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Abimbola S, van de Kamp J, Lariat J, Rathod L, Klipstein-Grobusch K, van der Graaf R, Bhakuni H. Unfair knowledge practices in global health: a realist synthesis. Health Policy Plan 2024; 39:636-650. [PMID: 38642401 PMCID: PMC11145905 DOI: 10.1093/heapol/czae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
Unfair knowledge practices easily beset our efforts to achieve health equity within and between countries. Enacted by people from a distance and from a position of power ('the centre') on behalf of and alongside people with less power ('the periphery'), these unfair practices have generated a complex literature of complaints across various axes of inequity. We identified a sample of this literature from 12 journals and systematized it using the realist approach to explanation. We framed the outcome to be explained as 'manifestations of unfair knowledge practices'; their generative mechanisms as 'the reasoning of individuals or rationale of institutions'; and context that enable them as 'conditions that give knowledge practices their structure'. We identified four categories of unfair knowledge practices, each triggered by three mechanisms: (1) credibility deficit related to pose (mechanisms: 'the periphery's cultural knowledge, technical knowledge and "articulation" of knowledge do not matter'), (2) credibility deficit related to gaze (mechanisms: 'the centre's learning needs, knowledge platforms and scholarly standards must drive collective knowledge-making'), (3) interpretive marginalization related to pose (mechanisms: 'the periphery's sensemaking of partnerships, problems and social reality do not matter') and (4) interpretive marginalization related to gaze (mechanisms: 'the centre's learning needs, social sensitivities and status preservation must drive collective sensemaking'). Together, six mutually overlapping, reinforcing and dependent categories of context influence all 12 mechanisms: 'mislabelling' (the periphery as inferior), 'miseducation' (on structural origins of disadvantage), 'under-representation' (of the periphery on knowledge platforms), 'compounded spoils' (enjoyed by the centre), 'under-governance' (in making, changing, monitoring, enforcing and applying rules for fair engagement) and 'colonial mentality' (of/at the periphery). These context-mechanism-outcome linkages can inform efforts to redress unfair knowledge practices, investigations of unfair knowledge practices across disciplines and axes of inequity and ethics guidelines for health system research and practice when working at a social or physical distance.
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Affiliation(s)
- Seye Abimbola
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
| | - Judith van de Kamp
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
| | - Joni Lariat
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Lekha Rathod
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
- Luxembourg Operational Research and Epidemiology Support Unit, Médecins Sans Frontières, Luxembourg City L-1617, Luxembourg
| | - Kerstin Klipstein-Grobusch
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Rieke van der Graaf
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
| | - Himani Bhakuni
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
- York Law School, University of York, York YO10 5GD, United Kingdom
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Ameen S, Shafiq SS, Ashrafee S, Saberin A, Saha PK, Alam HMS, Nahar S, Sarkar S, Adnan SD, ANM Ehtesham K, Amena B, Ahmed S, Khan MN, Banik G, Jabeen S, Hossain AT, Sarkar SS, Ahmed A, Chisti MJ, Islam MS, Islam MJ, El Arifeen S, Rahman AE. Stakeholder engagement to introduce a standardised register for improved inpatient care of newborns and sick children in Bangladesh. J Glob Health 2024; 14:04082. [PMID: 38751308 PMCID: PMC11096775 DOI: 10.7189/jogh.14.04082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
Background Despite a global decrease of 59% in under-five mortality rates from 1990 to 2021, child survival remains a pressing issue. This holds true for Bangladesh, as well. In response, the Government of Bangladesh introduced a standardised register for strengthening the inpatient management of newborns and sick children in 2021. Methods We employed a comprehensive four-phase stakeholder engagement process to implement an inpatient register for newborns and sick children. The first stage included identifying and prioritising potential stakeholders at the national and district levels. We identified eight organisations involved in newborn and child health and selected 24 participants from various other sectors for workshops aimed at raising awareness about the register's introduction. These stakeholders also participated in the register's design, development strategies planning, and implementation phases. These phases were led by the 'National Newborn Health and IMCI programme' with support from various partners. A technical working group reviewed existing registers and helped prepare training materials. Feedback from each workshop was crucial in finalising the register. Results The Government of Bangladesh has recognised the need for an indoor register for newborns and sick children, which was to be established in collaboration with development partners. This initiative can enhance the quality of care for sick children and increase service provider accountability. Due to its successful implementation, it will continue to be used in the Kushtia and Dinajpur districts, with plans for a nationwide scale-up. The Government has allocated funds in the next health sector programme for orientation and register printing. A strengths, weaknesses, opportunities, and threats (SWOT) analysis of the stakeholder engagement process highlighted strengths such as a context-specific approach and collaborative engagement, as well as challenges such as time resource requirements. Conclusions Implementing an inpatient register for newborns and sick children through stakeholder engagement can effectively improve child health care services. Aside from challenges such as resource intensiveness and stakeholder commitments, success depended on the organising authority's expertise in relationship building, budget allocation, time management, and workforce dedication. Therefore, strategic planning, staff recruitment, networking, and budgeting are crucial for successful stakeholder engagement and health care initiatives.
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Affiliation(s)
- Shafiqul Ameen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabit Saad Shafiq
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabina Ashrafee
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Ashfia Saberin
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Palash Kumar Saha
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Husam Md Shah Alam
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Salmun Nahar
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Supriya Sarkar
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Sheikh Daud Adnan
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | | | - Sabbir Ahmed
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | | | | | - Sabrina Jabeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Aniqa Tasnim Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sadman Sowmik Sarkar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anisuddin Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Md Jahurul Islam
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Drew N, McAllister M, Coffin J, Robinson M, Katzenellenbogen J, Armstrong E. Healing Right Way randomised control trial enhancing rehabilitation services for Aboriginal people with brain injury in Western Australia: translation principles and activities. BRAIN IMPAIR 2024; 25:IB23109. [PMID: 38640359 DOI: 10.1071/ib23109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/21/2024] [Indexed: 04/21/2024]
Abstract
Background This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017-2022), outlining activities to date. Healing Right Way was a stepped wedge cluster randomised controlled trial conducted in Western Australia, aimed at enhancing rehabilitation services and quality of life for Aboriginal Australians following acquired brain injury. The trial translation plan was aspirational and action-oriented, with its implementation iterative and ongoing. Translational activities aimed to inform service and research planning for Aboriginal people with brain injury. Situated in the intercultural space, the work guards against undertaking activities that are monocultural, colonial and appropriating in favour of work that is authentically viewed through the dual lens of whiteness and Aboriginal and Torres Strait Islander ways of knowing, being and doing, and is strengths-based. Methods Three translational and knowledge exchange components were identified, relating to the role of Aboriginal Brain Injury Coordinators, cultural training of hospital staff and the research process itself. Knowledge plans were developed for key audiences, with potential translation products to be monitored for ongoing impact. Results Results demonstrate that translational and knowledge exchange were iteratively embedded throughout the trial life cycle. Data sources included community engagement, partnership meetings and interviews. Activities involved presentations to diverse audiences including bureaucrats, community and participants. Conclusions This report provides a snapshot of the first translation knowledge exchange plan and activities constructed in relation to brain injury rehabilitation services for Aboriginal people. Challenges encountered, as well as successes to date, are discussed.
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Affiliation(s)
- Neil Drew
- Kurongkurl Katitjin, Edith Cowan University, Perth, WA, Australia
| | - Meaghan McAllister
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Juli Coffin
- Ngangk Yira Institute for Change, Murdoch University, Broome, WA, Australia
| | - Melanie Robinson
- Ngangk Yira Institute for Change, Murdoch University, Broome, WA, Australia
| | - Judith Katzenellenbogen
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Elizabeth Armstrong
- University Department of Rural Health South West, Edith Cowan University, Bunbury, Australia
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Metcalf CD, Ostler C, Thor P, Kheng S, Srors S, Sann R, Worsley P, Gates L, Donnovan-Hall M, Harte C, Dickinson A. Engaging multisector stakeholders to identify priorities for global health innovation, change and research: an engagement methodology and application to prosthetics service delivery in Cambodia. Disabil Rehabil 2024; 46:685-696. [PMID: 36823949 DOI: 10.1080/09638288.2023.2173313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/21/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE While innovation is known to catalyse solutions to global sustainable development challenges, lack of engagement from stakeholders during conceptualisation and development may influence the degree of success of implementation. METHODS AND MATERIALS This paper presents a complete and novel engagement methodology, developed from value led business modelling approaches, for working with multi-sector stakeholders. The methodology can be used to determine barriers and facilitators to clinical practice innovations or translational research, within a country-specific context. The approach has then been applied in the Cambodian prosthetics and orthotics sector to provide a practice-based exemplar application of the framework. RESULTS This approach seeks to ensure the suitability and sustainability of clinical practice and research programmes being implemented within a complex ecosystem. A theoretical basis, drawn from academic and business innovation sectors, has been consolidated and adapted for practical application to design, direct, and inform initiatives in low resource settings. CONCLUSIONS The methods presented provide a way to both develop and articulate the mission, vision, and goals of any proposed change, and to effectively communicate these with stakeholders in a way that engages the personal and professional values that exist in their ecosystem. It provides a structured process through which meaningful conversations can happen, and a basis for relationship management with key stakeholders; intrinsic to enable a sustained legacy from research and development.
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Affiliation(s)
- C D Metcalf
- School of Health Sciences, University of Southampton, Southampton, UK
- Exceed Research Network, Lisburn, Northern Ireland
| | - C Ostler
- School of Health Sciences, University of Southampton, Southampton, UK
- Exceed Research Network, Lisburn, Northern Ireland
- Portsmouth NHS, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - P Thor
- Department of Prosthetics & Orthotics, Phnom Penh, Cambodia
- Exceed Worldwide, Lisburn, Northern Ireland
| | - S Kheng
- Exceed Research Network, Lisburn, Northern Ireland
- Department of Prosthetics & Orthotics, Phnom Penh, Cambodia
- Exceed Worldwide, Lisburn, Northern Ireland
| | - S Srors
- Department of Prosthetics & Orthotics, Phnom Penh, Cambodia
- Exceed Worldwide, Lisburn, Northern Ireland
| | - R Sann
- National Institute of Social Affairs, Phnom Penh, Cambodia
- Elderly Welfare Department, Ministry of Social Affairs, Veterans and Youth Rehabilitation, National Elderly Care Center, Phnom Penh, Cambodia
| | - P Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
| | - L Gates
- School of Health Sciences, University of Southampton, Southampton, UK
| | - M Donnovan-Hall
- School of Health Sciences, University of Southampton, Southampton, UK
- Exceed Research Network, Lisburn, Northern Ireland
| | - C Harte
- Exceed Research Network, Lisburn, Northern Ireland
- Exceed Worldwide, Lisburn, Northern Ireland
| | - A Dickinson
- Exceed Research Network, Lisburn, Northern Ireland
- School of Engineering, University of Southampton, Southampton, UK
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Fernandes G, Williams S, Adab P, Gale N, de Jong C, de Sousa JC, Cheng KK, Chi C, Cooper BG, Dickens AP, Enocson A, Farley A, Jolly K, Jowett S, Maglakelidze M, Maghlakelidze T, Martins S, Sitch A, Stamenova A, Stavrikj K, Stelmach R, Turner A, Pan Z, Pang H, Zhang J, Jordan RE. Engaging stakeholders to level up COPD care in LMICs: lessons learned from the "Breathe Well" programme in Brazil, China, Georgia, and North Macedonia. BMC Health Serv Res 2024; 24:66. [PMID: 38216986 PMCID: PMC10790249 DOI: 10.1186/s12913-023-10525-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/24/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Effective stakeholder engagement in health research is increasingly being recognised and promoted as an important pathway to closing the gap between knowledge production and its use in health systems. However, little is known about its process and impacts, particularly in low-and middle-income countries. This opinion piece draws on the stakeholder engagement experiences from a global health research programme on Chronic Obstructive Pulmonary Disease (COPD) led by clinician researchers in Brazil, China, Georgia and North Macedonia, and presents the process, outcomes and lessons learned. MAIN BODY Each country team was supported with an overarching engagement protocol and mentored to develop a tailored plan. Patient involvement in research was previously limited in all countries, requiring intensive efforts through personal communication, meetings, advisory groups and social media. Accredited training programmes were effective incentives for participation from healthcare providers; and aligning research findings with competing policy priorities enabled interest and dialogue with decision-makers. The COVID-19 pandemic severely limited possibilities for planned engagement, although remote methods were used where possible. Planned and persistent engagement contributed to shared knowledge and commitment to change, including raised patient and public awareness about COPD, improved skills and practice of healthcare providers, increased interest and support from clinical leaders, and dialogue for integrating COPD services into national policy and practice. CONCLUSION Stakeholder engagement enabled relevant local actors to produce and utilise knowledge for small wins such as improving day-to-day practice and for long-term goals of equitable access to COPD care. For it to be successful and sustained, stakeholder engagement needs to be valued and integrated throughout the research and knowledge generation process, complete with dedicated resources, contextualised and flexible planning, and commitment.
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Affiliation(s)
- Genevie Fernandes
- International Primary Care Respiratory Group, London, UK.
- Usher Institute, University of Edinburgh, Edinburgh, UK.
| | - Siân Williams
- International Primary Care Respiratory Group, London, UK
| | - Peymané Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nicola Gale
- Health Services Management Centre, School of Social Policy, College of Social Sciences, University of Birmingham, Birmingham, UK
| | - Corina de Jong
- International Primary Care Respiratory Group, London, UK
| | - Jaime Correia de Sousa
- International Primary Care Respiratory Group, London, UK
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- PT Government Associate Laboratory, ICVS/3B's, Braga/Guimarães, Portugal
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Chunhua Chi
- Department of General Practice, Peking University First Hospital, Beijing, China
| | | | - Andrew P Dickens
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Observational and Pragmatic Research Institute, Midview City, Singapore
| | - Alexandra Enocson
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Amanda Farley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sue Jowett
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Maka Maglakelidze
- Georgian Respiratory Association, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Tamaz Maghlakelidze
- Georgian Respiratory Association, Tbilisi, Georgia
- Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Sonia Martins
- Family Medicine, ABC Medical School, São Paolo, Brazil
| | - Alice Sitch
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Aleksandra Stamenova
- Faculty of Medicine, Institute of Social Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Katarina Stavrikj
- Center for Family Medicine, Faculty of Medicine, Ss.Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paolo, Brazil
| | - Alice Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Zihan Pan
- Department of General Practice, Peking University First Hospital, Beijing, China
| | - Hui Pang
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jianxin Zhang
- Department of General Practice, Peking University First Hospital, Beijing, China
| | - Rachel E Jordan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Kasprowicz VO, Waddilove KD, Chopera D, Khumalo S, Harilall S, Wong EB, Karita E, Sanders EJ, Kilembe W, Gaseitsiwe S, Ndung’u T. Developing a diversity, equity and inclusion compass to guide scientific capacity strengthening efforts in Africa. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002339. [PMID: 38117812 PMCID: PMC10732426 DOI: 10.1371/journal.pgph.0002339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/10/2023] [Indexed: 12/22/2023]
Abstract
Diversity, equity and inclusion (DEI) in science is vital to improve the scientific process and ensure societal uptake and application of scientific results. DEI challenges include a full spectrum of issues from the lack of, and promotion of, women in science, to the numerous barriers in place that limit representation of African scientists in global scientific efforts. DEI principles in African science remain relatively underdeveloped, with limited engagement and discussion among all stakeholders to ensure that initiatives are relevant to local environments. The Sub-Saharan African Network for TB/HIV research Excellence (SANTHE) is a network of African-led research in HIV, tuberculosis (TB), associated co-morbidities, and emerging pathogens, now based in eight African countries. Our aim, as a scientific capacity strengthening network, was to collaboratively produce a set of DEI guidelines and to represent them visually as a DEI compass. We implemented a consortium-wide survey, focus group discussions and a workshop where we were able to identify the key DEI challenges as viewed by scientists and support staff within the SANTHE network. Three thematic areas were identified: 1. Conquering Biases, 2. Respecting the Needs of a Diverse Workforce (including mental health challenges, physical disability, career stability issues, demands of parenthood, and female-specific challenges), and 3. Promotion of African Science. From this we constructed a compass that included proposed steps to start addressing these issues. The use of the compass metaphor allows 're-adjustment/re-positioning' making this a dynamic output. The compass can become a tool to establish an institution's DEI priorities and then to progress towards them.
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Affiliation(s)
- Victoria O. Kasprowicz
- Africa Health Research Institute, Durban, South Africa
- HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | | | - Denis Chopera
- Africa Health Research Institute, Durban, South Africa
| | - Sipho Khumalo
- Africa Health Research Institute, Durban, South Africa
| | - Sashin Harilall
- Africa Health Research Institute, Durban, South Africa
- Ragon Institute of MGH, MIT and Harvard University, Cambridge, Massachusetts, United States of America
| | - Emily B. Wong
- Africa Health Research Institute, Durban, South Africa
| | - Etienne Karita
- Rwanda Zambia Health Research Group, Lusaka and Ndola, Zambia, Kigali, Rwanda
- Emory University, Atlanta, GA, United States of America
| | - Eduard J. Sanders
- Kenyan Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Clinical Medicine, Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Headington, United Kingdom
- The Aurum Institute, Johannesburg, South Africa
| | - William Kilembe
- Rwanda Zambia Health Research Group, Lusaka and Ndola, Zambia, Kigali, Rwanda
- Emory University, Atlanta, GA, United States of America
| | - Simani Gaseitsiwe
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- Department of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Thumbi Ndung’u
- Africa Health Research Institute, Durban, South Africa
- HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Ragon Institute of MGH, MIT and Harvard University, Cambridge, Massachusetts, United States of America
- Division of Infection and Immunity, University College London, London, United Kingdom
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Borst RAJ, Wehrens R, Nsangou M, Arikpo D, Esu E, Al Metleq A, Hobden O, Meremikwu M, Ongolo-Zogo P, Bal R, Kok MO. What makes knowledge translation work in practice? Lessons from a demand-driven and locally led project in Cameroon, Jordan and Nigeria. Health Res Policy Syst 2023; 21:127. [PMID: 38049826 PMCID: PMC10694879 DOI: 10.1186/s12961-023-01083-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/26/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Over the years, the knowledge translation (KT) field has moved from promoting linearized models to embracing the importance of interaction and learning. Likewise, there is now increased attention on the transfer of KT approaches to new environments. Some scholars, however, have warned that ideas about transferability still hinge on linear thinking and doing. In the current study, we therefore sought to use a more reflexive approach to KT and to study how actors align KT approaches with their local environments. METHODS Our (auto) ethnographic study took place in a wider KT project. This project intended to combine three components: (1) co-organizing demand-driven, locally led and embedded KT cycles in Cameroon, Jordan, and Nigeria, (2) building upon established KT methods and (3) equipping and empowering local teams. We conducted 63 semi-structured interviews with key KT actors, observed 472 h of KT practices, and collected a paper trail of documents. At the same time, we also compiled project exchanges, such as project documents, plans, protocols, field notes, meeting notes and an archive of (email) correspondence between project members. We analysed all data abductively. RESULTS We show that there were numerous moments where the design of our project indeed enabled us to align with local practices and needs. Yet this often did not suffice, and the project design sometimes conflicted with other logics and values. By analysing these tensions, we want to show that doing KT work which acts upon different values and knowledges and is sensitive towards the different effects that it produces demands both structuring projects in a specific way and requires significant alignment work of KT actors in practice. CONCLUSIONS We show that practising KT more reflexively relies on two important conditions. First, KT projects have to be structured with sufficient discretionary space. Second, even though the structure of a project is important, there will be continuous need for alignment work. It is important to facilitate such alignment work and to further support it. In the discussion of this paper, we therefore articulate three design principles and three sensitivities. These elements can be used to make future KT projects more reflexive and sensitive to (social) complexity.
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Affiliation(s)
- Robert A J Borst
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands.
| | - Rik Wehrens
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
| | - Moustapha Nsangou
- Centre pour le Dévéloppement des Bonnes Pratiques en Santé, Yaoundé, Cameroon
| | - Dachi Arikpo
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Ekpereonne Esu
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
- Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Ali Al Metleq
- The Higher Population Council, General Secretariat, Amman, Jordan
| | - Olivia Hobden
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
| | - Martin Meremikwu
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Pierre Ongolo-Zogo
- Centre pour le Dévéloppement des Bonnes Pratiques en Santé, Yaoundé, Cameroon
| | - Roland Bal
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
| | - Maarten Olivier Kok
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
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Boucher NA, Tucker MC, White BS, Ear B, Dubey M, Byrd KG, Williams JW, Gierisch JM. Frontline Clinician Appraisement of Research Engagement: "I feel out of touch with research". J Gen Intern Med 2023; 38:2671-2677. [PMID: 37072534 PMCID: PMC10112825 DOI: 10.1007/s11606-023-08200-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/05/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Health services research can benefit from frontline clinician input across all stages of research, yet their key perspectives are often not meaningfully engaged. OBJECTIVE How can we improve clinician engagement in research? DESIGN Convenience sampling and semi-structured interviews followed by descriptive content analysis with an inductive approach, followed by group participatory listening sessions with interviewees to further contextualize findings. PARTICIPANTS Twenty-one multidisciplinary clinicians from one healthcare system. KEY RESULTS We identified two major themes: perceptions of research (how research fits within job role) and characterizing effective engagement (what works and what does not work in frontline clinician engagement). "Perceptions of Research" encompassed three subthemes: prior research experience; desired degree of engagement; and benefits to clinicians engaging in research. "Characterizing Effective Engagement" had these subthemes: engagement barriers; engagement facilitators; and impact of clinician's racial identity. CONCLUSIONS Investing in frontline clinicians as research collaborators is beneficial to clinicians themselves, the health systems that employ them, and those for which they care. Yet, there are multiple barriers to meaningful engagement.
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Affiliation(s)
- Nathan A Boucher
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System HSR&D, Durham, NC, USA.
- Sanford School of Public Policy, Duke University, Durham, NC, USA.
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA.
- Department of Medicine (Geriatrics), School of Medicine, Duke University, Durham, NC, USA.
- Duke-Margolis Center for Health Policy, Durham, NC, USA.
| | - Matthew C Tucker
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System HSR&D, Durham, NC, USA
| | - Brandolyn S White
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System HSR&D, Durham, NC, USA
| | - Belinda Ear
- Cooperative Studies Program Epidemiology Center - Durham, Durham, NC, USA
| | - Manisha Dubey
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System HSR&D, Durham, NC, USA
| | - Kaileigh G Byrd
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System HSR&D, Durham, NC, USA
| | - John W Williams
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System HSR&D, Durham, NC, USA
- Division of General Internal Medicine, School of Medicine, Duke University, Durham, NC, USA
| | - Jennifer M Gierisch
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System HSR&D, Durham, NC, USA
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA
- Division of General Internal Medicine, School of Medicine, Duke University, Durham, NC, USA
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Rowbotham S, Walker P, Marks L, Irving M, Smith BJ, Laird Y. Building capacity for citizen science in health promotion: a collaborative knowledge mobilisation approach. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:36. [PMID: 37254184 DOI: 10.1186/s40900-023-00451-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/22/2023] [Indexed: 06/01/2023]
Abstract
Policymakers and practitioners in health promotion (e.g. those working for local, state or federal government organisations or community and non-government organisations with a focus on health and wellbeing) are increasingly interested in citizen science as a means of involving the public in research and decision making. The potential benefits of citizen science approaches in health promotion include increased research capacity, incorporation of community perspectives on problems and solutions, and improved public awareness and acceptance of actions to improve health. However, health promotion practitioners and policymakers report having limited familiarity and experience with citizen science and a desire to build their capacity in these approaches. The Citizen Science in Prevention (CSP) project aims to build capacity for citizen science in health promotion by: 1) supporting the development and implementation of citizen science projects by policymakers and practitioners, 2) establishing a network of health promotion stakeholders with familiarity and interest in citizen science approaches, and 3) co-designing resources to support the use of citizen science in policy and practice contexts. A comprehensive mixed methods evaluation will establish the reach, satisfaction, and impacts that can be attributed to the capacity building intervention. This paper describes the first known initiative to build capacity in the application of citizen science approaches in health promotion and we hope that this work will assist others in the development and implementation of capacity building activities for citizen science in health promotion and beyond.
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Affiliation(s)
- Samantha Rowbotham
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Pippy Walker
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, NSW, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
| | - Leah Marks
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Irving
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, NSW, Australia
| | - Ben J Smith
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Yvonne Laird
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Craig W, Rambharose S, Khan W, Stassen W. Emergency medicine doctoral education in Africa: a scoping review of the published literature. BMC MEDICAL EDUCATION 2023; 23:281. [PMID: 37095474 PMCID: PMC10127363 DOI: 10.1186/s12909-023-04278-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 04/19/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND While Africa accounts for a significant proportion of world population, and disease and injury burden, it produces less than 1% of the total research output within emergency care. Emergency care research capacity in Africa may be expanded through the development of doctoral programmes that aim to upskill the PhD student into an independent scholar, through dedicated support and structured learning. This study therefore aims to identify the nature of the problem of doctoral education in Africa, thereby informing a general needs assessment within the context of academic emergency medicine. METHODS A scoping review, utilising an a priori, piloted search strategy was conducted (Medline via PubMed and Scopus) to identify literature published between 2011 and 2021 related to African emergency medicine doctoral education. Failing that, an expanded search was planned that focused on doctoral education within health sciences more broadly. Titles, abstracts, and full texts were screened for inclusion in duplicate, and extracted by the principal author. The search was rerun in September 2022. RESULTS No articles that focused on emergency medicine/care were found. Following the expanded search, a total of 235 articles were identified, and 27 articles were included. Major domains identified in the literature included specific barriers to PhD success, supervision practices, transformation, collaborative learning, and research capacity improvement. CONCLUSIONS African doctoral students are hindered by internal academic factors such as limited supervision and external factors such as poor infrastructure e.g. internet connectivity. While not always feasible, institutions should offer environments that are conducive to meaningful learning. In addition, doctoral programmes should adopt and enforce gender policies to help alleviate the gender differences noted in PhD completion rates and research publication outputs. Interdisciplinary collaborations are potential mechanisms to develop well-rounded and independent graduates. Post-graduate and doctoral supervision experience should be a recognised promotion criterion to assist with clinician researcher career opportunities and motivation. There may be little value in attempting to replicate the programmatic and supervision practices of high-income countries. African doctoral programmes should rather focus on creating contextual and sustainable ways of delivering excellent doctoral education.
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Affiliation(s)
- Wesley Craig
- Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
| | - Sanjeev Rambharose
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Waseela Khan
- Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
| | - Willem Stassen
- Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
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Banks E, Haynes A, Lovett R, Yadav UN, Agostino J. Output-orientated policy engagement: a model for advancing the use of epidemiological evidence in health policy. Health Res Policy Syst 2023; 21:6. [PMID: 36647155 PMCID: PMC9843894 DOI: 10.1186/s12961-022-00955-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/22/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Use of epidemiological research in policy and practice is suboptimal, contributing to significant preventable morbidity and mortality. Barriers to the use of research evidence in policy include lack of research-policy engagement, lack of policy-relevant research, differences in policymaker and researcher practice norms, time constraints, difficulties in coordination, and divergent languages and reward systems. APPROACH AND OUTCOMES In order to increase policy-relevant research and research uptake, we developed the output-orientated policy engagement (OOPE) model, in Australia. It integrates a foundational approach to engagement with cycles of specific activity focused around selected research outputs. Foundational elements include measures to increase recognition and valuing of policymaker expertise, emphasis on policy uptake, policy awareness of the research group's work, regular policy engagement and policy-relevant capacity-building. Specific activities include (i) identification of an "output"-usually at draft stage-and program of work which are likely to be of interest to policymakers; (ii) initial engagement focusing on sharing "preview" evidence from this output, with an invitation to provide input into this and to advise on the broader program of work; and (iii) if there is sufficient interest, formation of a researcher-policy-maker partnership to shape and release the output, as well as inform the program of work. This cycle is repeated as the relationship continues and is deepened. As well as supporting policy-informed evidence generation and research-aware policymakers, the output-orientated model has been found to be beneficial in fostering the following: a pragmatic starting place for researchers, in often large and complex policy environments; purposeful and specific engagement, encouraging shared expectations; non-transactional engagement around common evidence needs, whereby researchers are not meeting with policymakers with the expectation of receiving funding; built-in translation; time and resource efficiency; relationship-building; mutual learning; policy-invested researchers and research-invested policy-makers; and tangible policy impacts. A case study outlines how the output-orientated approach supported researcher-policymaker collaboration to generate new evidence regarding Aboriginal and Torres Strait Islander cardiovascular disease risk and to apply this to national guidelines. CONCLUSION Output-orientated policy engagement provides a potentially useful pragmatic model to catalyse and support partnerships between researchers and policymakers, to increase the policy-relevance and application of epidemiological evidence.
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Affiliation(s)
- Emily Banks
- grid.1001.00000 0001 2180 7477National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT Australia
| | - Abby Haynes
- grid.1013.30000 0004 1936 834XInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Ray Lovett
- grid.1001.00000 0001 2180 7477National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT Australia
| | - Uday Narayan Yadav
- grid.1001.00000 0001 2180 7477National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT Australia
| | - Jason Agostino
- grid.1001.00000 0001 2180 7477School of Medicine and Psychology, ANU, Canberra, ACT Australia ,National Aboriginal Community Controlled Health Organisation, Canberra, ACT Australia
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de Rooij D, van de Watering M, van Dijk R, Veenstra T, Appels R, Swaan C, Timen A. Evaluating intra-action reviews at points of entry: ongoing learning opportunities during the COVID-19 pandemic. BMC Public Health 2023; 23:36. [PMID: 36609235 PMCID: PMC9816518 DOI: 10.1186/s12889-022-14706-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/22/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Long-lasting crises, such as the COVID-19 pandemic, require proper interim evaluation in order to optimize response. The World Health Organization and the European Center for Disease Control have recently promoted the in(tra)-action review (IAR) method for this purpose. We systematically evaluated the added value of two IARs performed in the Dutch point of entry (PoE) setting. METHODS Two online, 4-hour IAR meetings were organized in March 2021, for ports and airports respectively, to reflect on the ongoing COVID-19 response. Topics discussed were selected through a survey among participants. Participants were mainly self-selected by the (air)port public health service. Evaluation of the IAR method consisted of participant evaluation through a questionnaire, and hot and cold debriefs of the organizing team. Evaluation of the impact of the IAR was done through analysis of the meeting results, and a 3-month follow-up of the actions proposed during the meetings. RESULTS Thirty-nine professionals joined the IAR meetings. In the participant evaluation (n = 18), 89% agreed or totally agreed the IAR made it possible to identify challenges and problems in the COVID-19 response at PoE. Participants especially appreciated the resulting insight in regional and national partners. Regarding the online setting of the meeting, participants suggested to choose accessible and familiar online tools. After 3 months, all national actions and actions for ports had been executed; some regional actions for airports required further attention. A major result was a new meeting structure for all ports and the participating national authorities in which remaining and newly occurring issues were discussed. CONCLUSIONS Based on the evaluations, we conclude that the IAR method can be of value during long-term crises, such as the COVID-19 pandemic response. Although it is challenging to dedicate time and effort to the organization and attendance of IAR meetings during crisis, the IAR method is feasible in an online setting if appropriate organizing and technical capacity is available. A participatory set-up supports the IAR method as a starting point for continuous exchange and learning during ongoing crises.
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Affiliation(s)
- Doret de Rooij
- grid.31147.300000 0001 2208 0118Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands ,grid.12380.380000 0004 1754 9227Athena Institute, Free University of Amsterdam, Amsterdam, The Netherlands
| | - Miriam van de Watering
- grid.31147.300000 0001 2208 0118Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Remco van Dijk
- grid.31147.300000 0001 2208 0118Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands ,grid.5590.90000000122931605Faculty of Medical Sciences, Radboud University, Nijmegen, The Netherlands
| | - Thijs Veenstra
- grid.31147.300000 0001 2208 0118Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Rolf Appels
- grid.31147.300000 0001 2208 0118Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Corien Swaan
- grid.31147.300000 0001 2208 0118Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aura Timen
- grid.12380.380000 0004 1754 9227Athena Institute, Free University of Amsterdam, Amsterdam, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
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Gillam J, Evans C, Aworinde J, Ellis-Smith C, Ross J, Davies N. Co-design of a theory-based implementation plan for a holistic eHealth assessment and decision support framework for people with dementia in care homes. Digit Health 2023; 9:20552076231211118. [PMID: 38033518 PMCID: PMC10685752 DOI: 10.1177/20552076231211118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
Background Despite positive findings around the use of eHealth in dementia care, it is rarely translated into routine practice. This can be facilitated by early involvement of end-users in the development of an implementation plan. This study aimed to co-design strategies to implement an eHealth intervention, the EMBED-Care Framework, to support assessment and decision-making for people with dementia in care homes. Methods A qualitative co-design method was applied through a series of workshops. Participants included family carers and health and social care practitioners. People with dementia were included through a series of stakeholder engagement meetings. The workshops focused on co-developing strategies in response to identified determinants of implementation. A codebook thematic analytic approach was taken, guided by the Normalisation Process Theory (NPT). Results Three workshops were conducted from July 2021 to November 2021, attended by 39 participants. Three overarching phases of implementation were identified which aligned with the constructs of the NPT: (a) incentivising adoption of the Framework, which requires promotion of its benefits and alignment with recommendations for good quality dementia care to engage stakeholders, relating to 'coherence' and 'cognitive participation' constructs; (b) enabling its operation, which requires ensuring compatibility with care home processes, provision of training and support from 'champions', relating to 'collective action'; (c) sustaining use of the Framework, which requires monitoring of implementation and appraisal of its effects, relating to 'reflexive monitoring'. Conclusions We have developed a multi-strategy, theoretically driven plan to implement eHealth to support assessment and decision-making for people with dementia in care homes. Successful implementation requires incentivisation to adopt, ability to operate and motivation to sustain use of eHealth. The plan is strengthened through collaborating with end-users to increase its value, credibility and real-world relevance. The theoretically informed strategies target mechanisms of the NPT, demonstrated to shape the implementation process and outcomes, ready for testing.
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Affiliation(s)
- Juliet Gillam
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, King's College London, London, UK
| | - Catherine Evans
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, King's College London, London, UK
- Brighton General Hospital, Sussex Community NHS Foundation Trust, Brighton, UK
| | - Jesutofunmi Aworinde
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, King's College London, London, UK
| | - Clare Ellis-Smith
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Cicely Saunders Institute of Palliative Care, King's College London, London, UK
| | - Jamie Ross
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nathan Davies
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
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Ruwuya J, Juma BO, Woolf J. Challenges associated with implementing anti-doping policy and programs in Africa. Front Sports Act Living 2022; 4:966559. [PMID: 36570497 PMCID: PMC9772459 DOI: 10.3389/fspor.2022.966559] [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: 10/18/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
Concerns regarding the capability of the International Olympic Committee to address doping in sport catalyzed the formation of the World Anti-Doping Agency (WADA) in 1999. In its establishment phase, WADA sought geopolitical legitimacy and support from governments (including non-Western states) for financing and acceptance. Africa was not considered during WADA's creation, relegating African states to a passive role in the global anti-doping program, and yet is still subject to the strict compliance requirements for WADA's global policy. African countries face challenges establishing anti-doping support structures and implementing the universal policy, including competing macro-level policy demands that favor addressing legacies of colonialism and human capacity development. To develop robust anti-doping support structures, African nations must spearhead anti-doping initiatives by leveraging existing infrastructure and encouraging collaborations between NADOs such that capacity can be built for policy implementation.
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Factors to Consider During Identification and Invitation of Individuals in a Multi-stakeholder Research Partnership. J Gen Intern Med 2022; 37:4047-4053. [PMID: 35132560 PMCID: PMC9708980 DOI: 10.1007/s11606-022-07411-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/07/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification. OBJECTIVE We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams. DESIGN Consensus development. PARTICIPANTS We involved 16 stakeholders from the international Multi-Stakeholder Engagement (MuSE) Consortium, including patients and the public, providers, payers of health services/purchasers, policy makers, programme managers, peer review editors, and principal investigators. APPROACH We engaged stakeholders in factor development and as co-authors of this manuscript. Using a modified Delphi approach, we gathered stakeholder views concerning a preliminary list of 18 factors. Over two feedback rounds, using qualitative and quantitative analysis, we concentrated these into ten factors. KEY RESULTS We present seven highly desirable factors: 'expertise or experience', 'ability and willingness to represent the stakeholder group', 'inclusivity (equity, diversity and intersectionality)', 'communication skills', 'commitment and time capacity', 'financial and non-financial relationships and activities, and conflict of interest', 'training support and funding needs'. Additionally, three factors are desirable: 'influence', 'research relevant values', 'previous stakeholder engagement'. CONCLUSIONS We present factors for research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership. Policy makers and guideline developers may benefit from considering the factors in stakeholder identification and invitation. Research funders may consider stipulating consideration of the factors in funding applications. We outline how these factors can be implemented and exemplify how their use has the potential to improve the quality and relevancy of health research.
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Shrestha A, Tamrakar D, Shrestha B, Karmacharya BM, Shrestha A, Pyakurel P, Spiegelman D. Stakeholder engagement in a hypertension and diabetes prevention research program: Description and lessons learned. PLoS One 2022; 17:e0276478. [PMID: 36264860 PMCID: PMC9584412 DOI: 10.1371/journal.pone.0276478] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
Abstract
Background Stakeholder engagement is important from the management point of view to capture knowledge, increase ownership, reduce conflict, encourage partnership, as well as to develop an ethical perspective that facilitates inclusive decision making and promotes equity. However, there is dearth of literature in the process of stakeholder engagement. The purpose of this paper is to describe the process of increasing stakeholder engagement and highlight the lessons learnt on stakeholder engagement while designing, implementing, and monitoring a study on diabetes and hypertension prevention in workplace settings in Nepal. Methodology We identified the stakeholders based on the 7P framework: Patients and public (clients), providers, payers, policy makers, product makers, principal investigators, and purchasers. The identified stakeholders were engaged in prioritization of the research questions, planning data collection, designing, implementing, and monitoring the intervention. Stakeholders were engaged through focus group discussions, in-depth interviews, participatory workshops, individual consultation, information sessions and representation in study team and implementation committees. Results The views of the stakeholders were synthesized in each step of the research process, from designing to interpreting the results. Stakeholder engagement helped to shape the methods and plan, and process for participant’s recruitment and data collection. In addition, it enhanced adherence to intervention, mutual learning, and smooth intervention adoption. The major challenges were the time-consuming nature of the process, language barriers, and the differences in health and food beliefs between researchers and stakeholders. Conclusion It was possible to engage and benefit from stakeholder’s engagement on the design, implementation and monitoring of a workplace-based hypertension and diabetes management research program in Nepal.
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Affiliation(s)
- Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, Connecticut, United States of America
- Institute for Implementation Science and Health, Kathmandu, Nepal
- * E-mail:
| | - Dipesh Tamrakar
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Bhawana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Biraj Man Karmacharya
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Abha Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Prajjwal Pyakurel
- School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Donna Spiegelman
- Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, Connecticut, United States of America
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, United States of America
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Dewidar O, Kawala BA, Antequera A, Tricco AC, Tovey D, Straus S, Glover R, Tufte J, Magwood O, Smith M, Ooi CP, Dion A, Goetghebeur M, Reveiz L, Negrini S, Tugwell P, Petkovic J, Welch V. Methodological guidance for incorporating equity when informing rapid-policy and guideline development. J Clin Epidemiol 2022; 150:142-153. [PMID: 35863618 PMCID: PMC9359903 DOI: 10.1016/j.jclinepi.2022.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/30/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews. STUDY DESIGN AND SETTING This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for equity-focused systematic reviews (PRISMA-Equity) guideline. We identified Exemplar rapid reviews by searching COVID-19 databases and requesting examples from our team. RESULTS We proposed the following key steps: 1. involve relevant stakeholders with lived experience in the conduct and design of the review; 2. reflect on equity, inclusion and privilege in team values and composition; 3. develop research question to assess health inequities; 4. conduct searches in relevant disciplinary databases; 5. collect data and critically appraise recruitment, retention and attrition for populations experiencing inequities; 6. analyse evidence on equity; 7. evaluate the applicability of findings to populations experiencing inequities; and 8. adhere to reporting guidelines for communicating review findings. We illustrated these methods through rapid review examples. CONCLUSION Implementing this guidance could contribute to improving equity considerations in rapid reviews produced in public health emergencies, and help policymakers better understand the distributional impact of diseases on the population.
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Affiliation(s)
- Omar Dewidar
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada.
| | - Brenda Allen Kawala
- Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine-Master in Global Health, The Sahlgrenska Academy at University of Gothenburg, Box 414, SE-405 Gothenburg, Sweden
| | - Alba Antequera
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, Ontario M5B 1T8, Canada; Epidemiology Division, Dalla Lana School of Public Health & Institute of Health, Management, and Policy Evaluation, University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada; Queen's Collaboration for Health Care Quality, Joanna Briggs Institute Centre of Excellence, Queen's University, 92 Barrie Street, Room 214, Kingston, Ontario K7L 3N6, Canada
| | | | - Sharon Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, Ontario M5B 1T8, Canada
| | - Rebecca Glover
- Department of Health Services Research and Policy, Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | | | - Olivia Magwood
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Thompson Hall, 25 University Private, Ottawa, ON, Canada K1N 7K4
| | - Maureen Smith
- Cochrane Consumer Executive, Ottawa, Ontario, Canada
| | - Cheow Peng Ooi
- Endocrine Unit, Department of Medicine, Universiti Putra Malaysia Faculty of Medicine and Health Sciences, 43400 Serdang, Selangor, Malaysia
| | - Anna Dion
- Centre for Implementation Research, Ottawa Hospital Research Institute, The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada
| | - Mireille Goetghebeur
- Unit Methods, Ethics and Participation, INESSS, National Institute for Excellence in Health and Social Services, Montréal, Québec, Canada
| | - Ludovic Reveiz
- Evidence and Intelligence for Action in Health Department, Incident Management System for the Covid-19 Response. Pan American Health Organization, 525 23rd St, Northwest, WA 20037-2895, USA
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Peter Tugwell
- Department of Medicine, and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Jennifer Petkovic
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada
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Abudu R, Oliver K, Boaz A. What funders are doing to assess the impact of their investments in health and biomedical research. Health Res Policy Syst 2022; 20:88. [PMID: 35945538 PMCID: PMC9361261 DOI: 10.1186/s12961-022-00888-1] [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] [Received: 05/25/2022] [Accepted: 07/17/2022] [Indexed: 11/10/2022] Open
Abstract
As pressures to maximize research funding grow, biomedical research funders are increasingly tasked with demonstrating the long-term and real-world impacts of their funded research investments. Over the past three decades, research impact assessments (RIA) have emerged as an important tool for analysing the impacts of research by incorporating logic models, frameworks and indicators to track measures of knowledge production, capacity-building, development of research products, adoption of research into clinical guidelines and policies, and the realization of health, economic and social benefits. While there are currently several models for RIA within the literature, less attention has been paid to how funders can practically select and implement a RIA model to demonstrate the impacts of their own research portfolios. In this paper, a literature review was performed to understand (1) which research funders have performed RIAs of their research portfolios to date; (2) how funders have designed their assessments, including the models and tools they have used; (3) what challenges to and facilitators of success have funders found when adopting the RIA model to their own portfolio; and (4) who participates in the assessments. Forty-four papers from both published and grey literature were found to meet the review criteria and were examined in detail. There is a growing culture of RIA among funders, and included papers spanned a diverse set of funders from 10 countries or regions. Over half of funders (59.1%) used a framework to conduct their assessment, and a variety of methods for collecting impact data were reported. Issues of methodological rigour were observed across studies in the review, and this was related to numerous challenges funders faced in designing timely RIAs with quality impact data. Over a third of articles (36.4%) included input from stakeholders, yet only one article reported surveying patients and members of the public as part of the assessment. To advance RIA among funders, we offer several recommendations for increasing the methodological rigour of RIAs and suggestions for future research, and call for a careful reflection of the voices needed in an impact assessment to ensure that RIAs are having a meaningful impact on patients and the public.
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Affiliation(s)
- Rachel Abudu
- Department of Public Health, Environments and Society, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Kathryn Oliver
- Department of Public Health, Environments and Society, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Annette Boaz
- Department of Health Services Research and Policy, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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WEO newsletter. Dig Endosc 2022. [PMID: 35785494 DOI: 10.1111/den.14035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Mwendera CA, Mzilahowa T, Njiokou F, N'falé S, Amegee Quach J, Thomsen E, Dabire R, Ranson H, Alhassan N, Oronje R, Worrall E. Knowledge translation and evidence generation to increase the impact of vector control in Burkina Faso, Cameroon and Malawi. BMJ Glob Health 2022; 7:e008378. [PMID: 35545288 PMCID: PMC9096501 DOI: 10.1136/bmjgh-2021-008378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/13/2022] [Indexed: 11/07/2022] Open
Abstract
Lack of context-specific evidence and inadequate evidence-use for decision-making contribute to poor health. This paper reports on our work aimed at addressing the knowledge translation (KT) gap between evidence generators and users. We present our experiences of strengthening KT via technical advisory groups (TAGs) in parallel with increasing evidence generation through research fellowships and operational research. Vectorborne diseases (VBDs) impose substantial health and economic burdens in sub-Saharan Africa despite being preventable with vector control. The Partnership for Increasing the Impact of Vector Control aimed to reduce the burden of VBDs in Burkina Faso, Cameroon, Malawi and at regional and global levels. TAGs can promote evidence-use in policy and practice by engaging relevant stakeholders in both research and policy processes. TAGs and related activities are best facilitated by a coordinator with skills in research and policy. Contextual factors should influence the design and governance of TAGs, which will likely evolve over time. Relevant national stakeholders should be included in TAGs and be actively involved in developing research agendas to increase the relevance and acceptability of research findings for decision-making. The countries present three differing contexts with longer-term research and evaluation necessary to draw lessons on impact.
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Affiliation(s)
| | - Themba Mzilahowa
- Malaria Alert Centre, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Flobert Njiokou
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon
| | - Sagnon N'falé
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Jessica Amegee Quach
- Centre for Capacity Research, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Edward Thomsen
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Roch Dabire
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Hilary Ranson
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Rose Oronje
- African Institute for Development Policy, Nairobi, Kenya
| | - Eve Worrall
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
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Subramaniam M, Shahwan S, Goh CMJ, Tan GTH, Ong WJ, Chong SA. A Qualitative Exploration of the Views of Policymakers and Policy Advisors on the Impact of Mental Health Stigma on the Development and Implementation of Mental Health Policy in Singapore. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:404-414. [PMID: 34586525 PMCID: PMC9005417 DOI: 10.1007/s10488-021-01171-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Few studies have examined the views of policy makers regarding the impact of mental health stigma on the development and implementation of mental health policies. This study aimed to address this knowledge gap by exploring policymakers' and policy advisors' perspectives regarding the impact of mental health stigma on the development and implementation of mental health programmes, strategies, and services in Singapore. In all 13 participants were recruited for the study comprising practicing policymakers, senior staff of organisations involved in implementing the various mental health programmes, and policy advisors. Data was collected through semi-structured interviews, which were transcribed verbatim and analysed using reflexive thematic analysis. Data analysis revealed three superordinate themes related to challenges experienced by the policymakers/advisors when dealing with mental health policy and implementation of programmes. These themes included stigma as a barrier to mental health treatment, community-level barriers to mental health recovery, and mental health being a neglected need. Policymakers/advisors demonstrated an in-depth and nuanced understanding of the barriers (consequent to stigma) to mental healthcare delivery and access. Policymakers/advisors were able to associate the themes related to the stigma towards mental illness with help-seeking barriers based on personal experiences, knowledge, and insight gained through the implementation of mental health programmes and initiatives.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore.
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Chong Min Janrius Goh
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Gregory Tee Hng Tan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Wei Jie Ong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Rahman AE, Jabeen S, Fernandes G, Banik G, Islam J, Ameen S, Ashrafee S, Hossain AT, Alam HMS, Majid T, Saberin A, Ahmed A, A N M EK, Chisti MJ, Ahmed S, Khan M, Jackson T, Dockrell DH, Nair H, El Arifeen S, Islam MS, Campbell H. Introducing pulse oximetry in routine IMCI services in Bangladesh: A context-driven approach to influence policy and programme through stakeholder engagement. J Glob Health 2022; 12:06001. [PMID: 35441007 PMCID: PMC8994831 DOI: 10.7189/jogh.12.06001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Pneumonia is the leading cause of under-five child deaths globally and in Bangladesh. Hypoxaemia or low (<90%) oxygen concentration in the arterial blood is one of the strongest predictors of child mortality from pneumonia and other acute respiratory infections. Since 2014, the World Health Organization recommends using pulse oximetry devices in Integrated Management of Childhood Illness (IMCI) services (outpatient child health services), but it was not routinely used in most health facilities in Bangladesh until 2018. This paper describes the stakeholder engagement process embedded in an implementation research study to influence national policy and programmes to introduce pulse oximetry in routine IMCI services in Bangladesh. Methods Based on literature review and expert consultations, we developed a conceptual framework, which guided the planning and implementation of a 4-step stakeholder engagement process. Desk review, key informant interviews, consultative workshops and onsite demonstration were the key methods to involve and engage a wide range of stakeholders. In the first step, a comprehensive desk review and key informant interviews were conducted to identify stakeholder organisations and scored them based on their power and interest levels regarding IMCI implementation in Bangladesh. In the second step, two national level, two district level and five sub-district level sensitisation workshops were organised to orient all stakeholder organisations having high power or high interest regarding the importance of using pulse oximetry for pneumonia assessment and classification. In the third step, national and district level high power-high interest stakeholder organisations were involved in developing a joint action plan for introducing pulse oximetry in routine IMCI services. In the fourth step, led by a formal working group under the leadership of the Ministry of Health, we updated the national IMCI implementation package, including all guidelines, training manuals, services registers and referral forms in English and Bangla. Subsequently, we demonstrated its use in real-life settings involving various levels of (national, district and sub-district) stakeholders and worked alongside the government leaders towards carefully resuming activities despite the COVID-19 pandemic. Results Our engagement process contributed to the national decision to introduce pulse oximetry in routine child health services and update the national IMCI implementation package demonstrating country ownership, government leadership and multi-partner involvement, which are steppingstones towards scalability and sustainability. However, our experience clearly delineates that stakeholder engagement is a context-driven, time-consuming, resource-intensive, iterative, mercurial process that demands meticulous planning, prioritisation, inclusiveness, and adaptability. It is also influenced by the expertise, experience and positionality of the facilitating organization. Conclusions Our experience has demonstrated the value and potential of the approach that we adopted for stakeholder engagement. However, the approach needs to be conceptualised coupled with the allocation of adequate resources and time commitment to implement it effectively.
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Affiliation(s)
- Ahmed Ehsanur Rahman
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Sabrina Jabeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Genevie Fernandes
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Goutom Banik
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Jahurul Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Shafiqul Ameen
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Sabina Ashrafee
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Aniqa Tasnim Hossain
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Husam Md Shah Alam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Tamanna Majid
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Ashfia Saberin
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Anisuddin Ahmed
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | | | - Mohammod Jobayer Chisti
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | | | | | - Tracy Jackson
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - David H Dockrell
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Shams El Arifeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Harry Campbell
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
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Bislick L, Dietz A, Duncan ES, Garza P, Gleason R, Harley D, Kersey G, Kersey T, Mamlekar CR, McCarthy MJ, Noe V, Rushlow D, Rushlow JC, Van Allan S. Finding "Zen" in Aphasia: The Benefits of Yoga as Described by Key Stakeholders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:133-147. [PMID: 34797684 DOI: 10.1044/2021_ajslp-20-00330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Recently, the literature has witnessed a surging interest regarding the use of mind-body approaches with people who have aphasia, generating a plethora of possible outcome measures. During this same time, a core outcome set for aphasia has been recommended. The purpose of this clinical focus article is to give our survivor, co-survivor, and clinician stakeholder coauthors a platform to share their personal narrative regarding their yoga journey, with the goal of identifying primary outcome domains central to capturing the impact of yoga on the recovery process for people with poststroke aphasia. Ultimately, we hope this clinical focus article helps clinicians understand how yoga might benefit their patients and draws attention to potential outcome measures, while also highlighting the important fact that traditional aphasia assessments do not capture the improvements stakeholders pinpoint as crucial to the essence of mind-body interventions. METHOD This clinical focus article summarizes the case reports of Terri's and Chase's poststroke yoga journeys using the power of personal narrative and an adapted photovoice method. Additional stakeholders share in this storytelling process, using a variety of narrative tools. As this story is unveiled, several patient-identified outcome domains are highlighted as essential to document the impact of yoga on survivors. RESULTS Terri's and Chase's yoga journeys revealed the multifaceted impact of yoga on five domains: (a) feelings of wholeness and "zen," (b) increased attentional capacity for language tasks, (c) increased verbal fluency, (d) decreased pain, and (e) relationship mutuality. CONCLUSION Team Yoga realized that the practice of yoga-whether as a stand-alone practice or integrated into therapy sessions-fosters feelings of wholeness or "zen," which likely correlates with decreased pain with a simultaneous increase in resilience and flexibility of coping strategies to manage the host of chronic poststroke challenges. Supplemental Material https://doi.org/10.23641/asha.17003464.
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Affiliation(s)
- Lauren Bislick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - Aimee Dietz
- Department of Communication Sciences and Disorders, Georgia State University, Atlanta
| | - E Susan Duncan
- Department of Communication Sciences & Disorders, Lousiana State University, Baton Rouge
| | - Pilar Garza
- OrthoCincy Orthopaedics & Sports Medicine, Edgewood, KY
| | - Rachel Gleason
- Department of Rehabilitation, Exercise & Nutrition Sciences, University of Cincinnati College of Allied Health Sciences, OH
| | - Dana Harley
- School of Social Work, University of Cincinnati College of Allied Health Sciences, OH
| | | | - Terri Kersey
- Stroke Survivor, Research Volunteer, Cincinnati, OH
| | | | | | | | | | - J Chase Rushlow
- Super-Motivated Stroke Survivor, Therapy Patient, & 2015 Florida State University Graduate, Westerly, RI
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Political economy analysis of universal health coverage and health financing reforms in low- and middle-income countries: the role of stakeholder engagement in the research process. Health Res Policy Syst 2021; 19:143. [PMID: 34895251 PMCID: PMC8665578 DOI: 10.1186/s12961-021-00788-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Progress towards universal health coverage (UHC) is an inherently political process. Political economy analysis (PEA) is gaining momentum as a tool to better understand the role of the political and economic dimensions in shaping and achieving UHC in different contexts. Despite the acknowledged importance of actors and stakeholders in political economy considerations, their role in the PEA research process beyond “study subjects” as potential cocreators of knowledge and knowledge users has been overlooked so far. We therefore aimed to review the approaches with reference to stakeholder engagement during the research process adopted in the current published research on the political economy of UHC and health financing reforms, and the factors favouring (or hindering) uptake and usability of PEA work. Methods We reviewed the literature to describe whether, when and how stakeholders were involved in the research process of studies looking at the political economy of UHC and health financing reforms, and to identify challenges and lessons learned on effective stakeholder engagement and research uptake. We used a standardized search strategy with key terms across several databases; we screened and included articles that focused on PEA and UHC. Additionally, we conducted a short survey of the authors of the included studies to complement the information retrieved. Results Fifty articles met the inclusion criteria and were included in the analysis. We found overall little evidence of systematic engagement of stakeholders in the research process, which focused mostly on the data collection phase of the research (i.e., key informant interviews). Our study identifies some reasons for the varying stakeholder engagement. Challenges include PEA requiring specific skills, a focus on sensitive issues, and the blurriness in researchers’ and stakeholders’ roles and the multiple roles of stakeholders as research participants, study subjects and research users. Among the approaches that might favour usability of PEA work, we identified early engagement, coproduction of research questions, local partners and personal contact, political willingness, and trust and use of prospective analysis. Conclusions Stakeholder engagement and research uptake are multifaceted concepts and complex processes, particularly when applied to PEA. As such, stakeholder engagement in the research process of PEA of UHC and health financing reforms is limited and underreported. Despite the challenges, however, stakeholder engagement remains key to ensuring relevance, usability and research uptake of PEA studies. More efforts are required to ensure engagement at different stages of the research process and better reporting in published articles.
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Ormstad H, Jamtvedt G, Svege I, Crowe S. The Bridge Building Model: connecting evidence-based practice, evidence-based research, public involvement and needs led research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:77. [PMID: 34717755 PMCID: PMC8557598 DOI: 10.1186/s40900-021-00320-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
This paper describes a model developed by an interdisciplinary team of research and public engagement specialists, with backgrounds in health and social care research, higher education, evidence-based practice, leadership, commissioning research and public involvement and engagement. The model we propose combines evidence-based practice, evidence-based research, public involvement and needs led research. Our aim is to capitalise on the joining of the rationale and methods for these approaches, which have all been highlighted as important, but for which there has been a lack of models for integration. Our ambition is to argue for and show an effective and evidence-based way of working that bridges health and social care needs identification, evidence-based practice and research.
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Affiliation(s)
- Heidi Ormstad
- University of South-Eastern Norway, Drammen, Norway.
- Oslo Metropolitan University, Oslo, Norway.
| | | | - Ida Svege
- Oslo Metropolitan University, Oslo, Norway
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Desveaux L, Budhwani S, Stamenova V, Bhattacharyya O, Shaw J, Bhatia RS. Closing the Virtual Gap in Health Care: A Series of Case Studies Illustrating the Impact of Embedding Evaluation Alongside System Initiatives. J Med Internet Res 2021; 23:e25797. [PMID: 34477560 PMCID: PMC8449303 DOI: 10.2196/25797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/20/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Early decisions relating to the implementation of virtual care relied on necessity and clinical judgement, but there is a growing need for the generation of evidence to inform policy and practice designs. The need for stronger partnerships between researchers and decision-makers is well recognized, but how these partnerships can be structured and how research can be embedded alongside existing virtual care initiatives remain unclear. We present a series of case studies that illustrate how embedded research can inform policy decisions related to the implementation of virtual care, where decisions are either to (1) discontinue (red light), (2) redesign (yellow light), or (3) scale up existing initiatives (green light). Data were collected through document review and informal interviews with key study personnel. Case 1 involved an evaluation of a mobile diabetes platform that demonstrated a mismatch between the setting and the technology (decision outcome: discontinue). Case 2 involved an evaluation of a mental health support platform that suggested evidence-based modifications to the delivery model (decision outcome: redesign). Case 3 involved an evaluation of video visits that generated evidence to inform the ideal model of implementation at scale (decision outcome: scale up). In this paper, we highlight the characteristics of the partnership and the process that enabled success and use the cases to illustrate how these characteristics were operationalized. Structured communication included monthly check-ins and iterative report development. We also outline key characteristics of the partnership (ie, trust and shared purpose) and the process (ie, timeliness, tailored reporting, and adaptability) that drove the uptake of evidence in decision-making. Across each case, the evaluation was designed to address policy questions articulated by our partners. Furthermore, structured communication provided opportunities for knowledge mobilization. Structured communication was operationalized through monthly meetings as well as the delivery of interim and final reports. These case studies demonstrate the importance of partnering with health system decision-makers to generate and mobilize scientific evidence. Embedded research partnerships founded on a shared purpose of system service provided an effective strategy to bridge the oft-cited gap between science and policy. Structured communication provided a mechanism for collaborative problem-solving and real-time feedback, and it helped contextualize emerging insights.
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Affiliation(s)
- Laura Desveaux
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Suman Budhwani
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Vess Stamenova
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Onil Bhattacharyya
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - James Shaw
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - R Sacha Bhatia
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
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de Forcrand C, Flannery M, Cho J, Reddy Pidatala N, Batra R, Booker-Vaughns J, Chan GK, Dunn P, Galvin R, Hopkins E, Isaacs ED, Kizzie-Gillett CL, Maguire M, Navarro M, Rosini D, Vaughan W, Welsh S, Williams P, Young-Brinn A, Grudzen CR. Pragmatic Considerations in Incorporating Stakeholder Engagement Into a Palliative Care Transitions Study. Med Care 2021; 59:S370-S378. [PMID: 34228019 PMCID: PMC8263137 DOI: 10.1097/mlr.0000000000001583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Stakeholder involvement in health care research has been shown to improve research development, processes, and dissemination. The literature is developing on stakeholder engagement methods and preliminarily validated tools for evaluating stakeholder level of engagement have been proposed for specific stakeholder groups and settings. OBJECTIVES This paper describes the methodology for engaging a Study Advisory Committee (SAC) in research and reports on the use of a stakeholder engagement survey for measuring level of engagement. METHODS Stakeholders with previous research connections were recruited to the SAC during the planning process for a multicenter randomized control clinical trial, which is ongoing at the time of this writing. All SAC meetings undergo qualitative analysis, while the Stakeholder Engagement Survey instrument developed by the Patient-Centered Outcomes Research Institute (PCORI) is distributed annually for quantitative evaluation. RESULTS The trial's SAC is composed of 18 members from 3 stakeholder groups: patients and their caregivers; patient advocacy organizations; and health care payers. After an initial in-person meeting, the SAC meets quarterly by telephone and annually in-person. The SAC monitors research progress and provides feedback on all study processes. The stakeholder engagement survey reveals improved engagement over time as well as continued challenges. CONCLUSIONS Stakeholder engagement in the research process has meaningfully contributed to the study design, patient recruitment, and preliminary analysis of findings.
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Affiliation(s)
- Claire de Forcrand
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Mara Flannery
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine
| | - Jeanne Cho
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine
| | | | - Romilla Batra
- Senior Care Action Network (SCAN) Health Plan, Long Beach
| | | | - Garrett K. Chan
- Center for Education and Professional Development, Stanford Health Care, Stanford, CA
| | | | | | | | - Eric D. Isaacs
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA
| | | | | | - Martha Navarro
- Charles R. Drew University of Medicine & Science, Los Angeles
| | - Dawn Rosini
- University of Florida Shands Hospital, Gainesville, FL
| | | | - Sally Welsh
- Hospice and Palliative Nurses Foundation, Pittsburgh, PA
| | | | | | - Corita R. Grudzen
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine
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MacKay D, Freeman N, Boyle JA, Campbell S, McLean A, Peiris D, Corpus S, Connors C, Moore E, Wenitong M, Silver B, McIntyre HD, Shaw JE, Brown A, Kirkham R, Maple-Brown L. Improving systems of prenatal and postpartum care for hyperglycemia in pregnancy: A process evaluation. Int J Gynaecol Obstet 2021; 155:179-194. [PMID: 34331708 DOI: 10.1002/ijgo.13850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify successes to date and opportunities for improvement in the implementation of a complex health systems intervention aiming to improve prenatal and postpartum care and health outcomes for women with hyperglycemia in pregnancy in regional and remote Australia. METHODS A qualitative evaluation, underpinned by the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), was conducted mid-intervention. Semi-structured interviews were conducted with the participants, who included clinicians, regional policymakers and managers, and study implementation staff. RESULTS Interviewees (n = 45) reported that the early phase of the intervention had resulted in the establishment of a clinician network, increased clinician awareness of hyperglycemia in pregnancy, and improvements in management, including earlier referral for specialist care and a focus on improving communication with women. Enablers of implementation included existing relationships with stakeholders and alignment of the intervention with health service priorities. Challenges included engaging remote clinicians and the labor-intensive nature of maintaining a clinical register of women with hyperglycemia in pregnancy. CONCLUSION The early phase of this health systems intervention has had a positive perceived impact on systems of care for women with hyperglycemia in pregnancy. Findings have informed modifications to the intervention, including the development of a communication and engagement strategy.
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Affiliation(s)
- Diana MacKay
- Division of Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Natasha Freeman
- Division of Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sandra Campbell
- College of Nursing and Midwifery, Charles Darwin University, Cairns, Queensland, Australia
| | - Anna McLean
- Division of Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Diabetes and Endocrinology, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - David Peiris
- Centre for Health Systems Science, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Sumaria Corpus
- Danila Dilba Health Service, Darwin, Northern Territory, Australia
| | - Christine Connors
- Population & Primary Health Care, Top End Health Service, Northern Territory Department of Health, Darwin, Northern Territory, Australia
| | - Elizabeth Moore
- Aboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia
| | - Mark Wenitong
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bronwyn Silver
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - H David McIntyre
- Clinical Unit, Mater Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Jonathan E Shaw
- Aboriginal Health Domain, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Alex Brown
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Faculty of Health and Medical Science, University of Adelaide, Adelaide, South Australia, Australia
| | - Renae Kirkham
- Division of Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Louise Maple-Brown
- Division of Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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Varallyay NI, Bennett SC, Kennedy C, Ghaffar A, Peters DH. How does embedded implementation research work? Examining core features through qualitative case studies in Latin America and the Caribbean. Health Policy Plan 2021; 35:ii98-ii111. [PMID: 33156937 PMCID: PMC7646734 DOI: 10.1093/heapol/czaa126] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 01/04/2023] Open
Abstract
Innovative strategies are needed to improve the delivery of evidence-informed health interventions. Embedded implementation research (EIR) seeks to enhance the generation and use of evidence for programme improvement through four core features: (1) central involvement of programme/policy decision-makers in the research cycle; (2) collaborative research partnerships; (3) positioning research within programme processes and (4) research focused on implementation. This paper examines how these features influence evidence-to-action processes and explores how they are operationalized, their effects and supporting conditions needed. We used a qualitative, comparative case study approach, drawing on document analysis and semi-structured interviews across multiple informant groups, to examine three EIR projects in Bolivia, Colombia and the Dominican Republic. Our findings are presented according to the four core EIR features. The central involvement of decision-makers in EIR was enhanced by decision-maker authority over the programme studied, professional networks and critical reflection. Strong research-practice partnerships were facilitated by commitment, a clear and shared purpose and representation of diverse perspectives. Evidence around positioning research within programme processes was less conclusive; however, as all three cases made significant advances in research use and programme improvement, this feature of EIR may be less critical than others, depending on specific circumstances. Finally, a research focus on implementation demanded proactive engagement by decision-makers in conceptualizing the research and identifying opportunities for direct action by decision-makers. As the EIR approach is a novel approach in these low-resource settings, key supports are needed to build capacity of health sector stakeholders and create an enabling environment through system-level strategies. Key implications for such supports include: promoting EIR and creating incentives for decision-makers to engage in it, establishing structures or mechanisms to facilitate decision-maker involvement, allocating funds for EIR, and developing guidance for EIR practitioners.
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Affiliation(s)
- N Ilona Varallyay
- Department of International Health, Johns Hopkins School
of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States
- Corresponding author. Malabia 1970, Buenos Aires CABA 1414,
Argentina. E-mail:
| | - Sara C Bennett
- Department of International Health, Johns Hopkins School
of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States
| | - Caitlin Kennedy
- Social and Behavioral Interventions Program, Department of
International Health, Johns Hopkins School of Public Health, 615 N Wolfe St,
Baltimore, MD 21205, United States
| | - Abdul Ghaffar
- The Alliance for Health Policy and Systems Research at the
World Health Organization, 20 avenue Appia, 1211 Geneva, Switzerland
| | - David H Peters
- Department of International Health, Johns Hopkins School
of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States
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Ndlovu-Teijema MT, Kok MO, van Elsland SL, Smeets H, Barstow D, van Rooyen L, van Furth AM. Setting the global research agenda for community-based HIV service delivery through the faith sector. Health Res Policy Syst 2021; 19:81. [PMID: 34001142 PMCID: PMC8127184 DOI: 10.1186/s12961-021-00718-w] [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] [Received: 10/30/2020] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While leading AIDS organizations expect faith and health collaborations to play a crucial role in organizing and scaling up community-based HIV services, it is unclear how this can be realized. Little primary research has been conducted into which strategies for collaboration and service provision are most effective, efficient, scalable and sustainable. Seeking to align research with urgent needs, enhance coordination and increase the likelihood that results are used, this study aimed to set an inclusive global research agenda that reflects priority research questions from key stakeholders at the intersection of HIV healthcare and faith. METHODS In order to develop this global research agenda, we drew from document analyses, focus group discussions, interviews with purposively selected key informants from all continents (policy-makers, healthcare providers, faith leaders, academics and HIV activists), an online questionnaire, and expert meetings at several global conferences. We carried out focus group discussions and interviews with faith leaders in South Africa. Other stakeholder focus groups and interviews were carried out online or in person in France, Switzerland, the Netherlands and South Africa, and virtual questionnaires were distributed to stakeholders worldwide. Respondents were purposively sampled. RESULTS We interviewed 53 participants, and 110 stakeholders responded to the online questionnaire. The participants worked in 54 countries, with the majority having research experience (84%), experience with policy processes (73%) and/or experience as a healthcare provider (60%) and identifying as religious (79%). From interviews (N = 53) and questionnaires (N = 110), we identified 10 research themes: addressing sexuality, stigma, supporting specific populations, counselling and disclosure, agenda-setting, mobilizing and organizing funding, evaluating faith-health collaborations, advantage of faith initiatives, gender roles, and education. Respondents emphasized the need for more primary research and prioritized two themes: improving the engagement of faith communities in addressing sexuality and tackling stigma. CONCLUSIONS A wide range of respondents participated in developing the research agenda. To align research to the prioritized themes and ensure that results are used, it is essential to further engage key users, funders, researchers and other stakeholders, strengthen the capacity for locally embedded research and research uptake and contextualize priorities to diverse religious traditions, key populations and local circumstances.
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Affiliation(s)
- Martha T Ndlovu-Teijema
- Desmond and Leah Tutu Legacy Foundation, Cape Town, South Africa. .,Department of Paediatric Infectious Diseases and Immunology, AI&II, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Maarten O Kok
- Erasmus School of Health Policy and Management at Erasmus University Rotterdam, Rotterdam, The Netherlands.,Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sabine L van Elsland
- Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch, University, Cape Town, South Africa.,MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Hilleen Smeets
- Department of Paediatric Infectious Diseases and Immunology, AI&II, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David Barstow
- HIV and AIDS in 2030: A Choice Between Two Futures 2019, Corvallis, OR, USA
| | | | - A M van Furth
- Department of Paediatric Infectious Diseases and Immunology, AI&II, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Boaz A, Borst R, Kok M, O’Shea A. How far does an emphasis on stakeholder engagement and co-production in research present a threat to academic identity and autonomy? A prospective study across five European countries. RESEARCH EVALUATION 2021. [DOI: 10.1093/reseval/rvab013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
There is a growing recognition that needs more to be done to ensure that research contributes to better health services and patient outcomes. Stakeholder engagement in research, including co-production, has been identified as a promising mechanism for improving the value, relevance and utilization of research. This article presents findings from a prospective study which explored the impact of stakeholder engagement in a 3-year European tobacco control research project. That research project aimed to engage stakeholders in the development, testing and dissemination of a return-on-investment tool across five EU countries (the Netherlands, Spain, Hungary, Germany and the UK). The prospective study comprised interviews, observations and document review. The analysis focused on the extent to which the project team recognized, conceptualized and operationalized stakeholder engagement over the course of the research project. Stakeholder engagement in the European research project was conceptualized as a key feature of pre-designated spaces within their work programme. Over the course of the project, however, the tool development work and stakeholder engagement activities decoupled. While the modelling and tool development became more secluded, stakeholder engagement activities subtly transformed from co-production, to consultation, to something more recognizable as research participation. The contribution of this article is not to argue against the potential contribution of stakeholder engagement and co-production, but to show how even well-planned engagement activities can be diverted within the existing research funding and research production systems where non-research stakeholders remain at the margins and can even be seen as a threat to academic identify and autonomy.
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Affiliation(s)
- Annette Boaz
- Department of Health Services Research and Policy, Faculty of Public Health and Policy 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Robert Borst
- Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Maarten Kok
- Department of Health Sciences, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Alison O’Shea
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, St George’s Campus, 6th Floor Hunter Wing, Cranmer Terrace, London SW17 0RE, UK
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Okedo-Alex IN, Akamike IC, Olisaekee GO, Okeke CC, Uneke CJ. Identifying advocacy strategies, challenges and opportunities for increasing domestic health policy and health systems research funding in Nigeria: Perspectives of researchers and policymakers. Health Res Policy Syst 2021; 19:41. [PMID: 33752682 PMCID: PMC7983353 DOI: 10.1186/s12961-021-00701-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/03/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Poor funding for Health Policy and Systems Research (HPSR) is a major constraint to the development, generation and uptake of HPSR evidence in Low and Middle-Income countries. The study assessed the status of HPSR domestic funding and advocacy strategies for improving HPSR funding in Nigeria. It equally explored the knowledge and perception of the domestic funding status of HPSR and the effect of capacity building on the knowledge of domestic funding for HPSR in Nigeria. Methods This was a sub-national study involving policymakers and researchers from Enugu and Ebonyi States in Southeast Nigeria who participated in the sub-national Health Systems Global convening for the African region. A before-after study design (workshop) was utilized. Data collection employed semi-structured questionnaires, group and panel discussions. The workshop facilitated knowledge of HPSR, funding processes, and advocacy strategies for increased domestic funding for HPSR. Pre and immediate post-workshop knowledge assessments were done. Data were analyzed using SPSS version 25 and thematic analysis. Results Twenty-six participants were involved in the study. Half were females (50.0%) and 46.2% were aged 35–44 years. Policymakers constituted 23.1% of the participants. Domestic funding for HPSR in Nigeria was adjudged to be grossly inadequate. Identified barriers to domestic funding of HPSR included bureaucratic bottlenecks, political and policy transitions, and corruption. Potential opportunities centered on existing policy documents and emerging private sector willingness to fund health research. Multi-stakeholder advocacy coalitions, continuous advocacy and researcher skill-building on advocacy with active private sector involvement were the strategies proffered by the participants. Pre-workshop, understanding of the meaning of HPSR had the highest mean ratings while knowledge of budgeting processes and use of legal action to enable opportunities for budget advocacy for HPSR funding had the lowest mean ratings. Following the capacity-building workshop, all knowledge and understanding parameters markedly improved (percentage increase of 12.5%–71.0%). Conclusion This study found that there was paucity of domestic funding for HPSR in Nigeria alongside poor knowledge of budgeting and advocacy strategies among both policymakers and researchers. We recommend the deployment of these identified strategies and wider national and regional stakeholder engagement towards prioritizing and improving domestic funding for HPSR.
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Affiliation(s)
- Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria. .,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | | | | | - Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
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Essink DR, Ratsavong K, Bally E, Fraser J, Xaypadith S, Vonglokham M, Broerse JE, Kounnavong S. Developing a national health research agenda for Lao PDR: prioritising the research needs of stakeholders. Glob Health Action 2021; 13:1777000. [PMID: 32741341 PMCID: PMC7480602 DOI: 10.1080/16549716.2020.1777000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Currently the health research system in Lao PDR is fragmented and largely donor led.
Capacity among national public health institutes is limited to select priority research
questions for funding. Objective The objective of this capacity building and practice-oriented study is to describe the
process and outcome of the first National Health Research Agenda for Lao PDR and how the
agenda contributes to institutional capacity of the Ministry of Health, in order to
contribute to evidence-informed public health policy making. Method This activity used a mixed-methods approach. The overall design is based on principles
of the interactive Learning and Action approach and consists out of 6 phases: (1)
identification of needs, (2) shared analysis and integration, (3) nation-wide
prioritization of research domains, (4) exploring specific research questions, (5)
prioritization of research avenues, (6) dialogue and planning for action. The process
involved interviews with experts in health policy and research (n = 42), telephone-based
survey with district, provincial and national health staff (n = 135), a two-round Delphi
consultation with experts in health policy and research (n = 33), and a workshop with
policymakers, researchers, international organisations and civil society (n = 45) were
held to gather data and conduct shared analysis. Results 11 research domains were identified and prioritised: Health-seeking behaviour; Health
system research; Health service provision; Mother and child health (MCH); Sexual &
reproductive health; Health education; Non-communicable diseases (NCDs); Irrational drug
use; Communicable diseases (CDs); Road traffic accidents; Mental health. Within these
domains over 200 unique research questions were identified. Conclusion Our approach led to a comprehensive, inclusive, public health agenda for Lao PDR to
realise better informed health policies. Questions on the agenda are action-oriented,
originating in a desire to understand the problem so that immediate improvements can be
made. The agenda is used within the MoH as a tool to fund and approve research.
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Affiliation(s)
- Dirk R Essink
- Faculty of Science, Athena Institute , Amsterdam, Netherlands
| | - Kethmany Ratsavong
- Lao Tropical Institute and Public Health , Lao Peoples Democratic Republic
| | - Esmee Bally
- Faculty of Science, Athena Institute , Amsterdam, Netherlands
| | - Jessica Fraser
- Faculty of Science, Athena Institute , Amsterdam, Netherlands
| | - Sengdavy Xaypadith
- Department of Health Professional Education, Ministry of Health , Vientiane Capital, Vietnam
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Lester L, Haby MM, Chapman E, Kuchenmüller T. Evaluation of the performance and achievements of the WHO Evidence-informed Policy Network (EVIPNet) Europe. Health Res Policy Syst 2020; 18:109. [PMID: 32972421 PMCID: PMC7513318 DOI: 10.1186/s12961-020-00612-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/03/2020] [Indexed: 12/02/2022] Open
Abstract
Background The Evidence-informed Policy Network (EVIPNet) is one of the key mechanisms introduced by WHO to reduce the research-to-policy gap. EVIPNet Europe was launched in 2012. We evaluated the performance and achievements of EVIPNet Europe with the overall aims (1) to inform future developments and strategic planning of EVIPNet Europe and (2) to contribute to the evidence base for organisational knowledge translation activities by sharing the lessons learnt. Methods The evaluation covered the WHO Secretariat of EVIPNet Europe and its 21 member countries, from its inception to mid-2018. A mixed methods design was used to assess changes in three domains, including triangulation of quantitative and qualitative methods, based on the EVIPNet Europe Monitoring & Evaluation framework and theory of change. Data were collected between August and October 2018. Data collection comprised documentary review, social media analysis, online country evaluation, key informant interviews and validated tools. Two case studies were also developed. Results The evaluation showed promising results as well as lessons to guide the future development of EVIPNet in the WHO European Region and other regions of the world. EVIPNet Europe appears to be filling a niche in promoting the capacity of Network member countries for evidence-informed policy-making. There is evidence that EVIPNet Europe’s capacity-building programme of work is improving knowledge and skills at the individual level. There has been an increase in activity and outputs since its establishment and evidence has been used to inform new policies in some member countries. However, the speed at which member countries are developing or publishing products varies greatly and no formalised knowledge translation platforms have yet been created. Financial and human resources are limited and staff turnover is a cause for concern, both at the WHO Secretariat and country team levels. Conclusions Six years since the launch of EVIPNet Europe, the Network has grown quickly, is clearly valued and has had some successes. However, more work and support are needed if it is to achieve its vision of a Europe in which high-quality, context-sensitive evidence routinely informs health decision-making processes that ultimately serve to strengthen health outcomes across the Region.
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Affiliation(s)
- Louise Lester
- Public Health, Nottinghamshire County Council, West Bridgford, Nottinghamshire, England, UK
| | - Michelle M Haby
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora, Mexico.,Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Hennessy M, Byrne M, Laws R, Mc Sharry J, O'Malley G, Heary C. Childhood obesity prevention: priority areas for future research and barriers and facilitators to knowledge translation, coproduced using the nominal group technique. Transl Behav Med 2020; 9:759-767. [PMID: 30011024 DOI: 10.1093/tbm/iby074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Childhood obesity is a significant public health challenge, yet research priorities for childhood obesity prevention are not established. Coproduction of priorities leads to research which may be more translatable to the domains of policy and practice. The aim of the present study was to identify knowledge gaps and research priorities in addition to facilitators and barriers to knowledge translation in childhood obesity prevention. The nominal group technique involving consensus building with researchers, policymakers, and practitioners was employed during workshops at a national obesity conference held over 2 days in May 2017. Seventy-seven people participated in the first round of research prioritization on Day 1, while 14 stakeholders participated on Day 2. The top five research priorities identified were as follows: (i) Evaluate (including economic evaluation) current programs to inform practice and policy; (ii) How to change culture toward addressing the determinants of health; (iii) Implementation science: process; (iv) How to integrate obesity prevention into existing service structures; (v) How to enhance opportunities for habitual physical activity, including free play and active travel. Key themes emerging from this research prioritization exercise were the importance of funding and resources, coproduction of research, and a focus on both implementation research and social determinants within the field of childhood obesity prevention. The coproduced research priorities may help to shape the research agendas of funders and researchers, and aid in the conduct of policy-relevant research and the translation of research into practice in childhood obesity prevention.
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Affiliation(s)
- Marita Hennessy
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jenny Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Grace O'Malley
- Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.,Association for the Study of Obesity on the Island of Ireland, Dublin, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Laird Y, Manner J, Baldwin L, Hunter R, McAteer J, Rodgers S, Williamson C, Jepson R. Stakeholders' experiences of the public health research process: time to change the system? Health Res Policy Syst 2020; 18:83. [PMID: 32682426 PMCID: PMC7368787 DOI: 10.1186/s12961-020-00599-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 07/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The importance of engaging stakeholders in the research process is well recognised. Whilst engagement is important, guidelines and practices vary for how stakeholders should be involved in research and how to facilitate effective collaborative relationships. METHODS This study aimed to explore the perspectives and experiences of stakeholders involved in the policy and practice area of outdoor space and non-communicable disease prevention. Stakeholders interviewed included academics, practitioners, policy-makers, knowledge brokers and a funder. RESULTS The findings suggest that stakeholders had positive experiences when engaged meaningfully in the research process, where research projects were carefully planned and managed with attention to context and culture, and where the research team was effective, respectful and communicative. These factors help to facilitate the translation of research into policy and practice. However, multiple challenges of collaborative research were identified which related to structural and systemic challenges, building and maintaining relationships, use and collection of data and information, cultural perceptions of research and research generation, and getting evidence into action. Participants felt that changing the funding system, exploring more collaborative research methodologies, improved research translation, and more effective collaborative relationships at all stages of the research process could address some of these challenges. CONCLUSIONS The findings highlight that, whilst stakeholder engagement in research was considered important, structural, cultural and individual practices impacted how this worked in practice. Identifying and testing solutions to address these challenges could improve synergies between research, policy, and practice and lead to the production of impactful research that reduces wastage of public funding, improves implementation of findings and ultimately improves public health outcomes.
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Affiliation(s)
- Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia.
| | - Jillian Manner
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Louise Baldwin
- School of Public Health and Social Work, Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation, Brisbane, Australia
| | - Ruth Hunter
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Rodgers
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Chloë Williamson
- Physical Activity for Health Research Centre, Institute of Sport, Physical Education and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, United Kingdom
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
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Kasprowicz VO, Chopera D, Waddilove KD, Brockman MA, Gilmour J, Hunter E, Kilembe W, Karita E, Gaseitsiwe S, Sanders EJ, Ndung'u T. African-led health research and capacity building- is it working? BMC Public Health 2020; 20:1104. [PMID: 32664891 PMCID: PMC7359480 DOI: 10.1186/s12889-020-08875-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 05/07/2020] [Indexed: 12/29/2022] Open
Abstract
Background Africa bears a disproportionately high burden of globally significant disease but has lagged in knowledge production to address its health challenges. In this contribution, we discuss the challenges and approaches to health research capacity strengthening in sub-Saharan Africa and propose that the recent shift to an African-led approach is the most optimal. Methods and findings We introduce several capacity building approaches and recent achievements, explore why African-led research on the continent is a potentially paradigm-shifting and innovative approach, and discuss the advantages and challenges thereof. We reflect on the approaches used by the African Academy of Sciences (AAS)-funded Sub-Saharan African Network for TB/HIV Research Excellence (SANTHE) consortium as an example of an effective African-led science and capacity building programme. We recommend the following as crucial components of future efforts: 1. Directly empowering African-based researchers, 2. Offering quality training and career development opportunities to large numbers of junior African scientists and support staff, and 3. Effective information exchange and collaboration. Furthermore, we argue that long-term investment from international donors and increasing funding commitments from African governments and philanthropies will be needed to realise a critical mass of local capacity and to create and sustain world-class research hubs that will be conducive to address Africa’s intractable health challenges. Conclusions Our experiences so far suggest that African-led research has the potential to overcome the vicious cycle of brain-drain and may ultimately lead to improvement of health and science-led economic transformation of Africa into a prosperous continent.
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Affiliation(s)
- Victoria O Kasprowicz
- Africa Health Research Institute, Durban, South Africa.,HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Denis Chopera
- Africa Health Research Institute, Durban, South Africa
| | | | - Mark A Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | | | - Eric Hunter
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.,Rwanda Zambia Emory HIV Research Group, Zambia; Kigali, Rwanda and Emory University, Atlanta, USA
| | - William Kilembe
- Rwanda Zambia Emory HIV Research Group, Zambia; Kigali, Rwanda and Emory University, Atlanta, USA
| | - Etienne Karita
- Rwanda Zambia Emory HIV Research Group, Zambia; Kigali, Rwanda and Emory University, Atlanta, USA
| | - Simani Gaseitsiwe
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Department of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eduard J Sanders
- Kenyan Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.,Nuffield Department of Clinical Medicine, Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Headington, UK
| | - Thumbi Ndung'u
- Africa Health Research Institute, Durban, South Africa. .,HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa. .,Ragon Institute of MGH, MIT and Harvard University, Cambridge, MA, USA. .,Max Planck Institute for Infection Biology, Berlin, Germany. .,Division of Infection and Immunity, University College London, London, UK.
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Varallyay NI, Langlois EV, Tran N, Elias V, Reveiz L. Health system decision-makers at the helm of implementation research: development of a framework to evaluate the processes and effectiveness of embedded approaches. Health Res Policy Syst 2020; 18:64. [PMID: 32522238 PMCID: PMC7288439 DOI: 10.1186/s12961-020-00579-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 05/21/2020] [Indexed: 02/07/2023] Open
Abstract
Background Embedded approaches to implementation research (IR), whereby health system decision-makers participate actively in the research process, are gaining traction as effective approaches to optimise the delivery of health programmes and policies. However, the evidence base on the processes and effectiveness of such collaborative research remains inchoate. Standardised approaches to evaluate these initiatives are needed to identify core elements of ‘embeddedness’, unveil the underlying pathways of change, and assess contribution to evidence uptake in decision-making and overall outcomes of effect. The framework presented in this paper responds to this need, designed to guide the systematic evaluation of embedded IR. Methods This evaluation framework for embedded IR approaches is based on the experience of a joint initiative by the Pan American Health Organization/Alliance for Health Policy and Systems Research, which has supported 19 IR grants in 10 Latin American and Caribbean countries from 2014 to 2017. The conceptualisation of this framework drew on various sources of information, including empirical evidence and conceptual insights from the literature, interviews with content experts, and a prospective evaluation of the 2016 cohort that included semi-structured key informant interviews, document analysis, and a research team survey to examine key aspects of embedded research. Results We developed a widely applicable conceptual framework to guide the evaluation of embedded IR in various contexts. Focused on uncovering how this collaborative research approach influences programme improvement, it outlines expected processes and intermediate outcomes. It also highlights constructs with which to assess ‘embeddedness’ as well as critical contextual factors. The framework is intended to provide a structure by which to systematically examine such embedded research initiatives, proposing three key stages of evidence-informed decision-making – co-production of evidence, engagement with research, and enactment of programme changes. Conclusion Rigorous evaluation of embedded IR is needed to build the evidence on its processes and effectiveness in influencing decision-making. The evaluation framework presented here addresses this gap with consideration of the complexity of such efforts. Its applicability to similar initiatives is bolstered by virtue of being founded on real-world experience; its potential to contribute to a nuanced understanding of embedded IR is significant.
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Affiliation(s)
- N Ilona Varallyay
- Department of International Health of the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
| | - Etienne V Langlois
- Alliance for Health Policy and Systems Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Nhan Tran
- Unintentional Injury Prevention Department for the Management of Non-communicable Diseases, Disability, Violence, and Injury Prevention (NVI), World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Vanesa Elias
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization, 525 Twenty-third Street, N.W, Washington, D.C, USA
| | - Ludovic Reveiz
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization, 525 Twenty-third Street, N.W, Washington, D.C, USA
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Fadlallah R, El-Harakeh A, Bou-Karroum L, Lotfi T, El-Jardali F, Hishi L, Akl EA. A common framework of steps and criteria for prioritizing topics for evidence syntheses: a systematic review. J Clin Epidemiol 2020; 120:67-85. [PMID: 31846688 DOI: 10.1016/j.jclinepi.2019.12.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 11/26/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of the study was to systematically review the literature for proposed approaches and exercises conducted to prioritize topics or questions for systematic reviews and other types of evidence syntheses in any health-related area. STUDY DESIGN AND SETTING A systematic review. We searched Medline and CINAHL databases in addition to Cochrane website and Google Scholar. Teams of two reviewers independently screened the studies and extracted data. RESULTS We included 31 articles reporting on 29 studies: seven proposed approaches for prioritization and 25 conducted prioritization exercises (three studies did both). The included studies addressed the following fields: clinical (n = 19; 66%), public health (n = 10; 34%), and health policy and systems (n = 8; 28%), with six studies (21%) addressing more than one field. We categorized prioritization into 11 steps clustered in 3 phases (preprioritization, prioritization, and postprioritization). Twenty-eight studies (97%) involved or proposed involving stakeholders in the priority-setting process. These 28 studies referred to twelve stakeholder categories, most frequently to health care providers (n = 24; 86%) and researchers (n = 21; 75%). A common framework of 25 prioritization criteria was derived, clustered in 10 domains. CONCLUSION We identified literature that addresses different aspects of prioritizing topics or questions for evidence syntheses, including prioritization steps and criteria. The identified steps and criteria can serve as a menu of options to select from, as judged appropriate to the context.
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Affiliation(s)
- Racha Fadlallah
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon; Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Amena El-Harakeh
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Lama Bou-Karroum
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon; Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Tamara Lotfi
- Global Evidence Synthesis Initiative (GESI), American University of Beirut, Beirut, Lebanon; Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi El-Jardali
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon; Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Ontario, Canada
| | - Lama Hishi
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon; Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Ontario, Canada.
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Murunga VI, Oronje RN, Bates I, Tagoe N, Pulford J. Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries. Health Res Policy Syst 2020; 18:16. [PMID: 32039738 PMCID: PMC7011245 DOI: 10.1186/s12961-019-0524-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Knowledge translation (KT) is a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to yield beneficial outcomes for society. Effective KT requires researchers to play an active role in promoting evidence uptake. This paper presents a systematised review of evidence on low- and middle-income country (LMIC) researchers' KT capacity, practice and interventions for enhancing their KT practice (support) with the aim of identifying gaps and informing future research and interventions. METHODS An electronic search for peer-reviewed publications focusing on LMIC researchers' KT capacity, practice and support across all academic fields, authored in English and from the earliest records available to February 2019, was conducted using PubMed and Scopus. Selected studies were appraised using the Mixed Methods Appraisal Tool, data pertaining to publication characteristics and study design extracted, and an a priori thematic analysis of reported research findings completed. RESULTS The search resulted in 334 screened articles, of which 66 met the inclusion criteria. Most (n = 43) of the articles presented original research findings, 22 were commentaries and 1 was a structured review; 47 articles reported on researchers' KT practice, 12 assessed the KT capacity of researchers or academic/research institutions and 9 reported on KT support for researchers. More than half (59%) of the articles focused on sub-Saharan Africa and the majority (91%) on health research. Most of the primary studies used the case study design (41%). The findings suggest that LMIC researchers rarely conduct KT and face a range of barriers at individual and institutional levels that limit their KT practice, including inadequate KT knowledge and skills, particularly for communicating research and interacting with research end-users, insufficient funding, and inadequate institutional guidelines, structures and incentives promoting KT practice. Furthermore, the evidence-base on effective interventions for enhancing LMIC researchers' KT practice is insufficient and largely of weak quality. CONCLUSIONS More high-quality research on researchers' KT capacity, practice and effective KT capacity strengthening interventions is needed. Study designs that extend beyond case studies and descriptive studies are recommended, including better designed evaluation studies, e.g. use of realist approaches, pragmatic trials, impact evaluations, implementation research and participatory action research.
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Affiliation(s)
- Violet Ibukayo Murunga
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 3BX United Kingdom
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
- African Institute for Development Policy, 6th Floor, Block A, Westcom Point Bldg, Mahiga Mairu Ave Off Waiyaki Way, Westlands, Nairobi, Kenya
| | - Rose Ndakala Oronje
- African Institute for Development Policy, 6th Floor, Block A, Westcom Point Bldg, Mahiga Mairu Ave Off Waiyaki Way, Westlands, Nairobi, Kenya
| | - Imelda Bates
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
| | - Nadia Tagoe
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Office of Grants and Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justin Pulford
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
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Archana S, Karmacharya BM, Rashmi M, Abhinav V, Meghnath D, Natalia O, Rajeev S, Prajjwal P, Annette F, David C, Swornim B, Roman XD, Donna S, Rajendra K. Stakeholder Engagement in Planning the Design of a National Needs Assessment for Cardiovascular Disease Prevention and Management in Nepal. Glob Heart 2020; 14:181-189. [PMID: 31324373 DOI: 10.1016/j.gheart.2019.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 05/25/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is growing support for stakeholder engagement in health research, but the actual impact of such engagement has not been well established. OBJECTIVES This paper describes the stakeholder engagement process and evaluation during the planning of the national needs assessment for cardiovascular disease in Nepal. METHODS We used personal and professional networks to identify relevant stakeholders within the 7Ps framework (Patients and the Public, Providers, Purchasers, Payers, Public Policy Makers and Policy Advocates, Product Makers and the Principal Investigators) to develop a plan for assessing cardiovascular health needs in Nepal. We consulted 40 stakeholders through 2 meetings in small groups and a workshop in a large group to develop the study methods, conceptual framework, and stakeholder engagement process. We interviewed 33 stakeholders to receive feedback on the stakeholder engagement process. RESULTS We engaged 80% of the targeted stakeholders through small group discussions and a workshop. Three of 5 recommendations from the small group discussion were aimed at improving the stakeholder engagement process and 2 were aimed to improve the research methods. Eleven of 27 recommendations from the workshop aimed to improve the research methods, 4 aimed to improve stakeholder engagement, and 2 helped to expand the scope of dissemination. Ten were irrelevant or could not be incorporated due to resource limitation. Most stakeholders noted that the workshop provided an open platform for a multisectoral group to colearn from one another and share ideas. Others highlighted that the discussion generated insights to enhance research by incorporating expertise and ideas from different perspectives. The major challenges discussed were about committing the time for engagement. CONCLUSIONS The stakeholder engagement process positively affected the design of our research. This study provides important insights for future researchers that aim to engage stakeholders in national-level assessment programs in the health care system in the context of Nepal.
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Affiliation(s)
- Shrestha Archana
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Kavrepalanchwok, Nepal; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Biraj Man Karmacharya
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Kavrepalanchwok, Nepal; Department of Community Medicine, Dhulikhel Hospital-Kathmandu University Hospital, Kavrepalanchwok, Nepal
| | - Maharjan Rashmi
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Kavrepalanchwok, Nepal
| | - Vaidya Abhinav
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | | | - Oli Natalia
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Shrestha Rajeev
- Department of Pharmacology, Dhulikhel Hospital-Kathmandu University Hospital, Kavrepalanchwok, Nepal
| | - Pyakurel Prajjwal
- Department of Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Fitzpatrick Annette
- Department of Family Medicine, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Citrin David
- Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA; Nyaya Health Nepal/Possible, Kathmandu, Nepal; Department of Anthropology, University of Washington, Seattle, WA, USA; Henry M. Jackson School of International Studies, University of Washington, Seattle, WA, USA
| | - Bajracharya Swornim
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Kavrepalanchwok, Nepal
| | - Xu Dong Roman
- Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Spiegelman Donna
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics and Center for Methods on Implementation and Prevention Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Koju Rajendra
- Department of Cardiology, Dhulikhel Hospital-Kathmandu University Hospital, Kavrepalanchwok, Nepal
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El Hajj T, Gregorius S, Pulford J, Bates I. Strengthening capacity for natural sciences research: A qualitative assessment to identify good practices, capacity gaps and investment priorities in African research institutions. PLoS One 2020; 15:e0228261. [PMID: 31978119 PMCID: PMC6980527 DOI: 10.1371/journal.pone.0228261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 01/12/2020] [Indexed: 11/18/2022] Open
Abstract
Background Strengthening research capacity in low-and-middle-income countries is essential to drive socioeconomic development and to achieve the Sustainable Development Goals. Understanding strengths and weaknesses in institutions’ research capacity can guide effective targeting of investments and resources. This study assessed the capacity of institutions undertaking research in natural science topics in Africa to identify priority capacity gaps for future investment. Methods Assessments were conducted in eight African institutions that were partners in a UK-Africa programme to strengthen research capacity in renewable energy, soil-related science, and water and sanitation. Assessments involved eighty-six interviews and three focus group discussions to identify institutions’ research capacity strengths and gaps against an evidence-informed benchmark. Use of the same interview guides and data collection processes across all institutions meant that findings could be compared. Results Common research capacity gaps were: lack of, or poorly maintained, equipment; unreliable, slow procurement systems; insufficient opportunities for developing the skills of research support staff such as administrators and technicians; dysfunctional institutional email communication systems; insufficient focus on the development of ‘soft’ researcher skills such as ethics, academic writing and, in non-Anglophone countries, English language. Programme strengths were the South-South and South-North partnerships for sharing and cascading expertise and resources, joint writing of proposals and publications, and improved individual and institutional visibility. Conclusion There were many similarities in research capacity gaps irrespective of the institutions’ natural sciences research focus, and these were similar to those reported in the health sector. Common capacity needs are improving the skills of technicians and administrators to support research activities, soft skills training for researchers, and more effective pan-institutional e-communication systems. These could be strategic investment targets for the joint efforts of national governments and international organisations that fund programmes for strengthening research capacity in low- and middle-income countries.
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Affiliation(s)
- Taghreed El Hajj
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, England, United Kingdom
- * E-mail:
| | | | - Justin Pulford
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, England, United Kingdom
| | - Imelda Bates
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, England, United Kingdom
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Fritschi L, Smith PM. Value of occupational health research. Occup Environ Med 2019; 76:873-874. [PMID: 31481456 DOI: 10.1136/oemed-2019-106091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/22/2019] [Accepted: 08/25/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Peter M Smith
- Institute for Work and Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Valente M, Syurina EV, Donini LM. Shedding light upon various tools to assess orthorexia nervosa: a critical literature review with a systematic search. Eat Weight Disord 2019; 24:671-682. [PMID: 31228168 PMCID: PMC6647444 DOI: 10.1007/s40519-019-00735-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/07/2019] [Indexed: 12/25/2022] Open
Abstract
AIM The aim of this literature review was to identify the tools developed and used to assess orthorexia nervosa (ON). METHODS A systematic search was executed in PubMed, Biomed Central, and PsycINFO. The final list included 70 articles that were critically analyzed. RESULTS A total of six tools were reported to assess ON: the BOT, the ORTO-15, the EHQ, the DOS, the BOS, and the TOS. The tools were based upon different conceptualizations of ON and of its diagnostic criteria. Although they were different, all the conceptualizations derived from the initial definition of ON provided by Bratman in 1997. None of the methodologies adopted for tool construction considered end users or client perspectives and, when carried out, the validations of the tools were fragmented and often based on specific populations. CONCLUSION This study may be a starting point for the construction of a new diagnostic tool for ON. Starting from the methodological weaknesses identified by this review, it was possible to derive some suggestions for future research: (a) developing a modern re-conceptualization of ON, comprehensive of end-user perspectives; (b) adopting qualitative data collection techniques to gain insights into how to diagnose ON; and (c) actively involving diverse stakeholders for constructing a new tool. LEVEL OF EVIDENCE Level of Evidence: I, systematic review.
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Affiliation(s)
- Martina Valente
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Elena V Syurina
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Envisioning and shaping translation of knowledge into action: A comparative case-study of stakeholder engagement in the development of a European tobacco control tool. Health Policy 2019; 123:917-923. [PMID: 31383372 PMCID: PMC6876657 DOI: 10.1016/j.healthpol.2019.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/18/2019] [Accepted: 07/13/2019] [Indexed: 02/03/2023]
Abstract
Stakeholder engagement in health policy research is often said to increase 'research impact', but the active role of stakeholders in creating impact remains underexplored. We explored how stakeholders shaped the translation of health policy research into action. Our comparative case-study tracked a European research project that aimed to transfer an existing tobacco control return on investment tool. That project also aimed to increase its impact by engaging with stakeholders in further developing the tool. We conducted semi-structured interviews, using an actor-scenario mapping approach. Actor-scenarios can be seen as relational descriptions of a future world. We mapped the scenarios by asking stakeholders to describe who and what would play a role in the tool's utilisation. Our results show that stakeholders envisioned disparate futures for the tool. Some scenarios were specific, whereas most were generic projections of abstract potential users and responsibilities. We show how stakeholders mobilised elements of context, such as legislative support and agricultural practice, that would affect the tool's use. We conclude that stakeholders shape knowledge translation processes by continuously putting forth explicit or implicit scenarios about the future. Mapping actor-scenarios may help in aligning knowledge production with utilisation. Insights into potential roles and responsibilities could be fed back in research projects with the aim of increasing the likelihood that the study results may be used.
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How can we improve priority-setting for investments in health research? A case study of tuberculosis. Health Res Policy Syst 2019; 17:68. [PMID: 31324187 PMCID: PMC6642523 DOI: 10.1186/s12961-019-0473-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background Although enhanced priority-setting for investments in health research for development is essential to tackling inequalities in global health, there is a lack of consensus on an optimal priority-setting process. In light of the current surge in tuberculosis (TB) research investment, we use TB as a case study. Methods We investigated two critical aspects of a research prioritisation process, namely the criteria that should be used to rank alternative research options and which stakeholders should be involved in priority-setting. We conducted semi-structured interviews with 24 key informants purposively selected from four distinct groups – academia, funding bodies, international policy or technical agencies, and national disease control programmes. Interview transcripts were analysed verbatim using a framework approach. We also performed a systematic analysis of seven diverse TB research prioritisation processes. Results There was consensus that well-defined and transparent criteria for assessing research options need to be agreed at the outset of any prioritisation process. It was recommended that criteria should select for research that is likely to have the greatest public health impact in affected countries rather than research that mainly fills scientific knowledge gaps. Some interviewees expressed strong views about the need – and reluctance – to make politically challenging decisions that place some research areas at a lower priority for funding. The importance of taking input from stakeholders from countries with high disease burden was emphasised; such stakeholders were notably absent from the majority of prioritisation processes we analysed. Conclusions This study indicated two critical areas for improvement of research prioritisation processes such that inequalities in health are better addressed – the need to deprioritise some research areas to generate a specific and meaningful list for investment, and greater involvement of experts working in high disease-burden countries.
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Williamson A, Tait H, El Jardali F, Wolfenden L, Thackway S, Stewart J, O'Leary L, Dixon J. How are evidence generation partnerships between researchers and policy-makers enacted in practice? A qualitative interview study. Health Res Policy Syst 2019; 17:41. [PMID: 30987644 PMCID: PMC6466802 DOI: 10.1186/s12961-019-0441-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 03/19/2019] [Indexed: 12/20/2022] Open
Abstract
Background Evidence generation partnerships between researchers and policy-makers are a potential method for producing more relevant research with greater potential to impact on policy and practice. Little is known about how such partnerships are enacted in practice, however, or how to increase their effectiveness. We aimed to determine why researchers and policy-makers choose to work together, how they work together, which partnership models are most common, and what the key (1) relationship-based and (2) practical components of successful research partnerships are. Methods Semi-structured qualitative interviews were conducted with 18 key informants largely based in New South Wales, Australia, who were (1) researchers experienced in working in partnership with policy in health or health-related areas or (2) policy and programme developers and health system decision-makers experienced in working in partnership with researchers. Data was analysed thematically by two researchers. Results Researcher-initiated and policy agency-initiated evidence generation partnerships were common. While policy-initiated partnerships were thought to be the most likely to result in impact, researcher-initiated projects were considered important in advancing the science and were favoured by researchers due to greater perceived opportunities to achieve key academic career metrics. Participants acknowledged that levels of collaboration varied widely in research/policy partnerships from minimal to co-production. Co-production was considered a worthy goal by all, conferring a range of benefits, but one that was difficult to achieve in practice. Some participants asserted that the increased time and resources required for effective co-production meant it was best suited to evaluation and implementation projects where the tacit, experiential knowledge of policy-makers provided critical nuance to underpin study design, implementation and analysis. Partnerships that were mutually considered to have produced the desired outcomes were seen to be underpinned by a range of both relationship-based (such as shared aims and goals and trust) and practical factors (such as sound governance and processes). Conclusions Our findings highlight the important role of policy-makers in New South Wales in ensuring the relevance of research. There is still much to understand about how to initiate and sustain successful research/policy partnerships, particularly at the highly collaborative end. Electronic supplementary material The online version of this article (10.1186/s12961-019-0441-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Williamson
- The Sax Institute, PO Box K617, Haymarket, NSW, 1240, Australia. .,University of Sydney, Sydney, Australia. .,University of New South Wales, Sydney, Australia.
| | - Hannah Tait
- The Sax Institute, PO Box K617, Haymarket, NSW, 1240, Australia
| | | | - Luke Wolfenden
- University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, New Lambton, Australia
| | | | - Jessica Stewart
- Department of Family and Community Services (FACS) Insights, Analysis and Research (FACSIAR), Ashfield, Australia
| | - Lyndal O'Leary
- Western NSW & Far West Local Health Districts, Dubbo, Australia
| | - Julie Dixon
- South Eastern Sydney Local Health District (SESLHD), Carringbah, Australia
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Pisani E, Kok M. In the eye of the beholder: to make global health estimates useful, make them more socially robust. Glob Health Action 2018; 10:1266180. [PMID: 28532303 PMCID: PMC5124117 DOI: 10.3402/gha.v9.32298] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A plethora of new development goals and funding institutions have greatly increased the demand for internationally comparable health estimates in recent years, and have brought important new players into the field of health estimate production. These changes have rekindled debates about the validity and legitimacy of global health estimates. This paper draws on country case studies and personal experience to support our opinion that the production and use of estimates are deeply embedded in specific social, economic, political and ideational contexts, which differ at different levels of the global health architecture. Broadly, most global health estimates tend to be made far from the local contexts in which the data upon which they are based are collected, and where the results of estimation processes must ultimately be used if they are to make a difference to the health of individuals. Internationally standardised indicators are necessary, but they are no substitute for data that meet local needs, and that fit with local ideas of what is credible and useful. In other words, data that are both technically and socially robust for those who make key decisions about health. We suggest that greater engagement of local actors (and local data) in the formulation, communication and interpretation of health estimates would increase the likelihood that these data will be used by those most able to translate them into health gains for the longer term. Besides strengthening national information systems, this requires ongoing interaction, building trust and establishing a communicative infrastructure. Local capacities to use knowledge to improve health must be supported.
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Affiliation(s)
| | - Maarten Kok
- b Institute for Health Policy and Management , Erasmus University Rotterdam.,c Talma Institute , Vrije Universiteit Amsterdam
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Boaz A, Hanney S, Borst R, O'Shea A, Kok M. How to engage stakeholders in research: design principles to support improvement. Health Res Policy Syst 2018; 16:60. [PMID: 29996848 PMCID: PMC6042393 DOI: 10.1186/s12961-018-0337-6] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/06/2018] [Indexed: 11/17/2022] Open
Abstract
Background Closing the gap between research production and research use is a key challenge for the health research system. Stakeholder engagement is being increasingly promoted across the board by health research funding organisations, and indeed by many researchers themselves, as an important pathway to achieving impact. This opinion piece draws on a study of stakeholder engagement in research and a systematic literature search conducted as part of the study. Main body This paper provides a short conceptualisation of stakeholder engagement, followed by ‘design principles’ that we put forward based on a combination of existing literature and new empirical insights from our recently completed longitudinal study of stakeholder engagement. The design principles for stakeholder engagement are organised into three groups, namely organisational, values and practices. The organisational principles are to clarify the objectives of stakeholder engagement; embed stakeholder engagement in a framework or model of research use; identify the necessary resources for stakeholder engagement; put in place plans for organisational learning and rewarding of effective stakeholder engagement; and to recognise that some stakeholders have the potential to play a key role. The principles relating to values are to foster shared commitment to the values and objectives of stakeholder engagement in the project team; share understanding that stakeholder engagement is often about more than individuals; encourage individual stakeholders and their organisations to value engagement; recognise potential tension between productivity and inclusion; and to generate a shared commitment to sustained and continuous stakeholder engagement. Finally, in terms of practices, the principles suggest that it is important to plan stakeholder engagement activity as part of the research programme of work; build flexibility within the research process to accommodate engagement and the outcomes of engagement; consider how input from stakeholders can be gathered systematically to meet objectives; consider how input from stakeholders can be collated, analysed and used; and to recognise that identification and involvement of stakeholders is an iterative and ongoing process. Conclusion It is anticipated that the principles will be useful in planning stakeholder engagement activity within research programmes and in monitoring and evaluating stakeholder engagement. A next step will be to address the remaining gap in the stakeholder engagement literature concerned with how we assess the impact of stakeholder engagement on research use. Electronic supplementary material The online version of this article (10.1186/s12961-018-0337-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Annette Boaz
- Faculty of Health, Social Care and Education, a partnership between Kingston University and St George's, University of London, London, United Kingdom.
| | - Stephen Hanney
- Health Economics Research Group, Brunel University London, Uxbridge, United Kingdom
| | - Robert Borst
- Erasmus School of Health Policy & Management, Rotterdam, The Netherlands
| | - Alison O'Shea
- Faculty of Health, Social Care and Education, a partnership between Kingston University and St George's, University of London, London, United Kingdom
| | - Maarten Kok
- VU University Amsterdam, Amsterdam, The Netherlands
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50
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Neevel AMG, Hemrika T, Claassen E, van de Burgwal LHM. A research agenda to reinforce rabies control: A qualitative and quantitative prioritization. PLoS Negl Trop Dis 2018; 12:e0006387. [PMID: 29727444 PMCID: PMC5955568 DOI: 10.1371/journal.pntd.0006387] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/16/2018] [Accepted: 03/14/2018] [Indexed: 12/24/2022] Open
Abstract
Background Despite the existence of safe and effective vaccines, rabies disease still causes an estimated 59,000 human deaths a year in the endemic areas in Asia and Africa. These numbers reflect severe drawbacks regarding the implementation of PrEP and PEP in endemic settings, such as lack of political will and low priority given to rabies. Since these contextual factors have proven to be persistent, there is an urgency to improve current strategies or develop novel approaches in order to control rabies disease in the future. Methods/Findings This study aimed to identify and systematically prioritize the research needs, through interviews and questionnaires with key-opinion-leaders (KOLs). A total of 46 research needs were identified and prioritized. The top research needs are considered very high priority based on both importance for rabies control and need for improvement. KOLs agree that animal rabies control remains most important for rabies control, while research on human host, agent (rabies virus) and the environment should be prioritized in terms of need for improvement. A wide variety in perceptions is observed between and within the disciplines of virology, public health and veterinary health and between KOLs with more versus those with less experience in the field. Conclusion/Significance The results of this study give well-defined, prioritized issues that stress the drawbacks that are experienced by KOLs in daily practice. The most important research domains are: 1) cheap and scalable production system for RIG 2) efficacy of dog mass vaccination programs and 3) cheap human vaccines. Addressing these research needs should exist next to and may reinforce current awareness and mass vaccination campaigns. The differences in perspectives between actors revealed in this study are informative for effective execution of the One Health research agenda. Rabies is a 100% vaccine-preventable disease but invariably fatal once symptoms occur. Annually, tens of thousands of people die after being infected with rabies virus, predominantly through bites or scratches of infected dogs. The stable mortality rates highlight the limitations of current disease specific interventions, including prophylaxes, awareness campaigns and mass vaccination of dogs. Consequently, research is needed to develop improved and novel strategies that circumvent the barriers faced in implementation in endemic settings. Interest for rabies, however, is limited and to effectively allocate budgets the field would benefit from a more focused research agenda. This study prioritized research topics based on the importance for rabies control and the need for improvement. According to experts, research should focus on 1) cheap and scalable production systems for RIG; 2) efficacy of dog mass vaccination programs and; 3) development of a cheap human vaccine. By elucidating differences in perceptions of stakeholders between disciplines and between those with more versus those with less experience in the field, this study also provides practical insights to inform stakeholders concerned with the implementation of interdisciplinary collaboration in the field of rabies. The prioritization of rabies-specific research needs is a vital step in accelerating innovation necessary to decrease the burden of disease.
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Affiliation(s)
- Anne M. G. Neevel
- Athena Institute, VU University, Amsterdam, the Netherlands
- Viroclinics Biosciences, Rotterdam, the Netherlands
- * E-mail:
| | - Tessa Hemrika
- Athena Institute, VU University, Amsterdam, the Netherlands
| | - Eric Claassen
- Athena Institute, VU University, Amsterdam, the Netherlands
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