The Medical Scepticism Project together with Centric

WHAT DID WE DO:

In May 2020, TSIP’s research team and their community researchers (who later became Centric) was commissioned by Impact on Urban Health to explore how communities in Lambeth and Southwark were being affected by the COVID-19 pandemic. Medical scepticism and distrust of the healthcare system and services were core themes generated by this research, which was conducted with 40 local residents over a period of a few months. Themes around vaccine hesitancy prompted the research team to suggest that Medical Scepticism needed to be explored in more depth. TSIP sought to explore these themes further, looking beyond COVID-19, to understand their root causes and inform future research initiatives and interventions. In May 2021, The Medical Scepticism Project was born.

HOW DID WE DO IT:

TSIP adopted an innovative and community-centred approach to this research project, which involved black and minority residents of Lambeth, Lewisham and Southwark. Recognising the sensitivity of the topic, the study was designed to emphasise inclusion, regard, respect and empowerment. Research teams were embedded within communities, and researchers used their local knowledge and credibility to foster trust and engage with participants, enabling greater reach and community co-ownership. The data collection involved a three-pronged, iterative strategy, involving 120 semi-structured in-depth interviews, focus group discussions and a social media analysis, allowing for triangulation and an emergent analytic approach.

what were the outcomes: 

Participants most commonly identified as Black British, Jamaican and Nigerian. Seven key themes were generated, revealing both contemporary and historical factors influencing trust in healthcare systems. The majority of participants recounted experiences of discrimination within a healthcare setting, particularly maternity care, and felt the effects of NHS budget constraints through healthcare professionals’ perceived lack of time, care and empathy. These experiences, in conjunction with a knowledge of historical mistreatment of black and minority communities in healthcare, led many to seek alternative care and reduced their trust in the system overall. TSIP and the community researcher team wanted to ensure that the outputs from this project placed the stories of participants at the heart of the findings. They went on to produce video and written outputs which were shared back with the funder.

WHAT DID WE LEARN:

With its innovative approach, this project explored the root causes of medical scepticism and distrust among diverse London communities in Lambeth and Southwark while also fostering trust and community co-ownership. Community researchers were able to draw on their ‘insider’ perspective and credibility to overcome research fatigue and mistrust and engage participants authentically, garnering deep insights. These insights act as a catalyst for addressing health inequalities from a community perspective and amplifying the voices of underserved populations in policy decisions and healthcare reform, particularly within the NHS. The project highlights the importance of community-driven methodologies in creating meaningful impact. 

Testimonials

“So, I feel like there is a preconception, that its not as serious as much. I feel like they come into the conversation with already assumptions that you will, you're fine…And I feel like that can lead to a lot of mistrust, especially with my health with them.”

“So at the end of the day, there's a lot of things going to be questioned, and in my opinion, our community has been used as Guinea pigs and been abused for so many years and people are waking up now, people are waking up and realizing. So you will have this scepticism about people and what they think and how they use the NHS and the pharmaceutical companies or the pharmaceutical equipment or our medicine.”