Studies demonstrate ethnic variations in pathways to care during first episode psychosis (FEP). There are no extant studies, however, that have statistically examined the influence of culturally mediated illness attributions on these variations. We conducted an observational study of 123 (45 White; 35 Black; 43 Asian) patients recruited over a two-year period from an Early Intervention Service (EIS) in Birmingham, UK. Sociodemographic factors (age; sex; education; country of birth; religious practice; marital status; living alone), duration of untreated psychosis (DUP), service contacts (general practitioner; emergency services; faith-based; compulsory detention; criminal justice) and illness attributions (“individual;” “natural;” “social;” “supernatural;” “no attribution”) were assessed. Ethnic groups did not differ in DUP (p = 0.86). Asian patients were more likely to report supernatural illness attributions in comparison to White (Odds Ratio: 4.02; 95 % Confidence Intervals: 1.52, 10.62) and Black (OR: 3.48; 95 % CI: 1.25, 9.67) patients. In logistic regressions controlling for confounders and illness attributions, Black (OR: 14.00; 95 % CI: 1.30, 151.11) and Asian (OR: 13.29; 95 % CI: 1.26, 140.47) patients were more likely to consult faith-based institutions than White patients. Black patients were more likely to be compulsorily detained than White patients (OR: 4.56; 95 % CI: 1.40, 14.85). Illness attributions and sociodemographic confounders do not fully explain the ethnic tendency to seek out faith-based institutions. While Asian and Black patients are more likely to seek help from faith-based organisations, this does not appear to lead to a delay in contact with mental health services.

This paper describes the process, impact and outcomes of an innovative health policy project entitled Gym for Free in Birmingham, UK. To explore the short-term effectiveness of the pilot scheme in relation to access, utilisation, perceived benefits and sustainability. Cross-sectional study using survey and focus group interviews. Community-based physical activity intervention programme. Data were collected using a validated questionnaire (n = 257) and focus group interviews (n = 9). Descriptive and inferential analyses were conducted where appropriate. Focus group interviews were recorded, transcribed and analysed thematically. Findings showed that the pilot scheme increased the uptake of exercise particularly for women in an economically deprived inner city area. The use of leisure facilities also increased markedly (p < .05). Thus, the Gym for Free scheme was a step towards addressing health inequality by increasing access to and widening participation in exercise with multiple physical, mental and emotional benefits. Based on the findings of this pilot research project, Gym for Free won numerous national awards for its policy innovation, and, through the support and advocacy of the research team, was extended so as to be available to the whole population of Birmingham, between 9 a.m. and 5 p.m., 7 days a week.

This paper examines the views and experiences of using and providing mental health services from the perspectives of black African and black African Caribbean mental health service users, their carers, voluntary services and a range of statutory mental health professionals and commissioners in Birmingham, UK. Using a qualitative approach, data were collected through telephone interviews (n = 15), individual face-to-face (n = 20) and focus group interviews (n = 12), and analysed using Krueger's framework and Rabiee's guidelines. Findings showed differences in the experiences of mental health services amongst African Caribbean and their African counterparts, the impact of social inequality on mental health and the needs of asylum seekers and refugees. It highlighted the important role of voluntary organizations in provision of care and support, insufficient provision of psychological therapies and concerns about high dosage of medication. The implications for practice are discussed, particularly the role of health beliefs in help-seeking behaviour and barriers to accessibility of mental health services.

Background: Public health measures such as physical distancing and distance learning have been implemented during the COVID-19 pandemic. COVID-19 related knowledge deficit can increase fear that leads to negative mental health and COVID-19, especially among adolescents. Therefore, our study aimed to assess COVID-19 related knowledge deficit and its association with fear among higher education (HE) students during the first wave of COVID-19. Methods: A cross-sectional survey, COVID-19 International Students Well-being Study (C-19 ISWS) was conducted in 133 Higher Education Institutions (HEIs) in 26 countries between April 27 and July 7, 2020. A stratified convenience sampling technique was used. Descriptive, bivariate, mixed-effect logistic regression analyses were conducted using R software. Results: Out of 127,362 respondents, 72.1% were female, and 76.5% did not report a previous history of confirmed COVID-19. The majority of those without the previous infection 81,645 (83.7%) were from 21 European countries while the rest 15,850 (16.3%) were from 5 non-European countries. The most frequent correct response to COVID-19 related knowledge questions among respondents was having the virus without having symptoms (94.3%). Compared to participants with good knowledge, the odds of being afraid of acquiring SARS-COV-2 infection among those with poor knowledge was 1.05 (95%CI:1.03,1.08) and the odds of being afraid of contracting severe COVID-19 was 1.36 (95%CI:1.31,1.40). Conclusion: COVID-19 related knowledge was independently associated with both fear of acquiring SARS-COV-2 infection as well as contracting severe COVID-19. Our findings will serve as a basis for public health response for both the current and similar future pandemics by highlighting the need for addressing the COVID-19 knowledge deficit to fight the infodemic and prevent negative mental health outcomes.

A cross sectional study design was used based on 2 questionnaires; Rosenmoller et al’s and the WHO STEPS surveillance tool for chronic disease surveillance. Data on length of residency, dietary patterns, anthropometric and biochemical measurements were collected by trained interviewers. Descriptive statistics were reported as a percentage or mean, as appropriate. Chi-square test, Fisher’s exact test or independent t test, Univariate and Multivariate logistic regression analysis were used to compare the significance between variables. Both male and female participants showed a similar mean age (39.7 and 38.5 years). Approximately 61% of them had <5 year’s duration of residency. Significant gender differences were observed in blood pressure and biochemical measurements, with men showing higher mean systolic and diastolic blood pressure and dyslipidemia than women (P < .001). Women had significantly higher BMI (P < .001), showed higher mean food practice (P < .001) and awareness scores than men. Migration into Saudi Arabia from this subgroup showed marked changes in the food practice; acquisition of unhealthy dietary practices also co-existed despite improved awareness and the presence of comorbidities. Findings from this study have relevance to other migrant communities and public health policy.

This study assessed the impact of the first wave of the COVID-19 pandemic on well-being by measuring the changes to food security, dietary behaviour, and sleeping patterns of university staff in England, Poland, Saudi Arabia, and China. Using a cross-sectional study design, participants in four universities in the respective countries were surveyed between June and July 2020. The mean age of the 902 participants was 42 years old and 67% were female. The findings indicate a reduction in emotionally driven food behaviour [t (901.00) = −20.87, p < 0.001], food acquisition location [t (901.00) = −51.55, p < 0.001], skipping meals [t (901.00) = −24, p < 0.001], and consumption of canned fruit and vegetables [t (901.00) = −10.18, p < 0.001]. However, home cooking [t (901.00) = 36.61, p < 0.001] and the food shopping experience [t (901.00) = 4.53, p < 0.001] markedly increased during lockdown. The participants had higher levels of well-being during the pandemic and experienced a significant increase in sleeping hours (p < 0.001). Increased age and sleeping hours were positively associated with overall well-being. Conversely, emotionally driven food behaviour (i.e., buying and eating more food out of boredom/fear or anxiety) and skipping meals decreased the overall well-being. Lockdown had beneficial effects on dietary behaviours, sleeping patterns, and well-being, but there were variations between countries.