Engaging Roma women in the co-design of an antenatal care information resource (ERicar)

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Background Migrant women in the UK experience inequalities in health and wellbeing and in particular, their experiences of pregnancy and childbirth. Roma women from Central and Eastern Europe suffer barriers to healthcare in their original countries and across Europe contributing to a lack of engagement with health services. Further, like other migrant women, they are often unaccustomed to the way health services work in the UK. Language and cultural barriers, racial bias and discrimination also exist, leading to low uptake of antenatal care. This study aims to address this issue by creating a co-designed accessible antenatal care community information resource with a group of these women, through understanding their needs and preferences regarding existing antenatal care information, to inform design considerations for an evolving prototype of an antenatal care information resource. Objectives To explore with a group of Roma women, their experiences of healthcare services and cultural beliefs about pregnancy and childbirth To work with them to assess the accessibility and acceptability of a range of available antenatal information resources selected following a review of resources To explore and discuss options for forms of antenatal care information for example digital resources catering specifically to their needs To co-create a low-resolution paper prototype of a community-based antenatal care information resource that meets their needs Methods Months 1-2: Scoping review on Roma women's maternity needs, and?review of publicly accessible antenatal information resources to produce a selection for the women to consider Months 3-5: A series of up to eight 2-hour community participatory workshops using design-based participatory methods with Roma women will discuss engagement with health and social care, home remedies, diet and exercise during pregnancy, the effects of smoking and alcohol, and pregnancy-related health problems, to identify issues and gaps in their knowledge. An account of the evidence pathway is provided through audio and visual data collection methods. Months 6-8: Qualitative analysis and project report writing, culminating in a stakeholder engagement workshop, to determine scalability with project advisory group, with potential transferable insights to other marginalised newly arrived groups of migrant women. Outcomes: a) design considerations presented alongside the co-designed prototype for an antenatal care information resource, b) final design to be scaled up, piloted and evaluated with the wider Roma community of women, c) an inclusive and participatory approach for best practice that can be replicated with other marginalised groups of migrant communities, e) improved perinatal and maternal outcomes for Roma women.