The enlargement of the European Union since 2004 has led to an increase in the number of Eastern European migrants living in the UK. The health of this group is under-researched though some mixed evidence shows they are at higher risk of certain physical health conditions such as heart attacks, strokes, HIV and alcohol use and have poorer mental health. This is compounded by poor or insecure housing, low pay, isolation and prejudice. We aimed to understand the health needs and health service experiences of the Eastern European population in a town in Northern England. Five semi structured one-to-one and small group interviews and five focus groups were conducted with 42 Eastern European participants between June and September 2014. The majority of participants were Polish and other participants were from Belarus, Hungary, Latvia, Russia, Slovakia and Ukraine. The data were analysed using thematic framework analysis. Key findings included a good understanding the UK health service structure and high registration and use of general practice/primary care services. However, overall, there were high levels of dissatisfaction, frustration and distrust in General Practitioners (GP). The majority of participants viewed the GP as unhelpful and dismissive; a barrier to secondary/acute care; reluctant to prescribe antibiotics; and that GPs too often advised them to take paracetamol (acetaminophen) and rest. Overwhelmingly participants had strong opinions about access to primary care and the role of the general practitioners. Although the design of the UK health service was well understood, participants were unhappy with the system of GP as gatekeeper and felt it inferior to the consumer-focused health systems in their country of origin. More work is needed to promote the importance of self-care, reduce antibiotic and medication use, and to increase trust in the GP.

To conduct a 1-year evaluation of James’ Place, a suicidal crisis centre delivering a clinical intervention in a community setting.A case series study, following men entering the service during the...

Contemporary recovery-models of treatment for substance misuse prioritise community-based support systems that focus on developing individuals’ strengths and quality of life. The research project aimed to explore the perceived mechanisms and processes that underpinned support in three abstinence-based recovery communities (RCs) across England. Focus groups and telephone interviews were conducted with 44 individuals. This was to identify self-prioritised outcomes for members and other key factors contributing to the delivery of an effective recovery community. Data were thematically analysed. Along with a number of other key outcomes, the achievement and maintenance of abstinence by participants was considered to be a key indicator of an effective RC. RC processes were also viewed as underpinning the development of recovery capital. The study provides an insight into the processes of RCs and highlights that development and support of recovery capital is an important aspect of service provision and delivery for those in abstinence-based recovery.

Objective The social distancing measures governments implemented in response to the COVID-19 pandemic have had substantial impacts. For some communities, these impacts will be disproportionate, with those communities experiencing inequalities, marginalisation or discrimination facing specific challenges. Lesbian, gay, bisexual, queer and allied (LGBQ+) communities experience a range of well-being inequalities that may have been impacted by the pandemic. The study aimed to assess the comparative impact of the UK’s response to COVID-19 on LGBQ+ communities. Design A mixed-method explanatory sequential study of the general population using a cross-sectional online survey and semistructured interviews. Setting Community, North West of England. Participants Adults aged 18 years and over; 1540 participated in the survey (192, 12%, LGBQ+) with 49 undergoing semistructured interviews (15 LGBQ+) during spring and summer of 2020. Results Survey findings indicated that LGBQ+ people experienced similar positive and negative impacts to the rest of the population, but some negative impacts were more marked among the LGBQ+ community. LGBQ+ participants were more likely to disagree that ‘the government considered the impact on people like you’ when preparing guidance. They were significantly more likely to report being unable to access sufficient food and required medication, eating less healthily, exercising less regularly, experiencing poorer quality sleep and taking more pain medicine than usual. Interview data supported these differences; isolation, being unable to access social networks and concerns about health were commonly discussed by the LGBQ+ participants. Positive impacts, including better work–life balance, were similar across both groups. Conclusions The findings indicate LGBQ+ communities’ wellbeing inequalities have been compounded by the social distancing restrictions, for example, by impacts on social networks increasing loneliness. Preparedness planning for future pandemics should include equality impact assessments for potential interventions.

Background: Social prescribing (SP) is a system‐wide approach to reducing health inequalities through nonclinical healthcare interventions. The aim of this study was to explore the practices undertaken and the opinions held by various stakeholders involved in SP in relation to data collection and information utilisation within and between SP programmes/schemes. Methods: Semistructured interviews were conducted with nine stakeholders involved in SP planning and delivery within the Liverpool City Region (LCR), including SP link workers, service managers and commissioners. A deductive thematic analysis approach was used to analyse the transcripts. Results: Three themes were identified pertaining to quantitative data recording, qualitative data recording and the utilisation of data. The interviews revealed considerable variations in systems and consistency of data collection among stakeholders. While some data were collected via existing outcome measurement tools, their adequacy for use within SP in particular was critiqued. Case studies and qualitative feedback (formal and informal) were more frequently used and were felt to be more effective in capturing impact. Strengths of data sharing included the creation of data intelligence to inform more targeted service provision. Knowledge of national guidance pertaining to SP data collection and outcome recording was lacking. Conclusion: Further research on the acceptability of incorporating further SP‐specific indicators within commissioner reporting systems is needed, including formal acknowledgement of qualitative impact reporting on existing, quantitative health inequality indicators or key performance indicators. However, the burden of this on existing structures needs to be assessed. Support for data linkage arrangements and data recording processes, combined with wider routine outcome data recording, can support a targeted approach to increasing the evidence base for SP’s impact on health and wellbeing.

Research on use of geosocial networking (GSN) applications (e.g. Grindr, Tinder) by sexual minorities has primarily focused on risky behavior and negative health outcomes (e.g. sexually transmitted infections/HIV, drugs, alcohol, violence) among men who have sex with men. Taking a sex-positive approach, this study aimed to understand how sexual minority GSN app users in the UK and USA perceive impacts on their health and how they manage potential risks. Differences between countries and genders are explored. Qualitative, cross-cultural study in Merseyside (UK) and Connecticut (USA). Photo-elicitation (fake dating profiles) was used in semi-structured interviews conducted with app users seeking same gender partners (n = 31; 15 women, and 16 men) in 2018–2019. Participants were recruited through local LGBTQ+ organizations, social media and from a previous survey, within a quota sampling framework. Transcripts were analyzed using reflexive thematic analysis. Perceived positive health impacts included social and romantic/sexual connections, boosts to self-esteem, and pleasurable sexual experiences. Some negative outcomes were reported, mainly by men, including rejection and low self-esteem, and racism and discrimination. Participants of all genders used strategies to reduce risks to health. Women were particularly cautious of men on apps. No differences between UK and the USA were noted. GSN apps can enable positive sexual experiences and have the potential to increase social cohesion and improve mental wellbeing for stigmatized sexual minorities. All participants took measures to protect both their physical safety and mental wellbeing. Using a sex-positive health promotion approach could empower app users to build on their personal strengths and resources. Although GSN app companies may need to do more to tackle discrimination, apps show a promising opportunity for reducing isolation and health inequities. The similarity of the findings in both areas suggests evidence from the USA may be applicable in the UK.