title: UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): protocol for an exploratory, qualitative study.
abstract: BACKGROUND
  Gypsies, Travellers and Roma (referred to here as Travellers) experience significantly poorer health and have shorter life expectancy than the general population. They are also less likely to access health services including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. This study has two aims: (1) Investigate the barriers and facilitators to acceptability and uptake of immunisations among six Traveller communities in the UK; (2) Identify potential interventions to increase uptake in these Traveller communities.
  
  
  METHODS
  A three-phase qualitative study with six Traveller communities. PHASE 1: In each community, we will explore up to 45 Travellers' views about the influences on their immunisation behaviours and ideas for improving uptake in their community. PHASE 2: In each community, we will investigate 6-8 service providers' perspectives on barriers and facilitators to childhood and adult immunisations for Traveller communities with whom they work, and ideas to improve uptake. Interview data will be analysed using the Framework approach. PHASE 3: The findings will be discussed and interventions prioritised in six workshops, each with 10-12 phase 1 and 3-4 phase 2 participants.
  
  
  BACKGROUND
  This research received approval from NRES Committee Yorkshire and The Humber-Leeds East (Ref. 13/YH/02). It will produce (1) findings on the barriers and facilitators to uptake of immunisations in six Traveller communities; (2) a prioritised list of potentially feasible and acceptable interventions for increasing uptake in these communities; and (3) methodological development in undertaking research with diverse Traveller communities. The study has the potential to inform new ways of delivering services to ensure high immunisation uptake. Findings will be disseminated to participants, relevant UK organisations with responsibility for the implementation of immunisation policy and Traveller health/welfare; and submitted for publication in academic journals.
  
  
  BACKGROUND
  ISRCTN20019630.
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Cath
authors.initials: C
authors.lastname: Jackson
authors.affiliation: Institute of Child Heath, UCL, London, UK.
authors.forename: Helen
authors.identifier: http://orcid.org/0000-0003-0908-1380
authors.initials: H
authors.lastname: Bedford
authors.affiliation: College of Human and Health Sciences, Swansea University, Swansea, UK.
authors.forename: Louise
authors.identifier: http://orcid.org/0000-0003-2547-5603
authors.initials: L
authors.lastname: Condon
authors.affiliation: Formerly in the Gypsy and Traveller Team, Bristol City Council, Bristol, UK.
authors.forename: Annie
authors.initials: A
authors.lastname: Crocker
authors.affiliation: Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Emslie
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dyson
authors.affiliation: Formerly at South Glasgow Community Health Partnership, NHS Greater Glasgow & Clyde, Glasgow, UK.
authors.forename: Bridget
authors.initials: B
authors.lastname: Gallagher
authors.affiliation: Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Susan
authors.identifier: http://orcid.org/0000-0003-1841-8774
authors.initials: S
authors.lastname: Kerr
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Helen J
authors.identifier: http://orcid.org/0000-0002-2237-1369
authors.initials: HJ
authors.lastname: Lewis
authors.affiliation: Centre for Child and Adolescent Health, University of the West of England, Bristol, UK.
authors.forename: Julie
authors.identifier: http://orcid.org/0000-0002-0306-4750
authors.initials: J
authors.lastname: Mytton
authors.affiliation: Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK.
authors.forename: Sarah A
authors.identifier: http://orcid.org/0000-0002-2176-2325
authors.initials: SA
authors.lastname: Redsell
authors.affiliation: Formerly at the London Gypsy and Traveller Unit, London, UK.
authors.forename: Frieda
authors.initials: F
authors.lastname: Schicker
authors.affiliation: York Travellers Trust, York, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Shepherd
authors.affiliation: York Travellers Trust, York, UK.
authors.forename: Lesley
authors.initials: L
authors.lastname: Smith
authors.affiliation: Women and Children's Directorate, North Bristol NHS Trust, Bristol, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Vousden
authors.affiliation: School of Health Sciences, University of East Anglia, Norwich, UK.
authors.forename: Francine M
authors.identifier: http://orcid.org/0000-0001-7392-4624
authors.initials: FM
authors.lastname: Cheater
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007114:Immunization / Q000523:psychology; D007223:Infant; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011634:Public Health; D036301:Qualitative Research; D006178:Romani People / Q000523:psychology* / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology
keywords: Roma; gypsy; immunisation; traveller; vaccination