Designing for diversity: engaging with the Gypsy & Traveller community
There are an estimated 4,000 – 6,000 Gypsies and Travellers (GT) living in the Doncaster area in 2019. Average life expectancy for this group is likely to be at least 20 years lower than for the general population. Research has shown that the reason for this lower life expectancy is a mixture of lower education within the community around how to look after their health, but also because of the community accessing health services significantly less frequently than the Gorja (GT term for settled people) community. Doncaster CCG asked Co:Create to help them connect with the Doncaster GT community to explore the reasons behind this lack of uptake and co-design some potential solutions.
What we did
There were four stages to the project:
Co:Create and Doncaster CCG went through a process of researching all available literature that could be found on the Gypsy and Traveller population. We spoke to key individuals from across the public and voluntary sectors who were currently engaging with Gypsies and Travellers. The key things that came out of this stage were that GT people distrusted professionals and that the level of stigma and nuances of language around health concerns within the community meant discussing health issues would be very hard for us to do alone. We were therefore not the right people to engage the community.
Through our research, we came across The Rennsselaerville Institute’s Community Sparkplug Model©. This approach focuses on supporting members within communities, who are engaged, active and driven, to complete community projects. We borrowed from this principle and decided to use a community journalist approach, a method we had successfully employed previously when working with hard to reach communities. We aimed to get active and engaged members of the GT communities to negotiate the nuances of discussing health concerns, and conduct interviews about health and health services on our behalf.
Co:Create commissioned a Community Journalist trainer (Justine Gaubert), who Co:Create had worked with previously, to run a community journalist course. Through our research, we had discerned that the first contact with the community would be key. Justine researched individuals who had done similar work in the past. She found that Violet Cannon, Director of York Traveller Trust, had performed a Community Journalist project in Doncaster (2016) exploring community assets and Gypsy and Traveller Pride. We contacted Violet and then commissioned her to consult on recruitment of community journalists and ensure that the project was culturally sensitive.
The recruitment stage consisted of two strands. Firstly we went to Lee Gap horse fair, frequented by GT people from the Doncaster area, to conduct further research of GT people within the Doncaster area but also to push a recruitment drive for Community Journalists. The second recruitment strand was utilising Violet’s contacts and knowledge of engaged and driven people in the communities.
Once we had recruited community journalists we ran a training course which provided the journalists with skills on how to conduct interviews, be interviewed and cinematography. We also provided more specialist training for those that requested it, such as press training. In the final session the Community Journalists co-designed the five questions they would ask to their interviewees with Paul Hemmingway (Head of Communications and Engagement at Doncaster CCG). We then co-designed the risk assessment of the project.
The community journalists were then asked to conduct two interviews each and transcribe them along with completing appropriate E&D paperwork and GDPR forms. Community journalists were given a voucher payment of £50 for completing the work.
What we found
We found that the experiences of the Gypsy and Traveller population in Doncaster, when accessing health services, were largely reflective of the Gypsy and Traveller experiences of accessing health services across the United Kingdom. Some of the key things which came back were:
· Most of the people we interviewed had experienced prejudice by front line members of staff
· Nearly all of the people we interviewed said they would not feel comfortable talking to a health service professional if they were of the opposite sex to them
· In the GT community there is a strong level of stigma around discussing sexual health. This
stigma is intensified further when a GT person is asked to discuss anything regarding their health with someone of the opposite sex.
· A major theme which emerged out of our research was a belief amongst GT people that health and social care staff across Doncaster needed specific training around GT culture and how to engage with people from the communities.
· A significant finding was the importance of the use of language when discussing healthcare issues with the communities. This video we created with Abiline, one of the Community Journalists, clearly highlights how using culturally appropriate synonyms can improve health outcomes for the GT populations.
What happened because of this work?
The data we collected as part of this project has directly fed in to Doncaster CCG and Doncaster Metropolitan Borough Council’s Joint Strategic Commissioning Plan for the next two years. The results of this research will inform and help to direct how the CCG and Council involve GT voices in their commissioning practices over the next two years.
Our findings were also presented to the CCG’s Equality and Engagement Committee (EEC). As an outcome from this presentation, avenues are now being explored by the CCG on how they can fund roles which will directly improve health outcomes for GT people. These are both strategic and operational positions.