Co-production of 'Health Connections' - a community-based diet, physical activity, and healthy weight intervention for UK Black and Asian adults

有什么问题吗？目前的健康沟通和行为改变方案不支持英国黑人和亚洲人口做出更健康的饮食和体育活动（PA）选择，并保持更健康的体重。为了开发这个项目，我们与加勒比黑人、非洲黑人和南亚的男女以及卫生从业人员进行了交谈。在这些对话中，人们分享了他们非常积极地改善他们的饮食和PA行为，以预防严重的健康问题，如2型糖尿病。然而，一些人也告诉我们，担心或经历种族主义，以及时间和费用等其他障碍，使他们无法参加健康的生活方式方案。有人认为，现有的服务对黑人和亚洲人缺乏相关性，而且沟通不畅。当被问及对他们来说，改变健康行为的理想帮助是什么时，共同的意见是由同一族裔群体和相似生活经历的工作人员提供心理健康支持服务。他们还强调了能够继续吃传统食物的重要性，以及跳舞或散步是受欢迎的活动。如果需要的话，减肥被认为是一件自然发生的事情，只要能保持健康的习惯。在方案实施方面，有代表指出，需要低成本和灵活的会议，并优先考虑社区而不是医疗环境。我们还查看了现有的已发表的研究，虽然有一些研究是关于什么有助于和阻碍黑人和南亚族裔群体的健康行为，但很少有研究开发和测试适合这些群体的干预措施。如何解决这个问题？我们成立了一个由研究人员、公众、慈善机构、卫生专业人员和决策者组成的小组。我们的共同目标是共同设计“健康联系”，这是一种针对加勒比黑人、非洲黑人和南亚男性和女性的需求量身定制的新干预措施，以社区为基础，由社区教育工作者在卫生专业人员的支持下提供。我们将研究如何将文化敏感的宣传活动和心理健康支持纳入干预方案，以改善饮食和PA选择，并促进健康体重。我们还将研究如何培训卫生专业人员的文化能力（能够从其他文化的人的角度看问题），以便改善卫生专业人员和社区教育工作者之间的伙伴关系。在整个项目中，每两个月将举行一次会议和其他活动，如问卷调查和研讨会，并为来自公众的小组成员提供支持会议，以确保所有观点都得到代表。我们将对不同种族的男性和女性进行访谈，了解他们的经历、意见和干预需求，并补充我们现有的数据。调查结果将在一份简明的英语报告中进行总结。我们还将收集现有干预资源（如适应文化的食谱）和当地实践的例子。根据收集到的信息，我们将列出可能的项目会议、内容以及如何举办。项目组将完成关于清单的问卷调查，并在研讨会上讨论结果，以达成最佳想法的一致意见。我们将制作课程内容的示例（例如食谱卡和练习视频），我们将在英国利兹举行社区活动，看看公众对这些想法和材料的看法。最后阶段将是编写一份手册，记录干预措施，并在出版物，演示文稿和信息图表中分享项目发现。这些发现将成为规划下一阶段研究的基础，下一阶段研究将进行一项试验，以测试新设计的干预措施是否可以在黑人和南亚成年人中实施并被接受。

What is the problem? Current health communication and behaviour change programmes do not support UK Black and Asian populations in making healthier dietary and physical activity (PA) choices, and maintaining a healthier weight. We talked to Black Caribbean, Black African and South Asian women and men and to health practitioners to develop this project. In these conversations people shared that they are very motivated to improve their diet and PA behaviours to prevent serious health conditions such as type 2 diabetes. However, some also told us that worrying about or experiencing racism, and other barriers such as time and expense, stopped them from taking part in healthy lifestyle programmes. It was felt that existing services lacked relevance for Black and Asian people and were poorly communicated. When asked what ideal help with health behaviour change would look like to them, services with mental health support delivered by staff of the same ethnic group and similar lived experience were common opinions. The importance of being able to keep eating their traditional foods, and that dancing or walking were popular activities, was also emphasised. Weight loss, if needed, was seen as something that happened naturally, if healthy habits could be maintained. In terms of programme delivery, the need for low cost and flexible sessions, and a preference for community rather than medical settings, was stated. We also looked at existing published research and while there are some studies on what helps and hinders healthy behaviours among Black and South Asian ethnic groups, there has been very little research developing and testing interventions suitable for these groups. How will the problem be addressed? We have formed a group made up of researchers, members of the public, charities, health professionals, and policy makers. Together we aim to co-design 'Health Connections'- a new intervention tailored to the needs of Black Caribbean, Black African and South Asian men and women, based in communities and delivered by community educators supported by health professionals. We will look at how a culturally sensitive communication campaign and mental health support can be included in an intervention programme to improve diet and PA choices, and promote healthy weight. We will also examine how health professionals can be trained in cultural competency (being able to see things from the point of view of people from other cultures), so that partnerships between health professionals and community educators are improved. Throughout the project there will be meetings every two months and other activities such as questionnaires and a workshop, and support meetings for group members from the public, to make sure all views are represented. We will conduct interviews with men and women from diverse ethnic groups to understand their experiences, opinions and intervention needs, adding to our existing data. Findings will be summarised in a plain English report. We will also gather examples of existing intervention resources (such as culturally adapted recipes) and local practice. Based on the information gathered, we will make a list of potential programme sessions, their content, and how they will be delivered. The project group will complete questionnaires regarding the list, and discuss the results in a workshop to come to an agreement on the best ideas. Examples of session content (e.g. recipe cards and exercise videos) will be made and we will hold a community event in Leeds, UK, to see what the public think of the ideas and materials. The final stage will be to write a manual documenting the intervention and to share the project findings in publications, presentations, and an infographic. The findings will then be the basis of planning the next phase of research, which will be to carry out a trial to test whether the newly designed intervention can be carried out and is acceptable among Black and South Asian adults.