Identifying interventions with Gypsies, Roma and Travellers to promote immunisation uptake: methodological approach and findings

Dyson, Lisa; Bedford, Helen; Condon, Louise; Emslie, Carol; Ireland, Lana; Mytton, Julie; Overend, Karen; Redsell, Sarah; Richardson, Zoe; Jackson, Cath

Abstract

Background
In the UK, Gypsy, Roma and Traveller (GRT) communities are generally considered to be at risk of low or variable immunisation uptake. Many strategies to increase uptake for the general population are relevant for GRT communities, however additional approaches may also be required, and importantly one cannot assume that “one size fits all”. Robust methods are needed to identify content and methods of delivery that are likely to be acceptable, feasible, effective and cost effective. In this paper, we describe the approach taken to identify potential interventions to increase uptake of immunisations in six GRT communities in four UK cities; and present the list of prioritised interventions that emerged.

Methods
This work was conducted in three stages: (1) a modified intervention mapping process to identify ideas for potential interventions; (2) a two-step prioritisation activity at workshops with 51 GRTs and 25 Service Providers to agree a prioritised list of potentially feasible and acceptable interventions for each community; (3) cross-community synthesis to produce a final list of interventions. The theoretical framework underpinning the study was the Social Ecological Model.

Results
Five priority interventions were agreed across communities and Service Providers to improve the uptake of immunisation amongst GRTs who are housed or settled on an authorised site. These interventions are all at the Institutional (e.g. cultural competence training) and Policy (e.g. protected funding) levels of the Social Ecological Model.

Conclusions
The “upstream” nature of the five interventions reinforces the key role of GP practices, frontline workers and wider NHS systems on improving immunisation uptake. All five interventions have potentially broader applicability than GRTs. We believe that their impact would be enhanced if delivered as a combined package. The robust intervention development and co-production methods described could usefully be applied to other communities where poor uptake of immunisation is a concern

Citation

Dyson, L., Bedford, H., Condon, L., Emslie, C., Ireland, L., Mytton, J., Overend, K., Redsell, S., Richardson, Z., & Jackson, C. (2020). Identifying interventions with Gypsies, Roma and Travellers to promote immunisation uptake: methodological approach and findings. BMC Public Health, 20, Article 1574. https://doi.org/10.1186/s12889-020-09614-4

• Journal Article Type: Article
• Acceptance Date: Sep 27, 2020
• Online Publication Date: Oct 20, 2020
• Publication Date: Oct 20, 2020
• Deposit Date: Mar 16, 2021
• Publicly Available Date: Apr 20, 2021
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Article Number: 1574
• DOI: https://doi.org/10.1186/s12889-020-09614-4
• Keywords: Public Health, Environmental and Occupational Health
• Public URL: https://nottingham-repository.worktribe.com/output/5397948
• Publisher URL: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09614-4