Alison Hipwell, Andy Turner, Julie Barlow
Deaths from long-term health conditions (LTHCs) are set to escalate rapidly worldwide over the coming decade. Many people from South Asian (SA) backgrounds in the UK face a heightened risk of such conditions, as they already experience severe health inequalities compared with the majority population, including a raised prevalence of many LTHCs. To address these issues, the World Health Organization advocates the use of psycho-educational selfmanagement interventions, to empower people with LTHCs to improve their everyday management of the condition. In England andWales, pairs of trained volunteer lay tutors deliver one such intervention, the Expert Patients Programme (EPP). However, few people fromSA backgrounds attended the pilot phase of the EPP, raising disturbing concerns about exacerbating existing health inequalities. This exploratory, descriptive, cross-sectional study aimed to understand white lay tutors’ experiences of delivering the EPP to English-speaking SA attendees. Qualitative in-depth semi-structured interviews were conducted, then verbatim transcripts were analysed using interpretative phenomenological analysis, to gain insight into participants’ experiences. A divergence of tutors’ training needs and South Asian attendees’ perceived needs was identified. Conflicting and sometimes controversial views emerged about the tutors’ understanding of the appropriateness of single-ethnicity versus mixed-ethnicity courses, and the role of interpreters on the EPP, in the themes of integration versus segregation and interpreters. This paper concludes that while these tutors have some understanding of SA people’s needs in relation to the EPP, they may benefit from cultural competence training. The complexity of implementing both culturally integrated and ethnicity-specific public health interventions is highlighted, as is the requirement for genuine consultation with SA user groups.
