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IntroductionGlobal migration has steadily risen, with 16% of the UK population born abroad. Migrants (defined here as foreign-born individuals) face unique health risks, including potential higher rates and delays in diagnosis of infectious and non-communicable diseases, compounded by significant barriers to healthcare. UK Public Health guidelines recommend screening at-risk migrants, but primary care often faces significant challenges in achieving this, exacerbating health disparities. The Health Catch-UP! tool was developed as a novel digital, multidisease screening and catch-up vaccination solution to support primary care to identify at-risk adult migrants and offer individualised care. The tool has been shown to be acceptable and feasible and to increase migrant health screening in previous studies, but to facilitate use in routine care requires the development of an implementation package. This protocol describes the development and optimisation of an implementation package for Health Catch-UP! following the person-based approach (PBA), a participatory intervention development methodology, and evaluates our use of this methodological approach for migrant participants.Methods and analysisThrough engagement with both migrants and primary healthcare professionals (approximately 80–100 participants) via participatory workshops, focus groups and think-aloud interviews, the study aims to cocreate a comprehensive Health Catch-UP! implementation package. This package will encompass healthcare professional support materials, patient resources and potential Health Catch-UP! care pathways (delivery models), developed through iterative refinement based on user feedback and behavioural theory. The study will involve three linked phases (1) planning: formation of an academic–community coalition and cocreation of guiding principles, logic model and intervention planning table, (2) intervention development: focus groups and participatory workshops to coproduce prototype implementation materials and (3) intervention optimisation: think-aloud interviews to iteratively refine the final implementation package. An embedded mixed-methods evaluation of how we used the PBA will allow shared learning from the use of this methodology within the migrant health context.Ethics and disseminationEthics approval granted by the St George’s University Research Ethics Committee (REC reference: 2024.0191). A community celebration event will be held to recognise contributions and to demonstrate impact.

Background Migrants in the UK and Europe face vulnerability to vaccine-preventable diseases (VPDs) due to missed childhood vaccines and doses and marginalisation from health systems. Ensuring migrants receive catch-up vaccinations, including MMR, Td/IPV, MenACWY, and HPV, is essential to align them with UK and European vaccination schedules and ultimately reduce morbidity and mortality. However, recent evidence highlights poor awareness and implementation of catch-up vaccination guidelines by UK primary care staff, requiring novel approaches to strengthen the primary care pathway. Methods The ‘Vacc on Track’ study (May 2021–September 2022) aimed to measure under-vaccination rates among migrants in UK primary care and establish new referral pathways for catch-up vaccination. Participants included migrants aged 16 or older, born outside of Western Europe, North America, Australia, or New Zealand, in two London boroughs. Quantitative data on vaccination history, referral, uptake, and sociodemographic factors were collected, with practice nurses prompted to deliver catch-up vaccinations following UK guidelines. Focus group discussions and in-depth interviews with staff and migrants explored views on delivering catch-up vaccination, including barriers, facilitators, and opportunities. Data were analysed using STATA12 and NVivo 12. Results Results from 57 migrants presenting to study sites from 18 countries (mean age 41 [SD 7.2] years; 62% female; mean 11.3 [SD 9.1] years in UK) over a minimum of 6 months of follow-up revealed significant catch-up vaccination needs, particularly for MMR (49 [86%] required catch-up vaccination) and Td/IPV (50 [88%]). Fifty-three (93%) participants were referred for any catch-up vaccination, but completion of courses was low (6 [12%] for Td/IPV and 33 [64%] for MMR), suggesting individual and systemic barriers. Qualitative in-depth interviews ( n  = 39) with adult migrants highlighted the lack of systems currently in place in the UK to offer catch-up vaccination to migrants on arrival and the need for health-care provider skills and knowledge of catch-up vaccination to be improved. Focus group discussions and interviews with practice staff ( n  = 32) identified limited appointment/follow-up time, staff knowledge gaps, inadequate engagement routes, and low incentivisation as challenges that will need to be addressed. However, they underscored the potential of staff champions, trust-building mechanisms, and community-based approaches to strengthen catch-up vaccination uptake among migrants. Conclusions Given the significant catch-up vaccination needs of migrants in our sample, and the current barriers to driving uptake identified, our findings suggest it will be important to explore this public health issue further, potentially through a larger study or trial. Strengthening existing pathways, staff capacity and knowledge in primary care, alongside implementing new strategies centred on cultural competence and building trust with migrant communities will be important focus areas.

Background Migrants to the UK face disproportionate risk of infections, non-communicable diseases, and under-immunisation compounded by healthcare access barriers. Current UK migrant screening strategies are unstandardised with poor implementation and low uptake. Health Catch-UP! is a collaboratively produced digital clinical decision support system that applies current guidelines (UKHSA and NICE) to provide primary care professionals with individualised multi-disease screening (7 infectious diseases/blood-borne viruses, 3 chronic parasitic infections, 3 non-communicable disease or risk factors) and catch-up vaccination prompts for migrant patients. Methods We carried out a mixed-methods process evaluation of Health Catch-UP! in two urban primary healthcare practices to integrate Health Catch-UP! into the electronic health record system of primary care, using the Medical Research Council framework for complex intervention evaluation. We collected quantitative data (demographics, patients screened, disease detection and catch-up vaccination rates) and qualitative participant interviews to explore acceptability and feasibility. Results Ninety-nine migrants were assessed by Health Catch-UP! across two sites (S1, S2). 96.0% ( n  = 97) had complete demographics coding with Asia 31.3% ( n  = 31) and Africa 25.2% ( n  = 25), the most common continents of birth (S1 n  = 92 [48.9% female ( n  = 44); mean age 60.6 years (SD 14.26)]; and S2 n  = 7 [85.7% male ( n  = 6); mean age 39.4 years (SD16.97)]. 61.6% ( n  = 61) of participants were eligible for screening for at least one condition and uptake of screening was high 86.9% ( n  = 53). Twelve new conditions were identified (12.1% of study population) including hepatitis C ( n  = 1), hypercholesteraemia ( n  = 6), pre-diabetes ( n  = 4), and diabetes ( n  = 1). Health Catch-UP! identified that 100% ( n  = 99) of patients had no immunisations recorded; however, subsequent catch-up vaccination uptake was poor (2.0%, n  = 1). Qualitative data supported acceptability and feasibility of Health Catch-UP! from staff and patient perspectives, and recommended Health Catch-UP! integration into routine care (e.g. NHS health checks) with an implementation package including staff and patient support materials, standardised care pathways (screening and catch-up vaccination, laboratory, and management), and financial incentivisation. Conclusions Clinical Decision Support Systems like Health Catch-UP! can improve disease detection and implementation of screening guidance for migrant patients but require robust testing, resourcing, and an effective implementation package to support both patients and staff.

Background Participatory research (PR) approaches are increasingly prioritised globally, particularly in the UK, where many funders have emphasised meaningful collaboration with those with lived experience to improve health research relevance, translation and impact. Despite this, marginalised groups, such as migrants, remain underrepresented in research, perpetuating health inequities. Migrants, who comprise 16% of the UK population, face systemic barriers to engagement, including distrust, hierarchical academic structures, and lack of inclusivity. PR approaches offer a collaborative framework for empowering migrant voices, balancing research and action, and fostering trust to address these disparities. This case study describes the development of the Migrant Health Community Research Network (MHCRN), a collaboration between migrant community groups, individuals, academics and health professionals from the Migrant Health Research Group, City St Georges University of London (MHRG). Aim MHRG sought to develop a sustainable model for engaging migrants in health research through a co-created network addressing power imbalances and ensuring inclusivity. Methods MHRG adopted PR principles, reflecting on the groups collective experience of prior engagement practices and systematically reviewing best practices. A five-phase approach was used: (1) defining agenda and aspirations through group reflection; (2) identifying concerns and challenges through internal reflection and community consultation; (3) conducting community exploratory workshops with co-facilitation; (4) establishing initial network structure based on collectively agreed principles; (5) co-developing a lived experience advisory panel. Findings The process has resulted in the following outputs: the “Migrant Health Community Research Network” (MHCRN) with guiding principles (equity, diversity, respect, decolonisation, empowerment, community), a network steering group (LEAP, Lived Experience Advisory Panel), community-based collaborations embedding migrant voices at all research stages, capacity building through training and peer researcher roles, and award-winning projects. Key challenges identified include structural inequalities, funding limitations, and institutional barriers. Opportunities emerged around trust-building, shared leadership, and sustainable relationship development. Conclusions While the MHCRN represents an important step in embedding meaningful collaboration, challenges persist. This initiative highlights the need for systemic change in academia to support equitable partnerships and inform similar innovative initiatives. By prioritizing non-tokenistic engagement and co-production, the MHCRN sets a foundation for sustained, impactful collaboration to address health inequities and inform policy and practice. Plain English summary Many health research projects fail to involve people they aim to help, especially marginalised groups such as migrants. This often results in research that is neither relevant nor useful. We recognised that the way we have worked with people with lived experience of migration could be improved. Our aim was to create a way to work together long-term so that migrant voices are heard and acted on from the development of research ideas all the way to the delivery and sharing of findings. We decided after talking to many researchers, migrants, community organisations and health care professionals that a migrant health research network that brought together all these voices through relationship building and creative ways of working and sharing ideas would be a good way to do this. We established the Migrant Health Community Research Network (MHCRN) which brings together people living in the United Kingdom with lived experience of migration from all over the world, healthcare professionals working in the National Health Service (NHS) and researchers from City St George’s University of London to improve migrant health. Our network was built step-by-step, starting with open conversations with migrants, healthcare professionals and researchers about challenges they had experienced in involving migrant communities in research and how these could be overcome. We then ran a workshop to shape our vision and agreed on shared principles. The network aims to be long-term, inclusive, and led by those with lived migration experience. Although there are ongoing challenges, this process has taught us valuable lessons about working together in a meaningful way. Take home messages Sustained relationship building and transparency are essential : Meaningful engagement of migrants in health research requires moving beyond tokenistic involvement to true sustained partnership and shared leadership to create safe spaces which avoid “data extraction” and instead facilitate authentic participation. Creative methods, community leadership and practical support (childcare, accessible venues) can enhance engagement: Cultural sensitivity, people with lived experience in leading roles, and the use of arts-based and other innovative approaches can bridge gaps, enrich dialogue, and create inclusive spaces for collaboration and diverse participation. Structural challenges require systemic change: Traditional academic structures and funding mechanisms can impede sustainable community engagement, requiring institutional change through the recognition and proactive response to the resource implications (both time and funds) of doing participatory research well. Reflexivity is crucial : Academic researchers must continuously examine their own roles and privileges, ensuring that where possible power imbalances are addressed and avoided.

Concerns about the housing of migrants and asylum seekers have escalated since the COVID-19 pandemic. From the use of quasi-detention facilities and so-called contingency accommodation to outbreaks of diphtheria in processing centres, there is a worrying trend to normalise potentially damaging conditions. The aim of this study was to assess the health risks posed by contingency housing for asylum seekers in the UK. In this cross-sectional survey, a 10-point online questionnaire was sent to professional networks working with refugees and asylum seekers within the UK. Responses were collected between March 4, and April 11, 2022, using a mixture of convenience and snowballing sampling approach. The objectives of the survey were (1) to identify and document unmet needs, (2) to offer practical support, and (3) to map out services and organisation. The survey was designed by six medical professionals with experience of working with migrants and validated by three doctors who had experience running out-reach medical clinics for asylum seekers within contingency accommodation. Background details of geographical location and occupation were collected, and a combination of closed and open questions were used to collect information across five domains (medical, legal social, integration, and basic essentials) using a social determinants of health framework. A code book thematic analysis using a deductive/inductive hybrid approach was used to identify health and social needs as well as specific rights being denied. There were 68 responses from around the UK, of which 30 (44%) were health-care professionals, and 38 (56%) were from the wider voluntary sector. 45 (67%) had visited an accommodation site, and 21 (33%) had worked with those living in contingency accommodation in other respects. Respondents reported observations regarding sites across most parts of the UK. Major themes of access to health-care, access to other services, barriers to access, and safeguarding were identified, with subthemes on access to primary care, maternity, and mental health services (eg, “Vast unmet need in mental health provision, several suicide attempts”); access to basic essential services (eg, “Food was not fit for purpose” “[c]hildren often did not receive breakfast”); education, and legal support; and frequent moving and communication. Through several themes we highlight the substantial impact of structural isolation of asylum seekers through contingency housing, its major effects on wellbeing and the exacerbation of health inequities. We are using these results to work with asylum seekers and local non-governmental organisations to campaign for improved housing conditions. Study limitations include sampling bias, and a lack of voices of those with lived experience. None.