Research on Epilepsy Knowledge and Attitudes in the African Community

This report presents a research proposal focusing on health promotion and understanding the knowledge and attitudes towards epilepsy within the African community in England. The proposal outlines the background, rationale, aims, objectives, and methodology for the study. It addresses the prevalence of epilepsy, cultural beliefs, and the impact of social stigma, highlighting the need for research to inform effective health promotion strategies. The methodology includes literature search strategies, ethical considerations, and a project timeline. The study aims to identify knowledge gaps, address disparities in care, and propose interventions to improve epilepsy management and social integration within the African community. The research emphasizes the importance of community-based programs, public health policies, and educational initiatives to reduce stigma and enhance the quality of life for individuals with epilepsy.

1Running head: HEALTH PROMOTION
Health Promotion
Name of student:
Name of university:
Author note:

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Table of Contents
Research question.......................................................................................................................3
Introduction................................................................................................................................3
Background and rationale for the research.................................................................................4
Aims and objectives of the study...............................................................................................9
Methodology..............................................................................................................................9
Ethics and anti-oppressive practice..........................................................................................13
Project Outline.........................................................................................................................14
Project timetable.......................................................................................................................15
References................................................................................................................................16

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Research question
Knowledge and attitude towards epilepsy amongst the African community in England
is an important topic for undertaking research in the field of health promotion. The proposed
research would consider carrying out an analysis of the knowledge and attitude towards
epilepsy amongst the Africn community in England. The research question for the proposed
research is “What is the level of knowledge and attitude towards epilepsy amongst African
community in England”? The study would aim at addressing this research question that
would hold much significance for health promotion activities in the country in future.
Introduction
The aim of writing a research proposal is to bring into focus and justify the
requirement to study the chosen research problem. The paper is to present the practical
methods through which the study is to be conducted. The study design and elements for
carrying out the research must be governed by certain standards. Persuasive evidence is to be
presented to establish the need for the study (Flick 2015).
The present research proposal is the document proposing the research project on the
level of knowledge and attitude towards epilepsy among African community in England. The
proposal has been divided into major sections, each addressing certain points usually covered
in a proposal. The first section of the proposal highlights the background to the research and
the rationale for the study. This would provide background information of important
contextual and historical events related to the research topic that would inform how the
research problem exists. Studies conducted in relevance to the proposed study would be
analysed and mentioned in this section. The research to be conducted would be objectively
justified with the help of literary sources. The next section of the paper would mention the
aim and objectives of the proposed research in a clear manner.

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The subsequent section of the paper would describe the proposed methodology in
details. The complete method of conducting the study would be written in this section, which
is the research methodology. The literature search strategy would be thereby highlighted. The
search engines, academic databases, relevant keywords, and inclusion and exclusion criteria
to be used would be after that included. The next section of the paper would bring into focus
the ethical and anti-oppressive issues related to the research practice. The project outline for
the final paper would be discussed after that. Lastly, the project timetable would be
mentioned, highlighting the time frame within which the research is to be completed.
Background and rationale for the research
Epilepsy is a neurological condition in which the patient suffers recurrent seizures. In
the medical dictionary, a seizure is referred to the transient disturbance of the cerebral
function and abnormal paroxysms in the brain leading to the sudden excessive discharge of
the cerebral neurons. The patient suffers an instantaneous disturbance of sensation,
convulsive movements and loss of psychic function due to such discharge. Sociocultural
attitudes cause a drastic negative impact on the management of epilepsy in many nations.
Religious and sociocultural beliefs are known to make an impact on the treatment and
management received by epilepsy patients (Teferi and Shewangizaw 2015).
In the UK, 1 in every 103 people suffer from epilepsy and accounts for almost 600000
people in the country. every day, about 80 people are diagnosed with the disease. While 52
per cent of patients in the country is seizure free, 70 per cent can be made seizure free
through appropriate treatment. Epilepsy is covered by the Disability Discrimination Act in
Northern Ireland and the Equality Act in England, Scotland and Wales. Attitude and
knowledge of epilepsy are woven into religious and cultural practices in the UK. This is
further made complicated by the multiplicity of ethnic groups and diverse cultures. The
syncretic amalgamation of indigenous traditions with foreign cultures has made a drastic

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influence on popular attitudes towards epilepsy (Hamandi et al. 2017). Around 3 per cent of
the UK’s population was of Black origin as per the reports of the year 2011. Around 95% of
Black British live in England. Doctrines of different cultures that are foreign to that of the
UK, particularly African culture, have created distinct patterns of understanding of the
disease. Thus, there is a wide gap generated in the attitude of the populace in the country
(Snape et al. 2017).
Otte et al. (2013) pointed out that epilepsy is a common non-infectious neurologic
disease prevalent in a number of developing as well as developed countries. Around 50
million people across the world suffer from this disease and need health care facilities at an
adequate level. On the historical front, epilepsy was thought to be a sacred disease that is
caused by the invasion of the body by some supernatural forces. The convulsions were
believed to be the result of this supernatural power. Disappointingly, the historical legacy has
been found to continue to make a drastic public attitude towards epilepsy. As a result, the
diseases have been denoted as a dreaded one, and the patients have been misunderstood,
stigmatised and ostracised. The social implications of these in appropriate attitude is serious.
What is of prime importance sis that per the African belief, epilepsy is due to poisoning and
witchcraft. A combination of lack of medical care, poverty, traditional beliefs, and failure to
justify the social roles has made a deeply negative impact on the lives of epilepsy patients.
Margolis et al. (2018) had commented that it is unfortunate that epilepsy, in spite of
being a common disease, carries a social stigma which is much strong. The discrimination,
stigma and social attitude have prevented the adequate implementation of health promotion
strategies for those in need. Such discrepancies are more common for people from diverse
racial backgrounds such as those with African origin. A comprehensive epilepsy care has
been attempted to be delivered to people from different racial backgrounds; however, low
level of public awareness and poor social education have acted as barriers. Social

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discrimination varies among the population on the basis of the culture they uphold, and their
personal beliefs and viewpoints. There is a need for a comprehensive study that would
highlight the attitude towards epilepsy amongst people coming from the different cultural
background.
According to Allard et al. (2017), people suffering from epilepsy have more chances
of living in areas that are economically and socially deprived. This section of the population
is also prone to suffer from chronic physical conditions and ill health. People suffering from
the disease are not allowed to join particular professions and are implicitly discriminated in
the respective workplace. Though some patients suffering from the disease have comorbid
learning difficulties, antileptic medication is known to cause education impairment. A social
disadvantage might be apparent at diagnosis. Deprivation status has not been quantified
effectively in the recent past. The study conducted by the researchers had pointed out that the
prevalence of epilepsy is not uniform in the United Kingdom. Further, the variability can be
explained by the differences in components of socioeconomic deprivation. The study
conclusively demonstrated that there exists a distinct correlation between indicators of
socioeconomic deprivation and epilepsy prevalence on a population basis. The study
recommended that the designing and implementation of public health policies, which aim at
ameliorating the differences in approach towards epilepsy care, must be based on novice
strategies. In this regard, the strategies might be different for different cities in the country.
According to Ezeala-Adikaibe et al. (2014), one dimension of the sociocultural belief
regarding epilepsy is that the disease is contagious and can spread through body secretions.
This belief has resulted in the isolation of carers to protect and care for patients from injury
at the time of seizures. The sociocultural belief also greatly influences the health seeking
behaviour and the management. There is also a scarcity of trained personnel who can address
the health needs of individuals suffering from the disease.

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Research highlights that the health department in UK has been making several
attempts to address the needs of epilepsy patients at present. It is evident that the concerned
authorities are trying to set up valuable policies and reform the older ones in order to make
epilepsy care more successful. Health promotion for the disease has been has been given
much emphasis for a long time with sets of clear goals to be achieved. The gaps in
understanding the disease act as prime drivers of social stigma and negative attitude towards
non-native population, such as the Africans. It has been realised that there is an urgent need
of robust multi-faceted educational interventions that are aimed at bringing improvement in
the understanding and awareness of the condition by all segments of the community.
Interpersonal as well as mass media delivered programs are needed for this process (Ridsdale
et al. 2017).
At present, there is a scarcity of information on the prevalence of epilepsy among the
African community in the UK. There is a need for further research to establish the knowledge
and attitude of epilepsy among African population in the UK. The research gap generated
from previous research would form the basis for the research to be carried out in future.
Based on the further research, community-based epilepsy programs can outline for improving
the access to epilepsy treatment among African population in the UK. Healthcare
organisations can advocate the use of community-based services for equalising the social
integration of individuals living with the disease. For coming up with suitable public health
projects, there is a need for understanding the scenario of epilepsy knowledge and attitude
among African community in the UK (Krishnamoorthy, Shorvon and Schachter, 2017). A
rich pool of evidence points out that ethnic and racial minorities receive poor quality of care
than nonminorities. Even though several attempts have been made to eliminate the disparity
in care delivery between minority and non-minority population, there is still much to achieve.
Reporting on this inequality, scholars say that disparities cannot be eliminated adequately

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since research into such areas is limited. There is a scarcity of information on the exact
prevalence of certain diseases such as epilepsy, and the related social factors among the
ethnic groups. Interventions, therefore, are difficult to be outlined aligned with the
comprehensive needs of the patients. There is an urgent need of a renewed interest in gaining
an increased understanding of the reasons behind disparities, contributing factors, and
evaluation of effective interventions for these population (Noble et al. 2017).
For projects to be successful in this domain, three major aspects are to be researched
into. First is the prevalence of epilepsy amongst the African Community in England. Second
is the challenges and barriers faced by people with epilepsy among African cultures in
England. Last is the effectiveness of the local authority strategies. A study focusing on these
three aspects would effectively pave the way for improving services for people living with
epilepsy in England. Based on the findings, all interventions can be integrated completely
into the context of primary healthcare delivery. Local communities can be thereby brought
into the planning and implementation process with the aim of fostering long-term
sustainability. The chief aim of epilepsy awareness and education program for the public is to
address stigma, and public health professionals can only promote quality of life of patients
when the whole patient population is identified and approached. Since misconceptions and
misinformation regarding the disease have a long history in society, research is needed for
identifying the changes witnessed in this regard to come up with relevant policies. Comparing
contemporary attitudes with those prevalent decades back would be a valuable approach
(Berkovic 2017).

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Aims and objectives of the study
Research aim refers to the general intentions of the study that is to be carried out. The aim
emphasises on what is to be accomplished at the end of the research. In the present case the
proposed research would have the following aim-
 To examine the knowledge and attitude towards epilepsy amongst the African
Community in England.
Research objectives are the precise study outcomes and these give an accurate view of the
different elements of the research aim. The proposed research would have the following
research objectives-
 To critically investigate the prevalence of epilepsy among the African community in
England.
 To analyze the challenges faced by people with epilepsy among African cultures in
England.
 To analysis local authority strategies for improving services for people living with
epilepsy in England.
Methodology
Research design
The research design refers to the overall plan selected for integrating the different
elements of the research in a logical and coherent manner. The aim of selecting the proper
research design is to make sure that the evidence obtained can properly address the chosen
research problem in a logical manner. The type of design is determined by the research
problem (Taylor, Bogdan and DeVault 2015). The proposed research would be a systematic
literature review that would focus on analysing the attitude and knowledge of epilepsy among
the African population in England. Systematic literature review is a form of a literature

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review that collects and critically analyses a wide range of research studies against the
research question formulated. The aim of the proposed systematic literature review would be
to provide an exhaustive, complete summary of current literature against the research
question. Apart from health interventions, examination of public health interventions is also
possible with the help of such reviews (Flick 2015).
The question of what works best in development of national healthcare policy and
practice is best answered with a literature review that is conducted in a rigorous manner.
Since the urgency of creating advanced health promotion programs is felt at present, there is
an accountability of gathering maximum data from already existing research. Systematic
reviews are a transparent and rigorous form of a literature review that aids in extraction of
optimal information from literary sources. Evidence-based policy making can only be
possible when there is a proper use of empirical evidence on the relevant research.
Government funded programs and policies in many countries across the globe consider the
use of systematic reviews in development research (Neuman and Robson 2014).
A systematic review would be the most comprehensive and reliable review on the
topic of knowledge and attitude of epilepsy among African community in London as it would
help in synthesising and assessing all evidence. Both qualitative and quantitative studies can
be used for this purpose, enhancing the value of the research to a great extent. Such a review
would address the gaps in understanding about the research topic by critically evaluating and
integrating all the study findings that are of high quality. The assessment would establish to
what degree research gained success in clarifying the knowledge and attitude of epilepsy
among African community in the UK. Relationships between the cofactors of epilepsy
prevalence in the country can be established through the research. Further, inconsistencies
and gaps in literature can be brought into focus along with the reasons behind them.
Literature search strategy

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A systematic literature review is to be undertaken by completing a meticulous search
based on a pre-set strategy. The literature search strategy would determine the success of the
research in general (Panneerselvam 2014). The aim of the literature search would be to find
relevant published work throwing light on the research questions. The search would be done
with the help of important databases and keywords. With ideal searching comes the need of
carefully inspecting the same. The databases would be searched for relevant published work,
and a series of steps would be followed for making the search suitable. One database would
be searched on to at a time, and the next databased would be accessed when there would be
no more resources in that databases to consider. The title and the abstract of all the works
would be identified and read for understanding its relevance to the research topic. After the
first step of screening, the full text would be read to further understand whether the paper can
be included in the study. Shifting to full-text version is necessary to see whether the inclusion
criteria are met. At this stage, the pool of possible studies can be reduced rapidly by having a
focus on the content. Since the research aim is multidimensional, there would be need of
searching for ‘grey literature’. These are literature available in electronic and print form that
is not controlled by commercial publishers. These include reports from scientific research
groups, technical and research reports published by government agencies, doctoral
dissertation, official publications and conference proceedings.
Since the search would reveal a large number of results, it would be advisable to
export the search results to a citation manager such as he RefWorks and EndNote. There
would be much benefit in doing so since it would save time, enabling an electronic process
rather than a manual process. The research results can be saved, implying that there would be
no loss of valuable information. Further, duplicate versions of the same paper can be deleted
appropriately (Flick 2015).
Search engines and databases

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Search engines and online databases are the useful tools utilised by researchers who
aim at undertaking a proper systematic literature review for their research. One must be
careful while identifying the correct databases that can provide valuable information on the
research topic (Matthews and Ross 2014). The proposed research is to be undertaken by
using online databases such as PubMed, CINAHL, Ovid, Web Search, Proquest, Science
Direct and others. The above mentioned databases are known for the vast range of literary
sources they hold. These are some of the popular databases having information on public
health domain. The pool of journals and other sources are highly valuable. The databases
have access to full-text journal articles which are peer reviewed. This makes the paper
reliable and highly authentic. Apart from journal articles, one can get books, organisational
reports, dissertations, newspaper articles and other literary sources.
Keywords
Keywords are the search terms used and act as a crucial element of the systemtic
literature search. These are the words and short phrases extracted from the research question
and objectives and entered into the different search engines for extracting the relevant data.
Only suitable keywords can make the search a praiseworthy one and researchers must focus
on using as many as keywords as possible (Flick 2015). The keywords that are to be used for
the proposed research are knowledge, attitude, belief, perception, idea, epilepsy, health,
disease, African, United Kingdom, UK, London, population, prevalence, incidence,
community, challenge, barrier, difficulty, culture, strategy, plan.
Together with the significance of utilising proper keywords emerges the need of using
proper Boolean operations. These are the logical terms placed along with the keywords for
making the search process easier. An authentic search can be carried out if such operations
are used. The credibility of the operations lies in having the search process channelled in a
particular direction. The inappropriate hits can be eradicated with a proper combination of