Ethnic Minorities Experiences of Healthcare Intervention

NCT07211698 | Recruiting

• 2 other identifiers: 25044NIHR SPCR 2024-2027
• Study Type: observational
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

As ethnic diversity in Britain continues to grow, so do the health needs in a society with many different ethnic backgrounds, including the need for personalised healthcare. Studies show that people from ethnic minority groups are at a higher risk of illness and death compared to white people with the same health issues. For example, ethnic minority individuals have strokes five years earlier than white people and are at greater risk of serious problems, including an increased risk of falling. These differences are made worse because people from ethnic minority communities are less likely to use or engage with healthcare interventions delivered in the community, which increases health inequalities. Ethnic minorities have a greater susceptibility to falls because they are likely to have underlying health issues, such as high blood pressure and diabetes. We do not have enough evidence on what treatment can stop these falls. Older adults who fall can get hurt and may even die from their falls. Research hasn't found the best ways to prevent falls for ethnic minorities, because often, they are underrepresented in the study. The NHS wants to transform care delivery by providing more care in the community rather than in hospitals, by using more digital tools instead of paper methods and focusing more on keeping people healthy rather than just treating sickness. This means healthcare services need to be designed to meet the specific needs of different ethnic groups when they are provided at home or in community centres. This qualitative study is classified into two phases. The purpose of Phase 1 of the study is to understand how people from ethnic minority backgrounds feel about accessing healthcare delivered to them at home or in community centres, with the view to identifying how to help them participate in these services. Semi-structured interviews, focus groups or informal conversations will be conducted with adults from Asian, Black African, Black Caribbean, or Mixed ethnic backgrounds. The study aims to find out what changes can be made to better meet their needs. Phase 1 will explore broad areas of health due to health inequalities in diagnosis and treatment outcomes for the ethnic minority population. This will help understand the relevant factors to consider when delivering interventions. Phase 2 of the study will focus on falls prevention intervention due to the greater susceptibility to falls among ethnic minorities. A range of people deliver falls prevention in the community, for example, exercise instructors, personal trainers, support workers, nurses, AHPs, falls leads, community groups coordinators, etc. A semi-structured interview will be conducted with people delivering falls prevention interventions in the community to explore their experiences of providing tailored treatment to ethnic minorities.

Conditions

Study Focus is Healthcare Interventions and Health Inequalities; Healthcare Inequities; Health Intervention

Keywords

Ethnic minorities; Healthcare intervention; community service; home; Fall; falls prevention intervention

Outcome Measures

Primary Outcomes (1)

• Thematic analysis of qualitative data.

  Interviews, focus groups and informal conversational interview data will be thematically analysed by coding the data into categories, identifying patterns and themes to gain insights into the cultural, social and behavioural nuances that may influence ethnic minorities participation in healthcare interventions delivered in their own homes or community centres.

  12 months

Secondary Outcomes (1)

• Consolidated Framework for Implementation Research (CFIR) to measure or present facilitators to implementation of healthcare interventions.

  12 months

Study Arms (2)

Phase 1: Asian, Black African, Black Caribbean, or Mixed ethnic background

To explore the views of ethnic minorities on accessing healthcare interventions delivered at home or in community centres and to understand how they could be supported to utilise these healthcare interventions.

Other: Qualitative study - Phase 1

Phase 2: Individuals delivering falls prevention interventions in the community

In Phase 2, the population to be studied are individuals delivering falls prevention interventions in the community, for example, exercise instructors, personal trainers, support workers, nurses, AHPs, falls leads, community groups coordinators. An estimation of up to 15 participants will be recruited to explore how individuals delivering falls prevention interventions in the community provide tailored interventions to ethnic minorities at home or in community centres.

Other: Qualitative study - Phase 2

Interventions

Qualitative study - Phase 1 OTHER

Semi-structured interviews will enable an in-depth conversation between the researcher and the participant, delving deeply into personal and sometimes sensitive issues that participants are unable to talk about in a focus group. Focus groups allow participants to share their thoughts and experiences as part of a group, bouncing off each other instead of answering questions alone. People can discuss with each other and the researcher can learn not just what people think, but also how and why they think that way. Both semi-structured interviews and focus groups will be audio recorded with participants consent, which may influence what participants say or do not say during the conversations. This could also make people uncomfortable, and therefore, they may decide not to participate in the study. Therefore, an informal conversational interview is needed as an option. Informal conversations will not be recorded, creating a more friendly and comfortable atmosphere for people to share their

Also known as: semi-structured interviews, focus group, informal conversational interview

Phase 1: Asian, Black African, Black Caribbean, or Mixed ethnic background

Qualitative study - Phase 2 OTHER

Individuals delivering falls prevention intervention in the community will be recruited from established professional networks, social media and through existing collaborations and contacts. We want to understand how fall interventions are tailored and delivered in the community to ethnic minority individuals and what ideal falls prevention intervention services could look like when delivered in people's homes or community centres, so we can learn from experiences and inform future practice.

Also known as: semi-structured interview

Phase 2: Individuals delivering falls prevention interventions in the community

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

In Phase 1, up to 30 individuals from ethnic minority backgrounds (Asian, Black African, Black Caribbean, and people with a Mixed ethnic background) will be recruited into the study. In Phase 2, up to 15 individuals delivering falls prevention intervention in the community, irrespective of ethnic background, will be recruited. To ensure a diverse sample, the following attributes will be purposively sought: * Participants from both genders. * Participants from different ethnic minority groups will be identified through self-identification. * Adults who receive or deliver healthcare intervention at home or in community settings identified through self-identification. * Adults who declined healthcare intervention at home or in community settings identified through self-identification. * Support will be provided to participants who speak little English, have aphasia or a learning disability to take part in the study if they have the capacity to provide informed consent.

You may qualify if:

• Ethnic minority individuals
• Adults aged 18 and over
• Never accessed or accessed or used or declined health intervention
• Able to provide informed consent
• Lives in their own home or living with family/ friend or supported living facilities
• Lives in the United Kingdom at the time of study participation

You may not qualify if:

• Patients in hospital admissions
• Adults living in care homes
• Phase 2:
• Individuals delivering falls prevention interventions in the community, for example, exercise instructors, personal trainers, support workers, nurses, AHPs, falls leads, community groups coordinators, etc.
• From any ethnic background
• Adults aged 18 and over
• Able to provide informed consent
• Provides falls prevention intervention only to inpatients, or in hospital settings, or in care homes
• Lives outside of the United Kingdom at the time of study participation

Sponsors & Collaborators

• University of Nottingham: lead

Study Sites (1)

Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham

Nottingham, NG7 2UH, United Kingdom

RECRUITING

Related Publications (18)

• The Health Foundation (2025). Inequalities in diagnosed health conditions by ethnicity. (accessed 24 July 2025). https://www.health.org.uk/evidence-hub/health-inequalities/inequalities-in-diagnosed-health-conditions-by-ethnicity

  BACKGROUND

• GOV.UK (2024). Writing about ethnicity. Ethnicity facts and figures. https://www.ethnicity-facts-figures.service.gov.uk/style-guide/writing-about-ethnicity/ (accessed: 14 June 2025).

  BACKGROUND

• Cleland JA. The qualitative orientation in medical education research. Korean J Med Educ. 2017 Jun;29(2):61-71. doi: 10.3946/kjme.2017.53. Epub 2017 May 29.

  PMID: 28597869 BACKGROUND

• McKevitt C, Fudge N, Redfern J, Sheldenkar A, Crichton S, Rudd AR, Forster A, Young J, Nazareth I, Silver LE, Rothwell PM, Wolfe CD. Self-reported long-term needs after stroke. Stroke. 2011 May;42(5):1398-403. doi: 10.1161/STROKEAHA.110.598839. Epub 2011 Mar 24.

  PMID: 21441153 BACKGROUND

• Fluck D, Fry CH, Gulli G, Affley B, Robin J, Kakar P, Sharma P, Han TS. Adverse stroke outcomes amongst UK ethnic minorities: a multi-centre registry-based cohort study of acute stroke. Neurol Sci. 2023 Jun;44(6):2071-2080. doi: 10.1007/s10072-023-06640-z. Epub 2023 Feb 1.

  PMID: 36723729 BACKGROUND

• Stroke Association (2016). State of the Nation. Stroke Statistics. https://www.stroke.org.uk/sites/default/files/state_of_the_nation_2016_110116_0.pdf

  BACKGROUND

• Razieh C, Zaccardi F, Miksza J, Davies MJ, Hansell AL, Khunti K, Yates T. Differences in the risk of cardiovascular disease across ethnic groups: UK Biobank observational study. Nutr Metab Cardiovasc Dis. 2022 Nov;32(11):2594-2602. doi: 10.1016/j.numecd.2022.08.002. Epub 2022 Aug 11.

  PMID: 36064688 BACKGROUND

• Cousins, J. (2024). Research reveals ethnic minority heart failure patients at much higher risk of death than White patients. British Heart Foundation. (accessed 02 July 2025). https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2024/june/ethnic-minority-heart-failure-patients-at-much-higher-risk-of-death-than-white-patients

  BACKGROUND

• The King's Fund (2024). Health inequalities in a nutshell. (accessed 02 July 2025). https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/health-inequalities-nutshell

  BACKGROUND

• Smart A, Harrison E. The under-representation of minority ethnic groups in UK medical research. Ethn Health. 2017 Feb;22(1):65-82. doi: 10.1080/13557858.2016.1182126. Epub 2016 May 13.

  PMID: 27174778 BACKGROUND

• Kayani Z, Willis A, Salisu-Olatunji SO, Jeffers S, Khunti K, Routen A. Reporting and representation of underserved groups in intervention studies for patients with multiple long-term conditions: a systematic review. J R Soc Med. 2024 Sep;117(9):302-317. doi: 10.1177/01410768241233109. Epub 2024 Apr 16.

  PMID: 38626808 BACKGROUND

• Oskrochi, Y., Jeraj, S., Aldridge, R., Butt, J. and Miller, A. (2023). Not by choice - the unequal impact of the COVID-19 pandemic on disempowered ethnic minority and migrant communities. Race Equality Foundation. UCL. Doctors of the world. https://www.doctorsoftheworld.org.uk/wp-content/uploads/2018/11/Not-by-choice.pdf

  BACKGROUND

• Wade C. The role of patient safety in health inequities. Lancet. 2023 Jun 17;401(10393):2038. doi: 10.1016/S0140-6736(23)00451-8. No abstract available.

  PMID: 37330741 BACKGROUND

• Kirby T. Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities. Lancet Respir Med. 2020 Jun;8(6):547-548. doi: 10.1016/S2213-2600(20)30228-9. Epub 2020 May 10. No abstract available.

  PMID: 32401711 BACKGROUND

• Tai DBG, Shah A, Doubeni CA, Sia IG, Wieland ML. The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States. Clin Infect Dis. 2021 Feb 16;72(4):703-706. doi: 10.1093/cid/ciaa815.

  PMID: 32562416 BACKGROUND

• Morales DR, Ali SN. COVID-19 and disparities affecting ethnic minorities. Lancet. 2021 May 8;397(10286):1684-1685. doi: 10.1016/S0140-6736(21)00949-1. Epub 2021 Apr 30. No abstract available.

  PMID: 33939952 BACKGROUND

• Khunti K, Feldman EL, Laiteerapong N, Parker W, Routen A, Peek M. The Impact of the COVID-19 Pandemic on Ethnic Minority Groups With Diabetes. Diabetes Care. 2023 Feb 1;46(2):228-236. doi: 10.2337/dc21-2495.

  PMID: 35944272 BACKGROUND

• Blake., L. (2024). Delivering person-centred care for the UK's culturally diverse communities. National Children's Bureau: Research in Practice.

  BACKGROUND

MeSH Terms

Interventions

Focus Groups

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Officials

• Katie Robinson, PhD

  School of Medicine, University of Nottingham

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Joy O Watterson, MSc

CONTACT

+447812277091; mzxja3@nottingham.ac.uk

Katie Robinson, PhD

CONTACT

Katie.Robinson@nottingham.ac.uk

Study Design

• Study Type: observational
• Observational Model: ECOLOGIC OR COMMUNITY
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Research Fellow

Study Record Dates

• First Submitted: September 12, 2025
• First Posted: October 8, 2025
• Study Start: October 20, 2025
• Primary Completion (Estimated): July 31, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: February 10, 2026

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)