Participants
Participants were recruited from four ethnically diverse London boroughs, Southwark, Lewisham, Lambeth and Croydon, which constitute the catchment area of the South London and Maudsley National Health Service Foundation Trust, UK. The most recent census for this catchment area by the Office for National Statistics [43] estimated proportions of ethnic populations: 81.7% White, 10% Black, 4.4% South East Asian or Asian, 2.8% Mixed and 1% other. Employment data indicated that of the population aged 16 and above within the catchment area 88.1% are in employment, 4.1% students and 7.8% unemployed [43]. Of those unemployed 42.5% were White and 38.2% were from Black/African/Caribbean/Black British backgrounds.
Procedure
It is well acknowledged that community participation in the design and delivery of community interventions improve the effectiveness of community interventions [44]. We therefore worked in partnership with service users, experts by experience and staff in the community when developing materials for the intervention and delivering the interventions. These materials included an information leaflet on OCD, a signs and symptoms card, a leaflet describing the OCD treatment pathway, and a video [45] on service users and parents describing their experience of OCD and treatment.
Content of teaching was established following a focus group with six teachers and six young people separately at two different secondary schools within the catchment area. Feedback in focus groups was used to design presentation slides and slides included: description of OCD symptoms, a video on OCD [45], prevalence, evidence-based treatment, how to identify OCD within school settings, strategies for supporting students and how to share concerns with parents.
Information stalls and teaching workshops were then offered to a range of organisations (e.g., youth centres, libraries, religious centres, schools) in the catchment area, via email, telephone calls, and visits. Information stalls and teaching events were set up in organisations that expressed an interest. We contacted 135 organisations and of these, 37 (27.4%) expressed an interest. Religious centres had the lowest uptake with three (9%) of 28 contacted expressing an interest and only one where a stall was set up. Teaching events were held at secondary schools, high schools and youth centres. Participants were recruited over an eight-month period and consented to completing questionnaires before discussions at the information stall or before teaching events.
Information stalls Information stalls were set up in various locations with the resources above on display. People approaching the stall had the opportunity to have face-to-face discussions on OCD with a Clinical Psychologist or Assistant Psychologist of South East Asian and Mixed ethnicity, respectively. In these discussions, clinicians explained key facts about OCD in relation to symptomatology, prevalence and treatment. Participants also watched an animated video on OCD [46].
Teaching events A Clinical Psychologist, Assistant Psychologist and a young person with lived experience of OCD delivered the teaching and events ranged from 45 minutes to 75 minutes.
Measures Two questionnaires were developed by a Consultant Clinical Psychologist and Clinical Psychologist for information stalls and teaching events. Participants completed the questionnaire before and after visiting the information stall or attending the teaching event. Please see supplementary information for copies of the original questionnaires.
Information stalls The questionnaire required participants to give ratings for knowledge of OCD and likelihood of seeking help or supporting someone in seeking help when they first approached the stall and after they had had a chance to look and discuss the information in the stall. The questionnaire included four items (2 items completed pre-information stall and 2 items post information stall). Responses were measured on a Likert scale e.g., 1 = strongly disagree to 5 = strongly agree. Examples of items included: ‘Do you know how someone could get help for OCD?’
Teaching events The questionnaire required participants to give ratings for knowledge of OCDknowing how to support someone in seeking help and knowledge in recognising ethnic minority youth with OCD before and after the teaching event. included 6 items (3 items completed pre-teaching and 3 items completed post teaching). Responses were measured on a Likert scale range from 1 = very low to 10 = very high. Examples of items included: ‘How would you rate your knowledge of recognising OCD in the Black Asian and Minority Ethnic (BAME) population?’ and ‘How would you rate your skills in helping children and young people with OCD?’ Both questionnaires also had two or three open-ended questions respectively for generic feedback.
Statistical analysis
Normality of data was tested using Shapiro-Wilk test which indicated that all but one (pre-information stall help-seeking ratings, p = .609) questionnaire item data was not normally distributed (remaining items, p =.000 -.008). Non-parametric Wilcoxon signed-rank tests were therefore used to compare pre and post differences in median questionnaire ratings for each item. Bonferroni corrections were applied due to multiple comparisons. Two tests were corrected for in information stalls data and three tests were corrected for in teaching event data.