1. OUR HEALTH, OUR ACTION Tandrusti Research Findings Iram Naz (WEA Project Researcher)

2. Why we did the research? Gather Experiences and Assess needs: To map the health journeys of 50 BME/non BME individuals in Dudley Building Capacity and Sustainability: To develop 25 Community Health Champions Partnership Working: To work with public bodies to reduce health inequalities Sharing and Developing: To evaluate and disseminate the findings to shape future service provision.

3. Research Methods Qualitative Methodology 50 In-depth Semi Structured Interviews Ethical Consideration Constant Comparative Analysis

4. Stratified Random Sample: Representing Tandrusti students

5. HEADLINE FINDINGS

6. Health Attitudes Good Health Absence of Disease Being Older Having Poor Health Health Services Symptom Control Tandrusti aims to challenge these Health Attitudes

7. Health Awareness Difference between health knowledge and health awareness Awareness of personal health developing after diagnosis or threat of disease or illness The need for contextualised and appropriate health information and promotion

8. Accessing health Information Higher Literacy Level = better access to health information Over 65s = poor access to health information GP main source and gatekeepers to other services 90% preferred ‘interactive’ health information to leaflets, books.

9. Disparity in perceived and actual healthiness of diet Awareness of healthy eating is quite good Importance of healthy eating is understood but not practiced Steady cultural shift and education required to change life long habits Food labels are very rarely followed by all groups interviewed

10. Raising motivation and having positive role models Motivation towards exercising with Tandrusti is high Motivation towards a healthy lifestyle was low Lack of positive role models and support Being Healthy= Major changes and a Big Challenge, Tandrusti aims to motivate learners through a supportive health education approach

11. Dispelling subjective interpretations of recommended physical activity How much physical activity should an average adult aged 18 and over do in a week? Answer: 30 Minutes of moderate physical activity 5 times a week (DoH and WHO, 2005)

12. Physical Activity Levels of Sample No. of people in sample

13. Understanding of being physically active <25% of people interviewed were doing ideal or sufficient physical activity Poor understanding of exertion and frequency balance in physical activity Physical activity stereotypes need to be broken

14. Health Service Use No. of Tandrusti Students using services

15. Health Service Use Awareness of services is quite poor, restricting access and outcome. GP is the most widely used service, satisfaction is quite high with GP but low with appointment system Older South Asian patients have low expectations from the health services ‘Veterinary consultations’ if communication is poor between health services and patient

16. Cultural Factors and Health Modest descriptions of personal health by South Asian women issue for large surveys like Census ‘Purdah’ (veiling) a barrier to mainstream physical activity for Muslim women, Tandrusti provides a culturally appropriate service for this group. More younger women coming forward as a result. Tandrusti has broken some cultural myths through mixed gender exercise sessions, swimming classes.

17. Mental Health Physical and mental illness can be intertwined, easier to talk about physical symptoms Poor mental health = Social, emotional dysfunction so unfavourable to be shared outside family Mental health services need to understand intricacies of cultural norms and their impact on attitude and behaviour

18. Tandrusti’s Impact Reduced Blood Pressure readings in over 90% of learners Improved Posture, Stability and Flexibility in learners Awareness of the impact of exercise on the body Improved Self Confidence Emotional support and social networking through grouped exercise Motivation to improve health awareness Challenging cultural norms/stereotypes through mixed gender classes Exercise made fun and less chore like has increased participation Willingness to participate in further community cohesion activities

19. Tandrusti Action Plan based on findings Increasing awareness of recommended Intensity and Frequency of physical activity Physical Activity beyond the Tandrusti class Raising awareness of integrated physical activity (at home/work etc) Signposting to other health/education services (particularly mental health) Learner led physical activity Setting up Additional Classes/ equipment Provision and evaluation of relevant health education/promotion Reinforcement of Key Health Messages through teaching and learning Training and implementation of Community Health Volunteers within Tandrusti.

20. Community Health Volunteers 20 Volunteers recruited and trained from various ethnic backgrounds and age groups Volunteering activities: Walk leading, Initial Assessment in classes, recruiting, motivating and Supporting, Stress Management

21. Recommendations Individuals Community fitness services Health Policy makers, stakeholders and Practitioners

22. Recommendations for Stakeholders 1. Increase awareness of ethnic disparities in health care among the general public, key stakeholders and healthcare providers. 2. Use evidence based practice guidelines; enhance patient provider communication and trust. 3. Ensure adequate resources are allocated to meet the needs of patients likely to suffer health inequality and disadvantage. 4. Provide appropriate interpretation services where community need exists

23. Recommendations.. 5. Ensure health promotion is culturally competent; consider issues of user background, literacy levels, accessibility and the translation and appropriateness of health messages to user lifestyles. 6. Consider incorporating and developing community health workers/ volunteers to support and implement multi-disciplinary treatment and preventative care programmes. 7. Implement patient education programmes to increase patients’ knowledge on how to best access health care and participate in treatment decisions.

24. Recommendations… 8. Integrate cross cultural education into the training of all current and future health professionals. 9. Collect data on healthcare access and utilisation by patients’ ethnicity and socioeconomic status. Report ethnicity data and monitor the progress towards the elimination of health care disparities. 10. Commission research to identify sources of ethnic inequalities, on barriers to tackling inequalities and to assess intervention strategies to reduce inequalities.

25. Thank you