Background: The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion: The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary: Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.

People have been coming to the UK since the beginning of recorded time.1 The latest Census shows that England and Wales have become more ethnically diverse with the majority of individuals still identifying themselves as white British (80.6%).2 Over the past two decades, as a result of economic and political changes, migration patterns into the UK have shifted from postcolonial migration particularly referring to relatively discreet communities from the Indian sub-continent and West Indies settling in the UK, to a new type of migration with many different people arriving from many different places. This shift in pattern has resulted in a new kind of diversity which Vertovec3 has coined ‘super-diversity’ characterised by overlapping variables including country of origin (ethnicity, language, religious tradition, regional and/or local identities), migration experience (influenced by sex, age, education, specific social networks, economic factors), and legal status (encompassing a variety of entitlements and restrictions). Thus ethnic and cultural diversity is becoming more complex. While diversity has many benefits for the economy, science, and culture, it also presents health services and research with the challenges of meeting the needs of a population that is super-diverse in terms of their health profiles and behaviour.4 …

Over the last decade, patient and public involvement (PPI) has become a requisite in applied health research. Some funding bodies demand explicit evidence of PPI, while others have made a commitment to developing PPI in the projects they fund. Despite being commonplace, there remains a dearth of engagement with the ethical and theoretical underpinnings of PPI processes and practices. More specifically, while there is a small (but growing) body of literature examining the effectiveness and impact of PPI, there has been relatively little reflection on whether the concept/practice of PPI is internally coherent. Here, the authors unpick a ‘paradox’ within PPI, which highlights a tension between its moral and pragmatic motivations and its implementation. The authors argue that this ‘professionalisation paradox’ means we need to rethink the practice, and purpose, of PPI in research.

Increasing recognition of autism in Somali migrant communities means that appropriate support services are needed. Attitudes to autism and barriers related to help-seeking in these communities are poorly understood. We aimed to assess what families affected by autism need, and how health, education and social care services can support them. In partnership with the local Somali community the research team conducted 15 in-depth interviews with parents affected by autism. Two themes are reported; ‘Perceptions of Autism’ and ‘Navigating the System’. Our research shows the importance of understanding cultural views of autism and the need to raise awareness, reduce stigma and provide support to encourage families not to delay seeking help for their children.

Objectives: Social stigma is commonly experienced by parents of children with autism. Our aim was to understand the nature of stigma experienced by Somali parents of children with autism in the United Kingdom (UK), and to consider how they coped with or resisted such stigma. Design: We used a community-based participatory research approach, collaborating with a community organisation of Somali parents. In-depth interviews with simultaneous translation were conducted with 15 Somali parents of children with autism living in Bristol, UK, in 2015. Parents were sampled purposively to capture diversity in children’s age, severity of autism and time since diagnosis. Directed thematic analysis used Link and Phelan’s model of stigma. Results: Of the 15 participants, 12 were mothers (mean age 36). The 17 children with autism they cared for were 4–13 years’ old, and five were girls. Two main themes with sub-themes were identified: the nature of stigma (labelling and stereotyping; separation; emotional reactions, discrimination and power), and coping and resistance (the power of language; faith as a resource; learning, peer support and community relationships). Children with autism were labelled and stereotyped (e.g. as ‘sick’, ‘naughty’, ‘different’) and parents blamed for not controlling them, leading to social rejection and isolation. Stigma was associated with a poor understanding of autism, a lack of vocabulary related to autism in the Somali community, and prejudice against mental illness and disability. There was evidence of enacted and felt stigma and examples of discrimination. Finding their own language to describe their child’s condition and drawing on faith, learning and peer support were important resources in resisting stigma. Conclusions: Findings inform support for this community, highlighting the need to raise awareness of autism, enable parents to speak openly, and ensure appropriate professional services and interventions are available.