Virtual Health Research Capacity Strengthening in Low- and Middle‑Income Countries: A Systematic Integrative Review.

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Background: Effective and scalable strategies are needed to develop health research capacity in low- and middle‑income countries (LMICs). Health research capacity strengthening (HRCS) focuses on boosting production and utilization of health research, with clinicians as key target participants. Despite the increased prevalence of virtual HRCS programs, there has been no review of the evidence for those targeting LMIC clinicians to date. Objective: This review characterizes the use of virtual tools in HRCS programs for clinicians in LMICs and describes the impacts, facilitators, and barriers associated with these programs. Methods: Following our protocol (PROSPERO; CRD42020152510), we employed an integrative review methodology. We adapted Cooke's Research Capacity Development for Impact framework by adding "equity" as a new domain and used it to evaluate programmatic impacts. We retrieved relevant articles from five databases and gray literature. Included articles were extracted and stratified by degree of virtual delivery. We analyzed virtual tool usage via content analysis. Using NVivo, we coded until theoretical saturation and analyzed data using the constant comparison method. Findings: From 1397 articles, 58 met inclusion criteria. Most programs were hybrid, and e‑courses were the most used virtual tool. Articles described impacts across all framework domains; the most discussed were skills and confidence building. Facilitators included user‑friendly platforms, interactive content, and strategies to improve program access, including financial and technological support. Some programs incorporated hybrid strategies to foster trust among participants and virtual mentors. Barriers included a lack of or an unfavorable local research culture. Conclusions: Recommendations from this review may guide the design and implementation of virtual HRCS programs for LMIC clinicians. These include selecting well‑fitted program participants, intentionally designing program structure and content, conducting needs assessments or pilots, incorporating equity as a programmatic target, ensuring longitudinal program evaluation and monitoring, and utilizing a comprehensive conceptualization of program sustainability.