Covid-19 vaccination is an effective strategy to reduce the spread of infection and achieve herd immunity. However, evidence suggests that both vaccine uptake and intention to vaccinate differ amongst population groups. Vaccine hesitancy is highest amongst specific ethnic minority groups. There is currently no qualitative study of the barriers and facilitators to covid-19 vaccine uptake in BAME groups in the UK primary care.
Methods
We aim to conduct in-depth telephone interviews using semi-structured, open-ended questions about covid-19 vaccination in patients from South Asian (Bangladeshi/Pakistani) and Black African/African-Caribbean ethnicities in primary care in March 2021. Patients will be recruited using purposive sampling in 5 socially and ethnically diverse general practices in London. Interviews will be transcribed verbatim and subjected to thematic analysis. Data on age, sex, occupation, co-morbidities, previous vaccination status, geographical location, country of birth, education level will be also be obtained. Patients will be selected through EMIS search. All adults over 18 who are eligible for covid-19 vaccination regardless of priority status and can consent will be included in the study. Questions will relate to desire to take the vaccine, barriers and potential factors that would change their view and decision-making.
Results
We hypothesise that covid-19 vaccine hesitancy will be associated with deprivation, lower educational attainment, residential segregation, previous negative healthcare experiences, and poor trust of healthcare services. Other barriers and potential solutions will be explored in depth during the interview.
Conclusion
Covid-19 has had a disproportionate impact on ethnic minority groups with much higher mortality, and cases and hospitalisation rates compared to the White populations. Vaccination is an effective strategy in mitigating the risk. We need to understand the factors that cause vaccine reluctance, hesitancy and refusal, and how to facilitate engagement with vaccination programmes. This primary-care based study could help plan targeted public health campaigns to increase covid-19 vaccine uptake.
Background Higher 25(OH)D3 levels are associated with lower HbA1c, but there are limited UK interventional trials assessing the effect of cholecalciferol on HbA1c. Aims (1) To assess the baseline 25(OH)D3 status in a Manchester cohort of children with type 1 diabetes (T1D). (2) To determine the effect of cholecalciferol administration on HbA1c. Methods Children with T1D attending routine clinic appointments over three months in late winter/early spring had blood samples taken with consent. Participants with a 25(OH)D3 level <50 nmol/L were treated with a one-off cholecalciferol dose of 100,000 (2–10 years) or 160,000 (>10 years) units. HbA1c levels before and after treatment were recorded. Results Vitamin D levels were obtained from 51 children. 35 were Caucasian, 11 South Asian and 5 from other ethnic groups. 42 were vitamin D deficient, but 2 were excluded from the analysis. All South Asian children were vitamin D deficient, with mean 25(OH)D3 of 28 nmol/L. In Caucasians, there was a negative relationship between baseline 25(OH)D3 level and HbA1c ( r = −0.484, P < 0.01). In treated participants, there was no significant difference in mean HbA1c at 3 months ( t = 1.010, P = 0.328) or at 1 year ( t = −1.173, P = 0.248) before and after treatment. One-way ANCOVA, controlling for age, gender, ethnicity, BMI and diabetes duration showed no difference in Δ HbA1c level. Conclusion We report important findings at baseline, but in children treated with a stat dose of cholecalciferol, there was no effect on HbA1c. Further studies with larger sample sizes and using maintenance therapy are required.
Women comprise over three-quarters of the National Health Service workforce, yet remain underrepresented in senior medical grades, on managerial boards and in senior leadership roles. This is attributed to a wide range of internalised, interpersonal and structural factors.To explore the experiences of aspiring clinical leaders working with senior female leader colleagues and the perceived impact of these interactions on professional development and future aspirations.Healthcare professionals, self-identifying as female aspiring clinical leaders, were recruited via email and social media to participate in a focus group or semistructured interview. Interviews were recorded and reviewed and the key enablers, barriers and actions to facilitate opportunities for female clinical leaders in the workplace identified.Participants (n=11) had varied experiences of working with senior female colleagues. Reported barriers from existing leaders included 'Queen Bee' phenomenon and reticence to talk about barriers faced. Enablers included 'nudging' towards opportunities and women leaders sharing challenges they had faced and overcome.Supporting women to achieve their leadership potential requires individualised support, role modelling and mentorship, and organisational change to tackle workplace biases and microaggressions. These are crucial to ensuring gender balance across leadership in health and social care.
International evidence suggests that although the proportion of women speakers at medical conferences has increased during the last decade, women continue to be significantly underrepresented.1 Women comprise the majority of the health and social care workforce in the UK, yet occupy approximately 41% of seats on NHS organisational boards and remain underrepresented in senior leadership positions across the sector.2 Conferences offer unrivalled opportunities: to showcase diversity and inclusivity, for networking and as a lever for cultural and organisational change. Female representation at healthcare events is important in …
Introduction COVID-19 vaccination effectively reduces severe disease and death from COVID-19. However, both vaccine uptake and intention to vaccinate differ amongst population groups. Vaccine hesitancy is highest amongst specific ethnic minority groups. There is very limited understanding of the barriers and facilitators to COVID-19 vaccine uptake in Black and South Asian ethnicities. Therefore, we aimed to explore COVID-19 vaccination hesitancy in primary care patients from South Asian (Bangladeshi/Pakistani) and Black or Black British/African/Caribbean/Mixed ethnicities. Methods Patients from the above ethnicities were recruited using convenience sampling in four London general practices. Telephone interviews were conducted, using an interpreter if necessary, covering questions on the degree of vaccine hesitancy, barriers and potential facilitators, and decision-making. Interviews were transcribed verbatim and thematically analysed. Data collection and analysis occurred concurrently with the iterative development of the topic guide and coding framework. Key themes were conceptualised through discussion with the wider team. Results Of thirty-eight interviews, 55% (21) of these were in Black or Black British/African/Caribbean/Mixed ethnicities, 32% (12) in Asian / British Asian and 13% (5) in mixed Black and White ethnicities. Key themes included concerns about the speed of vaccine roll-out and potential impacts on health, mistrust of official information, and exposure to misinformation. In addition, exposure to negative messages linked to vaccination appears to outweigh positive messages received. Facilitators included the opportunity to discuss concerns with a healthcare professional, utilising social influences via communities and highlighting incentives. Conclusion COVID-19 has disproportionately impacted ethnic minority groups. Vaccination is an effective strategy for mitigating risk. We have demonstrated factors contributing to vaccine reluctance, hesitancy and refusal and highlighted levers for change.
The NHS is the largest employer in the UK, with 77% of its workforce made up by women. The UK Health and Safety Executive clearly states that 'risks to a pregnant woman and her baby must be minimised by employers'. Recent studies demonstrate that shift work, uncontrolled working hours and night shifts increase risks to the developing fetus; however, this evidence has not been taken up by the NHS. Our analysis explores women9s experience of conception and pregnancy in the NHS. The thematic analysis from the survey results identified several key areas: feeling unable to speak up to their trainers and programme directors; unable to control their work patterns; conflicting and inconsistent guidance; and being caught between occupational health and the trust or deaneries. This subsequently leads to greater stress, longer unnecessary exposure to occupational hazards, and complications in pregnancy and career outcomes.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
