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

背景英国的移民妇女在健康和幸福方面经历了不平等，特别是她们怀孕和分娩的经历。来自中欧和东欧的罗姆妇女在其原籍国和整个欧洲遭遇保健障碍，导致缺乏参与保健服务的机会。此外，像其他移民女性一样，她们往往不习惯英国医疗服务的工作方式。语言和文化障碍、种族偏见和歧视也存在，导致产前护理覆盖率较低。本研究旨在解决这一问题，通过与一群妇女共同设计一个可访问的产前护理社区信息资源，通过了解她们对现有产前护理信息的需求和偏好，为不断发展的产前护理信息资源原型提供设计考虑。目的与一组罗姆妇女探讨她们的保健服务经验和关于怀孕和分娩的文化信仰，与她们合作，评估在审查资源后选择的一系列可用的产前信息资源的可及性和可接受性，以探索和讨论各种形式的产前保健信息的备选方案，例如专门迎合她们需要的数字资源，以共同创建满足其需求的社区产前保健信息资源的低分辨率纸质原型。方法1-2月：对罗姆妇女的产妇需求进行范围审查，审查可公开获取的产前信息资源，以产生供妇女考虑3-5个月的选择：与罗姆妇女利用基于设计的参与式方法，举办一系列最多8个2小时的社区参与性讲习班，讨论参与保健和社会护理、家庭补救、怀孕期间的饮食和锻炼、吸烟和酒精的影响以及与怀孕有关的健康问题，以确定她们知识中的问题和差距。通过音频和视频数据收集方法提供了证据途径的说明。6-8个月：定性分析和项目报告撰写，最后是一个利益攸关方参与研讨会，以确定与项目咨询小组的可扩展性，并可能将见解转移到其他被边缘化的新来的移徙妇女群体。成果：(A)与共同设计的产前保健信息资源原型一起提出的设计考虑因素；(B)在更广泛的罗姆人妇女群体中推广、试行和评估的最终设计；(C)采用包容和参与性的最佳做法，可推广到其他被边缘化的移徙社区群体；(E)改善罗姆妇女的围产期和产妇结局。

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.