South Bucks Gypsy and Traveller Health Project: Community Health in Partnership Margaret Greenfields Buckinghamshire New University m.greenfields@bucks.ac.uk

Background to the Project Overwhelming evidence of health inequalities experienced by Gypsy/Traveller communities in the UK (Matthews, 2008; Parry et. al., 2004) Barriers to engagement with mainstream health services include registration difficulties with primary care providers; literacy issues; suspicion and hostility towards staff lacking ‘cultural competence’; disrupted treatment regimes (Van Cleemput et. al., 2007; Cemlyn et. al. 2009) Over-reliance on A&E departments, and consistent anecdotal evidence of avoidable mortality resulting from lack of early health intervention (Cemlyn et.al, 2009)

Rationale for Project Research suggests that community members would welcome advice & care provided by trained/qualified community members (Greenfields, 2008) Culturally appropriate educational materials and use of trusted community members as health advocates (in line with work carried out with other BME communities) are anticipated to reduce negative health impacts of membership of GRT communities. Proposal – to devise a training programme targeted at Gypsy and Traveller women to equip them to signpost services and provide health advocacy support to their peers.

Programme Aims & Content The project was devised in partnership between One Voice 4 Travellers Ltd, Bucks New University, Buckinghamshire Primary Care Trust and Buckinghamshire Community Foundation (funders) Key Aims: to undertake a culturally sensitive community health needs assessment of site residents [on-going] utilise community advocate skills to provide training and delivery of advice and information on specific health needs (such as accessing screening for cardio-vascular health or promoting healthy eating) to site residents Focus particularly on the health needs of older women and young mothers as a gateway to family health improvement Topics include: delivery on sensitive topics such as emotional wellbeing (based on Mental Health First Aid); recognising impacts of DV on children/families and communities; substance misuse as well as ‘women’s health’

Project Outcomes The six people currently working as health advocates in their community report confidence in sharing health information and offering advice to their peers and further afield (e.g. Activities at Gypsy horsefairs). The training has helped to prepare them to be able to maintain confidentiality, has developed interview skills and empowered theme to help community members. Feedback received from participants on the course tell us that they are actively passing on information to their husbands, parents and neighbours, e.g. first aid skills The interactive delivery of drug awareness and education using a drug box containing commonly used imitation drugs, has proved to be a useful tool for engaging and facilitating group discussions between students and presenters. Questionnaire – local health audit – currently awaiting analysis with intent of informing local health care delivery.

Key success has been that cultural and language barriers have been overcome so that advocates and communities are exchanging terms such as ‘nerves’ for mental health to reflect the true meaning of both positive and negative aspects to wellbeing. Professionals who participated in the programme report higher levels of cultural awareness and better links into neighbourhood groups. Smoking Cessation Intervention (follow-up one day training) completed May 2011

She said: “Due to my lifestyle this course and the practical tips I’ve received could potentially prove life-saving. For example, we visited the Uxbridge Campus and were given a class in resuscitation and how to place people in a recovery position.

Participant Feedback “Due to my lifestyle this course and the practical tips I’ve received could potentially prove life-saving. For example, we visited the Uxbridge Campus and were given a class in resuscitation and how to place people in a recovery position”. “The other women and I can now work as health advocates across all of the Traveller communities and use what we have learnt to benefit others. I have a much clearer, balanced picture now, and can actually help people by giving them proper advice and the truth.”