Co-producing a research proposal to co-develop community-led wellbeing interventions among Gypsy, Roma and Traveller Communities
Funding
NHS Bristol, North Somerset and South Gloucestershire ICB Research Capability Funding.
What is the problem?
The need for this project was identified through conversations with project partners and women attending an existing group for GRT communities.
GRT refers to Gypsy, Roma and Traveller communities but also includes other groups who practice nomadism (i.e. Show People, New Travellers and Boaters). These communities are considered ‘‘priority communities” under the Inclusion Health agenda(1), which means action is urgently needed to ensure they are able to access and benefit from the health services they need. Evidence highlights that GRT communities experience the greatest health inequalities in the UK, with higher rates of many long‐term conditions, and considerably poorer health outcomes than the general population(2, 3). It is estimated that GRT communities have life expectancies of between 10 and 25 years shorter than the general population(4). Mental health is a huge problem, with many of the communities experiencing anxiety and depression(5). Suicide rates are estimated to be seven times higher for GRT communities than the general population and is thought to be the cause of 11% of deaths for Irish Travellers(5).
In order to support engagement in healthcare, services must be co-designed with the communities so that they are acceptable, accessible, and overcome the specific barriers communities face. This requires collaborations between research teams and communities that are equal, empowering and foster a sense of ownership and shared responsibility. Research teams need to adopt flexible and culturally appropriate methods to meet the needs of the communities.
What is the aim of the research?
This project aims to work closely with GRT communities to better understand mental health priorities and to develop future research that is shaped by their needs and experiences. A key goal is to build strong, trusting and lasting relationships between GRT communities and researchers, based on mutual respect and shared learning.
The project will use participatory approaches, meaning that group members will help decide what topics are discussed, how conversations take place, and what the project produces. We will invite people from GRT communities to attend group sessions every two weeks over 12 months. Groups will meet in a familiar, accessible community space, with food and refreshments provided. Creating a safe, welcoming and flexible environment is central to the project, particularly in light of past and ongoing mistrust between GRT communities and health services. Health information will be shared by trusted professionals, while recognising the expertise and knowledge within the community.
Meetings will include creative and interactive activities such as crafts, and small-group discussions to support open and comfortable conversations about mental health and experiences of health research. These discussions will help identify what matters most to the group and how research can be more inclusive. These conversations will inform a co-produced funding application grounded in the needs of the community.
How will this be achieved?
The RCF work with GRT communities will lead to the development of a funding application for the NIHR Public Health Programme. The aim of the NIHR project will be to better understand how community-based approaches can support wellbeing, ensuring that NHS England’s shift from hospital to community and from treatment to prevention addresses health inequalities experience by this underserved population. We will work closely with charities and local councils that already support GRT communities. We have existing links with two local authorities, and more partners will be identified through planned relationship-building activities.
The project will have two main parts. First, we will look at how current community activities support wellbeing. This will include interviews and workshops with community members to hear their views on local initiatives, such as community events, information sessions, health and safety days, and women’s groups. We will explore what works well and what could be improved. These insights will be combined with existing research evidence to help organisations make practical improvements to their activities.
Second, we will evaluate the improved community initiatives to understand how and why they work, who they work for, and in what situations. This recognises that GRT communities are diverse and that local contexts matter. We will use interviews, workshops and project materials to build case studies at each site.
Findings will be shared in accessible ways with communities, partners and councils, and more widely through policy, practice and academic networks to support learning and impact.
Who is leading the research?
This research is led by Dr Sarah Denford and Dr Hannah Bowers, Senior Research Fellows at the University of Bristol and the University of Southampton.
Further information
For more information or to get involved with this project, please email bnssg.research@nhs.net