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Objectives: To establish uptake of influenza vaccine amongst care home clinical staff in Greater Nottingham, and to investigate what could be done to improve vaccine uptake in this group., Study Design: Postal questionnaire surveys were used. In the first instance, a total sample survey was used. In the second instance, a sample of care home staff was surveyed, randomized at the care home level., Methods: A postal questionnaire completed by care home matrons was used to obtain a preliminary estimate of staff vaccine uptake. Individual staff questionnaires were then used to validate this finding, and measure attitudes, beliefs and behaviours associated with vaccination., Results: Vaccine uptake among those working in care homes with nursing was found to be low. Vaccine uptake was higher in homes with a policy recommending vaccination of staff. Most respondents who had received vaccination reported that they had done so because of an existing medical condition, rather than because of being a healthcare worker. A statistically significant relationship (P=0.02) was found between individuals' reported beliefs on how well they could resist influenza and their vaccination status., Conclusions: All care homes for the elderly should have a vaccination policy which recommends staff vaccination. Educational campaigns, vaccination in the workplace and free provision of the influenza vaccine may help to improve vaccine uptake in this group.

Objectives: To explore barriers to, and ways to improve, uptake of cervical screening among Somali women in Camden, London., Study Design: A qualitative research study using focus group discussions and in-depth interviews., Methods: A qualitative study (comprising seven focus groups and eight in-depth interviews) was conducted with 50 first-generation Somali women aged 25-64 years. Both the groups and the interviews explored participants' understanding of the purpose of cervical screening, and the various risk factors for cervical cancer, as well as their opinions on barriers to screening and suggestions for overcoming those barriers., Results: Knowledge about the purpose of cervical screening was limited among Somali women. There was also a lack of understanding of risk factors for cervical cancer, and many of the women held fatalistic attitudes, associated with the idea of 'God's will', about this cancer and other aspects of health. Another culturally specific barrier was embarrassment associated with female circumcision, i.e. female genital mutilation. Other barriers suggested by the participants were: lack of knowledge about the need for cervical screening, practical problems such as appointment times and childcare needs, language difficulties, fear of the test and negative past experiences. Possible solutions suggested by the participants included the provision of education and information about cervical screening in the Somali language by Somali community workers. They also suggested that healthcare staff should be trained about Somali culture, particularly regarding female circumcision, and that general practitioners should more proactively encourage Somali women to attend screening., Conclusions: Language difficulties and specific cultural issues are key barriers to first-generation Somali women attending cervical screening. Providing education and information orally, as well as improving access to a more culturally appropriate screening service, could lead to improved uptake among this group.

Background: The aim of this study was to evaluate the process of an innovative 'presentation with discussion' approach to the Director of Public Health's (DPH) annual report for North Derbyshire Health Authority., Study Design: Mixed methods-survey and interviews., Methods: Survey methods were used to obtain qualitative and quantitative data. Key stakeholders were sent a postal questionnaire, individuals attending presentations could respond via a printed slip or letter, structured group discussions following presentations were recorded manually, and presenters and producers were interviewed., Results: Thirty-five of 41 (85.4%) key stakeholders returned questionnaires, 18 people responded individually, discussions following 26/30 (86.7%) presentations were documented, and all eight presenters and 11 producers were interviewed. The general response was extremely positive with 25 of 35 (71%) key stakeholders, 100% of presenters and 80% of producers preferring the new format to the previous year's report. People felt that it conveyed the public health message effectively, and appreciated the opportunity to contribute to the recommendations for improving health in North Derbyshire. Many were concerned that the circulation should be wide, and key stakeholders were keen to have a printed reference document to support their work. Presenters enjoyed the process although tailoring the presentations to unfamiliar audiences proved difficult. The production team found the process more efficient and focused, although direct production costs were increased. Presenters and producers were concerned that the process for implementing recommendations for action was not fully considered., Conclusions: Most people preferred this innovative approach to the traditional annual report, and it is therefore recommended that this format should be used for future DPH annual reports. Key stakeholders still require a reference document, and presenters' briefing notes could be adapted for this purpose. Circulation of the report should be wide, and further consideration of how participants' recommendations for action are implemented is needed.