411 How do we develop inclusive healthcare services that account for structural and systemic factors? Lessons from a qualitative study on the lived experience of navigating health services as a Black person living with stroke in England

Abstract OP 14: Health Services 3, B302 (FCSH), September 3, 2025, 17:00 - 18:00 Background Black people are twice as likely to experience stroke, with first stroke occurring earlier and more likely to experience adverse outcomes that White people. Clinical factors and socio-economic status account for some of this increased risk, suggesting that structural and systemic factors are also involved. Methods The aims of this study was to gain greater understanding of how Black people living with stroke (BPLS) in the UK perceive and experience health care services. Twenty semi -structured interviews were conducted with those living with stroke identifying as African, Afro-Caribbean or of mixed heritage. Results Findings highlighted that BPLS experience a plethora of barriers while accessing services including healthcare providers (HCPs) failing to acknowledge risk or symptoms, not being believed, leading to delay in seeking treatment. While navigating the system as a Black person, they found that services were misaligned with their culture or age. Participants rejected services due to distrust of treatment, stigma associated with seeking support, lack of representation and previous negative experiences, such as microaggression, stereotyping and racism. Conclusion Implications for practice will be discussed including the need for a systemic approach to developing cultural safety and humility education, community engagement to improve access to equitable services, advocacy to navigate service, overcoming stigma and building trust.