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      Series: Public engagement with research. Part 2: GPs and primary care researchers working inclusively with minoritised communities in health research to help address inequalities

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          Abstract

          Public engagement in health research is vital for addressing health disparities and promoting inclusivity among minoritised communities who often face barriers to accessing healthcare. Minoritised communities are groups, which have been made minorities by a dominant culture, race, ethnic group and/or social class and may experience health inequalities as a result. By incorporating diverse perspectives and lived experiences of minoritised communities, this approach aims to achieve contextually relevant research outcomes that reduce health inequalities and improve overall well-being. However, underrepresentation and lack of inclusivity challenges persist, necessitating the establishment of inclusive partnerships and grassroots participatory methodologies.

          To foster inclusive public engagement, it is important to overcome structural and cultural barriers, address socioeconomic challenges, and build trust with minoritised communities. This can be achieved by promoting a cultural shift that values inclusivity, providing comprehensive training to researchers, and collecting rigorous data on engagement demographics for transparency and accountability. Involving minoritised communities in decision-making through participatory research approaches enhances trust and yields successful outcomes. Additionally, allocating sufficient resources, collaborating in co-production, and prioritising the diverse needs and perspectives of stakeholders contribute to fostering inclusive public engagement in research.

          Overall, inclusive engagement practices particularly in primary care research have the potential to reduce health inequalities and cater to the unique requirements of minoritised communities, thereby creating more impactful outcomes and promoting equitable healthcare access.

          KEY MESSAGES

          • There is an important need to engage with minoritised communities in primary care research

          • Engaging diverse communities in research helps produce relevant research to address health inequalities.

          • The exclusion of minoritised communities from research can be addressed by taking action towards more inclusive engagement.

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          Most cited references28

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          The value and challenges of participatory research: strengthening its practice.

          The increasing use of participatory research (PR) approaches to address pressing public health issues reflects PR's potential for bridging gaps between research and practice, addressing social and environmental justice and enabling people to gain control over determinants of their health. Our critical review of the PR literature culminates in the development of an integrative practice framework that features five essential domains and provides a structured process for developing and maintaining PR partnerships, designing and implementing PR efforts, and evaluating the intermediate and long-term outcomes of descriptive, etiological, and intervention PR studies. We review the empirical and nonempirical literature in the context of this practice framework to distill the key challenges and added value of PR. Advances to the practice of PR over the next decade will require establishing the effectiveness of PR in achieving health outcomes and linking PR practices, processes, and core elements to health outcomes.
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            How to increase value and reduce waste when research priorities are set.

            The increase in annual global investment in biomedical research--reaching US$240 billion in 2010--has resulted in important health dividends for patients and the public. However, much research does not lead to worthwhile achievements, partly because some studies are done to improve understanding of basic mechanisms that might not have relevance for human health. Additionally, good research ideas often do not yield the anticipated results. As long as the way in which these ideas are prioritised for research is transparent and warranted, these disappointments should not be deemed wasteful; they are simply an inevitable feature of the way science works. However, some sources of waste cannot be justified. In this report, we discuss how avoidable waste can be considered when research priorities are set. We have four recommendations. First, ways to improve the yield from basic research should be investigated. Second, the transparency of processes by which funders prioritise important uncertainties should be increased, making clear how they take account of the needs of potential users of research. Third, investment in additional research should always be preceded by systematic assessment of existing evidence. Fourth, sources of information about research that is in progress should be strengthened and developed and used by researchers. Research funders have primary responsibility for reductions in waste resulting from decisions about what research to do. Copyright © 2014 Elsevier Ltd. All rights reserved.
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              Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition

              Background Eliminating indigenous and ethnic health inequities requires addressing the determinants of health inequities which includes institutionalised racism, and ensuring a health care system that delivers appropriate and equitable care. There is growing recognition of the importance of cultural competency and cultural safety at both individual health practitioner and organisational levels to achieve equitable health care. Some jurisdictions have included cultural competency in health professional licensing legislation, health professional accreditation standards, and pre-service and in-service training programmes. However, there are mixed definitions and understandings of cultural competency and cultural safety, and how best to achieve them. Methods A literature review of 59 international articles on the definitions of cultural competency and cultural safety was undertaken. Findings were contextualised to the cultural competency legislation, statements and initiatives present within Aotearoa New Zealand, a national Symposium on Cultural Competence and Māori Health, convened by the Medical Council of New Zealand and Te Ohu Rata o Aotearoa – Māori Medical Practitioners Association (Te ORA) and consultation with Māori medical practitioners via Te ORA. Results Health practitioners, healthcare organisations and health systems need to be engaged in working towards cultural safety and critical consciousness. To do this, they must be prepared to critique the ‘taken for granted’ power structures and be prepared to challenge their own culture and cultural systems rather than prioritise becoming ‘competent’ in the cultures of others. The objective of cultural safety activities also needs to be clearly linked to achieving health equity. Healthcare organisations and authorities need to be held accountable for providing culturally safe care, as defined by patients and their communities, and as measured through progress towards achieving health equity. Conclusions A move to cultural safety rather than cultural competency is recommended. We propose a definition for cultural safety that we believe to be more fit for purpose in achieving health equity, and clarify the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development. The unintended consequences of a narrow or limited understanding of cultural competency are discussed, along with recommendations for how a broader conceptualisation of these terms is important.
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                Author and article information

                Journal
                Eur J Gen Pract
                Eur J Gen Pract
                The European Journal of General Practice
                Taylor & Francis
                1381-4788
                1751-1402
                13 March 2024
                2024
                13 March 2024
                : 30
                : 1
                : 2322996
                Affiliations
                [a ]Centre for Evidence Based Medicine | Nuffield Department of Primary Care Health Sciences |, University of Oxford Radcliffe Primary Care Building, University of Oxford , Oxford, UK
                [b ]Public Contributor , London, UK
                [c ]Manchester University NHS Foundation Trust , Manchester, UK
                [d ]Centre for Academic Primary Care, University of Bristol , Bristol, UK
                [e ]University of Limerick, Family Medicine Limerick , Limerick, Ireland
                [f ]Institute of Applied Health Research, University of Birmingham , Birmingham, UK
                [g ]Academic Collaborative Centers, Knowledge Transfer Office, Tilburg University , Tilburg, The Netherlands
                [h ]Athena Institute, Vrije Universiteit Amsterdam , Amsterdam, The Netherlands
                Author notes

                Supplemental data for this article can be accessed online at https://doi.org/10.1080/13814788.2024.2322996.

                CONTACT Yumna Masood yumna.masood@ 123456phc.ox.ac.uk ; yumna.masood@ 123456manchester.ac.uk Centre for Evidence Based Medicine | Nuffield Department of Primary Care Health Sciences | University of Oxford Radcliffe Primary Care Building, University of Oxford, Radcliffe Observatory Quarter , Woodstock Road, Oxford, OX2 6GG, .
                Author information
                https://orcid.org/0000-0002-0903-6945
                https://orcid.org/0000-0001-9841-5682
                https://orcid.org/0000-0001-9981-5637
                https://orcid.org/0000-0002-6700-6445
                https://orcid.org/0000-0003-2010-3691
                https://orcid.org/0000-0002-2629-3126
                https://orcid.org/0009-0000-2528-1708
                https://orcid.org/0000-0002-2795-4790
                Article
                2322996
                10.1080/13814788.2024.2322996
                10939099
                38477291
                2c019049-0077-4165-81f3-ff3c047c7082
                © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

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                Page count
                Figures: 0, Tables: 0, Pages: 7, Words: 4866
                Categories
                Comment
                Opinion Paper

                Medicine
                public engagement,health inequalities,minoritised communities,primary care
                Medicine
                public engagement, health inequalities, minoritised communities, primary care

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