Mentoring health researchers globally: Diverse experiences, programmes, challenges and responses

Health research mentorship in low-income and middle-income countries: a global qualitative evidence synthesis of data from a crowdsourcing open call and scoping review

INTRODUCTION

Research mentorship is critical for advancing science, but there are few practical strategies for cultivating mentorship in health research resource-limited settings. WHO/TDR Global commissioned a group to develop a practical guide on research mentorship. This global qualitative evidence synthesis included data from a crowdsourcing open call and scoping review to identify and propose strategies to enhance research mentorship in low/middle-income country (LMIC) institutions.

METHODS

The crowdsourcing open call used methods recommended by WHO/TDR and solicited descriptions of strategies to enhance research mentorship in LMICs. The scoping review used the Cochrane Handbook and predefined the approach in a protocol. We extracted studies focused on enhancing health research mentorship in LMICs. Textual data describing research mentorship strategies from the open call and studies from the scoping review were coded into themes. The quality of evidence supporting themes was assessed using the Confidence in the Evidence from Reviews of Qualitative research approach.

RESULTS

The open call solicited 46 practical strategies and the scoping review identified 77 studies. We identified the following strategies to enhance research mentorship: recognising mentorship as an institutional responsibility that should be provided and expected from all team members (8 strategies, 15 studies; moderate confidence); leveraging existing research and training resources to enhance research mentorship (15 strategies, 49 studies; moderate confidence); digital tools to match mentors and mentees and sustain mentorship relations over time (14 strategies, 11 studies; low confidence); nurturing a culture of generosity so that people who receive mentorship then become mentors to others (7 strategies, 7 studies; low confidence); peer mentorship defined as informal and formal support from one researcher to another who is at a similar career stage (16 strategies, 12 studies; low confidence).

INTERPRETATION

Research mentorship is a collective institutional responsibility, and it can be strengthened in resource-limited institutions by leveraging already existing resources. The evidence from the crowdsourcing open call and scoping review informed a WHO/TDR practical guide. There is a need for more formal research mentorship programmes in LMIC institutions.

Supporting early-career women researchers: lessons from a global mentorship programme

Mentorship is an important contributor to strengthening research capacity among health researchers. Formal mentorship programmes, targeting women mentees can help mitigate some of the gendered power dynamics and can also help early career researchers learn from others' experiences of navigating these challenges. In 2020, the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction at the World Health Organization launched a mentorship programme geared towards early career women researchers. This paper describes the process of designing and implementing a mentorship programme for early career women sexual and reproductive health and rights researchers from low- and middle-income countries including valuable lessons learned vis-à-vis existing evidence. Some of these findings have been incorporated into iterations of the programme launched in 2022. Critical points include: ensuring considerations for language and geographical distribution; allowing mentees to participate in the matching process; providing training and opportunities to network and learn from other participants; offering the support and structure for developing these relationships. Providing women researchers with the tools - through mentorship - to navigate the unique challenges they face in their career journeys, can have a lasting impact on research capacity. Countries and institutions committed to strengthening research capacity need to focus on the holistic growth and motivation of individuals in a way that ensures gender equality.

Training in the art and science of facilitation to scale research mentor training in low and middle income countries

Advancing biomedical research in low and middle income countries (LMICs) to expand the capacity for LMICs to integrate biomedical research into their health care systems and education has been the focus of many programs in global health over the past two decades. Central to the success of these programs is effective research mentoring, characterized by academic, career and psychosocial support through culturally appropriate practices. Research mentoring is a learned skill, developed through training, mutual discussions, practice and feedback. The majority of extant training programs are designed and delivered by US partners, so the next stage in building capacity is to train facilitators within the LMIC partner institutions to contextualize and advance mentoring specifically within their cultural and institutional norms by co-developing, delivering and evaluating semi-annual research mentoring training. To this end, we describe the development, delivery and outcome evaluation of a 5-week course in the art and skill of facilitation. Care was taken to explicitly distinguish between concepts of "teaching" and "facilitation," since "teaching" is closely connected to a transmission or banking model of education, which is characterized by "top-down," hierarchical relationship. The course discussed power and positionality, themes that resonate with partners in Nigeria and Tanzania. These themes provided unique entry into deeper conversations core to advancing mentoring practice away from the traditional dyadic power structure that remains from colonization. Evaluation findings indicate significant advances in awareness of differences between teaching and facilitating, increased confidence in facilitation skills, especially in the area of structured planning and organization, as well as improved communication and interpersonal skills. All respondents felt that students in Nigeria and Tanzania would respond well to the facilitation approach conveyed during the course and they found value in participating in the course as a cohort.

Support, networks, and relationships: Findings from a mixed-methods evaluation of a mentorship programme for early career women researchers in sexual and reproductive health and rights

Low research output among women researchers in health research has been linked to inadequate mentorship opportunities for early career women researchers and particularly in sexual and reproductive health and rights (SRHR) field. Mentorship has been recognized as a contributor to strengthening research capacity and as beneficial for both mentors and mentees. Women researchers oftentimes experience negative impacts of organizational and structural gender inequities related to formal and informal mentoring. In 2020, the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction at WHO launched a mentorship programme for early career SRHR women researchers from low- and middle-income countries. The programme sought to provide professional skill-building, promote and share networking opportunities, and offer support in navigating personal and professional life. We conducted a convergent parallel mixed-methods evaluation of the 2020 pilot programme, which included 26 participants, through an online survey and semi-structured in-depth interviews (IDIs). Data collection occurred between March and May 2022. Nineteen responded to the online survey (12 mentees, 7 mentors) and 11 IDIs (7 mentees, 4 mentors) were completed. Based on a preliminary framework, we used deductive and inductive methods to identify six themes: views on mentorship; reasons for applying and expectations of participation in the programme; preferred aspects of programme implementation; challenges with the programme implementation; perceived lasting benefits of the programme; and recommendations for improvement. All participants found the initial training useful, most discussed work-life prioritization throughout the mentorship relationship, and most planned to continue with the relationship. There appear to be ample benefits to mentorship, especially when planned and implemented in a structured manner. These attributes can be particularly beneficial when they are conceived as a two-way relationship of mutual learning and support, and especially for women at the start of their research careers as they navigate structural gender inequities.

Health research mentorship in low- and middle-income countries: a scoping review

OBJECTIVE

The objective of this scoping review was to explore and synthesize the available literature on health research mentorship in low- and middle-income countries (LMICs).

INTRODUCTION

Research mentorship is broadly considered a useful strategy to improve research capacities and research outputs. Existing literature and guidance on research mentorship have focused on high-income countries and assumed resource-rich environments. Despite the successful endeavors to improve health research capacity in LMICs, the strategies that work best under different circumstances are poorly understood. There is a need to map and understand the evidence on health research mentorship in the context of LMICs.

INCLUSION CRITERIA

Sources that reported existing practices, barriers, and mitigation strategies related to health research mentorship in LMICs were included.

METHODS

We searched for published and unpublished studies and reports written in English, Spanish, or Portuguese. The search strategy was not limited by search dates and the last search was conducted on January 28, 2022. The databases searched included MEDLINE (PubMed), Embase, Web of Science Core Collection, CINAHL (EBSCOhost), Cochrane Database of Systematic Reviews, and JBI Evidence Synthesis . We also searched for gray literature in a selection of websites and digital repositories. The JBI scoping review methodology was used.

RESULTS

A total of 77 studies and reports were included in the review. The majority of the papers were from Africa (n=28). Others were from the Americas (n=7), South East Asia (n=4), East Mediterranean (n=2), and Western Pacific (n=2). The remaining studies were from LMICs that included at least 2 regional offices. Most of the mentorship projects (n=55) were initiated and funded by institutions from high-income countries. The first authors of 41 papers were primarily affiliated with LMICs. The findings were categorized under a description of research mentorship practices, barriers related to research mentorship, and suggested mitigation strategies. Deliverable-driven training using intensive hands-on mentorship and ongoing peer mentorship programs were some of the non-regular, non-institutionalized approaches used to improve research capacity for junior researchers in LMICs. None of the included papers focused on institutional components of research mentorship in LMICs. The barriers to research mentorship activities in LMICs included lack of clarity on mentorship, cultural variations, unbalanced power dynamics, socio-political influences, language barriers, lack of experienced mentors, and limited local funding. Institutionalizing research mentorship, adapting mentoring methodologies relying on local resources, and addressing and respecting diversity in mentorship programs were among the main strategies identified to effectively implement research mentorship in LMICs.

CONCLUSIONS

Research mentorship initiatives and practices are limited in LMICs. Few available practices have been introduced by researchers and research institutions from high-income countries and those that have are not yet institutionalized. The identified existing practices, barriers, and facilitators on health research mentorship could help the design, implementation, and evaluation of programs to institutionalize health research mentorship in LMICs.

REVIEW REGISTRATION

Open Science Framework osf.io/jqa9z/.

SUPPLEMENTAL DIGITAL CONTENT

A Spanish-language version of the abstract of this review is available as supplemental digital content: http://links.lww.com/SRX/A32.

Strengthening Mentorship in Global Health for US Medical Students

US medical students demonstrate strong interest in receiving global health training. In 2012, the Center for Global Health (CGH) at the University of Illinois College of Medicine (UICOM) developed a Global Medicine (GMED) program to match this interest. From its initiation, mentorship has been a key component of the GMED program. More recently, this has been strengthened by applying additional evidence-informed approaches toward mentoring. These include the "mentor up" approach, a "network of mentors," and an individualized development plan (IDP). Applying these changes were associated with increases in the number of student abstract presentations and peer-reviewed journal publications. Mentorship based upon evidence-informed approaches should be a key component of global health education in academic medical centers.

Re-Imagining Reproduction: Citation and Chosen Kin

Reproduction is political. Citation is political. In this essay, I link the anthropological concept of reproduction (biological and social), which is closely tied to kin-making, to citation. I suggest that citation can be viewed as "academic" reproduction and kin-making. To make this argument, I describe my professional and intellectual journey as a Black woman anthropologist based in the global South. I show how the amalgamation of the various contexts in which I was immersed brought up questions of race, nationality, colonialism, profession, and gender and influenced the direction my research took, as well as my scholarly position and engagement. In the article, I lay bare the academic stakes of the path that I have chosen. [citation, reproduction, scholarship, politics, anthropology].

Elevating Mentorship Competency for Sustained Impact via the University of Zambia Mentor Training Program

The University of Zambia (UNZA) Mentor Training Program is conducted annually to strengthen the mentorship capacity of postgraduate programs for the health professions. This intensive five-session course trains faculty members in the mentorship of students. Established by senior UNZA leaders and US-based collaborators, this program was designed to address gaps in mentorship identified at the institutional level. Faculty facilitators developed the course curriculum and used a train-the-trainer model to ensure program sustainability. Participants were faculty members who mentor PhD and Master of Medicine students. To assess the program's impact, mentors and their mentees completed questionnaires on the mentor's mentoring competencies at the end of the course and 1 year later. Competency scores were compared longitudinally to quantify potential changes in mentoring behaviors. Mentors and mentees alike noted mentor growth in all competency domains from postcourse to 1 year later, providing evidence of a trend toward improvement in mentorship and that the program may have sustainable and positive effects on mentoring behaviors over time. Salient areas of growth corresponded to emphasized topics and discussions, including addressing diversity, aligning expectations, assessing capacities, motivating mentees, and fostering independence. These findings suggest that mentors internalized this content and transferred it to behavior change. The behavior changes may reveal a larger change in the institutional environment around the mentoring of students. The UNZA Mentor Training Program appears to have sustained impact after a year and should bode well for future benefits to students, faculty, and the institution.

Consortium for violence prevention research, leadership training, and implementation for excellence (CONVERGE): a protocol to train science leaders in gender-based-violence and violence-against-children research for impact

Background

Gender-based violence (GBV) and violence against children (VAC) are two prevalent and highly interconnected global health challenges, yet data and research capacities to study these forms of violence and to generate evidence-based policies and programs remain limited. To address critical shortages in research capacity in Vietnam and to establish a model for other Low- and Middle-Income Countries (LMICs), we are establishing CONVERGE-the Consortium for Violence Prevention Research, Implementation, and Leadership Training for Excellence.

Methods

Based on a needs assessment with partners in Vietnam, CONVERGE will provide a comprehensive research training program supporting 15 long-term, postdoctoral trainees with multi-disciplinary research training in GBV and VAC. We also will offer in-country trainings and short-courses to 40 short-term mid-career academic trainees and 60 short-term practitioner/stakeholder trainees over 5  years to build productive GBV and VAC academic, scientific, and practitioner networks. The CONVERGE training program has four components: (1) 14 h of virtual/in-person annual mentorship training to prepare research mentors and to create a pipeline of future mentors in Vietnam; (2) a one-month intensive research training for long-term postdoctoral fellows at Emory University; (3) a structured 17-month, in-country mentored research project for long-term trainees that results in a peer-reviewed manuscript and a subsequent grant submission; and, (4) week-long in-country intensive translational trainings on implementation science, advanced topics in leadership, and advanced topics in science dissemination. Opportunities for on-going virtual training and professional networking will be provided for CONVERGE trainees and mentors in Vietnam with other trainees and mentors of D43s focused on injury/violence prevention, D43s housed at Emory, and D43s with other institutions in Southeast Asia. To assess the reach, implementation, fidelity, and effectiveness of these four components, we will implement a rigorous, mixed-methods, multi-level evaluation strategy using process and outcome measures. Findings from the evaluation will be used to refine program components for future trainee and mentor cohorts and to assess long-term program impact.

Discussion

Led by Emory University in the US and Hanoi Medical University in Vietnam, CONVERGE represents leading institutions and experts from around the world, with a goal of providing mentorship opportunities for early-career scientists with an interest in violence prevention.

Capacity building through comprehensive implementation research training and mentorship: an approach for translating knowledge into practice

BACKGROUND

Implementation research (IR) is increasingly gaining popularity as the act of carrying an intention into effect. It is thus an important approach to addressing individual practices, policies, programmes and other technologies to solving public health problems. Low- and middle-income countries (LMICs) continue to experience public health problems which could be addressed using implementation research. These countries however fall behind prioritizing implementation research due to the disorganized approach used to providing knowledge about the value and scope of implementation research. This paper seeks to explain steps taken to resolve this by capacity strengthening activities through a comprehensive implementation research training and mentorship programme which was informed by needs assessment.

METHODS

The roll-out of the comprehensive implementation research training and mentorship was done in phases, including engaging the implementation research community through TDR Global, competency building for programme officers and ethical review board/committee members, and practical guidance to develop an implementation research proposal. The Bloom taxonomy guided the training whilst the Kirkpatrick Model was used for the evaluation of the effectiveness of the capacity building.

RESULTS

The findings identified critical areas of mentors and how mentorship should be structured and the most effective ways of delivering mentorship. These findings were used to develop a mentorship guide in IR. The mentorship guidance is to be used as a check-tool for mentoring participants during trainings as part of the package of resources in implementation research. It is also to be used in equipping review board members with knowledge on ethical issues in implementation research.

CONCLUSION

The approach for providing comprehensive implementation research training and mentorship for programme personnel has provided an opportunity for both potential mentors and mentees to make inputs into developing a mentorship guidance for LMICs. This guidance would help address mentorship initiation and implementation challenges in IR.

Barriers to sustainable health research leadership in the Global South: Time for a Grand Bargain on localization of research leadership?

BACKGROUND

Strong Global South (GS) health research leadership, itself both dependent on and a requisite for strong health research systems, is essential to generate locally relevant research and ensure that evidence is translated into policy and practice. Strong GS health research systems and leadership are important for health development and in turn for strong health systems. However, many GS countries struggle to produce research and to improve performance on widely used research metrics measuring productivity and reflecting leadership. Drawing on literature from a rapid review, this viewpoint paper considers the barriers to GS health research leadership and proposes strategies to address these challenges.

FINDINGS

GS researchers and institutions face numerous barriers that undermine health research leadership potential. Barriers internal to the GS include researcher-level barriers such as insufficient mentorship, limited financial incentives and time constraints. Institutional barriers include limited availability of resources, restrictive and poorly developed research infrastructures, weak collaboration and obstructive policies and procedures. Structural barriers include political will, politicization of research and political instability. External barriers relate to the nature and extent of Global North (GN) activities and systems and include allocation and distribution of funding and resources, characteristics and focus of GN-GS research collaborations, and publication and information dissemination challenges.

CONCLUSIONS

Strengthening GS health research leadership requires acknowledgement of the many barriers, and adoption of mitigating measures by a range of actors at the institutional, national, regional and global levels. Particularly important are leadership capacity development integrating researcher, institutional and systems initiatives; new GN-GS partnership models emphasizing capacity exchange and shared leadership; supporting GS research communities to set, own and drive their research agendas; addressing biases against GS researchers; ensuring that GS institutions address their internal challenges; enhancing South-South collaborations; diversifying research funding flow to the GS; and learning from models that work. The time has come for a firm commitment to improving localization of research leadership, supported by adequate funding flow, to ensure strong and sustainable research systems and leadership in and from the GS. Just as the humanitarian donor and aid community adopted the Grand Bargain commitment to improve funding flow through local and national responders in times of crisis, we strongly urge the global health research community to adopt a Grand Bargain for research leadership.

Training the Next Generation of Diabetes Researchers: Evaluation of the Diabetes Action Canada Training and Mentoring Program

BACKGROUND

The Diabetes Action Canada Training and Mentoring (DAC-TM) Program launched in June 2017, with the goal of building capacity in the next generation of diabetes researchers in Canada in patient-oriented research (POR).

METHODS

We conducted a program evaluation of the DAC-TM program using a sequential, mixed-methods research design.

RESULTS

Our analysis of 82 surveys and 22 in-depth interviews from a wide range of DAC-TM Program stakeholders revealed consistent patterns in experience with the program. The training sessions were perceived to be well-organized, convenient educational opportunities to gain new knowledge about POR and become integrated into a community of practice of POR researchers who study diabetes and its complications in Canada. The content of the training was perceived to be useful and relevant to participants, although improvements could be made to help address the training needs of the broader DAC community. There is broad support for and appreciation of the mentorship awards, which were perceived to be appropriately targeted to early-career investigators. The mentor-mentee relationships were perceived to be positive, productive and career-advancing overall, but could benefit from a more strategic design and promote better connectivity to foster mentor-mentee relationships. In addition, feedback about opportunities to network and forge new connections was mixed and represents another opportunity for improvement to strengthen capacity building.

CONCLUSIONS

Findings from this formative evaluation study show key strengths and opportunities to improve the DAC-TM Program, which can be used to help enhance its function and promote its long-term sustainability.

Research Capacity Training on Environmental Health and Noncommunicable Diseases in the Country of Georgia: Challenges and Lessons Learned during the COVID-19 Pandemic

COVID-19 presented challenges for global health research training programs. The Clean Air Research and Education (CARE) program, which aims to enhance research capacity related to noncommunicable diseases and environmental health in the country of Georgia, was launched in 2020—as the COVID-19 pandemic began. At its foundation is mentorship and mentored research, alongside formal didactic training, informal training/meetings, and other supports. Current analyses examined CARE’s initial 1.5 years (e.g., program benefits, mentorship relationships) using data from an evaluation survey among trainees and faculty in January 2022. Trainees (100% response rate: n = 12/12; 4 MPH, 8 PhD) and faculty (86.7% response rate: n = 13/15; 7 Georgia-based, 6 United States-based) rated factors related to mentor-mentee relationships highly, particularly mutual consideration of each other’s thoughts, opinions, and perspectives; one major challenge was completing goals planned. Trainees and faculty identified several growth experiences and program benefits (e.g., skills development, expanding professional network) but also identified challenges (e.g., meeting program demands, communication gaps, unclear expectations)—exacerbated by the pandemic. Findings underscore the importance of strong mentorship relationships and that the pandemic negatively impacted communication and clarity of expectations. Given the likely ongoing impact of the pandemic on such programs, program leaders must identify ways to address these challenges.

A roadmap of strategies to support cardiovascular researchers: from policy to practice

Cardiovascular disease remains the leading cause of death worldwide. Cardiovascular research has therefore never been more crucial. Cardiovascular researchers must be provided with a research environment that enables them to perform at their highest level, maximizing their opportunities to work effectively with key stakeholders to address this global issue. At present, cardiovascular researchers face a range of challenges and barriers, including a decline in funding, job insecurity and a lack of diversity at senior leadership levels. Indeed, many cardiovascular researchers, particularly women, have considered leaving the sector, highlighting a crucial need to develop strategies to support and retain researchers working in the cardiovascular field. In this Roadmap article, we present solutions to problems relevant to cardiovascular researchers worldwide that are broadly classified across three key areas: capacity building, research funding and fostering diversity and equity. This Roadmap provides opportunities for research institutions, as well as governments and funding bodies, to implement changes from policy to practice, to address the most important factors restricting the career progression of cardiovascular researchers.

A Global Crowdsourcing Open Call to Improve Research Mentorship in Low- and Middle-Income Countries: A Mixed Methods Analysis

Research mentoring programs are limited in many low- and middle-income countries (LMICs). The TDR Global initiated a global crowdsourcing open call soliciting proposals on how to improve research mentorship in LMICs. The purpose of this study is to examine ideas submitted to this open call to identify the ways to improve research mentorship in LMICs. Open calls have a group of individuals solve all or part of a problem and then share solutions. A WHO/TDR/SESH crowdsourcing guide was used to structure the open call. Each submission was judged by three independent individuals on a 1-10 scale. Textual submissions were extracted from eligible proposals and qualitatively analyzed via inductive and deductive coding techniques to identify themes. The open call received 123 submissions from 40 countries in Asia (49), Africa (38), Latin America (26), and Europe (10). Among all participants, 108 (87%) had research experience. A total of 21 submissions received a mean score of 7/10 or higher. Our thematic analysis identified three overarching themes related to prementoring, facilitation, and evaluation. Prementoring establishes mentor-mentee compatibility to lay foundations for mentorship. Facilitation involves iterative cycles of planning, communication, and skill improvement. Evaluation creates commitment and accountability within a framework of monitoring. This global crowdsourcing open call generated numerous mentorship ideas, including LMIC-contextualized facilitation tools. The open call demonstrates a need for greater focus on mentorship. Our data may inform the development of formal and informal mentoring programs in LMIC settings.

A mixed methods needs assessment and gap analysis for establishment of a cancer research training program in East Africa

Background

The burden of non-communicable diseases (NCDs), including cancer, in Africa is rising. Policymakers are charged with formulating evidence-based cancer control plans; however, there is a paucity of data on cancers generated from within Africa. As part of efforts to enhance cancer research training in East Africa, we performed a needs assessment and gap analysis of cancer-related research training resources in Tanzania.

Methods

A mixed-methods study to evaluate existing individual, institutional, and national resources supporting cancer research training in Tanzania was conducted. Qualitative data were collected using in-depth interviews while quantitative data were collected using self-administered questionnaires and online surveys. The study also included a desk-review of policy and guidelines related to NCD research and training. Study participants were selected to represent five groups: (i) policymakers; (ii) established researchers; (iii) research support personnel; (iv) faculty members in degree training programs; and (v) post-graduate trainees.

Results

Our results identified challenges in four thematic areas. First, there is a need for coordination and monitoring of the cancer research agenda at the national level. Second, both faculty and trainees identified the need for incorporation of rigorous training to improve research competencies. Third, sustained mentoring and institutional investment in development of mentorship resources is critical to empowering early career investigators. Finally, academic institutions can enhance research outputs by providing adequate research infrastructure, prioritizing protected time for research, and recognizing research accomplishments by trainees and faculty.

Conclusions

As we look towards establishment of cancer research training programs in East Africa, investment in the development of rigorous research training, mentorship resources, and research infrastructure will be critical to empowering local health professionals to engage in cancer research activities.

Feasibility of implementing formal long-distance mentorship for public health physicians: a case study of Association of Public Health Physicians of Nigeria

BACKGROUND

Conflicting schedules and geographic access limit prospects for mutually beneficial relationships between experts and early career professionals. A formal long-distance mentorship program could address these barriers and potentially bridge the gap of traditional face-to-face mentorship. This study was done to determine the feasibility of implementing a formal long-distance mentorship program amongst public health physicians of Nigeria.

METHOD

A mixed-method study comprising of in-depth interviews and surveys was used to collect information from members of the Association of Public Health Physicians in Nigeria. A total of 134 survey participants were recruited consecutively during an annual scientific meeting of the association. In-depth interviewees were purposively selected to ensure diversity in expertise, experience, and social stratifiers such as age. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed using thematic content analysis.

RESULTS

Public health physicians of Nigeria are willing to participate in a formal Long-Distance Mentorship Program, and four elements of feasibility were highlighted as necessary for implementing the program. Namely i) capacity to coordinate LDMP, ii) technical expertise and individual competence to provide mentorship, iii) financial capacity to implement and sustain LDMP, and iv) demand for mentorship by mentees. There is a consensus that the organizational structure of the National Postgraduate Medical College of Nigeria and West African College of Physicians provide an enabling environment to initiate a LDMP for public health physicians of Nigeria. The vast human resources with various expertise and the annual National conferences can be leveraged upon to champion and administer the program. However, there is a need for an administrative structure and technical expertise to enable proper coordination. More so, the need for demand creation and the financial requirement was considered gaps that need to be filled to be able to ensure feasibility. Bivariate analysis showed a significant relationship between the dependent variable (preferred role- mentor/mentee) and independent variables (age, year of graduation, and the number of years of practice), while the binary logistic regression model showed that physicians are more likely to participate as mentors with each unit increase in the number of years of practice. This further buttressed the need to commence the mentoring process as soon as trainees gain entrance into the program, as mentorship does not just prepare them for excellent public health practice, but also builds their capacity to mentor the younger and upcoming public health physicians.

CONCLUSION

There are enabling structures to incorporate a formal long-distance mentorship program for public health physicians in Nigeria, and physicians are willing to participate in such a program. However, the feasibility of establishing a successful and sustainable program will require robust coordination, technical expertise, demand creation, and financial commitment at both institutional and college levels.

The Call for Global Health Research Mentorship for Doctorally Prepared Nurses in Low- and Middle-Income Countries

Limited research about nursing mentorship in low- and middle-income countries (LMICs) is holding science back. This article describes the strengths and challenges associated with global health research mentorship for doctorally prepared nurses whose scholarship focuses on LMICs. Using reflexive narrative accounts from current and former nurse mentors and nurse mentees who participated in a NIH-funded global health doctoral research program, emerging themes revealed the perspectives of mentors and mentees, producing a global health mentoring model for nursing research mentorship relevant to LMICs. Identified themes, which applied across roles and primary affiliations, included 1) collaborative mentor-mentee relationships and 2) enthusiasm for global health nursing. Our global health nursing research mentor-mentee interaction systems conceptual model focuses on nursing science mentoring in LMICs incorporating interpersonal, institutional, and cultural factors. We describe successful components of global nurse researcher mentorship and summarize directions for future research in the field. Our model can be used to create more effective mentee-centered mentoring for nurses or health professionals conducting global research. To advance science, we encourage doctorally prepared nurses to support mentee-centered research mentorship experiences that are sensitive to the unique needs of interdisciplinary global health scholarship.

Implementation of Online Research Training and Mentorship for Sub-Saharan African Family Physicians

Background:

To improve the delivery and reach of primary health care, a robust scientific foundation driven by research is needed. However, few family physicians conduct research, especially in sub-Saharan Africa. Early-career and trainee family physicians are a key part of the primary care research pipeline and have an expressed need for research training and mentorship.

Objective:

AfriWon Research Collaborative (ARC) was an online research training and mentorship pilot program whose objective was to increase research activity among participants from AfriWon Renaissance, the family physician young doctors’ movement of sub-Saharan Africa.

Methods:

ARC utilized a 10-module online curriculum, supported by peer and faculty e-mentorship, to guide participants through writing a research protocol. The feasibility, acceptability, and scalability of this program was evaluated via a mixed-methods RE-AIM-guided process evaluation using descriptive statistics and inductive/deductive thematic analysis.

Findings:

The pilot reached participants from Botswana, Democratic Republic of the Congo, Ghana, Nigeria and Sierra Leone and was adopted by mentors from 11 countries across three continents. Four of the 10 pilot participants completed a full research protocol by the end of the six-month core program. Seven out of the 10 participants, and nine out of the 15 mentors, planned to continue their mentorship relationships beyond the core program. The program helped instill a positive research culture in active participants. Some participants’ and mentors’ engagement with the ARC program was limited by confusion over mentorship structure and role, poor network connectivity, and personal life challenges.

Conclusions:

Online research training and mentorship for trainee and early-career family physicians in sub-Saharan Africa is feasible and acceptable to participants and mentors. Similar programs must pay careful attention to mentorship training and provide a flexible yet clearly organized structure for mentee-mentor engagement. Additional work is needed to determine optimal implementation strategies and ability to scale.

Developing Research Potential and Building Partnerships: A Report of the Fundamentals of Surgical Research Course at the College of Surgeons of East, Central, and Southern Africa

BACKGROUND

Approximately a decade after the inaugural Fundamentals of Surgical Research Course (FSRC) at the West African College of Surgeons meeting (2008), the Association for Academic Surgery expanded the course offering to the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA). After the second annual offering of the course in 2019, participants were surveyed to assess the impact of the course.

METHODS

A survey was distributed to the attendees of the 2019 second COSECSA FSRC course, held in December 2019 in Kampala, Uganda. Approximately 80 people attended at least a portion of the full-day course. Forty-nine participants completed the voluntary survey questionnaire distributed to assess each session of the course at course completion.

RESULTS

Ten different countries were represented among the attendees. Of the 49 evaluations, 35 respondents were male and six were female. Eight respondents did not identify a gender. Surgical residents comprised 19 of the 49 attendees, and one of the 49 attendees was a medical student. Thirty-five respondents indicated that their views of surgical research had changed after attending the course.

CONCLUSIONS

The second annual FSRC at COSECSA confirmed significant interest in building research skills and partnerships in sub-Saharan Africa. A wide variety of learners attended the course, and a majority of the sessions received overwhelmingly positive feedback. Multiple conference attendees expressed interest in serving as faculty for the course moving forward, highlighting a viable path for sustainability as the Association for Academic Surgery develops an international research education platform.

Mixed-methods evaluation of family medicine research training and peer mentorship in Lesotho

Background

Strengthening primary care research capacity is a priority globally. Family medicine training programmes in sub-Saharan Africa represent an important opportunity to build primary care research; however, they are often limited by insufficient research training and mentorship. Peers can be used to extend research mentorship capacity, but have not been evaluated in this context.

Aim

The aim of this study was to evaluate one family medicine training programme’s research capacity building efforts through a blended research curriculum and peer mentorship.

Setting

Lesotho is a landlocked country within South Africa of approximately two million people. The Family Medicine Specialty Training Programme (FMSTP) is the only accredited postgraduate medical education programme in Lesotho.

Methods

This two-year mixed-methods evaluation used: (1) Likert-scale surveys measuring trainee research confidence, (2) written evaluations by trainees, peers, programme faculty and administrators and (3) in-depth, semi-structured interviews. Survey data were analysed using Friedman and sign tests. Interview and written data were analysed thematically via a mixed inductive-deductive approach using Cooke’s framework.

Results

Family Medicine Specialty Training Programme trainees (n = 8) experienced moderate increases in research confidence that were statistically significant. Skill-building occurred primarily via experiential learning. Research was grounded in trainees’ clinical practice and locally relevant. A positive research culture was created, promising for sustainability. We identified infrastructure gaps, including funding and protected time. Peer research mentorship supported trainees’ motivation and provided a safe space for questions.

Conclusion

The FMSTP research curriculum and peer mentorship programme were successful in positively impacting a number of Cooke’s research capacity domains. This evaluation identified improvements that are now being implemented.

The Global Leadership Mentoring Community: building capacity across seven global regions

AIM

The purpose of this paper is to report on the evaluation of the online Global Leadership Mentoring Community, a programme designed to build relationships across seven global regions and promote leadership development for emerging nurse leaders.

BACKGROUND

There is a pressing need and opportunity for sustainable global leadership mentoring programmes. This programme of Sigma Theta Tau International (Sigma) brought mentors and mentees together from across the world to build leadership capacity, understand global leadership issues and build networks. Community coordinators purposively selected mentors from each of Sigma's seven Global Regions, and mentees were chosen through a process of snowball sampling. Mentors and mentees met monthly with quarterly group calls.

METHODS

The study followed a programme evaluation, outcomes-focused approach. All eleven pairs of mentors-mentees were invited to complete online surveys at the outset and end of programme capturing both quantitative and qualitative data. Quantitative data were analysed using descriptive statistics and for qualitative data, a thematic analysis.

FINDINGS

Quantitative data confirmed that all 22 participants gained from the experience. From qualitative analysis, themes emerged illustrating the scope of achievements: 1. facilitation of successful outcomes for both mentors and mentees, 2. challenges of global mentoring and 3. strategies for successful global mentoring.

DISCUSSION/CONCLUSION

Participants reported that creating global leadership is a longitudinal process that needs sustained attention to effect change. This evaluation identified many strengths of the programme and recommended its continuation to help further development of global leaders, particularly through focusing more purposefully on policy issues.

IMPLICATIONS FOR NURSING POLICY

Empowerment of nurses globally through a Global Leadership Mentoring Community can improve leadership at all levels, thus emboldening their voices to influence nursing and health policy and ultimately improve patient care.

The role of mentoring in research ecosystems in Sub-Saharan Africa: Some experiences through the CARTA opportunity

Mentoring is important for improving capacity development in population and public health research in sub-Saharan Africa. A variety of experiences have been documented since Consortium for Advanced Research Training in Africa (CARTA) admitted the first cohort in 2011. However, the experience of mentoring opportunities in CARTA has not been studied. Our study focused on the perceptions, experiences and challenges of mentoring among CARTA fellows. We adopted a descriptive design based on data collected from the fellows using an online semi-structured questionnaire. Out of 143 fellows in the programme, a total of 52 fellows from seven cohorts completed the questionnaire. Fifty-three percent of the respondents were females, more than half belonged to the health sciences while 35% were in the social sciences. Fellows received mentoring from CARTA graduates and experienced researchers in the CARTA network, but they also engaged in peer-mentoring with one another. Teaching, publishing, conference attendance and grant application were considered particularly important in mentoring, but mentors and mentees highlighted personal and social issues such as networking, work-family life balance, and managing stress and time, as challenges. There is a need for more formalised but flexible mentorship initiative in the CARTA fellowship to facilitate enduring relationships for career development.

Capacity building for implementation research: a methodology for advancing health research and practice

BACKGROUND

Implementation research is increasingly being recognised as an important discipline seeking to maximise the benefits of evidence-based interventions. Although capacity-building efforts are ongoing, there has been limited attention on the contextual and health system peculiarities in low- and middle-income countries. Moreover, given the challenges encountered during the implementation of health interventions, the field of implementation research requires a creative attempt to build expertise for health researchers and practitioners simultaneously. With support from the Special Programme for Research and Training in Tropical Diseases, we have developed an implementation research short course that targets both researchers and practitioners. This paper seeks to explain the course development processes and report on training evaluations, highlighting its relevance for inter-institutional and inter-regional capacity strengthening.

METHODS

The development of the implementation research course curriculum was categorised into four phases, namely the formation of a core curriculum development team, course content development, internal reviews and pilot, and external reviews and evaluations. Five modules were developed covering Introduction to implementation research, Methods in implementation research, Ethics and quality management in implementation research, Community and stakeholder engagement, and Dissemination in implementation research. Course evaluations were conducted using developed tools measuring participants' reactions and learning.

RESULTS

From 2016 to 2018, the IR curriculum has been used to train a total of 165 researchers and practitioners predominantly from African countries, the majority of whom are males (57%) and researchers/academics (79.4%). Participants generally gave positive ratings (e.g. integration of concepts) for their reactions to the training. Under 'learnings', participants indicated improvement in their knowledge in areas such as identification of implementation research problems and questions.

CONCLUSION

The approach for training both researchers and practitioners offers a dynamic opportunity for the acquisition and sharing of knowledge for both categories of learners. This approach was crucial in demonstrating a key characteristic of implementation research (e.g. multidisciplinary) practically evident during the training sessions. Using such a model to effectively train participants from various low- and middle-income countries shows the opportunities this training curriculum offers as a capacity-building tool.

Exploring gaps, strategies and solutions for primary care research mentorship in the African context: A workshop report

BACKGROUND

Primary care needs research to generate evidence relevant to community needs; however, there is a lack of research engagement among primary care physicians, especially in sub-Saharan Africa. Improved research mentorship for family physicians (FPs) can help address prevailing knowledge and practice gaps in primary care research.Workshop process: During the 6th annual Africa Regional Conference of the World Organization of Family Doctors (WONCA), we conducted three workshops on research mentorship for African FPs. Two workshops (one online and one onsite at the pre-conference) were geared towards the young doctors' movement of WONCA Africa. The third was onsite during the main conference. Following a brief presentation on the concept of research mentorship and known gaps, participants broke into small groups and discussed additional gaps, solutions and anticipated readiness for implementing these solutions. We used a content analysis to summarise key concepts and had participants to review the findings.Workshop findings: Identified gaps related to mentees' difficulty initiating and maintaining mentorship relationships and an overall shortage of capable and willing mentors. Organisational solutions focused on capacity building and creating a culture of mentorship. Interpersonal solutions focused on reducing the power distance and increasing reflectivity and feedback. Increasing the use of research networks and both peer and online mentorship were advocated. Barriers to readiness included resource constraints and competing priorities.

CONCLUSION

A multi-level approach is needed to address the gaps in research mentorship for African FPs. Identified solutions hold potential for supporting the research engagement needed to improve the population health across Africa.

Barriers and Solutions to Advancing Emergency Medicine Simulation-based Research: A Call to Action

Simulation technology has successfully improved patient safety and care quality through training and assessment of individuals, teams, and health care systems. Emergency medicine (EM) continues to be a leader and pioneer of simulation, including administration of simulation-based fellowships and training programs. However, EM simulation-based research has been limited by low rates of publication and poor methodologic rigor. The Society for Academic Emergency Medicine (SAEM) Simulation Academy is leading efforts to improve the quality of scholarship generated by the EM simulation community and to foster successful research careers for future generations of EM simulationists. Through a needs assessment survey of our membership and a year-long consensus-based approach, we identified two main clusters of barriers to simulation-based research: lack of protected time and dedicated resources and limited training and mentorship. As a result, we generated four position statements with implications for education, training, and research in EM simulation and as a call to action for the academic EM community. Recommendations include expansion of funding opportunities for simulation-based research, creation of multi-institutional simulation collaboratives, and development of mentorship and training pathways that promote rigor in design and methodology within EM simulation scholarship.

Strengthening Mentoring in Low- and Middle-Income Countries to Advance Global Health Research: An Overview

Mentoring is a proven path to scientific progress, but it is not a common practice in low- and middle-income countries (LMICs). Existing mentoring approaches and guidelines are geared toward high-income country settings, without considering in detail the differences in resources, culture, and structure of research systems of LMICs. To address this gap, we conducted five Mentoring-the-Mentor workshops in Africa, South America, and Asia, which aimed at strengthening the capacity for evidence-based, LMIC-specific institutional mentoring programs globally. The outcomes of the workshops and two follow-up working meetings are presented in this special edition of the American Journal of Tropical Medicine and Hygiene. Seven articles offer recommendations on how to tailor mentoring to the context and culture of LMICs, and provide guidance on how to implement mentoring programs. This introductory article provides both a prelude and executive summary to the seven articles, describing the motivation, cultural context and relevant background, and presenting key findings, conclusions, and recommendations.

Evaluating Academic Mentorship Programs in Low- and Middle-Income Country Institutions: Proposed Framework and Metrics

A growing number of low- and middle-income country (LMIC) institutions have developed and implemented formal programs to support mentorship. Although the individual-level benefits of mentorship are well established, such activities can also sustainably build institutional capacity, bridge inequities in health care, and catalyze scientific advancement. To date, however, evaluation of these programs remains limited, representing an important gap in our understanding about the impact of mentoring. Without rigorous and ongoing evaluation, there may be missed opportunities for identifying best practices, iteratively improving program activities, and demonstrating the returns on investment in mentorship. In this report, we propose a framework for evaluating mentorship programs in LMIC settings where resources may be constrained. We identify six domains: 1) mentor–mentee relationship, 2) career guidance, 3) academic productivity, 4) networking, 5) wellness, and 6) organizational capacity. Within each, we describe specific metrics and how they may be considered as part of evaluation plans. We emphasize the role of measurement and evaluation at the institutional level, so that programs may enhance their mentoring capacity and optimize the management of their resources. Although we advocate for a comprehensive approach to evaluation, we recognize that—depending on stage and relative maturity—some domains may be prioritized to address short- and medium-term program goals.

Mentoring the Mentors: Implementation and Evaluation of Four Fogarty-Sponsored Mentoring Training Workshops in Low-and Middle-Income Countries

A growing body of evidence highlights the importance of competent mentoring in academic research. We describe the development, implementation, and evaluation of four regional 2-day intensive workshops to train mid- and senior-level investigators conducting public health, clinical, and basic science research across multiple academic institutions in low- and middle-income countries (LMICs) on tools and techniques of effective mentoring. Sponsored by the Fogarty International Center, workshops included didactic presentations, interactive discussions, and small-group problem-based learning and were conducted in Lima, Peru; Mombasa, Kenya; Bangalore, India; and Johannesburg, South Africa, from 2013 to 2016. Mid- or senior-level faculty from multiple academic institutions within each region applied and were selected. Thirty faculty from 12 South America–based institutions, 29 faculty from eight East Africa–based institutions, 37 faculty from 14 South Asia–based institutions, and 36 faculty from 13 Africa-based institutions participated, with diverse representation across disciplines, gender, and academic rank. Discussions and evaluations revealed important comparisons and contrasts in the practice of mentoring, and specific barriers and facilitators to mentoring within each cultural and regional context. Specific regional issues related to hierarchy, the post-colonial legacy, and diversity arose as challenges to mentoring in different parts of the world. Common barriers included a lack of a culture of mentoring, time constraints, lack of formal training, and a lack of recognition for mentoring. These workshops provided valuable training, were among the first of their kind, were well-attended, rated highly, and provided concepts and a structure for the development and strengthening of formal mentoring programs across LMIC institutions.

Global Health Mentoring Toolkits: A Scoping Review Relevant for Low- and Middle-Income Country Institutions

Capacity building in low- and middle-income country (LMIC) institutions hinges on the delivery of effective mentorship. This study presents an overview of mentorship toolkits applicable to LMIC institutions identified through a scoping review. A scoping review approach was used to 1) map the extent, range, and nature of mentorship resources and tools available and 2) to identify knowledge gaps in the current literature. To identify toolkits, we collected and analyzed data provided online that met the following criteria: written in English and from organizations and individuals involved in global health mentoring. We searched electronic databases, including PubMed, Web of Science, and Google Scholar, and Google search engine. Once toolkits were identified, we extracted the available tools and mapped them to pre-identified global health competencies. Only three of the 18 identified toolkits were developed specifically for the LMIC context. Most toolkits focused on individual mentor-mentee relationships. Most focused on the domains of communication and professional development. Fewer toolkits focused on ethics, overcoming resource limitations, and fostering institutional change. No toolkits discussed strategies for group mentoring or how to adapt existing tools to a local context. There is a paucity of mentoring resources specifically designed for LMIC settings. We identified several toolkits that focus on aspects of individual mentor-mentee relationships that could be adapted to local contexts. Future work should focus on adaptation and the development of tools to support institutional change and capacity building for mentoring.

The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building: a program protocol for building implementation science and mental health research and policymaking capacity in Malawi and Tanzania

Background

Mental health (MH) disorders in low and middle-income countries (LMICs) account for a large proportion of disease burden. While efficacious treatments exist, only 10% of those in need are able to access care. This treatment gap is fueled by structural determinants including inadequate resource allocation and prioritization, both rooted in a lack of research and policy capacity. The goal of the Sub-Saharan Africa Regional Partnership for Mental Health Capacity Building (SHARP), based in Malawi and Tanzania, is to address those research and policy-based determinants.

Methods

SHARP aims to (1) build implementation science skills and expertise among Malawian and Tanzanian researchers in the area of mental health; (2) ensure that Malawian and Tanzanian policymakers and providers have the knowledge and skills to effectively apply research findings on evidence-based mental health programs to routine practice; and (3) strengthen dialogue between researchers, policymakers, and providers leading to efficient and sustainable scale-up of mental health services in Malawi and Tanzania. SHARP comprises five capacity building components: introductory and advanced short courses, a multifaceted dialogue, on-the-job training, pilot grants, and “mentor the mentors” courses.

Discussion

Program evaluation includes measuring dose delivered and received, participant knowledge and satisfaction, as well as academic output (e.g., conference posters or presentations, manuscript submissions, grant applications). The SHARP Capacity Building Program aims to make a meaningful contribution in pursuit of a model of capacity building that could be replicated in other LMICs. If impactful, the SHARP Capacity Building Program could increase the knowledge, skills, and mentorship capabilities of researchers, policymakers, and providers regarding effective scale up of evidence-based MH treatment.

What really matters for successful research environments? A realist synthesis

CONTEXT

Research environments, or cultures, are thought to be the most influential predictors of research productivity. Although several narrative and systematic reviews have begun to identify the characteristics of research-favourable environments, these reviews have ignored the contextual complexities and multiplicity of environmental characteristics.

OBJECTIVES

The current synthesis adopts a realist approach to explore what interventions work for whom and under what circumstances.

METHODS

We conducted a realist synthesis of the international literature in medical education, education and medicine from 1992 to 2016, following five stages: (i) clarifying the scope; (ii) searching for evidence; (iii) assessing quality; (iv) extracting data, and (v) synthesising data.

RESULTS

We identified numerous interventions relating to research strategy, people, income, infrastructure and facilities (IIF), and collaboration. These interventions resulted in positive or negative outcomes depending on the context and mechanisms fired. We identified diverse contexts at the individual and institutional levels, but found that disciplinary contexts were less influential. There were a multiplicity of positive and negative mechanisms, along with three cross-cutting mechanisms that regularly intersected: time; identity, and relationships. Outcomes varied widely and included both positive and negative outcomes across subjective (e.g. researcher identity) and objective (e.g. research quantity and quality) domains.

CONCLUSIONS

The interplay among mechanisms and contexts is central to understanding the outcomes of specific interventions, bringing novel insights to the literature. Researchers, research leaders and research organisations should prioritise the protection of time for research, enculturate researcher identities, and develop collaborative relationships to better foster successful research environments. Future research should further explore the interplay among time, identity and relationships.

Development and evaluation of a capacity building program in gender-relevant tobacco control research: A Brazilian experience

INTRODUCTION

There is an increased need for capacity building of researchers and professionals in low- and middle-income countries with evidence-based approaches across the tobacco control continuum, particularly with regard to gender-relevant strategies. We describe the development, implementation, and evaluation of a Career Development and Research Training Program (CDRTP) in tobacco control.

METHODS

The CDRTP is organized into two modules: Module I is open to the public and provides an overview of tobacco control; Module II, consists of a one-year program with multi-mode sessions toward the development of a pilot research project. Activities are implemented through co-learning to facilitate cross-fertilization of knowledge, collaborations, and team science.

RESULTS

Between 2010 and 2015, 255 individuals participated in Module I with 57 applying for Module II's selective process. Out of these, 35 were selected, 29 completed the program (83%), 21 submitted pilot research projects that have undergone review, and 16 were approved for funding. Pre- and post-tests among the 29 participants who completed the training indicated improvement in scholars' perceived knowledge and skills on all of the components.

CONCLUSION

In addition to attracting researchers and professionals who have not been working in tobacco control, the capacity building program has promoted knowledge, skills, and confidence among participants to pursue gender-relevant tobacco control research.

Supporting capacity for research on malaria in Africa

Substantial progress has been made in the control of malaria in Africa but much remains to be done before malaria elimination on the continent can be achieved. Further progress can be made by enhancing uptake of existing control tools but, in high transmission areas, additional tools will be needed. Development and evaluation of these new tools will require a substantial cadre of African scientists well trained in many different disciplines. This paper describes the activities undertaken by the Malaria Capacity Development Consortium (MCDC) to support the careers of PhD students and postdoctoral fellows undertaking research on malaria at five African universities. A systematic assessment of constraints on PhD training and research support systems was undertaken at each partner African university at the beginning of the programme and many of these constraints were remedied. The success of the programme is shown by the fact that 18 of the 21 PhD students recruited to the programme completed their theses successfully within a 4-year period and that all 27 scientists recruited to the postdoctoral programme were still working in Africa on its completion. The work of the consortium will be continued through Career Development Groups established at each partner university and at an affiliated institution at the University of Nairobi and through the Developing Excellence in Leadership, Training and Science award from the Wellcome Trust made to one of the African partners. Lessons learnt during the MCDC programme may help the planning and execution of other research capacity development programmes in Africa.

What can we learn from interventions that aim to increase policy-makers' capacity to use research? A realist scoping review

Background

Health policy-making can benefit from more effective use of research. In many policy settings there is scope to increase capacity for using research individually and organisationally, but little is known about what strategies work best in which circumstances. This review addresses the question: What causal mechanisms can best explain the observed outcomes of interventions that aim to increase policy-makers’ capacity to use research in their work?

Methods

Articles were identified from three available reviews and two databases (PAIS and WoS; 1999–2016). Using a realist approach, articles were reviewed for information about contexts, outcomes (including process effects) and possible causal mechanisms. Strategy + Context + Mechanism = Outcomes (SCMO) configurations were developed, drawing on theory and findings from other studies to develop tentative hypotheses that might be applicable across a range of intervention sites.

Results

We found 22 studies that spanned 18 countries. There were two dominant design strategies (needs-based tailoring and multi-component design) and 18 intervention strategies targeting four domains of capacity, namely access to research, skills improvement, systems improvement and interaction. Many potential mechanisms were identified as well as some enduring contextual characteristics that all interventions should consider. The evidence was variable, but the SCMO analysis suggested that tailored interactive workshops supported by goal-focused mentoring, and genuine collaboration, seem particularly promising. Systems supports and platforms for cross-sector collaboration are likely to play crucial roles. Gaps in the literature are discussed.

Conclusion

This exploratory review tentatively posits causal mechanisms that might explain how intervention strategies work in different contexts to build capacity for using research in policy-making.

Electronic supplementary material

The online version of this article (10.1186/s12961-018-0277-1) contains supplementary material, which is available to authorized users.

Population health intervention research training: the value of public health internships and mentorship

BACKGROUND

Better alignment between academia and public health practice and policies are critical to improve public health actions. Training of future researchers to address complex issues and to conduct transdisciplinary and collaborative research will help improve this alignment. In this paper, we describe the role of internship placements and mentorship for trainees' skills development in population health intervention research and the benefits of embedding research trainees within public health organizations.

METHODS

This qualitative descriptive study assessed the perceptions of the role and benefits of internships and mentorship for population health intervention research training among former doctoral and postdoctoral students, public health mentors, and senior public health managers who participated in the 4P Program, a research training program which bridges academic training and the public health system in Quebec, Canada. Two types of interviews were conducted: telephone semi-structured interviews by an external evaluator and face-to-face trainee "exit" interviews by the Program co-director. Semi-annual evaluation reports from each trainee were also reviewed. Qualitative data were subjected to a thematic analysis.

RESULTS

Internships provided trainees with a working knowledge of the public health system and the context in which decisions and public health interventions are implemented. It was an opportunity for trainees to interact with knowledge-user partners and assess the gap between research and practice. Effective mentorship was key to help trainees interpret the public health reality and develop population health intervention research skills. Trainees learned to ask the "how" questions that are critical for in-depth understanding of complex interventions and the conditions under which they can be best implemented. Conditions of success of internships and mentorship for population health intervention research included the alignment of the interests between the trainee, the mentor and the public health organization, quality mentoring, and the acquisition of specific population health intervention skills, especially collaborative research skills.

CONCLUSIONS

The findings suggest that public health internships and mentorship facilitate trainee engagement in applied public health research.

Distance mentoring of health researchers: Three case studies across the career-development trajectory

Despite the crucial role of mentoring, little literature exists that addresses distance mentoring among health researchers. This article provides three case studies showcasing protégés at different stages of career development (one in graduate school, one as an early-stage researcher, and one as an established researcher). Each case study provides a brief history of the relationship, examines the benefits and challenges of working together at a distance, and discusses the lessons learned from both the mentor and the protégé over the course of these relationships. A mentoring model, examples of mentoring communications, and potential promising practices are also provided and discussed.

Qualitative study to develop processes and tools for the assessment and tracking of African institutions' capacity for operational health research

OBJECTIVES

Research is key to achieving global development goals. Our objectives were to develop and test an evidence-informed process for assessing health research management and support systems (RMSS) in four African universities and for tracking interventions to address capacity gaps.

SETTING

Four African universities.

PARTICIPANTS

83 university staff and students from 11 cadres.

INTERVENTION/METHODS

A literature-informed 'benchmark' was developed and used to itemise all components of a university's health RMSS. Data on all components were collected during site visits to four African universities using interview guides, document reviews and facilities observation guides. Gaps in RMSS capacity were identified against the benchmark and institutional action plans developed to remedy gaps. Progress against indicators was tracked over 15 months and common challenges and successes identified.

RESULTS

Common gaps in operational health research capacity included no accessible research strategy, a lack of research e-tracking capability and inadequate quality checks for proposal submissions and contracts. Feedback indicated that the capacity assessment was comprehensive and generated practical actions, several of which were no-cost. Regular follow-up helped to maintain focus on activities to strengthen health research capacity in the face of challenges.

CONCLUSIONS

Identification of each institutions' strengths and weaknesses against an evidence-informed benchmark enabled them to identify gaps in in their operational health research systems, to develop prioritised action plans, to justify resource requests to fulfil the plans and to track progress in strengthening RMSS. Use of a standard benchmark, approach and tools enabled comparisons across institutions which has accelerated production of evidence about the science of research capacity strengthening. The tools could be used by institutions seeking to understand their strengths and to address gaps in research capacity. Research capacity gaps that were common to several institutions could be a 'smart' investment for governments and health research funders.

Achieving success in clinically based research: the importance of mentoring

Within the professions of radiation therapy and medical imaging, clinician led research activity is becoming more prevalent. However, more is needed. A key component of continuing to develop professional groups who are both research active and producing high quality clinical research, is research mentoring. The authors of this paper share a common interest in enhancing research capacity through research mentoring within the health workforce, and came together to run a workshop on this issue at the 11th Annual Scientific Meeting of Medical Imaging and Radiation Therapy (ASMMIRT 2016) conference in Brisbane. Theory, clinical insights and issues regarding research mentoring were raised in the workshop as were the benefits of having dedicated research positions embedded within the health workforce to help provide support and build capacity. Key elements from this workshop are shared within this article, with the objective to encourage clinicians and clinical researchers to invest the time and effort into seeking and providing good quality research mentoring. A single service example is used to demonstrate how this can lead to enhanced research engagement and productivity.

Building a mentoring network

BACKGROUND

Mentoring has long been regarded as one of the key components of research training and faculty development.

PURPOSE

The Robert Wood Johnson Foundation Nurse Faculty Scholars program purposely facilitated scholars' development of a mentoring network by providing each individual with three mentors: a school-of-nursing mentor (primary), a university-based non-nurse research mentor (research), and a nationally-recognized nurse leader at another university (national).

METHOD

The Mentorship Effectiveness Scale was used to assess the effectiveness of each type of mentor in the first five completed cohorts.

DISCUSSION

The ratings of mentorship effectiveness for all three kinds of mentors were generally high. Scholars valued most their mentors' support and advocacy; the biggest weakness in dealing with all mentors was accessibility.

CONCLUSION

Even when one mentor proved a poor match, another mentor turned out to be an advocate and helpful, thus reaffirming the benefits of a mentoring network as opposed to only a single mentoring relationship. One lesson learned is the importance of preparing mentors for their role via written materials, in-person or phone orientations, and discussions at the annual meeting.

Structured Mentoring for Workforce Engagement and Professional Development in Public Health Settings

Mentoring is commonly used to facilitate professional growth and workforce development in a variety of settings. Organizations can use mentoring to help achieve broader personnel goals including leadership development and succession planning. While mentorship can be incorporated into training programs in public health, there are other examples of structured mentoring, with time commitments ranging from minutes to months or longer. Based on a review of the literature in public health and aggregated personal subject matter expertise of existing programs at the Centers for Disease Control and Prevention, we summarize selected mentoring models that vary primarily by time commitments and meeting frequency and identify specific work situations to which they may be applicable, primarily from the federal job experience point of view. We also suggest specific tasks that mentor-mentee pairs can undertake, including review of writing samples, practice interviews, and development of the mentee's social media presence. The mentor-mentee relationship should be viewed as a reciprocally beneficial one that can be a source of learning and personal growth for individuals at all levels of professional achievement and across the span of their careers.

Post-doctoral research fellowship as a health policy and systems research capacity development intervention: a case of the CHESAI initiative

BACKGROUND

Building capacity in health policy and systems research (HPSR), especially in low- and middle-income countries, remains a challenge. Various approaches have been suggested and implemented by scholars and institutions using various forms of capacity building to address challenges regarding HPSR development. The Collaboration for Health Systems Analysis and Innovation (CHESAI) - a collaborative effort between the Universities of Cape Town and the Western Cape Schools of Public Health - has employed a non-research based post-doctoral research fellowship (PDRF) as a way of building African capacity in the field of HPSR by recruiting four post-docs. In this paper, we (the four post-docs) explore whether a PDRF is a useful approach for capacity building for the field of HPSR using our CHESAI PDRF experiences.

METHODS

We used personal reflections of our written narratives providing detailed information regarding our engagement with CHESAI. The narratives were based on a question guide around our experiences through various activities and their impacts on our professional development. The data analysis process was highly iterative in nature, involving repeated meetings among the four post-docs to reflect, discuss and create themes that evolved from the discussions.

RESULTS

The CHESAI PDRF provided multiple spaces for our engagement and capacity development in the field of HPSR. These spaces provided us with a wide range of learning experiences, including teaching and research, policy networking, skills for academic writing, engaging practitioners, co-production and community dialogue. Our reflections suggest that institutions providing PDRF such as this are valuable if they provide environments endowed with adequate resources, good leadership and spaces for innovation. Further, the PDRFs need to be grounded in a community of HPSR practice, and provide opportunities for the post-docs to gain an in-depth understanding of the broader theoretical and methodological underpinnings of the field.

CONCLUSION

The study concludes that PDRF is a useful approach to capacity building in HPSR, but it needs be embedded in a community of practice for fellows to benefit. More academic institutions in Africa need to adopt innovative and flexible support for emerging leaders, researchers and practitioners to strengthen our health systems.