Musculoskeletal research priorities of people of South Asian, Black, African or Caribbean heritage in the United Kingdom

People from racially marginalised groups are underserved in healthcare and research. There is a clear need to address these inequalities and ensure that people from minoritised groups are involved in all stages of the research process, from research prioritisation to dissemination. Health research should include all members of the community for whom the research is relevant. To address this, the UK National Institute for Health Research (NIHR) initiated the Innovations in Clinical Trial Design and Delivery for the underserved (INCLUDE) project, which aims to improve the inclusion of underserved groups in clinical trials (Witham et al., 2020). In 2020, the INCLUDE Ethnicity Framework was developed which aims to improve the inclusion of people from racially marginalised groups in trials (Treweek et al., 2021). The framework was designed to help researchers systematically consider how disease severity and prevalence, language, culture, faith, intervention, and trial design may affect the participation of people from different ethnicities. In addition to trial design and participation, the INCLUDE project provides a broader overview of improving the inclusion of underserved groups across the life course of research, acknowledging that this starts with research priority setting (Witham et al., 2020).

Research priority setting is undertaken to identify and prioritise research questions deemed important to stakeholders (Tong et al., 2019). This informs funding calls and facilitates research funding provision to the areas of highest priority. However, setting the health research agenda has historically been driven largely by health professionals and academics, with poor patient representation (Chalmers & Glasziou, 2009). There have been increasing efforts to improve engagement and involvement of all stakeholders, particularly within the James Lind Alliance Priority Setting Partnerships. However, these initiatives often pose barriers to inclusion of people from minority ethnic communities (Franck et al., 2018; NIHR Race Equality Framework, 2022), including language barriers, power dynamics that inhibit people from expressing their opinions freely, and perceived difficulty by researchers with accessing relevant communities (Erves et al., 2017; Iqbal et al., 2021).

Diverse and responsive methods should be used in research priority setting activities to reflect the needs and preferences of different populations and environments in which the work is undertaken. Approaches need to be co-designed with communities to ensure the most culturally appropriate and inclusive methods are used to facilitate meaningful involvement in the research priority setting process (Bryan et al., 2020; Franck et al., 2018; Iqbal et al., 2021). We have previously co-developed guidance for researchers to promote good practice for inclusive involvement of people from racially marginalised communities in health research (Jameson et al., 2023). Continuing this partnership between academics and community groups, this work aimed to produce a list of musculoskeletal research questions which reflect the priorities of people from South Asian, Black, African or Caribbean heritage attending community groups in Bristol.