The UK’s first known study of the physical and mental health status of Travelling Showpeople undertaken in two areas (Cambridgeshire and Greater Manchester).
The project also includes a survey and focus groups with health professionals working with community to explore awareness of their needs and access issues.
Background
‘Showmen’ have long been recognized as a discrete community related to GTR populations but other than passing reference in a few Gypsy Traveller Accommodation and other Need Assessments no extant research exists pertaining to this group. Showmen were included for the first time in the 2021 Census and it is acknowledged by bodies including Public Health England, ONS, Department for Levelling Up, Housing and Communities: formerly MHCLG, that there is a lacuna in evidence pertaining to the needs and circumstances of this group.
This pilot study consists of an investigation into the health status (physical and mental) and best practice and support provided by health professionals to the Showman community; focusing on two pilot areas, Cambridgeshire and Greater Manchester.
Research Questions and aims
The project has been designed to incorporate mixed and creative methods (including photo-elicitation activities), documentary analysis, surveys and focus groups to respond to the following research questions:
- What level of health care need exists for Travelling Showmen populations and how do they access health care when resident in Yards or travelling for employment?
- What are the most commonly identified health conditions experienced by the communities?
- How do health professionals engage with the populations and what level of cultural understanding do they have of the health care needs of this group?
- How can Showmen and Health Professionals collaborate to enhance understanding of health conditions and risk factors and enhance health literacy for the populations?
- What is required to enhance and increase levels of culturally appropriate health care support provided to the populations and reduce barriers to access to care. and h needs/barriers to accessing support and mutually?
Aim:
to ascertain the health status, needs, trends in self-reported conditions, barriers and solutions to accessing accessible, effective, culturally competent health care for members of the Showmen/Fairground communities.
The objectives of the study are to:
- enhance awareness of the health needs and status of Travelling Showmen both amongst the communities themselves, and also for health professionals,
- to make recommendations for practical solutions to enhance access to care and screening for this population (particularly when travelling)
- to identify gaps in health literacy knowledge amongst Showmen
- identify levels of knowledge and support the development of cultural competence for health care providers and commissioners supporting the Showmen community.
Project activity
Following ethics approval from the School of Education and Social Care Research Ethics Panel in the Faculty of Health, Education, Medicine and Social Care at Anglia Ruskin University (Reference: ESC-SREP-21-202) (May 2023) a scoping review of the very limited literature on Showmen has been undertaken and engagement with key agencies including the Showmen’s Guild per accessible data has taken place (nb Census 2021 data on Showmen will not be made available until 2023).
To date an online survey has been distributed which is open to health professionals based in any area of the country to explore their knowledge of and experience in supporting Showmen as well as any perceptions of particular health conditions prevalent amongst the population.
71/80 surveys and 9/20 interviews with Showmen divided fairly equally across the two localities have been undertaken (September 2023).
Focus groups (in one locality) have been completed (separately) with Showmen and Health Professionals with a discussion group bringing together health workers and Showmen planned.
Mirror focus groups are planned for the second locality. Photo-elicitation workshops (1 per locality) utilising images taken during the project are planned, to explore narrative pertaining to representations of work-life amongst the community on Yards and Fairgrounds. All fieldwork is anticipated to be completed by end November 2023.
Preliminary analysis of survey data obtained so far is underway, and write-up will occur following completion of field-work and validation of findings/recommendations with community members.
Anticipated Outputs
We will produce a report and briefing paper for health care professionals, and a minimum of two academic and practice focused journal articles.
Preliminary conversations are already taking place in one study area with health policy specialists working with commissioners with regard to preliminary findings from a focus group with health workers. This responsive interest creates scope to feed into the community partner working to develop training for health professionals working in localities with a large number of Showmen’s Yards specifically in relation to outreach, developing cultural competency for health professionals, and raising awareness of the prevalence of particular conditions amongst the communities.
It is anticipated that the team will explore the potential for the development of culturally appropriate health education materials to be co-designed and distributed to the populations in response to identified trends and prevalence of particular conditions.
Preliminary findings indicate that there are concerns when Showpeople are ‘on the road’ in some localities in relation to access to some health services. We anticipate that some recommendations can be made which are low cost or fiscally neutral to support improved access to health for travelling members of the community. Further proposals with regard to accessible health information outreach and screening opportunities will be developed over the course of the research
Papers and resources
- Exhibition of photographs of Showmen and their lives
- Report and academic papers to follow in 2023
Next Steps
In Greater Manchester we still need to complete the Photo-Elicitation workshop which will bring together Showmen and Health Professionals to share/discuss findings (Autumn 2022) and explore how the images taken within the project represent the community and physical/mental health stressors pertinent to their lives as Travelling Showmen.
In East Anglia/Cambridgeshire one focus group with Health Professionals and a joint Group discussion between health professionals and Showmen needs to be held (October-November 2022), alongside a photo-elicitation workshop as above, to enable us to finalise the data collection phase of the study.
Analysis and writing up of findings , following validation of results with community representatives, will take place between November 2022-March 2023 leading to the production of a report and recommendations aimed at health professionals and commissioners.
Dissemination events will take place from Spring 2023 onwards (with preliminary/emergent findings presented in selected settings – including meetings with health professionals, public engagement settings etc prior to completion of the report.
Articles to be prepared for publication in Spring/Summer 2023
Recent Activity
- Exhibition of photographs created within the project which will be used to engage Showmen and Health Workers in discussion on their life and working practices has been displayed as an open access exhibition for World FunFair month 2022 (September 2022) at the Anglia Ruskin Cambridge campus.
- 13th October 2022, Chelmsford – an open access public engagement event will take place as part of Science Week to raise awareness of the project (aimed members of the public, Showmen community and health professionals) display some of the images and allow discussion on emergent findings from the survey and interviews with Showmen https://aru.ac.uk/community-engagement/chelmsford-science-festival/in-fair-healt
