TY - JOUR
T1 - If relevant, yes; If not, no
T2 - General practitioner (GP) users and GP perceptions about asking ethnicity questions in Irish general practice: A qualitative analysis using Normalization Process Theory
AU - Roura, Maria
AU - LeMaster, Joseph W.
AU - Hannigan, Ailish
AU - Papyan, Anna
AU - McCarthy, Sharon
AU - Nurse, Diane
AU - Villarroel, Nazmy
AU - MacFarlane, Anne
N1 - Publisher Copyright:
© 2021 Public Library of Science. All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Context The use of ethnic identifiers in health systems is recommended in several European countries as a means to identify and address heath inequities. There are barriers to implementation that have not been researched. Objective This study examines whether and how ethnicity data can be collected in Irish general practices in a meaningful and acceptable way. Methods Qualitative case study data generation was informed by Normalization Process Theory (NPT) constructs about sense making and engagement . It consisted of individual interviews and focus group discussions based on visual participatory techniques. There were 70 informants, including 62 general practitioner (GP) users of diverse ethnic backgrounds recruited through community organisations and eight GPs identified through an inter-Agency steering group. Data were analysed according to principles of thematic analysis using NPT. Results The link between ethnicity and health was often considered relevant because GP users grasped connections with genetic (skin colour, lactose intolerance), geographic (prevalence of disease, early years exposure), behavioural (culture/food) and social determinant (housing) factors. The link was less clear with religion. There was some scepticism and questions about how the collection of data would benefit GP consultations and concerns regarding confidentiality and the actual uses of these data (e.g. risk of discrimination, social control). For GPs, the main theme discussed was relevance: what added value would it bring to their consultations and was it was their role to collect these data? Their biggest concern was about data protection issues in light of the European Union (EU) General Data Protection Regulation (GDPR). The difficulty in explaining a complex concept such as ethnicity in the limited time available in consultations was also worrying. Conclusions Implementation of an ethnicity identifier in Irish general practices will require a strong rationale that makes sense to GP users, and specific measures to ensure that its benefits outweigh any potential harm. This is in line with both our participants views and the EU GDPR.
AB - Context The use of ethnic identifiers in health systems is recommended in several European countries as a means to identify and address heath inequities. There are barriers to implementation that have not been researched. Objective This study examines whether and how ethnicity data can be collected in Irish general practices in a meaningful and acceptable way. Methods Qualitative case study data generation was informed by Normalization Process Theory (NPT) constructs about sense making and engagement . It consisted of individual interviews and focus group discussions based on visual participatory techniques. There were 70 informants, including 62 general practitioner (GP) users of diverse ethnic backgrounds recruited through community organisations and eight GPs identified through an inter-Agency steering group. Data were analysed according to principles of thematic analysis using NPT. Results The link between ethnicity and health was often considered relevant because GP users grasped connections with genetic (skin colour, lactose intolerance), geographic (prevalence of disease, early years exposure), behavioural (culture/food) and social determinant (housing) factors. The link was less clear with religion. There was some scepticism and questions about how the collection of data would benefit GP consultations and concerns regarding confidentiality and the actual uses of these data (e.g. risk of discrimination, social control). For GPs, the main theme discussed was relevance: what added value would it bring to their consultations and was it was their role to collect these data? Their biggest concern was about data protection issues in light of the European Union (EU) General Data Protection Regulation (GDPR). The difficulty in explaining a complex concept such as ethnicity in the limited time available in consultations was also worrying. Conclusions Implementation of an ethnicity identifier in Irish general practices will require a strong rationale that makes sense to GP users, and specific measures to ensure that its benefits outweigh any potential harm. This is in line with both our participants views and the EU GDPR.
UR - http://www.scopus.com/inward/record.url?scp=85105669625&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0251192
DO - 10.1371/journal.pone.0251192
M3 - Article
C2 - 33979383
AN - SCOPUS:85105669625
SN - 1932-6203
VL - 16
SP - -
JO - PLoS ONE
JF - PLoS ONE
IS - 5 May 2021
M1 - e0251192
ER -