provide services which meet the diverse needs of patients, but little is known about the access and use of these services by minority ethnic groups. Objective To assess the available evidence regarding the ethnic profile of adults who access secondary and tertiary chronic pain services in the UK. Methods A scoping review was conducted (August 2021–October 2021), comprising comprehensive literature searches using Embase, Medline and CINAHL databases and the grey literature. Studies were included if they reported on (i) access to chronic pain services in secondary and/or tertiary care in the UK, (ii) adults and (iii) stated the ethnicity of the involved participants. Studies were included if published between 2004 and 2021, as demographic data during this period would be broadly representative of the UK population, as per the 2021 UK census. A descriptive synthesis of the extracted data was performed. Results The search yielded 124 records after duplicates were removed. Following title and abstract screening, 44 full texts were screened, ten of which were included in the review. Conclusions This is the first review to explore access to chronic pain services for adults from minority ethnic groups in the UK. Given the limited number of studies that met the inclusion criteria, the review highlights the need for routine collection of ethnicity data using consistent ethnic categories within UK chronic pain services and increased involvement of minority ethnic groups within chronic pain research. Findings should inform future research that aims to improve access to UK chronic pain services for adults from minority ethnic groups.

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Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study (Preprint)

Dowthwaite¹,

Fischer²,

Vallejos³

et al. 2021

Preprint

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BACKGROUND Digital contact tracing is employed to monitor and manage the spread of Covid-19. However, to be effective the system must be adopted by a substantial proportion of the population. Studies of (mostly hypothetical) contact tracing apps show generally high acceptance, but little is known about the drivers and barriers to adoption of deployed systems. OBJECTIVE The aim of this study is to investigate adoption and attitudes towards the NHS Covid-19 smartphone app, the digital contact tracing solution in the UK. METHODS An online survey based on the technology acceptance model (TAM2) with the added factor of trust was carried out with a representative sample of the UK population. Statistical analysis shows adoption rates, attitudes towards and trust in the app, compliance with self-isolation advice, and highlights differences for vulnerable populations (older adults and members of black, Asian, and minority ethnic (BAME) communities). RESULTS Around half of the 1001 respondents had downloaded and kept the app, but more than a third either did not intend to download it or had deleted it. Significantly more BAME respondents had deleted the app, and significantly more older adults did not intend to download it. Reasons for uptake were broadly to help the NHS and other people, especially among older adults, although significantly fewer BAME agreed that they did so to help the NHS. Reported compliance with received notifications to self-isolate was high, but significantly lower than reported intended compliance without received notifications. Of those who had ever used the app, only a fifth understood that the decision to send self-isolation notification is automated by the app. There were a range of significantly more negative views among BAME participants, including lower trust in the NHS, whilst older adults were often significantly more positive. Respondents without the app reported significantly lower trust and more negative views towards the app and were less likely to report they understood how the app works. CONCLUSIONS Whilst compliance of the ~50% who have the app is fairly high, there are issues surrounding trust and understanding that hinder adoption and therefore the effectiveness of digital contact tracing, particularly amongst BAME communities. The study highlights that more needs to be done to improve adoption among groups who are more vulnerable to the effects of the virus to enhance uptake and acceptance of contact tracing apps.

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Structural racism remains a primary public health risk amidst COVID and beyond in the United Kingdom

Cited by 3 publications

References 4 publications

Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study

Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study

Access to Chronic Pain Services for Adults from Minority Ethnic Groups in the United Kingdom (UK): a Scoping Review

Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study (Preprint)

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