1
|
Gleriano JS, Krein C, Chaves LDP. Aspects that facilitate access to care for viral hepatitis: An evaluative research. SAO PAULO MED J 2024; 142:e2023078. [PMID: 38477774 DOI: 10.1590/1516-3180.2023.0078.r1.29112023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 11/29/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Viral hepatitis is a major public health concern worldwide. OBJECTIVES This study aimed to analyze the factors that facilitate access to care for viral hepatitis. DESIGN AND SETTING Using a sequential mixed method, this evaluation research was conducted in the state of Mato Grosso, Brazil. METHODS Mapping of references and selection of regions were made based on the quantity and heterogeneity of services. The stakeholders, including the managers of the State Department of Health and professionals from reference services, were identified. Nine semi-structured interviews were conducted using content analysis and discussions guided by the dimensions of the analysis model of universal access to health services. RESULTS In the political dimension, decentralizing services and adhering to the Intermunicipal Health Consortium are highly encouraged. In the economic-social dimension, a commitment exists to allocate public funds for the expansion of referral services and subsidies to support users in their travel for appointments, medications, and examinations. In the organizational dimension, the availability of inputs for testing, definition of user flow, ease of scheduling appointments, coordination by primary care in testing, collaboration following the guidelines and protocols, and engagement in extramural activities are guaranteed. In the technical dimension, professionals actively commit to the service and offer different opening hours, guarantee the presence of an infectious physician, expand training opportunities, and establish intersectoral partnerships. In the symbolic dimension, professionals actively listen to the experiences of users throughout their care trajectory and demonstrate empathy. CONCLUSIONS The results are crucial for improving comprehensiveness, but necessitate managerial efforts to enhance regional governance.
Collapse
Affiliation(s)
- Josué Souza Gleriano
- PhD. Nurse, Adjunct Professor, Department of Nursing, Faculty of Agricultural, Biological, Engineering and Health Sciences, Universidade do Estado de Mato Grosso (UNEMAT), Tangará da Serra (MT), Brazil
| | - Carlise Krein
- Msc. Nurse, Department of General and Specialized Nursing, Ribeirão Preto School of Nursing, Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil
| | - Lucieli Dias Pedreschi Chaves
- PhD. Nurse, Associate Professor, Department of General and Specialized Nursing, Ribeirão Preto School of Nursing, Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil
| |
Collapse
|
2
|
Finding Cases of Hepatitis C for Treatment Using Automated Screening in the Emergency Department is Effective, but What Is the Cost? Can J Gastroenterol Hepatol 2022; 2022:3449938. [PMID: 36276913 PMCID: PMC9586809 DOI: 10.1155/2022/3449938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/29/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Case detection remains a major challenge for hepatitis C virus (HCV) elimination. We have previously published results from a pilot of an emergency department (ED) semiautomated screening program, SEARCH; Screening Emergency Admissions at Risk of Chronic HCV. Several refinements to SEARCH have been developed to streamline and reduce cost. All direct costs of HCV testing until direct-acting antiviral (DAA) therapy initiation were calculated. Cost was assessed in 2018 Australian Dollars. A cost analysis of the initial program and refinements are presented. Sensitivity analysis to understand impact of variation in staff time, laboratory test cost, changes in HCV antibody (Ab) prevalence, RNA positivity percentage, and rate of linkage to care was conducted. Impact of refinements (SEARCH (2)) to cost is presented. The total SEARCH pilot, testing 5000 patients was estimated to cost $110,549.52 (range $92,109.79-$129,581.24) comprising of $68,278.67 for HCV Ab testing, $21,568.99 for follow-up and linkage to care of positive patients and $20,701.86 to prepare HCV RNA positive patients for treatment. Internal program refinements resulted in a 25% cost reduction. Following refinements, the cost of HCV antibody screening was $8.46 per test and the total cost per positive HCV Ab, positive HCV RNA, and per treated patient were $611.77, $2,168.64, and $3,566.11, respectively. Our sensitivity analysis indicates costs per HCV case found are modest so long as HCV Ab prevalence was at least 1%. ED screening is an affordable strategy for HCV case detection and elimination.
Collapse
|
3
|
Expanding community engagement and advocacy in chronic viral hepatitis. Lancet Gastroenterol Hepatol 2022; 7:902-904. [DOI: 10.1016/s2468-1253(22)00234-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 11/23/2022]
|
4
|
Ulitin A, Mier-Alpaño JD, Labarda M, Juban N, Mier AR, Tucker JD, Tang W, Auplish M, Chan PL. Youth social innovation during the COVID-19 pandemic in the Philippines: a quantitative and qualitative descriptive analyses from a crowdsourcing open call and online hackathon. BMJ INNOVATIONS 2022. [PMCID: PMC9157324 DOI: 10.1136/bmjinnov-2021-000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Young people have played a pivotal role as part of the COVID-19 response, including developing health messages and social innovations. Social innovation in health engages multiple stakeholders in linking social change and health improvement. The study examined the feasibility of youth ideas and innovations to address the impacts of the COVID-19 pandemic using quantitative and qualitative descriptive analyses. Methods In partnership with the WHO, academic institutions, youth organisations and civil society groups, we conducted a crowdsourcing open call among Filipino youth (15–30 years old) using a structured Special Programme for Research and Training in Tropical Diseases/Social Innovation in Health Initiative process. The open call had three categories: youth voices to cocreate the post-COVID-19 world (entries were texts, images, videos and music), youth-led COVID-19 social innovations, and youth-led social innovations not related to COVID-19. Each submission was evaluated by three independent judges. Finalists were selected in each of the categories alongside four grand winners. All finalists were invited to attend a 1 day online civic hackathon. Results We received a total of 113 entries (youth voices to cocreate the post-COVID world=76; youth-led COVID-19 social innovations=17; youth-led social innovations not related to COVID-19=20). Twelve entries focused on youth mental health during the pandemic. The online hackathon provided the participants mentorship for further development of their ideas. Finalists were able to produce draft health communication campaigns and improved social innovations. Conclusion Many Filipino youth created exceptional entries in response to the open call. This suggests the feasibility of including youth voices in strategic planning processes. A global youth social innovation call is recommended.
Collapse
Affiliation(s)
- Allan Ulitin
- Institute of Health Policy and Development Studies - National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | | | - Meredith Labarda
- Department of Medicine, University of the Philippines Manila - School of Health Sciences, Palo, Leyte, Philippines
| | - Noel Juban
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | | | - Joseph D Tucker
- IGHID, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
| | - Mallika Auplish
- World Health Organization-Regional Office for the Western Pacific, Manila, Philippines
| | - Po-lin Chan
- World Health Organization-Regional Office for the Western Pacific, Manila, Philippines
| |
Collapse
|
5
|
Han L, Tang W, Ritchwood T, Day S, Wei S, Bao H, John R, Kpokiri E, Mathanga D, Awor P, Juban N, Castro-Arroyave D, Ambil V, Xiong Y, Oppong E, Tucker J. Joint international consensus statement on crowdsourcing challenge contests in health and medicine: results of a modified Delphi process. BMJ Open 2021; 11:e048699. [PMID: 34740928 PMCID: PMC8573649 DOI: 10.1136/bmjopen-2021-048699] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To develop a consensus statement to provide advice on designing, implementing and evaluating crowdsourcing challenge contests in public health and medical contexts. DESIGN Modified Delphi using three rounds of survey questionnaires and one consensus workshop. SETTING Uganda for face-to-face consensus activities, global for online survey questionnaires. PARTICIPANTS A multidisciplinary expert panel was convened at a consensus-development conference in Uganda and included 21 researchers with experience leading challenge contests, five public health sector workers, and nine Ugandan end users. An online survey was sent to 140 corresponding authors of previously published articles that had used crowdsourcing methods. RESULTS A subgroup of expert panel members developed the initial statement and survey. We received responses from 120 (85.7%) survey participants, which were presented at an in-person workshop of all 21 panel members. Panelists discussed each of the sections, revised the statement, and participated in a second round of the survey questionnaire. Based on this second survey round, we held detailed discussions of each subsection with workshop participants and further revised the consensus statement. We then conducted the third round of the questionnaire among the 21 expert panelists and used the results to finalize the statement. This iterative process resulted in 23 final statement items, all with greater than 80% consensus. Statement items are organised into the seven stages of a challenge contest, including the following: considering the appropriateness, organising a community steering committee, promoting the contest, assessing contributions, recognising contributors, sharing ideas and evaluating the contest (COPARSE). CONCLUSIONS There is high agreement among crowdsourcing experts and stakeholders on the design and implementation of crowdsourcing challenge contests. The COPARSE consensus statement can be used to organise crowdsourcing challenge contests, improve the rigour and reproducibility of crowdsourcing research and enable large-scale collaboration.
Collapse
Affiliation(s)
- Larry Han
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
| | - Weiming Tang
- Project China, University of North Carolina at Chapel Hill, Guangzhou, China
- STD Control Department, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, China
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Tiarney Ritchwood
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | - Suzanne Day
- Department of Medicine-Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Shufang Wei
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
| | - Huanyu Bao
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
| | - Randall John
- Department of Health Policy and Management, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Eneyi Kpokiri
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Don Mathanga
- Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Southern Region, Malawi
| | - Phyllis Awor
- School of Public Health, Makerere University, Kampala, Uganda
| | - Noel Juban
- Department of Clinical Epidemiology, University of the Philippines Manila College of Medicine, Manila, Metro Manila, Philippines
| | | | - Vibhu Ambil
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
| | - Yuan Xiong
- Social Entrepreneurship to Spur Health, Guangzhou, Guangdong, China
| | | | - Joseph Tucker
- Department of Medicine-Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
6
|
Kpokiri EE, John R, Wu D, Fongwen N, Budak JZ, Chang CC, Ong JJ, Tucker JD. Crowdsourcing to develop open-access learning resources on antimicrobial resistance. BMC Infect Dis 2021; 21:914. [PMID: 34488673 PMCID: PMC8419975 DOI: 10.1186/s12879-021-06628-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 08/20/2021] [Indexed: 12/15/2022] Open
Abstract
Objectives Antimicrobial resistance (AMR) is a significant threat to global public health. Many medical curricula have limited clinical cases and materials focused on AMR, yet enhanced AMR education and training are needed to support antimicrobial stewardship programmes. We used crowdsourcing methods to develop open-access, learner-centred AMR resources. Crowdsourcing is the process of having a large group, including experts and non-experts, solve a problem and then share solutions with the public. Methods We organised a global crowdsourcing contest soliciting AMR-related multiple-choice questions, infographics, and images. First, we convened a diverse steering committee group to finalise a call for entries. Second, we launched the contest and disseminated the call for entries using social media, blog posts, email, and an in-person event. Partner institutions included two digital healthcare platforms: Figure 1® and Ding Xiang Yuan. Both organizations serve as online communities for healthcare specialists and professionals to report and comment on clinical information. At the end of the call, solicited entries were screened for eligibility and judged on merit and relevance to AMR learning and education. Exceptional entries were recognised, awarded prizes, and further reviewed for sharing with the public via open-access platforms. Results We received 59 entries from nine countries. These included 54 multiple-choice questions, four infographics, and one image. Eligible entries (n = 56) were reviewed and assigned a score on a 1–10 scale. Eight entries received mean scores greater than 6.0 and were selected as finalists. The eight finalist entries consisted of three infographics and five multiple-choice questions. They were disseminated through open-access publications and online medical communities. Although we launched a global call, we relied heavily on medical student groups and the entries received were not entirely globally representative. Conclusions We demonstrate that crowdsourcing challenge contests can be used to identify infectious disease teaching materials. Medical educators and curriculum developers can adapt this method to solicit additional teaching content for medical students. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06628-0.
Collapse
Affiliation(s)
- Eneyi E Kpokiri
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., Bloomsbury, London, WC1E 7HT, UK.
| | - Randall John
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Dan Wu
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., Bloomsbury, London, WC1E 7HT, UK
| | - Noah Fongwen
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., Bloomsbury, London, WC1E 7HT, UK
| | - Jehan Z Budak
- Department of Medicine, Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Christina C Chang
- Partners ID Images, Department of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - Jason J Ong
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., Bloomsbury, London, WC1E 7HT, UK.,Central Clinical School, Monash University, Melbourne, Australia
| | - Joseph D Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., Bloomsbury, London, WC1E 7HT, UK.,Social Entrepreneurship To Spur Health (SESH), Guangzhou, China.,Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
7
|
Kpokiri EE, Chen E, Li J, Payne S, Shrestha P, Afsana K, Amazigo U, Awor P, de Lavison JF, Khan S, Mier-Alpaño J, Ong A, Subhedar S, Wachmuth I, Cuervo LG, Mehta KM, Halpaap B, Tucker JD. Social Innovation For Health Research: Development of the SIFHR Checklist. PLoS Med 2021; 18:e1003788. [PMID: 34516565 PMCID: PMC8475987 DOI: 10.1371/journal.pmed.1003788] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 09/27/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Social innovations in health are inclusive solutions to address the healthcare delivery gap that meet the needs of end users through a multi-stakeholder, community-engaged process. While social innovations for health have shown promise in closing the healthcare delivery gap, more research is needed to evaluate, scale up, and sustain social innovation. Research checklists can standardize and improve reporting of research findings, promote transparency, and increase replicability of study results and findings. METHODS AND FINDINGS The research checklist was developed through a 3-step community-engaged process, including a global open call for ideas, a scoping review, and a 3-round modified Delphi process. The call for entries solicited checklists and related items and was open between November 27, 2019 and February 1, 2020. In addition to the open call submissions and scoping review findings, a 17-item Social Innovation For Health Research (SIFHR) Checklist was developed based on the Template for Intervention Description and Replication (TIDieR) Checklist. The checklist was then refined during 3 rounds of Delphi surveys conducted between May and June 2020. The resulting checklist will facilitate more complete and transparent reporting, increase end-user engagement, and help assess social innovation projects. A limitation of the open call was requiring internet access, which likely discouraged participation of some subgroups. CONCLUSIONS The SIFHR Checklist will strengthen the reporting of social innovation for health research studies. More research is needed on social innovation for health.
Collapse
Affiliation(s)
- Eneyi E. Kpokiri
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth Chen
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jingjing Li
- Social Entrepreneurship to Spur Health (SESH), Global Health Center Office, Guangzhou City, Guangdong Province, Guangzhou, China
| | - Sarah Payne
- Department of Medical Anthropology, School of Global Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Priyanka Shrestha
- International Diagnostics Centre, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kaosar Afsana
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Uche Amazigo
- Pan-African Community Initiative on Education and Health (PACIEH), Enugu, Nigeria
| | - Phyllis Awor
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
| | | | - Saqif Khan
- BRAC Health Programme, BRAC Centre, Dhaka, Bangladesh
| | - Jana Mier-Alpaño
- Social Innovation in Health Initiative (SIHI) Philippines Hub, Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Philippines
| | - Alberto Ong
- Alliance for Improving Health Outcomes (AIHO), Quezon City, Philippines
| | - Shivani Subhedar
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | - Isabelle Wachmuth
- Service Delivery and Safety Department, Health Systems and Innovation, World Health Organization, Geneva, Switzerland
| | - Luis Gabriel Cuervo
- Research for Health, Pan American Health Organization, Washington, DC, United States of America
| | - Kala M. Mehta
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | - Beatrice Halpaap
- TDR, the Special Programme for Research and Training in Tropical Diseases, cosponsored by UNICEF, UNDP, the World Bank, and WHO, Geneva, Switzerland
| | - Joseph D. Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Social Entrepreneurship to Spur Health (SESH), Global Health Center Office, Guangzhou City, Guangdong Province, Guangzhou, China
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, United States of America
| |
Collapse
|
8
|
Rosenberg NE, Obiezu-Umeh C, Gbaja-Biamila T, Tahlil KM, Nwaozuru U, Oladele D, Musa AZ, Idigbe I, Okwuzu J, David AN, Bamidele TA, Tang W, Ezechi O, Tucker JD, Iwelunmor J. Strategies for enhancing uptake of HIV self-testing among Nigerian youths: a descriptive analysis of the 4YouthByYouth crowdsourcing contest. BMJ INNOVATIONS 2021; 7:590-596. [PMID: 35965675 PMCID: PMC9369456 DOI: 10.1136/bmjinnov-2020-000556] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Youth are often the intended beneficiaries of HIV programs but are rarely involved in program design. Engaging youth in program design is one potential way of identifying promising approaches for HIV service delivery. The purpose of this study is to examine the feasibility of using a crowdsourcing contest to solicit ideas on ways to promote HIV self-testing (HIVST) services among Nigerian youths. METHODS From October-November, 2018 Nigerian youth 10-24 years old submitted ideas to a crowdsourcing contest on how to promote HIVST among their peers. Submissions were scored on feasibility, desirability, and impact, with an integer score of 1 (low) to 3 (high) in each domain. The three-domain scores were added to calculate a total score (3-9). The demographic characteristics of contestants were calculated using descriptive statistics. RESULTS Nine-hundred and three entries were received, 831 had unique valid responses, and 769 were eligible for scoring. Youth submitted ideas on paper (44.9%), Google Forms (39.4%), WhatsApp (9.6%), and email (6.1%). Participants' ages were 10-14 years (37%), 15-19 years (44%), and 20-24 years (22%).Approximately half were female (51.2%). Mean scores were 1.4/3.0 (SD=0.6) for feasibility, 1.4/3.0 (SD=0.6) for desirability, 1.2/3.0 (SD=0.5) for impact, and 4.0/9.0 (SD=1.5) overall. Eight percent of submissions had an overall score >7. A disproportionate share of these high-quality submissions came from email and Google submissions. CONCLUSION The 4 Youth by Youth crowdsourcing contest engaged a broad audience and is a feasible way to elicit potential strategies to distribute HIVST kits to other youth. Several high-quality ideas require further evaluation.
Collapse
Affiliation(s)
- Nora E. Rosenberg
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chisom Obiezu-Umeh
- Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, MO, USA
| | | | - Kadija M. Tahlil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ucheoma Nwaozuru
- Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, MO, USA
| | - David Oladele
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | - Ifeoma Idigbe
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Jane Okwuzu
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | | | - Weiming Tang
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Oliver Ezechi
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joseph D. Tucker
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Faculty of Infectious and Tropical Diseases, London School of Tropical Medicine and Hygiene, London, UK
| | - Juliet Iwelunmor
- Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, MO, USA
| |
Collapse
|
9
|
Heffernan A, Ma Y, Nayagam S, Chan P, Chen Z, Cooke GS, Guo Y, Liu C, Thursz M, Zhang W, Zhang X, Zhang X, Jia M, Hallett TB. Economic and epidemiological evaluation of interventions to reduce the burden of hepatitis C in Yunnan province, China. PLoS One 2021; 16:e0245288. [PMID: 33439903 PMCID: PMC7806158 DOI: 10.1371/journal.pone.0245288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/24/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The paradigm shift in hepatitis C virus (HCV) treatment options in the last five years has raised the prospect of eliminating the disease as a global health threat. This will require a step-change in the number being treated with the new direct-acting antivirals (DAAs). Given constrained budgets and competing priorities, policy makers need information on how to scale-up access to HCV treatment. To inform such decisions, we examined the cost effectiveness of screening and treatment interventions in Yunnan, China. METHODS AND FINDINGS We simulated the HCV epidemic using a previously published model of HCV transmission and disease progression, calibrated to Yunnan data, and implemented a range of treatment and screening interventions from 2019. We incorporated treatment, diagnosis, and medical costs (expressed in 2019 US Dollars, USD) to estimate the lifetime benefits and costs of interventions. Using this model, we asked: is introducing DAAs cost effective from a healthcare sector perspective; what is the optimal combination of screening interventions; and what is the societal return on investment of intervention? The incremental cost-effectiveness ratio (ICER) of switching to DAAs with a median cost of 7,400 USD (50,000 Chinese Yuan) per course is 500 USD/disability adjusted life year (DALY) averted; at a threshold of 50% of Yunnan gross domestic product (2,600 USD), switching to DAAs is cost effective 94% of the time. At this threshold, the optimal, cost-effective intervention comprises screening people who inject drugs, those in HIV care, men who have sex with men, and ensuring access to DAAs for all those newly diagnosed with HCV. For each USD invested in this intervention, there is an additional 0·80 USD (95% credible interval: 0·17-1·91) returned through reduced costs of disease or increased productivity. Returns on investment are lower (and potentially negative) if a sufficiently long-term horizon, encompassing the full stream of future benefits, is not adopted. The study had two key limitations: costing data were not always specific to Yunnan province but were taken from China-level studies; and modelled interventions may require more operational research to ensure they can be effectively and efficiently rolled-out to the entire province. CONCLUSIONS Introducing DAAs is cost effective, the optimal package of screening measures is focussed on higher risk groups, and there are likely to be positive returns from investing in such HCV interventions. Our analysis shows that targeted investment in HCV interventions will have net benefits to society; these benefits will only increase as DAA costs fall.
Collapse
Affiliation(s)
- Alastair Heffernan
- School of Public Health, Imperial College London, London, United Kingdom
| | - Yanling Ma
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Shevanthi Nayagam
- School of Public Health, Imperial College London, London, United Kingdom
| | - Polin Chan
- World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Zhongdan Chen
- World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Graham S. Cooke
- School of Public Health, Imperial College London, London, United Kingdom
| | - Yan Guo
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Chuntao Liu
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Mark Thursz
- School of Public Health, Imperial College London, London, United Kingdom
| | - Wanyue Zhang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xiaobing Zhang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xiujie Zhang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Manhong Jia
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Timothy B. Hallett
- School of Public Health, Imperial College London, London, United Kingdom
| |
Collapse
|
10
|
Kpokiri E, Chen E, Li J, Payne S, Shrestha P, Afsana K, Amazigo U, Awor P, de Lavison JF, Khan S, Mier-Alpaño JD, Ong A, Subhedar S, Wachmuth I, Mehta KM, Halpaap B, Tucker JD. Social innovation research checklist: A crowdsourcing open call and digital hackathon to develop a checklist for research to advance social innovation in health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.03.20225110. [PMID: 33173931 PMCID: PMC7654927 DOI: 10.1101/2020.11.03.20225110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
While social innovations in health have shown promise in closing the healthcare delivery gap, especially in low- and middle-income countries (LMICs), more research is needed to evaluate, scale up, and sustain social innovations. Research checklists can standardize and improve reporting of research findings, promote transparency, and increase replicability of study results and findings. This article describes the development of a 17-item social innovation in health research checklist to assess and report social innovation projects and provides examples of good reporting. The checklist is adapted from the TIDieR checklist and will facilitate more complete and transparent reporting and increase end user engagement. SUMMARY POINTS While many social innovations have been developed and shown promise in closing the healthcare delivery gap, more research is needed to evaluate social innovationThe Social Innovation in Health Research Checklist, the first of its kind, is a 17-item checklist to improve reporting completeness and promote transparency in the development, implementation, and evaluation of social innovations in healthThe research checklist was developed through a three-step process, including a global open call for ideas, a scoping review, and a three-round modified Delphi processUse of this research checklist will enable researchers, innovators and partners to learn more about the process and results of social innovation in health research.
Collapse
Affiliation(s)
- Eneyi Kpokiri
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Elizabeth Chen
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Jingjing Li
- Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China
| | - Sarah Payne
- Department of Medical Anthropology, School of Global health, University of North Carolina, Chapel Hill, NC, USA
| | - Priyanka Shrestha
- International Diagnostics Centre, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Kaosar Afsana
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Uche Amazigo
- Pan-African Community Initiative on Education and Health (PACIEH), Enugu, Nigeria
| | - Phyllis Awor
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
| | | | - Saqif Khan
- BRAC Health Programme, BRAC Centre, Dhaka, Bangladesh
| | - Jana D. Mier-Alpaño
- Social Innovation in Health Initiative (SIHI) Philippines Hub, Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Philippines
| | - Alberto Ong
- Alliance for Improving Health Outcomes (AIHO), West Avenue, West Triangle, Quezon City, Philippines
| | - Shivani Subhedar
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Isabelle Wachmuth
- Service Delivery and Safety Department, Health Systems and Innovation, World Health Organization, Geneva, Switzerland
| | - Kala M. Mehta
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Beatrice Halpaap
- TDR, the Special Programme for Research and Training in Tropical Diseases co-sponsored by UNICEF, UNDP, the World Bank and WHO, Geneva, Switzerland
| | - Joseph D. Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
11
|
Halpaap BM, Tucker JD, Mathanga D, Juban N, Awor P, Saravia NG, Han L, de Villiers K, Kitamura M, Cuervo LG, Peeling R, Reeder JC. Social innovation in global health: sparking location action. LANCET GLOBAL HEALTH 2020; 8:e633-e634. [PMID: 32353305 DOI: 10.1016/s2214-109x(20)30070-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 02/14/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Beatrice M Halpaap
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou 510095, China; Social Entrepreneurship to Spur Health (SESH), Guangzhou, China; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Don Mathanga
- School of Public Health and Family Medicine, University of Malawi, Blantyre, Malawi
| | - Noel Juban
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | - Phyllis Awor
- Department of Community Health and Behavioural Sciences, Makerere University, Kampala Uganda
| | - Nancy G Saravia
- Centro Internacional de Entrenamiento e Investigaciones Medicas CIDEIM, Cali, Colombia; Universidad Icesi, Cali, Colombia
| | - Larry Han
- University of North Carolina Project-China, Guangzhou 510095, China; Social Entrepreneurship to Spur Health (SESH), Guangzhou, China; Harvard School of Public Health, Boston, MA, USA
| | - Katusha de Villiers
- Bertha Centre for Social Innovation and Entrepreneurship, University of Cape Town, South Africa
| | - Makiko Kitamura
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
| | | | - Rosanna Peeling
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - John C Reeder
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
| |
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW With increasing availability of generic direct-acting antivirals (DAAs) and associated price reductions, various governments, multilateral institutions, and donors have started providing testing and treatment for hepatitis C virus (HCV) infection. More data on the quality of these generic medicines and on cost-effectiveness of their use are becoming widely available. This review seeks to describe some of the treatment programs for HCV that are evolving in Cambodia, India, Indonesia, Malaysia, Myanmar, and Thailand. RECENT FINDINGS The quality of multiple generic DAAs has been shown to be bioequivalent to innovator formulations, with generic versions achieving high cure rates in real-world settings. Although published materials are limited, there is expanding experience with local pilot and national treatment programs which are largely being funded by national governments and other institutions. SUMMARY Countries and other public health stakeholders are recognizing the need to scale up HCV diagnosis and treatment programs using generic DAAs. However, local pilot or national treatment programs need to be massively expanded to eliminate HCV in high-burden areas.
Collapse
|
13
|
Crowdsourcing in health and medical research: a systematic review. Infect Dis Poverty 2020; 9:8. [PMID: 31959234 PMCID: PMC6971908 DOI: 10.1186/s40249-020-0622-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/07/2020] [Indexed: 12/31/2022] Open
Abstract
Background Crowdsourcing is used increasingly in health and medical research. Crowdsourcing is the process of aggregating crowd wisdom to solve a problem. The purpose of this systematic review is to summarize quantitative evidence on crowdsourcing to improve health. Methods We followed Cochrane systematic review guidance and systematically searched seven databases up to September 4th 2019. Studies were included if they reported on crowdsourcing and related to health or medicine. Studies were excluded if recruitment was the only use of crowdsourcing. We determined the level of evidence associated with review findings using the GRADE approach. Results We screened 3508 citations, accessed 362 articles, and included 188 studies. Ninety-six studies examined effectiveness, 127 examined feasibility, and 37 examined cost. The most common purposes were to evaluate surgical skills (17 studies), to create sexual health messages (seven studies), and to provide layperson cardio-pulmonary resuscitation (CPR) out-of-hospital (six studies). Seventeen observational studies used crowdsourcing to evaluate surgical skills, finding that crowdsourcing evaluation was as effective as expert evaluation (low quality). Four studies used a challenge contest to solicit human immunodeficiency virus (HIV) testing promotion materials and increase HIV testing rates (moderate quality), and two of the four studies found this approach saved money. Three studies suggested that an interactive technology system increased rates of layperson initiated CPR out-of-hospital (moderate quality). However, studies analyzing crowdsourcing to evaluate surgical skills and layperson-initiated CPR were only from high-income countries. Five studies examined crowdsourcing to inform artificial intelligence projects, most often related to annotation of medical data. Crowdsourcing was evaluated using different outcomes, limiting the extent to which studies could be pooled. Conclusions Crowdsourcing has been used to improve health in many settings. Although crowdsourcing is effective at improving behavioral outcomes, more research is needed to understand effects on clinical outcomes and costs. More research is needed on crowdsourcing as a tool to develop artificial intelligence systems in medicine. Trial registration PROSPERO: CRD42017052835. December 27, 2016.
Collapse
|
14
|
Heffernan A, Cooke GS, Nayagam S, Thursz M, Hallett TB. Scaling up prevention and treatment towards the elimination of hepatitis C: a global mathematical model. Lancet 2019; 393:1319-1329. [PMID: 30704789 PMCID: PMC6484702 DOI: 10.1016/s0140-6736(18)32277-3] [Citation(s) in RCA: 184] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/13/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The revolution in hepatitis C virus (HCV) treatment through the development of direct-acting antivirals (DAAs) has generated international interest in the global elimination of the disease as a public health threat. In 2017, this led WHO to establish elimination targets for 2030. We evaluated the impact of public health interventions on the global HCV epidemic and investigated whether WHO's elimination targets could be met. METHODS We developed a dynamic transmission model of the global HCV epidemic, calibrated to 190 countries, which incorporates data on demography, people who inject drugs (PWID), current coverage of treatment and prevention programmes, natural history of the disease, HCV prevalence, and HCV-attributable mortality. We estimated the worldwide impact of scaling up interventions that reduce risk of transmission, improve access to treatment, and increase screening for HCV infection by considering six scenarios: no change made to existing levels of diagnosis or treatment; sequentially adding the following interventions: blood safety and infection control, PWID harm reduction, offering of DAAs at diagnosis, and outreach screening to increase the number diagnosed; and a scenario in which DAAs are not introduced (ie, treatment is only with pegylated interferon and oral ribavirin) to investigate the effect of DAA use. We explored the effect of varying the coverage or impact of these interventions in sensitivity analyses and also assessed the impact on the global epidemic of removing certain key countries from the package of interventions. FINDINGS By 2030, interventions that reduce risk of transmission in the non-PWID population by 80% and increase coverage of harm reduction services to 40% of PWID could avert 14·1 million (95% credible interval 13·0-15·2) new infections. Offering DAAs at time of diagnosis in all countries could prevent 640 000 deaths (620 000-670 000) from cirrhosis and liver cancer. A comprehensive package of prevention, screening, and treatment interventions could avert 15·1 million (13·8-16·1) new infections and 1·5 million (1·4-1·6) cirrhosis and liver cancer deaths, corresponding to an 81% (78-82) reduction in incidence and a 61% (60-62) reduction in mortality compared with 2015 baseline. This reaches the WHO HCV incidence reduction target of 80% but is just short of the mortality reduction target of 65%, which could be reached by 2032. Reducing global burden depends upon success of prevention interventions, implemention of outreach screening, and progress made in key high-burden countries including China, India, and Pakistan. INTERPRETATION Further improvements in blood safety and infection control, expansion or creation of PWID harm reduction services, and extensive screening for HCV with concomitant treatment for all are necessary to reduce the burden of HCV. These findings should inform the ongoing global action to eliminate the HCV epidemic. FUNDING Wellcome Trust.
Collapse
Affiliation(s)
- Alastair Heffernan
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK
| | - Graham S Cooke
- Division of Infectious Diseases, St Mary's Hospital, Imperial College London, London, UK
| | - Shevanthi Nayagam
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK; Division of Digestive Diseases, St Mary's Hospital, Imperial College London, London, UK
| | - Mark Thursz
- Division of Digestive Diseases, St Mary's Hospital, Imperial College London, London, UK
| | - Timothy B Hallett
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.
| |
Collapse
|
15
|
Tang W, Wei C, Cao B, Wu D, Li KT, Lu H, Ma W, Kang D, Li H, Liao M, Mollan KR, Hudgens MG, Liu C, Huang W, Liu A, Zhang Y, Smith MK, Mitchell KM, Ong JJ, Fu H, Vickerman P, Yang L, Wang C, Zheng H, Yang B, Tucker JD. Crowdsourcing to expand HIV testing among men who have sex with men in China: A closed cohort stepped wedge cluster randomized controlled trial. PLoS Med 2018; 15:e1002645. [PMID: 30153265 PMCID: PMC6112627 DOI: 10.1371/journal.pmed.1002645] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/26/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND HIV testing rates are suboptimal among at-risk men. Crowdsourcing may be a useful tool for designing innovative, community-based HIV testing strategies to increase HIV testing. The purpose of this study was to use a stepped wedge cluster randomized controlled trial (RCT) to evaluate the effect of a crowdsourced HIV intervention on HIV testing uptake among men who have sex with men (MSM) in eight Chinese cities. METHODS AND FINDINGS An HIV testing intervention was developed through a national image contest, a regional strategy designathon, and local message contests. The final intervention included a multimedia HIV testing campaign, an online HIV testing service, and local testing promotion campaigns tailored for MSM. This intervention was evaluated using a closed cohort stepped wedge cluster RCT in eight Chinese cities (Guangzhou, Shenzhen, Zhuhai, and Jiangmen in Guangdong province; Jinan, Qingdao, Yantai, and Jining in Shandong province) from August 2016 to August 2017. MSM were recruited through Blued, a social networking mobile application for MSM, from July 29 to August 21 of 2016. The primary outcome was self-reported HIV testing in the past 3 months. Secondary outcomes included HIV self-testing, facility-based HIV testing, condom use, and syphilis testing. Generalized linear mixed models (GLMMs) were used to analyze primary and secondary outcomes. We enrolled a total of 1,381 MSM. Most were ≤30 years old (82%), unmarried (86%), and had a college degree or higher (65%). The proportion of individuals receiving an HIV test during the intervention periods within a city was 8.9% (95% confidence interval [CI] 2.2-15.5) greater than during the control periods. In addition, the intention-to-treat analysis showed a higher probability of receiving an HIV test during the intervention periods as compared to the control periods (estimated risk ratio [RR] = 1.43, 95% CI 1.19-1.73). The intervention also increased HIV self-testing (RR = 1.89, 95% CI 1.50-2.38). There was no effect on facility-based HIV testing (RR = 1.00, 95% CI 0.79-1.26), condom use (RR = 1.00, 95% CI 0.86-1.17), or syphilis testing (RR = 0.92, 95% CI 0.70-1.21). A total of 48.6% (593/1,219) of participants reported that they received HIV self-testing. Among men who received two HIV tests, 32 individuals seroconverted during the 1-year study period. Study limitations include the use of self-reported HIV testing data among a subset of men and non-completion of the final survey by 23% of participants. Our study population was a young online group in urban China and the relevance of our findings to other populations will require further investigation. CONCLUSIONS In this setting, crowdsourcing was effective for developing and strengthening community-based HIV testing services for MSM. Crowdsourced interventions may be an important tool for the scale-up of HIV testing services among MSM in low- and middle-income countries (LMIC). TRIAL REGISTRATION ClinicalTrials.gov NCT02796963.
Collapse
Affiliation(s)
- Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Chongyi Wei
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Social and Behavioral Health Sciences, School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| | - Bolin Cao
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Dan Wu
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
| | - Katherine T. Li
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Weill Cornell Medical College, New York, New York, United States of America
| | - Haidong Lu
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Wei Ma
- Shandong University School of Public Health, Jinan, China
| | - Dianmin Kang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Haochu Li
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Shandong University School of Public Health, Jinan, China
| | - Meizhen Liao
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Katie R. Mollan
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Michael G. Hudgens
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Chuncheng Liu
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Department of Sociology, University of California San Diego, La Jolla, California, United States of America
| | - Wenting Huang
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
| | - Aifeng Liu
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
| | - Ye Zhang
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - M. Kumi Smith
- Department of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States of America
| | - Kate M. Mitchell
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jason J. Ong
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hongyun Fu
- Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, Virginia, United States of America
| | - Peter Vickerman
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Ligang Yang
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Joseph D. Tucker
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
16
|
Tucker JD, Pan SW, Mathews A, Stein G, Bayus B, Rennie S. Ethical Concerns of and Risk Mitigation Strategies for Crowdsourcing Contests and Innovation Challenges: Scoping Review. J Med Internet Res 2018; 20:e75. [PMID: 29523500 PMCID: PMC5866301 DOI: 10.2196/jmir.8226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Crowdsourcing contests (also called innovation challenges, innovation contests, and inducement prize contests) can be used to solicit multisectoral feedback on health programs and design public health campaigns. They consist of organizing a steering committee, soliciting contributions, engaging the community, judging contributions, recognizing a subset of contributors, and sharing with the community. OBJECTIVE This scoping review describes crowdsourcing contests by stage, examines ethical problems at each stage, and proposes potential ways of mitigating risk. METHODS Our analysis was anchored in the specific example of a crowdsourcing contest that our team organized to solicit videos promoting condom use in China. The purpose of this contest was to create compelling 1-min videos to promote condom use. We used a scoping review to examine the existing ethical literature on crowdsourcing to help identify and frame ethical concerns at each stage. RESULTS Crowdsourcing has a group of individuals solve a problem and then share the solution with the public. Crowdsourcing contests provide an opportunity for community engagement at each stage: organizing, soliciting, promoting, judging, recognizing, and sharing. Crowdsourcing poses several ethical concerns: organizing-potential for excluding community voices; soliciting-potential for overly narrow participation; promoting-potential for divulging confidential information; judging-potential for biased evaluation; recognizing-potential for insufficient recognition of the finalist; and sharing-potential for the solution to not be implemented or widely disseminated. CONCLUSIONS Crowdsourcing contests can be effective and engaging public health tools but also introduce potential ethical problems. We present methods for the responsible conduct of crowdsourcing contests.
Collapse
Affiliation(s)
- Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, United States
| | - Stephen W Pan
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health, Guangzhou, China
- Department of Public Health, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Allison Mathews
- Social Entrepreneurship to Spur Health, Guangzhou, China
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, United States
| | - Gabriella Stein
- Social Entrepreneurship to Spur Health, Guangzhou, China
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, United States
| | - Barry Bayus
- Kenan-Flagler School of Business, University of North Carolina, Chapel Hill, NC, United States
| | - Stuart Rennie
- Social Medicine Department, University of North Carolina, Chapel Hill, NC, United States
| |
Collapse
|
17
|
Chou R, Easterbrook P, Hellard M. Methodological challenges in appraising evidence on diagnostic testing for WHO guidelines on hepatitis B and hepatitis C virus infection. BMC Infect Dis 2017; 17:694. [PMID: 29143626 PMCID: PMC5688453 DOI: 10.1186/s12879-017-2766-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Linking persons with hepatitis B (HBV) and hepatitis C (HCV) infection with appropriate prevention and treatment requires that they first be diagnosed. The World Health Organization (WHO) has developed its first guidelines on testing for chronic HBV and HCV infection, using a framework based on methods from the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group for the formulation of recommendations, including determining the strength of recommendations and quality of evidence. Recommendations were formulated based on the overall quality of the evidence, in addition to other considerations, including the balance between benefits and harms, values and preferences, feasibility and resource implications. This article summarizes methodological challenges and additional considerations encountered in applying these procedures to diagnostic testing for viral hepatitis, and strategies to address these. Direct evidence on the effects of tests and test strategies on clinical outcomes was not available. Given the availability of effective treatments for HBV and HCV that are generally acceptable to patients, the Guidelines Development Group (GDG) considered diagnostic accuracy a reasonable surrogate for clinical outcomes. In order to increase the number of patients identified with chronic HBV and HCV infection who could benefit from treatments, the GDG determined that tests and testing strategies associated with slightly lower diagnostic accuracy could be recommended when associated with lower costs; increased testing access, uptake, and linkage to care; greater feasibility; or if preferred by patients.
Collapse
Affiliation(s)
- Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon, USA.
| | - Philippa Easterbrook
- Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland
| | - Margaret Hellard
- Centre for Population Health, Burnet Institute, Melbourne, Australia
| |
Collapse
|