Tushna Vandrevala

Introduction: Underserved communities including ethnic minorities, refugees and migrants, experience higher mental health needs than the general population, yet engage less with cultural and green community assets (CGCAs) that could support wellbeing. While access barriers are known, less is understood about the cultural meanings and processes underpinning inequalities shaping engagement. This study examined the cultural drivers and mechanisms of these inequalities and how they might be addressed to improve mental health. Methods: A multi‐site qualitative study in England with community voice champions (CVCs) recruited through five underserved community organisations. A lived experience storytelling methodology with thematic analysis was used, informed by a theoretical model of cultural processes and causal pathways to inequality. Twelve workshops were held, following which CVCs collected community stories. Results: Twenty‐seven CVCs participated and collected 147 stories. Symbolic, place‐based and material inequalities emerged across three themes: cultural influences on mental health; unknown spaces and unfriendly environments; and creating spaces of safety and belonging. Even when CGCAs were available and known, racial stigmatisation and cultural dissonance reinforced exclusion. Community‐led initiatives, facilitation and peer support helped make CGCAs safer and more welcoming. Conclusions: Engagement with CGCAs is not only about access, but a negotiated process shaped by intertwined inequalities. Nevertheless, these inequalities are not fixed. Community‐led activities grounded in trust and collective action can transform exclusionary environments into inclusive ones to support mental health. Patient or Public Contribution: Community organisation leads contributed to study design, participant recruitment and support, data interpretation, and are co‐authors. CVCs participated in workshops, collected and interpreted data, and validated findings.

Background Understanding proposal evaluation helps explain the science of peer review. This study aimed to identify how experienced reviewers use application information when making funding recommendations. Methods Social judgement theory methods were used to examine experienced peer reviewers’ funding recommendations. The research had three phases. Phases: I) ‘think aloud’ interviews was undertaken by 7 reviewers on a grant proposal they reviewed for the Wellcome Trust’s ‘Research Fellowship in Humanities and Social Sciences’ scheme, to uncover quality factors used: II) 28 expert reviewers identified and ranked the 10 most important quality factors, which were then used to generate a set of 60 fellowship application vignettes using fractional factorial design III) 24 reviewers made funding recommendations individually, on the vignettes. Multiple regression analysis was used to model the weighting given to the factors. Results Fifty-seven quality factors were initially uncovered through the content analysis of the think aloud protocols, and the 10 factors deemed most important in assessing the quality of fellowship applications were identified. Accounting for 92% of the variance, the 24 expert reviewers used all 10 factors in their decision making; the applicant’s publication record was the most significant in terms of funding recommendation, followed by the applicant’s experience and expertise. Reliability of the mean ratings across 22 reviewers’ recommendations was very high: ICC(2,22) = 0.94 (95% CI, 0.915 to 0.96). Conclusions There was high interrater reliability of reviews in this funding scheme. The focus on the candidate’s publication record and experience is likely to be due to the funding scheme being for ‘fellowships’, where the potential development of the individual is central to the award. This information may be used differently when considering ‘project’ funding applications. The Narrative CV has helped widen recognition of research contributions beyond traditional metrics. Findings will support the ongoing development of peer reviewing approaches.

Health literacy is essential for making informed healthcare decisions, yet ethnic minority communities often face disparities due to limited access to culturally relevant information. This qualitative study explores how South Asian and Black communities in the United Kingdom (UK) assess health information credibility, examining cultural influences and expectations. Sixty-eight participants (42 South Asian, 26 Black) were recruited using purposive sampling; data collection involved semi-structured interviews (n = 30) and community observations (n = 38). Findings revealed that cultural expectations shape perceptions of healthcare professionals and health information sources. Trusted sources included personal contacts and social media. Health information lacking personal or culturally relevant content led participants to seek alternative sources. While some credibility-seeking behaviours overlap with those observed in the general population, the unique social, cultural, and historical experiences of these populations shape how and why such behaviours are enacted, resulting in distinct patterns of trust and information use. Providers must recognise these dynamics to create personalised, culturally sensitive resources that enhance trust, health literacy, and equity. Tailored approaches, including trusted intermediaries and relevant communication channels, are crucial, while digital platforms must address misinformation.

Objectives: Despite their higher risk of stroke and known inequities in post-stroke outcomes, research amongst minoritised ethnic communities who have experienced stroke is scarce. This study aimed to explore the experiences of Black people in England and identify implications for supported self-management. Methods: Between December 2023 and June 2024 qualitative interviews were conducted with 20 Black people living with stroke in England. Interviews were conducted in-person or online, depending on participants’ preferences. Data were analysed iteratively using reflexive thematic analysis. Results: Three themes were developed: (1) “My world after stroke” capturing emotional and social identity-related impacts and adjustments; (2)“My support”: Family, Community and Peers, encapsulating different facets of support and the relational nature of self-management; and (3) “Supported self-management as a negotiated partnership with healthcare professionals”, highlighting the varied nature and outcomes of patient-professional interactions and their social embeddedness, including underlying power and historical racial dynamics. Conclusions: Our study confirms the need for closer examination of how supported self-management can be provided to different populations. The post-stroke experiences of the Black people who participated in our study were inextricably shaped by their specific familial, social and cultural settings. Their adaptation to and management of the physical and emotional aspects of their condition was enacted across family systems, community and peer networks as well as healthcare services, with varying outcomes. In addition, their interactions and engagement with healthcare professionals were influenced by a broader historical context of discrimination and racism. Our study reveals the importance of delivering supported self-management to Black people living with stroke which responds to their specific social contexts and intersectional identities and which also strives to reduce power imbalances and address historical discrimination, thereby ensuring ‘cultural safety’ in service provision. Overlooking these aspects risks undermining self-management and underserving those who already face significant health inequities.

Research leadership is central to shaping research culture, advancing institutional excellence, and fostering innovation, yet opportunities for leadership development remain unevenly distributed across disciplines, career stages, and professional roles. Inequalities in access risk reproducing privilege in academic research, raising questions about how programmes can support equitable participation and career progression. This paper examines equality, research culture, and career progression in research leadership development through a comparative case study of two research leadership academies: a university-based academy open to researchers across disciplines (Kingston University Rise Research Leadership Academy) and a national academy for applied health and care research (National Institute for Health and Care Research (NIHR) Research Leadership Academy). The study draws on survey data from six cohorts (2023–2025; n = 464), equality, diversity and inclusion monitoring, and longitudinal follow-up at 12 and 24 months. Findings indicate that while both academies enhanced participants’ self-reported leadership skills, confidence, and strategic collaboration, differences in institutional context and programme design shaped who accessed leadership development, and how learning was applied in practice. Inclusive pedagogies, including action learning sets, mentoring, and flexible online delivery, supported participation across career stages and research roles, particularly for applied researchers. Structural and organisational factors affected leadership gains, highlighting persistent barriers to equitable outcomes. The paper contributes to higher education research by conceptualising research leadership development as an equality issue, showing how institutional and national academies can both mitigate and reproduce inequalities, influence research culture, and shape careers. The findings offer evidence-informed insights for designing more inclusive and sustainable research leadership in higher education.

Objectives: To describe the impact associated with congenital cytomegalovirus (cCMV) infection and experiences and perceptions of people with experience of CMV in pregnancy and families / caregivers of children diagnosed with cCMV, who responded to a UK National Screening Committee (UK NSC) public consultation on cCMV screening. Methods: The public consultation was conducted in 2021-22 on a draft evidence review and was aimed at informing the UK NSC’s decision on newborn screening for cCMV. Data were analysed using framework analysis: a subgroup of responses was inductively coded, codes were refined and initial themes identified, before targeted coding of the remainder of the data and identification of final themes and sub-themes. Results: Of a total 155 responses, 125 (describing 128 pregnancy/child outcomes) contained information relevant to the coding framework and were included. Most (n = 109) described a live birth of a surviving child, of whom 90% (98/109) were living with symptoms or long-term sequelae of cCMV at the time of the response. Two main themes were identified: missed opportunities and emotional impacts attributed by respondents to not screening for cCMV. Many families described delays in their child’s cCMV diagnosis, including due to healthcare professionals’ lack of awareness of cCMV, and viewed newborn screening as a solution to avoid delays in diagnostic pathways. Diagnostic delays resulted in a lasting sense of injustice and unfairness due to possible missed opportunities to improve outcomes (e.g., through antiviral treatment or early therapies), as well as uncertainty and anxiety. Conclusions: Responses were predominantly from parents and caregivers of children with cCMV who experienced long term disability. They highlight significant gaps in awareness, support and health care for affected children that need addressing, regardless of national screening policy decisions. These responses contribute to the literature on lived experiences of individuals and families affected by cCMV.

Background: Black people are twice as likely to experience stroke, more likely to have a stroke younger and have poorer outcomes than White people. Clinical factors and socio-economic status account for only half of the increased risk, suggesting systemic and structural factors are also involved. Lived experience of Black people living with stroke (BPLS) in England is under-researched. Candidacy Theory describes how people access health services, how perceptions of eligibility and suitability are socially constructed, and how this can perpetuate disadvantage. By applying Candidacy Theory to the findings of our qualitative study on the experiences of BPLS in accessing and navigating health services, we identified some key drivers of current inequalities and ways of addressing them. Methods: Our study aimed to gain greater understanding of how BPLS in England engage with and experience healthcare services. We applied Candidacy Theory to gain insight into experiences of and inequalities faced by this community and implications for service provision. 20 semi-structured interviews were conducted with adults living with stroke, identifying as African, Caribbean or of mixed heritage. Purposeful sampling included men and women with a broad range of ages and ethnicities, recruited via community and national organisation gatekeepers. Interviews were analysed using Reflexive Thematic Analysis and mapped onto the Candidacy Theory framework. Results: Findings highlighted the plethora of barriers facing BLPS in accessing services, including lack of knowledge of stroke risk or symptoms, and not being believed or listened to by healthcare professionals. While navigating services, participants encountered misalignment with their cultural and age-specific needs. Offers of services were sometimes rejected due to distrust of medical treatment, stigma associated with mental health support, lack of representation, and previous negative experiences, such as microaggression, stereotyping and racism. Participants suggested that trust-building with healthcare professionals could be impeded by historic negative experiences, further exacerbated where there is poor awareness and communication. Conclusions: BPLS face particular disadvantages and barriers in reducing their stroke risk and accessing health services post-stroke. To address these, a holistic, systemic approach is needed, to develop inclusive and “culturally safe” services, build trust and improve accessibility of services.

Background: Community resilience and health emergency communication are both crucial in promoting a community’s ability to endure crises and recover from emergency events. Yet, a notable gap in theory and evidence exists in the relationship between them. We aim to explore the relationship between community resilience and health emergency communication and to identify strategies and interventions to strengthen their usefulness to each other. Based on the results, a secondary aim was to develop a model of community-centred resilience and health emergency communication. Methods: A systematic review of literature published between January 1990 and February 2024 was undertaken following Joanna Briggs Institute guidelines. Electronic databases (Web of Science, Social Science Citation Index, PubMed/MEDLINE) were searched using key terms. Eligibility criteria were developed from the literature and the knowledge of the multidisciplinary team. Inductive thematic analysis generated key themes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to present the findings. Results: The searches identified 300 articles, of which 86 met the inclusion criteria. Two main themes were identified from the literature: (i) the relationship between emergency communication and community resilience, including subthemes: building trust and collaboration within communities, identifying resources and their distribution, tailoring communication strategies, considering inclusion and equity, and community engagement and feedback and (ii) strategies and interventions, including subthemes: facilitating community structures as channels for communication, respecting personal and private boundaries in health communication, targeting outreach for effective crisis communication, building resilience through training and communication initiatives, and demonstrating commitment to equity and inclusion. Conclusions: There is a small, yet valuable, body of evidence to demonstrate the value of bolstering community-centred resilience for emergency preparedness, response and recovery. The model of community-centred resilience and health emergency communication developed can inform policy, research and practice. Further research is required to develop and test community-centred approaches to enhance inclusive risk communication and equitable recovery.

Background: Vaccination during pregnancy is an important healthcare intervention for safeguarding the health of the mother and their infants. Ethnic disparities in recruitment to vaccine research studies during pregnancy potentially contribute to health inequalities. The aim of the current study was to explore the barriers and enablers influencing the willingness of pregnant women from ethnic minority backgrounds to participate in vaccine research studies. Methods and findings: Semi-structured qualitative online interviews were conducted with 23 pregnant women from diverse ethnic backgrounds in the UK. Interviews were transcribed verbatim, and thematically analysed. Our findings suggest that participants perceived vaccines and vaccine research, in principle, to be beneficial to the individual and to society, and understood the value of vaccination in mitigating severity of disease and protecting the health of mothers and their infants. Apprehension over the safety of vaccination in pregnancy was common and reduced willingness to participate. For those that decided to participate in vaccine trials in pregnancy, this was seen as an act of solidarity, a way to contribute to a collective responsibility for the public health of the community. Personal and community connections and representation—seeing people from their own communities represented in in the recruitment process shapped decisions about vaccine trial participating. Trust and mistrust in health systems, shaped by past experiences of interacting with healthcare professionals were likely to inform whether they would consider participating. Practical considerations such as excessive time commitments related to study procedures, travel and organising childcare were barrier to participation. The level of invasiveness of trial procedures were also a concern, although increased monitoring during the trial was seen as a potential benefit, mitigating some safety concerns. Conclusions: Our study reinforcing previously identified barriers to vaccine participation among pregnant women from diverse ethnic communities. This study underlines the need to develop tailored interventions that focus on fostering trust with the aid of community engagement to understand cultural contexts, establishing authentic representation, and address practical considerations, to contribute to enhancing vaccine trial participation in pregnancy in those from diverse ethnic communities.