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Anjum G, Aziz M. Advancing equity in cross-cultural psychology: embracing diverse epistemologies and fostering collaborative practices. Front Psychol 2024; 15:1368663. [PMID: 38638521 PMCID: PMC11024300 DOI: 10.3389/fpsyg.2024.1368663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
Psychology, and cross-cultural psychology (CCP) in particular, plays a pivotal role in understanding the intricate relationship between culture and human behavior. This paper sheds light on the challenges of inequity and marginalization, especially concerning scholarship from the Global South, which have roots in historical colonial practices. It highlights how intellectual extractivism and the predominance of Western research methodologies often overlook the contributions of Global South scholars and indigenous ways of knowing. Such imbalances risk narrowing the scope of psychological inquiry, privileging American and European perspectives, and undermining the richness of global human experiences. This paper calls for a shift toward more equitable collaborations and the recognition of diverse epistemologies. By advocating for genuine representation in research and valuing local knowledge, it proposes pathways for a more inclusive and authentic exploration of human behavior across cultures.
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Kiwanuka GN, Bajunirwe F, Alele PE, Oloro J, Mindra A, Marshall P, Loue S. Public health and research ethics education: the experience of developing a new cadre of bioethicists at a Ugandan institution. BMC MEDICAL EDUCATION 2024; 24:1. [PMID: 38172860 PMCID: PMC10763195 DOI: 10.1186/s12909-023-04974-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
Research ethics education is critical to developing a culture of responsible conduct of research. Many countries in sub-Saharan Africa (SSA) have a high burden of infectious diseases like HIV and malaria; some, like Uganda, have recurring outbreaks. Coupled with the increase in non-communicable diseases, researchers have access to large populations to test new medications and vaccines. The need to develop multi-level capacity in research ethics in Uganda is still huge, being compounded by the high burden of disease and challenging public health issues. Only a few institutions in the SSA offer graduate training in research ethics, implying that the proposed ideal of each high-volume research ethics committee having at least one member with in-depth training in ethics is far from reality. Finding best practices for comparable situations and training requirements is challenging because there is currently no "gold standard" for teaching research ethics and little published information on curriculum and implementation strategies. The purpose of this paper is to describe a model of research ethics (RE) education as a track in an existing 2-year Master of Public Health (MPH) to provide training for developing specific applied learning skills to address contemporary and emerging needs for biomedical and public health research in a highly disease-burdened country. We describe our five-year experience in successful implementation of the MPH-RE program by the Mbarara University Research Ethics Education Program at Mbarara University of Science and Technology in southwestern Uganda. We used curriculum materials, applications to the program, post-training and external evaluations, and annual reports for this work. This model can be adapted and used elsewhere in developing countries with similar contexts. Establishing an interface between public health and research ethics requires integration of the two early in the delivery of the MPH-RE program to prevent a disconnect in knowledge between research methods provided by the MPH component of the MPH-RE program and for research in ethics that MPH-RE students are expected to perform for their dissertation. Promoting bioethics education, which is multi-disciplinary, in institutions where it is still "foreign" is challenging and necessitates supportive leadership at all institutional levels.
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Affiliation(s)
- Gertrude N Kiwanuka
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Francis Bajunirwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Paul E Alele
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joseph Oloro
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Arnold Mindra
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Patricia Marshall
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Sana Loue
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Chaudhry I, Thurtle V, Foday E, Leather AJM, Samai M, Wurie H, Parmar D. Strengthening ethics committees for health-related research in sub-Saharan Africa: a scoping review. BMJ Open 2022; 12:e062847. [PMID: 36410802 PMCID: PMC9680187 DOI: 10.1136/bmjopen-2022-062847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Health-related research in sub-Saharan Africa (SSA) has grown over the years. However, concerns have been raised about the state of research ethics committees (RECs). This scoping review examines the literature on RECs for health-related research in SSA and identifies strategies that have been applied to strengthen the RECs. It focuses on three aspects of RECs: regulatory governance and leadership, administrative and financial capacity and technical capacity of members. DESIGN A scoping review of published literature, including grey literature, was conducted using the Joanna Briggs Institute approach. DATA SOURCES BioOne, CINAHL, Embase (via Ovid), Education Abstracts, Global Health, Google Scholar, Jstor, OpenEdition (French), Philosopher's Index, PsycINFO, PubMed, Science Citation and Expanded Index (Web of Science), reference lists of included studies and specific grey literature sources. ELIGIBILITY CRITERIA We included empirical studies on RECs for health-related research in SSA, covering topics on REC leadership and governance, administrative and financial capacity and the technical capacity of REC members. We included studies published between 01 January 2000 and 18 February 2022 and written in English, French, Portuguese or Swahili. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened the records. Data were extracted by one reviewer and cross-checked by another. Owing to the heterogeneity of included studies, thematic analysis was used. RESULTS We included 54 studies. The findings show that most RECs in SSA work under significant administrative and financial constraints, with few opportunities for capacity building for committee members. This has an impact on the quality of reviews and the overall performance of RECs. Although most countries have national governance systems for RECs, they lack regulations on accountability, transparency and monitoring of RECs. CONCLUSIONS This review provides a comprehensive overview of the literature on RECs for health-related research in SSA and contributes to our understanding of how RECs can be strengthened.
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Affiliation(s)
- Iqra Chaudhry
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Val Thurtle
- King's Centre for Global Health and Health Partnerships, School of Life Course and Population Sciences, King's College London, London, UK
| | - Edward Foday
- Sierra Leone Ethics and Scientific Review Committee, Directorate of Training and Research, Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Andrew J M Leather
- King's Centre for Global Health and Health Partnerships, School of Life Course and Population Sciences, King's College London, London, UK
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Haja Wurie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Divya Parmar
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
- King's Centre for Global Health and Health Partnerships, School of Life Course and Population Sciences, King's College London, London, UK
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Thurtle V, Leather AJ, Wurie H, Foday E, Samai M, Parmar D. Strengthening ethics committees for health-related research in sub-Saharan Africa: a scoping review protocol. BMJ Open 2021; 11:e046546. [PMID: 34385239 PMCID: PMC8362705 DOI: 10.1136/bmjopen-2020-046546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Health research in low-income and middle-income countries, which face the greatest burden of disease, is a vital component of efforts to combat global health inequality. With increased research, there has also been concern about ethical and regulatory issues and the state of research ethics committees, with various attempts to strengthen them. This scoping review examines the literature on ethics committees for health-related research in sub-Saharan Africa, with a focus on regulatory governance and leadership, administrative and financial capacity, and conduct of ethical reviews. METHODS AND ANALYSIS We will use the methodological approach proposed by Arksey and O'Malley and adapted by Levac et al and the Joanna Briggs Institute. Inclusion and exclusion criteria are based on the 'Population-Concept-Context' framework. Literature (from January 2000 to December 2020) will be searched in multiple databases including Embase and PubMed and websites of relevant organisations. All records will be screened by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review flowchart: two reviewers will independently screen titles and abstracts, and full text of included records. Using an inductive approach, we will synthesise the literature, identify best practice and gaps in evidence on strengthening research ethics committees. ETHICS AND DISSEMINATION Ethical approval is not required as the review will include only published literature. The findings will be published in a peer-reviewed journal and presented at stakeholder meetings and conferences.
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Affiliation(s)
- Val Thurtle
- King's Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Andy Jm Leather
- King's Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Haja Wurie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Edward Foday
- Sierra Leone Ethics and Scientific Review Committee, Directorate of Policy, Planning and Information, Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Western Area, Sierra Leone
| | - Divya Parmar
- King's Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, King's College London, London, UK
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Chongwe G, Sikateyo B, Kampata L, Ali J, Hallez K, Hyder AA, Kass N, Michelo C. Assessing training needs in health research ethics: a case study from the University of Zambia School of Medicine. Glob Bioeth 2020; 31:155-163. [PMID: 33343189 PMCID: PMC7734000 DOI: 10.1080/11287462.2020.1853001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In many settings, and perhaps especially in low-middle income countries, training institutions do not adequately prepare their students for the ethical challenges that confront them in professional life. We conducted a survey to assess the training needs in research ethics among the faculty at the University of Zambia, School of Medicine (UNZASoM) using a structured questionnaire distributed to faculty members in January 2015. The study was approved by the University of Zambia Biomedical Research Ethics Committee. Seventy-five faculty members of various ranks completed the questionnaire. It was found that 31% of the faculty had not received any research ethics training. Of those who had received training, most of them had received it through short workshops of five days or less (57.4%, n = 31), while only 27.7% received ethics training as a component of an academic degree and 22.2% obtained it through electronic web-based courses. While most faculty (70.7%) reported being well-prepared to guide their students in developing a research methods section of a research protocol, only 25.3% felt they were well-prepared to guide on ethical considerations. This study has demonstrated gaps in research ethics training among faculty members at UNZASoM. Mandatory instruction in research ethics among faculty and students is recommended.
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Affiliation(s)
- Gershom Chongwe
- Department of Epidemiology and Biostatistics, University of Zambia School of Public Health, Lusaka, Zambia
| | - Bornwell Sikateyo
- Department of Health Policy and Management, University of Zambia School of Public Health, Lusaka, Zambia
| | - Linda Kampata
- Department of Health Policy and Management, University of Zambia School of Public Health, Lusaka, Zambia
| | - Joseph Ali
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kristina Hallez
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Nancy Kass
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Charles Michelo
- Department of Epidemiology and Biostatistics, University of Zambia School of Public Health, Lusaka, Zambia
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Ntseane DM, Ali J, Hallez K, Mokgweetsi B, Kasule M, Kass NE. The features and qualities of online training modules in research ethics: a case study evaluating their institutional application for the University of Botswana. Glob Bioeth 2019; 31:133-154. [PMID: 33343188 PMCID: PMC7733899 DOI: 10.1080/11287462.2019.1592305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/05/2019] [Indexed: 10/27/2022] Open
Abstract
Research ethics remains a cornerstone of the scientific enterprise as it defines the boundaries of responsible conduct of research. Our aim was to systematically identify, review and test online training courses in research ethics which could be considered most appropriate for future training at the University of Botswana (UB). We used an evaluative tool that included both descriptive and evaluative criteria for assessing the strengths, weaknesses and appropriateness of 10 online research ethics courses which are publicly accessible. We then assembled Focus Group Discussions (FGDs) to engage the UB community to select the best 2-3 online courses that are considered most suited for use in future training of research ethics at UB. Twenty respondents participated in three FGDs. Our findings show that there is limited research ethics training capacity in low resourced academic institutions like UB. Online training opportunities could be used to address this challenge. Our analysis reveal that out of the 10 online courses reviewed, CITI program, Family Health International, and Training and Resource in Research Ethics Evaluation have characteristics that would make them suitable for utilization in Botswana. We believe the findings from this case study will be of value to other similarly situated research institutions.
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Affiliation(s)
| | - Joseph Ali
- Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kristina Hallez
- Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
| | | | - Mary Kasule
- Office of Research and Development, University of Botswana, Gaborone, Botswana
| | - Nancy E. Kass
- Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kass NE, Ali J, Hallez K, Hyder AA. Bioethics training programmes for Africa: evaluating professional and bioethics-related achievements of African trainees after a decade of Fogarty NIH investment. BMJ Open 2016; 6:e012758. [PMID: 27633644 PMCID: PMC5030587 DOI: 10.1136/bmjopen-2016-012758] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Our primary aim was to evaluate the impact of US National Institutes of Health (NIH)-funded bioethics training programmes (Fogarty bioethics training programmes, FBTPs) that trained individuals from Africa over the programme's first 10 years to examine changes between pretraining and post-training in individual achievement and to document any associations between individual, training programme and post-training accomplishments. DESIGN We surveyed trainees from the 10 bioethics programmes funded by NIH Fogarty International Center from 2000 to 2011 that included African trainees. McNemar's and Wilcoxon signed rank-sum tests were used to analyse pre-post levels of general and bioethics-related professional achievement. Likelihood of specific post-training achievement outcomes was measured using logistic regression including demographic, pretraining and intratraining variables. SETTING 10 different FBTPs that trained individuals from Africa from 2000 to 2011. PARTICIPANTS Of 253 eligible respondents, 171 completed the survey (response rate 67.6%). PRIMARY OUTCOME MEASURES Pre-post comparisons of professional achievement indicators (eg, serving in leadership roles, teaching, publishing manuscripts); likelihood of specific post-training achievement outcomes. RESULTS Post-training, respondents were significantly more likely to report serving in a leadership role, being an investigator on a research grant, serving on international committees, serving as a mentor, and publishing manuscripts than at pretraining. Post-training, significantly greater numbers of respondents reported bioethics-related achievements including being a bioethics instructor, serving on an Institutional Review Board (IRB), being an investigator on a bioethics grant and publishing bioethics-related manuscripts than pretraining. Controlling for other factors, there were no significant differences by gender in the post-training success of these participants in terms of leadership roles, being instructors, investigators on grants and holding IRB roles. CONCLUSIONS African trainees who participated in FBTPs reported significantly higher levels of professional achievement after training. There was no single factor-either demographic, related to a trainee's professional background, or in programme design-that consistently predicted greater levels of post-training achievement.
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Affiliation(s)
- Nancy E Kass
- Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joseph Ali
- Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland, USA
| | - Kristina Hallez
- Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland, USA
| | - Adnan A Hyder
- Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Geissler C, Amuna P, Kattelmann KK, Zotor FB, Donovan SM. The eNutrition Academy: Supporting a New Generation of Nutritional Scientists around the World. Adv Nutr 2016; 7:190-8. [PMID: 27180382 PMCID: PMC4717896 DOI: 10.3945/an.115.010728] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Nutrition training and building capacity to provide a competent workforce to support national and regional efforts to combat malnutrition remain a major challenge in Africa and other developing regions of the world. The capacity to provide the necessary intellectual drive for nutrition research, policy, and practice in countries lacking in readiness for nutrition actions is imperative to improve the health of their people. To help address this need, the eNutrition Academy (eNA) was formed as a global partnership organization by the African Nutrition Society, the Federation of African Nutrition Societies, the Nutrition Society of the United Kingdom and Ireland, the ASN, and the International Union of Nutritional Sciences, supported by Cambridge University Press. The primary objective of this partnership is to provide an online learning platform that is free to access, enabling users to benefit from a wide range of learning materials from basic tools to more-advanced learning materials for teachers and researchers in developing countries. The goal of this article was to summarize the findings of a symposium held at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2015, which explored the themes of international capacity development, with a particular focus on the African continent, online learning, and the eNA e-learning platform. Given the vast human capacity present in Africa that is poised to create new solutions to address the public health needs of the continent, now is an opportune time to establish South-North and South-South partnerships to develop the next generation of African nutritional scientists.
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Affiliation(s)
| | - Paul Amuna
- University of Greenwich/Primary Health Care Corporation Qatar, Doha, Qatar
| | | | - Francis B Zotor
- African Nutrition Society and University of Health & Allied Science, Volta Region, Ghana; and
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Huber J, Nepal S, Bauer D, Wessels I, Fischer MR, Kiessling C. Tools and instruments for needs assessment, monitoring and evaluation of health research capacity development activities at the individual and organizational level: a systematic review. Health Res Policy Syst 2015; 13:80. [PMID: 26691766 PMCID: PMC4687225 DOI: 10.1186/s12961-015-0070-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 12/07/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND In the past decades, various frameworks, methods, indicators, and tools have been developed to assess the needs as well as to monitor and evaluate (needs assessment, monitoring and evaluation; "NaME") health research capacity development (HRCD) activities. This systematic review gives an overview on NaME activities at the individual and organizational level in the past 10 years with a specific focus on methods, tools and instruments. Insight from this review might support researchers and stakeholders in systemizing future efforts in the HRCD field. METHODS A systematic literature search was conducted in PubMed and Google Scholar. Additionally, the personal bibliographies of the authors were scanned. Two researchers independently reviewed the identified abstracts for inclusion according to previously defined eligibility criteria. The included articles were analysed with a focus on both different HRCD activities as well as NaME efforts. RESULTS Initially, the search revealed 700 records in PubMed, two additional records in Google Scholar, and 10 abstracts from the personal bibliographies of the authors. Finally, 42 studies were included and analysed in depth. Findings show that the NaME efforts in the field of HRCD are as complex and manifold as the concept of HRCD itself. NaME is predominately focused on outcome evaluation and mainly refers to the individual and team levels. CONCLUSION A substantial need for a coherent and transparent taxonomy of HRCD activities to maximize the benefits of future studies in the field was identified. A coherent overview of the tools used to monitor and evaluate HRCD activities is provided to inform further research in the field.
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Affiliation(s)
- Johanna Huber
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Sushil Nepal
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Daniel Bauer
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Insa Wessels
- bologna.lab, Humboldt-Universität zu Berlin, Hausvogteiplatz 5-7, 10117, Berlin, Germany.
| | - Martin R Fischer
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Claudia Kiessling
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany. .,Medizinische Hochschule Brandenburg Theodor Fontane, Fehrbelliner Straße 38, 16816, Neuruppin, Germany.
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Fisher CB, Yuko E. The HIV and Drug Abuse Prevention Research Ethics Training Institute: Training Early-Career Scientists to Conduct Research on Research Ethics. J Empir Res Hum Res Ethics 2015; 10:470-80. [PMID: 26564944 PMCID: PMC5817912 DOI: 10.1177/1556264615614937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The responsible conduct of HIV/drug abuse prevention research requires investigators with both the knowledge of and ability to generate empirical data that can enhance global ethical practices and policies. This article describes a multidisciplinary program offering early-career professionals a 2-year intensive summer curriculum along with funding to conduct a mentored research study on a wide variety of HIV/drug abuse research ethics topics. Now in its fifth year, the program has admitted 29 trainees who have to date demonstrated increased knowledge of research ethics, produced 17 peer-reviewed publications, 46 professional presentations, and submitted or been awarded five related federal grants. The institute also hosts a global information platform providing general and HIV/drug abuse relevant research ethics educational and research resources that have had more than 38,800 unique visitors from more than 150 countries.
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Mugabo L, Rouleau D, Odhiambo J, Nisingizwe MP, Amoroso C, Barebwanuwe P, Warugaba C, Habumugisha L, Hedt-Gauthier BL. Approaches and impact of non-academic research capacity strengthening training models in sub-Saharan Africa: a systematic review. Health Res Policy Syst 2015; 13:30. [PMID: 26055974 PMCID: PMC4464866 DOI: 10.1186/s12961-015-0017-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 05/25/2015] [Indexed: 11/10/2022] Open
Abstract
Background Research is essential to identify and prioritize health needs and to develop appropriate strategies to improve health outcomes. In the last decade, non-academic research capacity strengthening trainings in sub-Saharan Africa, coupled with developing research infrastructure and the provision of individual mentorship support, has been used to build health worker skills. The objectives of this review are to describe different training approaches to research capacity strengthening in sub-Saharan Africa outside academic programs, assess methods used to evaluate research capacity strengthening activities, and learn about the challenges facing research capacity strengthening and the strategies/innovations required to overcome them. Methodology The PubMed database was searched using nine search terms and articles were included if 1) they explicitly described research capacity strengthening training activities, including information on program duration, target audience, immediate program outputs and outcomes; 2) all or part of the training program took place in sub-Saharan African countries; 3) the training activities were not a formal academic program; 4) papers were published between 2000 and 2013; and 5) both abstract and full paper were available in English. Results The search resulted in 495 articles, of which 450 were retained; 14 papers met all inclusion criteria and were included and analysed. In total, 4136 people were trained, of which 2939 were from Africa. Of the 14 included papers, six fell in the category of short-term evaluation period and eight in the long-term evaluation period. Conduct of evaluations and use of evaluation frameworks varied between short and long term models and some trainings were not evaluated. Evaluation methods included tests, surveys, interviews, and systems approach matrix. Conclusions Research capacity strengthening activities in sub-Saharan Africa outside of academic settings provide important contributions to developing in-country capacity to participate in and lead research. Institutional support, increased funds, and dedicated time for research activities are critical factors that lead to the development of successful programs. Further, knowledge sharing through scientific articles with sufficient detail is needed to enable replication of successful models in other settings.
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Affiliation(s)
- Lambert Mugabo
- Partners In Health-Inshuti Mu Buzima, P.O. Box 3432, Kigali, Rwanda. .,Global Health Corps, One Penn Plaza, Suite 6271, New York, NY, 10119, USA.
| | - Dominique Rouleau
- Partners In Health-Inshuti Mu Buzima, P.O. Box 3432, Kigali, Rwanda.
| | - Jackline Odhiambo
- Partners In Health-Inshuti Mu Buzima, P.O. Box 3432, Kigali, Rwanda.
| | | | - Cheryl Amoroso
- Partners In Health-Inshuti Mu Buzima, P.O. Box 3432, Kigali, Rwanda.
| | - Peter Barebwanuwe
- Partners In Health-Inshuti Mu Buzima, P.O. Box 3432, Kigali, Rwanda.
| | | | | | - Bethany L Hedt-Gauthier
- Partners In Health-Inshuti Mu Buzima, P.O. Box 3432, Kigali, Rwanda. .,Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.
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Wadhwaniya S, Meddings D, Gururaj G, Ozanne-Smith J, Ameratunga S, Hyder AA. E-mentoring for violence and injury prevention: early lessons from a global programme. Glob Public Health 2015; 10:501-19. [PMID: 25672216 DOI: 10.1080/17441692.2014.1001766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To address the growing burden of violence and injuries, especially in low- and middle-income countries, in 2007 the World Health Organization launched MENTOR-VIP, a global violence and injury prevention (VIP)-mentoring programme. The programme aims to develop human resource capacity through 12-month mentoring arrangements between individual VIP experts (mentors) and less-experienced injury practitioners (mentees). In this paper, we review the first five years of the programme (2007-2011) using a systems analysis and SWOT (Strengths, Weaknesses, Opportunities and Threats) frameworks, discuss programme findings and make recommendations. A well-defined programme with clear instructions, successful matching of mentorship pairs with similar interests and language, a formal accord agreement, institutional support and effective communication were identified as programme strengths. Overambitious projects, lack of funds and difficulties with communications were identified as programme weaknesses. Mentorship projects that require institutional permissions or resources could be potential threats to the success of mentorship. The study resulted in the four following recommendations to strengthen the programme: (1) institute additional steps in selection and matching mentor-mentee pair; (2) train mentors on e-mentoring; (3) conduct special orientation for mentees to the programme; and (4) maintain effective and open communication throughout the programme.
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Affiliation(s)
- Shirin Wadhwaniya
- a Department of International Health, Johns Hopkins International Injury Research Unit , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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Hyder AA, Ali J, Hallez K, White T, Sewankambo NK, Kass NE. Exploring Institutional Research Ethics Systems: A Case Study From Uganda. AJOB Empir Bioeth 2015; 6:1-14. [PMID: 26594648 PMCID: PMC4652948 DOI: 10.1080/23294515.2014.981316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The increasing globalization of research drives a need for greater research ethics capacity in low resource countries. Several programs have attempted to expand research ethics capacity by training individuals, but few have focused on broader research ethics systems and institutions. This study describes and applies an institutional research ethics model to assess the institutional research ethics capacity of Makerere University College of Heath Sciences (MakCHS) in 2011. METHODS Internal and external stakeholders conducted the assessment of MakCHS using the multidimensional Octagon framework. Five methods were used to collect data on current ethical processes and institutional relationships. RESULTS MakCHS scored in the mid range on all Octagon domains, with some variation between external and internal assessments. The external Octagon scores suggest that MakCHS's areas of strengths are in identity, structure, relevance, target groups, and working environment; needs are greater in the areas of production, competence, and systems of finance and administration. Discrepancies in external and internal assessment can serve as a useful platform to shape ongoing discussions and strategic efforts. CONCLUSIONS The assessment identified strengths, opportunities, and challenges for institutional research ethics capacity at MakCHS. We believe this systematic approach was helpful in evaluating research ethics needs and provides a benchmark for institutions to measure progress over time.
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Affiliation(s)
- Adnan A Hyder
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins Berman Institute of Bioethics, USA
| | - Joseph Ali
- Johns Hopkins Berman Institute of Bioethics, USA
| | | | - Tara White
- Johns Hopkins Berman Institute of Bioethics, USA
| | | | - Nancy E Kass
- Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Berman Institute of Bioethics, USA
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14
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Abstract
The aim of the present paper is to review capacity building in public health nutrition (PHN), the need for which has been stressed for many years by a range of academics, national and international organisations. Although great strides have been made worldwide in the science of nutrition, there remain many problems of undernutrition and increasingly of obesity and related chronic diseases. The main emphasis in capacity building has been on the nutrition and health workforce, but the causes of these health problems are multifactorial and require collaboration across sectors in their solution. This means that PHN capacity building has to go beyond basic nutrition and beyond the immediate health workforce to policy makers in other sectors. The present paper provides examples of capacity building activities by various organisations, including universities, industry and international agencies. Examples of web-based courses are given including an introduction to the e-Nutrition Academy. The scope is international but with a special focus on Africa. In conclusion, there remains a great need for capacity building in PHN but the advent of the internet has revolutionised the possibilities.
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Jordan P, Quadrelli S, Heres M, Belli L, Ruhl N, Colt H. Examining patients' preferences for participation in clinical decision-making: the experience in a Latin American chronic obstructive pulmonary disease and cancer outpatient population. Intern Med J 2014; 44:281-7. [PMID: 24373195 DOI: 10.1111/imj.12351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 12/16/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS It is generally accepted that patients prefer to be told the truth by their physicians; however, the practice of partial truth-telling is frequent with an existing 'norm of nondisclosure.' Our primary objective was to determine what patients wanted to be told about their illness, and whether there might be differences between patients with either cancer or advanced chronic obstructive pulmonary disease (COPD). A second objective was to determine how these patients envisioned their participation, or lack thereof, in the treatment decision-making process. METHODS Subjects were eligible for this prospective study if they were attending the oncology or pulmonary outpatient consultation services at the British Hospital or the Sanatorio Güemes Private Hospital in Buenos Aires, Argentina between June 2009 and May 2010. RESULTS Ninety-nine patients were recruited. Forty-four had a diagnosis of COPD, and 55 patients had cancer. Seventeen of the patients expected their health to improve in the future, but a significantly higher proportion of patients with malignant disorders expected to get better in the near future as compared with those with COPD (98.2% vs 62.8%, P < 0.001). Most study participants expressed a desire to receive all the information available about their condition. A majority of the participants expressed a preference for making treatment decisions in collaboration with their physician (40.4%) CONCLUSIONS While they considered the role of their families relevant and wanted information to be shared so that family members might participate in decision-making, they did not want their families to have a right to withhold information, make final decisions.
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Affiliation(s)
- P Jordan
- Buenos Aires British Hospital and Buenos Aires Sanatorio Güemes, Buenos Aires, Argentina
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Mbuagbaw L, Slogrove A, Sas J, Kunda J, Morfaw F, Mukonzo J, Thabane L. CIHR canadian HIV trials network HIV workshop: ethical research through community participation and strengthening scientific validity. Pan Afr Med J 2014; 19:44. [PMID: 25667706 PMCID: PMC4315477 DOI: 10.11604/pamj.2014.19.44.4766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 09/11/2014] [Indexed: 12/04/2022] Open
Abstract
The CIHR canadian HIV trials network mandate includes strengthening capacity to conduct and apply clinical research through training and mentoring initiatives of HIV researchers by building strong networks and partnerships on the African continent. At the17th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), the CTN facilitated a two-day workshop to address ethical issues in the conduct of HIV research, and career enhancing strategies for young African HIV researchers. Conference attendees were allowed to attend whichever session was of interest to them. We report on the topics covered, readings shared and participants’ evaluation of the workshop. The scientific aspects of ethical research in HIV and career enhancement strategies are relevant issues to conference attendees.
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Affiliation(s)
- Lawrence Mbuagbaw
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada ; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare-Hamilton, ON, Canada ; Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Amy Slogrove
- Department of Paediatrics & Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa ; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Jacqueline Sas
- CIHR Canadian HIV Trials Network, University of British Columbia, Canada
| | - John Kunda
- Community Information and Epidemiological Technologies, Lusaka, Zambia
| | - Frederick Morfaw
- Department of Obstetrics and Gynaecology, Faculty of Medicines and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jackson Mukonzo
- School of Biomedical Sciences, College of Health Sciences, University of Makerere, Kampala, Uganda
| | - Lehana Thabane
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada ; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare-Hamilton, ON, Canada ; Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, ON, Canada ; Centre for Evaluation of Medicine, St Joseph's Healthcare-Hamilton, ON, Canada ; Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
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Ali J, Kass NE, Sewankambo NK, White TD, Hyder AA. Evaluating international research ethics capacity development: an empirical approach. J Empir Res Hum Res Ethics 2014; 9:41-51. [PMID: 24782071 PMCID: PMC4280230 DOI: 10.1525/jer.2014.9.2.41] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The US national institutes of health, Fogarty International Center (NIH-FIC) has, for the past 13 years, been a leading funder of international research ethics education for resource-limited settings. Nearly half of the NIH-FIC funding in this area has gone to training programs that train individuals from sub-Saharan Africa. Identifying the impact of training investments, as well as the potential predictors of post-training success, can support curricular decisionmaking, help establish funding priorities, and recognize the ultimate outcomes of trainees and training programs. Comprehensive evaluation frameworks and targeted evaluation tools for bioethics training programs generally, and for international research ethics programs in particular, are largely absent from published literature. This paper shares an original conceptual framework, data collection tool, and detailed methods for evaluating the inputs, processes, outputs, and outcomes of research ethics training programs serving individuals in resource-limited settings. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.
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Affiliation(s)
- Joseph Ali
- Johns Hopkins Berman Institute of Bioethics (USA)
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Ndebele P, Wassenaar D, Benatar S, Fleischer T, Kruger M, Adebamowo C, Kass N, Hyder AA, Meslin EM. Research ethics capacity building in Sub-Saharan Africa: a review of NIH Fogarty-funded programs 2000–2012. J Empir Res Hum Res Ethics 2014; 9:24-40. [PMID: 24782070 PMCID: PMC4280231 DOI: 10.1525/jer.2014.9.2.24] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The last fifteen years have witnessed a significant increase in investment in research ethics capacity development throughout the world. We examine nine research ethics training programs that are focused on Sub-Saharan Africa and supported by the US National Institutes of Health. We collected data from grants awards' documents and annual reports supplemented by questionnaires completed by the training program directors. Together, these programs provided long-term training in research ethics to 275 African professionals, strengthened research ethics committees in 19 countries in Sub-Saharan Africa, and created research ethics curricula at many institutions and bioethics centers within Africa. Trainees' leadership resulted in new national systems and policies on research ethics, human tissue storage and export, and methods of monitoring compliance with research ethics guidelines. Training programs adapted to challenges that arose due to varied trainees' background knowledge in ethics, duration of time available for training, spoken and written English language skills, administrative obstacles, and the need to sustain post-training research ethics activities. Our report showcases the development of awareness of research ethics and building/strengthening of basic research ethics infrastructure in Sub-Saharan Africa. Nevertheless, the increasing amount and complexity of health research being conducted in Sub-Saharan Africa suggests the need for continued investment in research ethics capacity development in this region. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.
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Alfano SL. Conducting research with human subjects in international settings: ethical considerations. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2013; 86:315-21. [PMID: 24058306 PMCID: PMC3767216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Biomedical research in international settings is undergoing expansive growth and may potentially result in far-reaching benefits, such as direction of research resources toward solving basic health care needs of world populations. However, key ethical concerns surround this expansion and must be carefully considered by international researchers. International research is impacted by differences in language, culture, regulatory structures, financial resources, and possibly ethical standards. Local community leadership involvement in the planning stages of research is imperative. Especially in resource-poor countries, the research agenda must be designed to address local needs and provide local benefit. Capacity strengthening efforts, aimed at improving institutional support for ethical conduct of human subjects research, must continue to be supported by wealthier nations.
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Affiliation(s)
- Sandra L Alfano
- Research Scientist, General Internal Medicine, and Chair, Human Investigation Committee, Yale University, New Haven, Connecticut
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Mamotte N, Wassenaar D, Singh N. Compensation for Research-Related Injury in NIH-Sponsored HIV/AIDS Clinical Trials in Africa. J Empir Res Hum Res Ethics 2013; 8:45-54. [DOI: 10.1525/jer.2013.8.1.45] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Concern has been voiced in the research ethics literature that under U.S. federal regulations U.S. sponsors, particularly the NIH, are not required to provide compensation for the treatment of research-related injury for trial participants or to allow grant funds to be used by investigators for appropriate insurance. This is problematic in developing country contexts because most participants are unlikely to have health insurance, resulting in overburdened and under-resourced health systems in many developing countries being responsible for providing care and treatment for research-related injury. This study provides preliminary insight into how respondent principal investigators of NIH-sponsored HIV/AIDS clinical trials in Africa and African research ethics committees deal with compensation for research-related injury. The majority of PIs surveyed provided free treatment for research-related injury, but few provided other forms of financial reparation to participants. The study also found that half of the PIs surveyed indicated that NIH funds were used for compensation, highlighting a contradiction between literature and practice. The majority of REC chairs surveyed indicated that their RECs routinely reviewed compensation plans for research-related injury and that their ethics application forms specifically requested information on compensation. Findings from one southern African country revealed that NIH funds were not used to provide treatment and/or financial reparation for research-related injury. Instead, PIs from this country relied on the government or the individual research participant (and/or their medical aid/health insurer) to cover the costs of research-related injury. The findings are discussed in the light of the recent (December 2011) U.S. Presidential Commission for the Study of Bioethics report which recommends that research participants are morally entitled to compensation for research-related injury.
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