How important is trust between Gypsies, Travellers and Roma people and health services?
How important is trust between Gypsies, Travellers and Roma people and health services, and if it is important, what can we do to increase it? These are important questions that a team of researchers from Dundee and York universities and Leeds Gypsy and Traveller Exchange (Leeds GATE) are investigating. It is well known that Gypsies and Travellers have poor health compared to other groups in the UK. We also know that they use health services less (or later on a health journey when things are more acute). There are many reasons why Gypsies and Travellers are less likely to use health services than other groups. A mobile lifestyle can make it difficult to access health services. Even when settled Gypsies and Travellers often face misunderstandings and discrimination, for example, when trying to register with a GP. These poor experiences can lead to low expectations and mistrust of health services and health care staff. One suggestion is that involving the community, in this case Gypsies and Travellers, would help increase trust and use of health services. This community engagement can range from consulting with Gypsies and Travellers about what they need from health services to actually involving then in the design and delivery of services. So, the question that our research is trying to answer is: which approaches to community engagement are best at increasing trust between Gypsies and Travellers, and mainstream health services?
We thought that it would be too much to look at every kind of health service in our study so we decided to concentrate on services for families with young children. This means our study is mostly about maternity care, child health services, and child dental health services.
How are we going to do this? First we plan to do 3 literature reviews to look at studies that have already been done and that could help us answer our question. Our first review is about how Gypsies, Travellers and Roma people use health services, what barriers they face and what activities have been used to try to increase their use of health services. As Trust is a term that is often used but almost never defined, our second review will look at how trust has been defined and explained, especially in connection with health services and health care staff. Our third and final review will try to find explanations for how community engagement can work to increase trust. We have started doing these literature reviews and will be able to share what we found soon.
The second part of our study is a survey of community groups and health services in the UK to identify barriers and successful approaches to engaging Gypsies, Travellers and Roma people. We circulated our survey to as many different health services and community groups as we could and were very pleased to get almost 200 responses. We will soon be finished analysing the responses and hope to share the findings in the next few months.
The third and main part of our study is to examine 4 places (case studies) where there are good examples of working with Gypsies, Travellers or Roma people to improve their use of health services. In each case study we are talking to mothers of young children, health care staff and members of community organisations like Leeds GATE. We want to find out about their experiences of maternity care, child health services and dental health services in the area, and what they think could be done to improve trust between Gypsies, Travellers and Roma people and health services. We have nearly finished the first 2 case studies which are in Leeds, and in Fife in Scotland. We are just starting the second two case studies in Sheffield and London.
Finally, in Autumn 2017, we will hold 2 events to discuss the findings of our study and to agree the recommendations to make to the Department of Health who have funded the research. We also plan to share the findings with health service commissioners, health care staff and community organisations.
We are very grateful to Leeds GATE for helping us with the study and for hosting a small group of Gypsy and Traveller mothers who have advised us on the best way to conduct the study.
If you would like to know more about our study, or to see the findings when they are ready, please e-mail: TrustResearch@dundee.ac.uk You can also look out for further blogs on this website.
Dr Alison McFadden, Senior Research Fellow, Mother and Infant Research Unit, University of Dundee