“It’s possibly made us feel a little more alienated”: How people from ethnic minority communities conceptualise COVID-19 and its influence on engagement with testing

Abstract

Objectives:The cultural beliefs, practices and experiences of ethnic minority groups, alongside structural inequalities and the political economy play a critical, but overlooked role in health promotion. The current study aims to address this deficit, understanding how these groups conceptualise COVID–19, and how this influences engagement in testing, with the future aim of developing targeted communications to address the challenges of testing uptake. Method:Black (African and Caribbean) and South (Asian Indian, Pakistani and Bangladeshi) community members were purposefully recruited across the UK. Fifty seven semi–structured interviews were conducted and analysed using principles of Grounded Theory. Results:The findings illustrate that Black and South Asians conceptualise COVID–19 as a disease that makes them visible to others outside their community, in having more severe risk and suffering worst consequences, resulting in fear, stigmatisation and alienation. Views about COVID-19 were embedded in cultural beliefs, relating to culturally specific ideas around disease, such as ill-health being the will of God. Challenges brought about by the pandemic were conceptualised as one of many struggles, with the saliency of the virus contextualised against life experiences. These themes and others influenced engagement with COVID–19 testing. Testing was less about accessing timely and effective treatment for themselves, and more about acting to protect the family and community. Testing symbolised a loss of income, anxiety and isolation, accentuated by issues of mistrust of the system, and not being valued, or being treated unfairly. Conclusion:In tackling these challenges, we conclude that health communications should focus on counterbalancing the mistrust, alienation and stigmatisation that act as barriers to testing, with trust built using local credible sources.

The use of social media platforms by migrant and ethnic minority populations during the COVID-19 pandemic: a systematic review

“…Robust interventions relying on behavioural science to tackle misinformation using social media and evaluations are a plausible next step to address immunisation challenges for COVID-19 vaccines but also routine vaccines. Building trust in public health messaging, identifying information gaps, finding innovate ways of disseminating health information, and detecting and responding to misinformation as it emerges remain a priority for public health 66 67 .…”

Behavioural responses to Covid-19 health certification: a rapid review

“…Evidence from both testing and vaccination suggests that increased inequalities would be a possible harm of health certification. Participation in NHS Test & Trace is lower in marginalised groups [71,72] and in areas of high deprivation [73]. The Liverpool mass testing pilot found that uptake in the most deprived areas (16.8%) was half that in the least deprived areas (33.4%) [74].…”

“…Data from the UK and other countries suggest that those with lower incomes or education and from minority ethnic groups have lower intentions to undergo COVID-19 vaccination than others [75][76][77]. In part these differences in testing and vaccination uptake reflect higher mistrust in government amongst marginalised communities [71,[78][79][80]. Stigmatisation, discrimination and racism might also reduce migrants' and ethnic minority communities' willingness to come forward [71].…”

“…In part these differences in testing and vaccination uptake reflect higher mistrust in government amongst marginalised communities [71,[78][79][80]. Stigmatisation, discrimination and racism might also reduce migrants' and ethnic minority communities' willingness to come forward [71]. In addition, certification will likely be most readily available as a digital record, which has the potential to exclude those without access to electronic platforms [72].…”

Unpacking COVID-19 and Conspiracy Theories in the UK Black Community

“…More specifically, we aim to develop a theory explaining the relationship between the development of conspiratorial beliefs around COVID-19 and such behaviours. Understanding this relationship and the development and nature of conspiracy beliefs is important for practitioners who are striving to communicate and create interventions to promote COVID health protective behaviours; such as vaccination up-take and testing, which has been lower in Britain’s Black community compared to other minority ethnic groups (Office for National Statistics, 2021; Vandrevala et al, 2022).…”