Kristin Hanson

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.

BackgroundResearch has consistently identified the tendency of minority ethnic groups to more strongly endorse universal conspiracy theories (where the general public is targeted) as well as ingroup conspiratorial beliefs (where one’s ethnic group is specifically targeted). However, the two types of conspiratorial beliefs have been studied in isolation, and thus their relationship remains unknown. MethodsAcross two studies, we assessed both universal and ingroup conspiratorial beliefs in an ethnically diverse sample from the United Kingdom (n = 900 across Black, South Asian, and white ethnic/racial groups) and United States (n = 900 across Black, Hispanic, and White ethnic/racial groups). Moreover, we explored institutional trust, lack of group recognition, and discrimination as potential predictors of ingroup conspiratorial beliefs.ResultsOur results indicate that ethnic minority groups’ greater support for universal conspiratorial beliefs emerges fully from their support for ingroup conspiracy theories. Further, lack of group recognition, but not institutional trust nor discrimination, predicted ingroup conspiratorial beliefs.ConclusionsInterventions aimed at decreasing conspiratorial beliefs as a barrier to health-protective behaviours in ethnic communities should focus on measures that address ingroup, rather than universal, conspiratorial belief.

Objective: Local authority-led online campaigns offer the possibility of targeted health promotion to connect local services and residents. This study assesses the evidence for medium (e.g., click-trhoughs) and high (off-line behaviour change) levels of public engagement with four local authority-led campaigns across a variety of public health promotions (sexual health, weight loss, and vaccination), online marketing approaches (social media marketing, search engine marketing, and programmatic marketing) and target demographics (language, gender, age, income, ethnicity) undertaken by a London borough local authority. Methods: Employing quasi-experimental and observational study designs, engagement with local health services during the course of the campaigns was evaluated. The first three campaigns were evaluated based on an interrupted time series model of intervention assessment comparing outcome variables of interest during the campaign to periods before and after the campaign period. The results of the fourth campaign, an observational case-study, are discussed using descriptive statistics only. Results: The analyses of the high engagement data for two of the three campaigns statistically assessed clearly supported the effectiveness of the campaigns. While the effect of high engagement could not be determined in the other two campaigns, they provide data that may be useful in online campaign design. Conclusions: The evidence assessed in this study across a variety of platforms, health promotion initiatives, and population targets suggests that local authority-led online marketing campaigns for health promotion may be useful for increasing participation in public health programmes.

In national elections, national identity is a great mobiliser of the electorate and candidates strive to cast themselves as embodiments of the nation. Like many conservative parties throughout the world, the Republican party in the United States has an advantage in simplicity through offering a national identity aligned with symbolism, history, and the status quo. National identity on the political left is less clearly understood. This study investigates the rhetoric of American national identity within the Democratic party elite. A qualitative and lexical analysis of speeches from the 2020 Presidential Democratic primary campaign are analysed to identify how national identity is represented and the extent to which this varies across the ideological spectrum within the party. We find differences between party progressives and moderates that may contribute to the challenge of presenting a coherent proposition of American national identity on the political left. Candidates differed as to i) whether change to the country should be through revolution or evolution, ii) the values identified as important to the nation, and iii) the extent to which candidates discussed the country as a symbolic group or a collection of individuals. Implications are discussed for the Democratic and other left of centre parties worldwide.

Objectives: Conspiracy theories are associated with significant COVID‐19 health consequences including lower engagement with protective behaviours. This study uses sensemaking theory, a process of constructing meanings through interpersonal exchanges that enable people to interpret their world to explain the theoretical process underlying the development of conspiratorial beliefs around COVID‐19 within Black African and Caribbean communities in the UK. Design: Qualitative, in‐depth interviews were used. Methods: Twenty‐eight members of the communities were recruited: semi‐structured interviews were analysed using grounded theory. Results: Our findings provide an explanation of how an environment of crisis combined with current and historical mistrust, perceived injustice and inequality provided a context in which alternative conspiracy narratives could thrive. The nature of these conspiratorial beliefs made more sense to many of our respondent's than institutional sources (such as the UK Government). Critically, these alternative beliefs helped respondents shape their decision‐making, leading to non‐engagement with COVID protective behaviours. Conclusions: We conclude that the uncertainty of the pandemic, combined with historical and contemporary perceived injustice and mistrust, and a lack of specific identity‐aligned messaging, created a perfect environment for conspiratorial sense‐making to thrive. This alternative sensemaking was inconsistent with the health‐protection messaging espoused by the Government. To ensure all groups in society are protected, and for health promotion messages to take purchase, the experiences of different target audiences must be taken into account, with sensemaking anchored in lived experience.

Objectives Conspiracy theories are associated with significant COVID-19 health consequences including lower engagement with protective behaviours. This study uses sensemaking theory, a process of constructing meanings through interpersonal exchanges that enable people to interpret their world to explain the theoretical process underlying the development of conspiratorial beliefs around COVID-19 within Black African and Caribbean communities in the UK. Design Qualitative, in-depth interviews were used. Methods Twenty-eight members of the communities were recruited; semi-structured interviews were analysed using grounded theory. Results Our findings provide an explanation of how an environment of crisis combined with current and historical mistrust, perceived injustice and inequality provided a context in which alternative conspiracy narratives could thrive. The nature of these conspiratorial beliefs made more sense to many of our respondent’s than institutional sources (such as the UK Government). Critically, these alternative beliefs helped respondents shape their decision-making, leading to non-engagement with COVID protective behaviours. Conclusions We conclude that the uncertainty of the pandemic, combined with historical and contemporary perceived injustice and mistrust, and a lack of specific identity-aligned messaging, created a perfect environment for conspiratorial sense-making to thrive. This alternative sensemaking was inconsistent with the health-protection messaging espoused by Government. To ensure all groups in society are protected, and for health promotion messages to take purchase, the experiences of different target audiences must be taken into account, with sensemaking anchored in lived experience.

The recognition and representation of BAME community as ‘high risk’ of Covid-19 in the UK presents both a health and an identity threat to this ethnic group. This study employed thematic analysis to explore response to these threats as related by a sample of 13 middle class members of the South Asian community. This work advances both health and identity psychological theory by recognising the affinity between expressions of health efficacy and identity. Our findings identify South Asian intragroup stigmatisation and commonalities that have implications for the promotion of health behaviour and health communications for minority groups.

The recognition and representation of BAME community as “high risk” of Covid-19 in the UK presents both a health and an identity threat to this ethnic group. This study employed thematic analysis to explore response to these threats as related by a sample of thirteen middle class members of the South Asian community. This work advances both health and identity psychological theory by recognising the affinity between expressions of health efficacy and identity. Our findings identify South Asian intragroup stigmatisation and commonalities that have implications for the promotion of health behaviour and health communications for minority groups.