OUR HEALTH, OUR ACTION

1. OUR HEALTH, OUR ACTION Tandrusti Research Findings Iram Naz (WEA Project Researcher)

2. Why we did the research? • Gather Experiences and Assess needs: To map the health journeys of 50 BME/non BME individuals in Dudley • Building Capacity and Sustainability: To develop 25 Community Health Champions • Partnership Working: To work with public bodies to reduce health inequalities • Sharing and Developing: To evaluate and disseminate the findings to shape future service provision.

3. Research Methods • Qualitative Methodology • 50 In-depth Semi Structured Interviews • Ethical Consideration • Constant Comparative Analysis

4. Stratified Random Sample: Representing Tandrusti students

5. HEADLINE FINDINGS

6. Health Attitudes • Good Health Absence of Disease • Being Older Having Poor Health • Health Services Symptom Control • Tandrusti aims to challenge these Health Attitudes

7. Health Awareness • Difference between health knowledge and health awareness • Awareness of personal health developing after diagnosis or threat of disease or illness • The need for contextualised and appropriate health information and promotion

8. Accessing health Information • Higher Literacy Level = better access to health information • Over 65s = poor access to health information • GP main source and gatekeepers to other services • 90% preferred ‘interactive’ health information to leaflets, books.

9. Disparity in perceived and actual healthiness of diet • Awareness of healthy eating is quite good • Importance of healthy eating is understood but not practiced • Steady cultural shift and education required to change life long habits • Food labels are very rarely followed by all groups interviewed

10. Raising motivation and having positive role models • Motivation towards exercising with Tandrusti is high • Motivation towards a healthy lifestyle was low • Lack of positive role models and support • Being Healthy= Major changes and a Big Challenge, Tandrusti aims to motivate learners through a supportive health education approach

11. Dispelling subjective interpretations of recommended physical activity • How much physical activity should an average adult aged 18 and over do in a week? • Answer: 30 Minutes of moderate physical activity 5 times a week (DoH and WHO, 2005)

12. Physical Activity Levels of Sample No. of people in sample

13. Understanding of being physically active • <25% of people interviewed were doing ideal or sufficient physical activity • Poor understanding of exertion and frequency balance in physical activity • Physical activity stereotypes need to be broken

14. Health Service Use No. of Tandrusti Students using services

15. Health Service Use • Awareness of services is quite poor, restricting access and outcome. • GP is the most widely used service, satisfaction is quite high with GP but low with appointment system • Older South Asian patients have low expectations from the health services • ‘Veterinary consultations’ if communication is poor between health services and patient

16. Cultural Factors and Health • Modest descriptions of personal health by South Asian women issue for large surveys like Census • ‘Purdah’ (veiling) a barrier to mainstream physical activity for Muslim women, Tandrusti provides a culturally appropriate service for this group. More younger women coming forward as a result. • Tandrusti has broken some cultural myths through mixed gender exercise sessions, swimming classes.

17. Mental Health • Physical and mental illness can be intertwined, easier to talk about physical symptoms • Poor mental health = Social, emotional dysfunction so unfavourable to be shared outside family • Mental health services need to understand intricacies of cultural norms and their impact on attitude and behaviour

18. Tandrusti’s Impact • Reduced Blood Pressure readings in over 90% of learners • Improved Posture, Stability and Flexibility in learners • Awareness of the impact of exercise on the body • Improved Self Confidence • Emotional support and social networking through grouped exercise • Motivation to improve health awareness • Challenging cultural norms/stereotypes through mixed gender classes • Exercise made fun and less chore like has increased participation • Willingness to participate in further community cohesion activities

19. Tandrusti Action Plan based on findings • Increasing awareness of recommended Intensity and Frequency of physical activity • Physical Activity beyond the Tandrusti class • Raising awareness of integrated physical activity (at home/work etc) • Signposting to other health/education services (particularly mental health) • Learner led physical activity • Setting up Additional Classes/ equipment • Provision and evaluation of relevant health education/promotion • Reinforcement of Key Health Messages through teaching and learning • Training and implementation of Community Health Volunteers within Tandrusti.

20. Community Health Volunteers • 20 Volunteers recruited and trained from various ethnic backgrounds and age groups • Volunteering activities: Walk leading, Initial Assessment in classes, recruiting, motivating and Supporting, Stress Management

21. Recommendations • Individuals • Community fitness services • Health Policy makers, stakeholders and Practitioners

22. Recommendations for Stakeholders • 1. Increase awareness of ethnic disparities in health care among the general public, key stakeholders and healthcare providers. • 2. Use evidence based practice guidelines; enhance patient provider communication and trust. • 3. Ensure adequate resources are allocated to meet the needs of patients likely to suffer health inequality and disadvantage. • 4. Provide appropriate interpretation services where community need exists

23. Recommendations.. • 5. Ensure health promotion is culturally competent; consider issues of user background, literacy levels, accessibility and the translation and appropriateness of health messages to user lifestyles. • 6. Consider incorporating and developing community health workers/ volunteers to support and implement multi-disciplinary treatment and preventative care programmes. • 7. Implement patient education programmes to increase patients’ knowledge on how to best access health care and participate in treatment decisions.

24. Recommendations… • 8. Integrate cross cultural education into the training of all current and future health professionals. • 9. Collect data on healthcare access and utilisation by patients’ ethnicity and socioeconomic status. Report ethnicity data and monitor the progress towards the elimination of health care disparities. • 10. Commission research to identify sources of ethnic inequalities, on barriers to tackling inequalities and to assess intervention strategies to reduce inequalities.

25. Thank you