Background : The roll out of coronavirus disease 2019 (COVID-19) vaccines are now underway in the UK, and ensuring good uptake in vulnerable communities will be critical to reducing hospital admissions and deaths. There is emerging evidence that vaccine hesitancy is higher in ethnic minorities and deprived areas, and that this may be caused by misinformation in the community. This study aims to understand COVID-19 vaccine hesitancy in an ethnically diverse and deprived population. Methods : Questionnaire surveys were sent to parents in the Born in Bradford study. Cross tabulations explored variation by ethnicity and deprivation. Text from open-ended questions was analysed using thematic analysis. Results : 535 (31%) of 1727 invited between 29 th October-9 th December 2020 participated in the study. 154 (29%) of respondents do want a vaccine, 53 (10%) do not. The majority had not thought about it (N=154, 29%) or were unsure (N=161, 30%). Vaccine hesitancy differed significantly by ethnicity and deprivation: 43% (95% CIs: 37-54%) of White British and 60% (35-81%) in the least deprived areas do want a vaccine, compared to 13% (9-19%) of Pakistani heritage and 20% (15-26%) in the most deprived areas. Those that distrusted the NHS were more likely to not want a vaccine (30%, 15-50%). Reasons for not wanting a vaccine were commonly explained by confusion and distrust caused by prevalent misinformation. Conclusions : There is a much higher level of vaccine hesitancy in ethnic minorities, those living in deprived areas and those that distrust the NHS. There is an urgent need to tackle the overwhelming misinformation about COVID-19 that is leading to this uncertainty and confusion about the vaccines. If not addressed there is a high risk of unequitable roll out of the vaccination programme in the UK.

Green space is beneficial for health, and the co-design of green spaces is vital to allow community input into their development and encourage their use. However, to date there is limited evidence about the most effective ways to ensure the co-design, maintenance and ownership of green spaces by communities over time. Participatory methods such as transect walks with photovoice offer an opportunity to explore these issues. This study describes an original participatory project in a deprived, multi-ethnic part of Bradford, UK, which aims to use innovative participatory methods to explore how the maintenance, co-design and ownership of green spaces affect their use for health benefits. Participatory methods will be used to explore local community perceptions of and satisfaction with their local green spaces. Three phases of data collection will be conducted in a longitudinal qualitative study spanning 3 years. Each phase will use transect walks with photovoice and semi-structured interviews (n= 24), and focus groups (participant n=40) in four green space locations in Bradford, UK.

This study aims to understand the experience and impact of the initial COVID-19 lockdown in young families with children aged below 4 years. Free text questions were administered to participants in the ORIGINS (Australia) and Born in Bradford (UK) cohort studies to collect qualitative information on worries, concerns and enjoyable experiences during the pandemic. A total of 903 (400 for ORIGINS and 503 for BiB) participants completed the two surveys during April 2020. Despite varying in geography, levels of socio-economic disadvantage and their situational context during the pandemic, respondents from both cohorts reported similar worries and challenges during the lockdown period, including: employment/finances, health anxiety, mental health and social isolation, caring for children and child development. Families across the globe experienced both positive and negative immediate impacts of COVID-19. Population-based data can be used to inform the development of support services, public health campaigns and universal interventions to assist families in future health crises.

Background : The roll out of coronavirus disease 2019 (COVID-19) vaccines are underway in the UK, and ensuring good uptake in vulnerable communities will be critical to reducing hospital admissions and deaths. There is emerging evidence that vaccine hesitancy is higher in ethnic minorities and deprived areas, and that this may be caused by distrust and misinformation in the community. This study aims to understand COVID-19 vaccine hesitancy in an ethnically diverse and deprived population of Bradford through the Born in Bradford (BiB) research programme. Methods : Surveys were sent to parents in BiB who had taken part in a previous Covid-19 survey (n=1727). Cross tabulations explored variation by ethnicity and deprivation. Answers to a question asking the main reason for hesitancy was analysed using thematic analysis. Results : 535 (31%) of those invited between 29 th October-9 th December 2020 participated. 48% were White British, 37% Pakistani heritage and 15% from other ethnicities; 46% were from the most deprived quintile of the Index of Multiple Deprivation. 29% of respondents do want a vaccine, 10% do not. The majority had not thought about it (29%) or were unsure (30%). Vaccine hesitancy differed by ethnicity and deprivation: 43% (95% CIs: 37-54%) of White British and 60% (35-81%) in the least deprived areas do want a vaccine, compared to 13% (9-19%) of Pakistani heritage and 20% (15-26%) in the most deprived areas. Reasons for not wanting a vaccine were commonly explained by confusion and distrust which was linked to exposure to misinformation. Conclusions : There is a risk of unequitable roll out of the vaccination programme in the UK with higher vaccine hesitancy in ethnic minorities and those living in deprived areas. There is an urgent need to tackle misinformation that is leading to uncertainty and confusion about the vaccines.

Background: Positive parent infant relationships are key to achieving long term child outcomes. Identifying parents who may need support is difficult because of a lack of robust assessment tools. Working in partnership with health services we piloted the Maternal Postnatal Attachment Scale (MPAS) in a deprived, multi-ethnic urban community in Bradford, UK. The pilot aimed to assess the clinical utility of MPAS to identify need for support: Was it administered to a representative group of women? Is MPAS valid for this population? Methods: Data were linked to a cohort study in the pilot area (Born in Bradford’s Better Start - BiBBS). Chi Square tests assessed sample representativeness (age, ethnicity, parity, English language, education, deprivation). Exploratory factor analysis explored MPAS’ validity. Results: 563 women in BiBBS were eligible, 210 (37%) completed MPAS. No differences were found between completers and non-completers, suggestive of a representative sample. In total, 336 women completed MPAS in the pilot. MPAS had ceiling effects and a satisfactory factor structure could not be identified, indicating poor psychometric properties Conclusions: Health visitors were successful in administering MPAS to a representative sample, but poor psychometric robustness indicates that MPAS is unsuitable for routine use in this setting. A gap for such a measure remains.

Background The COVID-19 pandemic led to a multitude of immediate social restrictions for many across the world. In the UK, the lives of children and young people were quickly impacted when COVID-19 restrictions led to school closures for most children and restrictions on social interactions. The Born in Bradford COVID-19 longitudinal research study explored the impact of the COVID-19 pandemic on the lives of children and their families living in Bradford. Methods Surveys were administered during the first wave of the pandemic (March to June 2020) and compared to findings from before the pandemic. The current study examined the social and emotional wellbeing of children from before to during the pandemic, measured using the parent completed Strengths and Difficulties questionnaire (SDQ). Regression analyses looked at associations between a range of social determinants of health and changes in SDQ scores. Results The results showed that those children most likely to experience difficulties during the pandemic were boys, younger children, those from White British ethnicity (compared to Pakistani heritage children) and those living in the most deprived areas. There were associations between experiencing difficulties and: food insecurity; financial worry; getting below recommended levels of physical activity; and having less than the recommended amount of sleep. Conclusions The effect of COVID-19 restrictions are likely to have had negative consequences on children that could, in time, have long-lasting impacts on the health, wellbeing and development of children in the UK.