Capacity Building Interventions Research Articles

Organizational Capacity Building in Nursing Facilities to Promote Resident Mobility: A Systematic Review.

The objective of the present systematic review was to investigate the effects of organizational capacity building interventions on the environment, nursing staff capacity, and mobility of residents in nursing facilities. Systematic review. Nursing facilities, staff, and residents. We conducted a systematic review according to the methods of the Cochrane Collaboration. The systematic review was prospectively registered in the PROSPERO database of systematic reviews (registration number CRD42020202996). We searched for studies in MEDLINE (via PubMed), CINAHL (via EBSCO), the Physiotherapy Evidence Database (PEDro), and the Cochrane Library (07/20). A narrative synthesis was conducted because of the high heterogeneity of the included studies. We identified 6747 records and included 14 studies in our review. We clustered the 14 interventions into 3 different categories (environmental modification, nursing staff capacity, and multifactorial interventions). Three studies assessed outcomes at the nursing staff level, and all studies reported outcomes at the resident level. We found highly heterogeneous and inconsistent effects of organizational capacity building on increasing nursing staff capacity and/or resident mobility. The findings emphasize the need for further research focusing on an international understanding and definition of organizational capacity building. Additionally, research and intervention development for organizational capacity building interventions to promote resident mobility are needed while applying the framework of the Medical Research Council. Furthermore, studies should assess outcomes regarding the environment and nursing staff to better understand if and how environmental structures and nursing staff capacity effect resident mobility.

A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam.

People living with HIV who use drugs (PLHWUD) face enormous challenges to access antiretroviral therapy (ART), addiction treatment, and other healthcare services. This study evaluated the effect of a community capacity-building approach on PLHWUD's access to healthcare services. A cluster randomized controlled trial was conducted in four provinces of Vietnam. Trained commune health workers in the intervention condition were encouraged to provide services to PLHWUD in the community and engage them in HIV/addiction treatment and care using learned knowledge and skills. A total of 241 PLHWUD participated in surveys at the baseline and every three months for one year. The primary outcome was PLHWUD's reported barriers to seeking healthcare. A linear mixed-effects regression model with a difference in difference approach was used to estimate the intervention effect on the primary outcome. Adjusted analyses indicated that significant intervention effects were observed at the Sixth and ninth month follow-ups for those on ART at the baseline and increased motivation to engage in treatment at the 3-month follow-up (60.2% vs 34.4% for the intervention and control groups, respectively). The community capacity-building intervention had shown promising yet limited outcomes among a subset of PLHWUD in the community, that is, PLHWUD who had already initiated ART.

Acceptability and feasibility of the school-engaged social and behavior change communication approach on malaria prevention in Ethiopia: implications for engagement, empowerment, and retention (EER) of education sectors in malaria elimination efforts

BackgroundEvidence on process outcomes such as acceptability, and feasibility of behavior change communication interventions are important in program evaluation to understand how, and why such a program works. However; documented evidence on the issue is not available as far as the social and behavior change communication (SBCC) on malaria is concerned. Enrolling the frontline providers this study measured the acceptability and feasibility of the school-engaged SBCC strategy on malaria prevention in malaria-endemic settings of Ethiopia.MethodsA school-engaged SBCC strategy involving various communication and capacity-building interventions aimed to advance malaria preventive practices in primary schools in Jimma were implemented from 2017 to 2019. A cross-sectional study was conducted with 205 key stakeholders at the end of the intervention. Both acceptability and feasibility were measured using standardized tools. Data were collected using a structured questionnaire and filled by the study participants. The SPSS version 26 was used to analyze the data. Multivariate general linear modeling was performed to identify the predictors of acceptability and feasibility of the program. P-value < 5% was considered to decide statistical significance.ResultsThe result showed the mean scores (M, range = R) of acceptability and feasibility of the program were (M = 25.63, R = 6 to 30) and (M = 19.35, R = 5 to 25) respectively. The multivariate linear modeling showed acceptability was affected by self-efficacy; (β = 0.438, P < 0.001), community support; (β = 0.417, P < 0.001), school climate; (β = − 0.16; P = 0.003), perceived malaria threat; (β = 0.40, P < 0.001) and knowledge; (β = 0.229, P = 0.013). Similarly, feasibility was influenced by self-efficacy; (β = 0.352, P < 0.001), community support; (β = 0.591, P < 0.001), school climate; (β = − 0.099, P-value < 0.030) and perceived malaria threat; (β = 0.172, P = 0.002).ConclusionWith a considerably high level of acceptability, the school-engaged SBCC strategy to enhance malaria preventive practices seems feasible. The SBCC strategy targeting personal factors such as malaria threat perceptions, knowledge and skills on the program, and contextual factors that include school social climate and community support would be fruitful to facilitate the implementation of the program. The result implicates the benefit of intensifying such a strategy to engage, empower, and retain the education sectors in malaria elimination efforts and beyond.

Policymakers’ Research Capacities, Engagement, and Use of Research in Public Health Policymaking

The use of research in public health policymaking is one of the prerequisites for successfully implemented health policies which have better population health as an outcome. This policy process is influenced by the actors involved under the policy umbrella, with inter-related contextual factors and specific structural and institutional circumstances. Our study investigates how policymakers’ research capacities influence the use of research in the health policy process and identify areas where capacity-building interventions give the most meaning and impact. Furthermore, we investigate policymakers’ research engagement and use this to inform public health policy in the public sector in Denmark. We collect and report data using Seeking, Engaging with, and Evaluation Research (SEER) methodology. Policymakers are reported to have research capacity, but it is questionable how those competences have actually been used in policymaking. Decision-makers were often not aware or did not know about the existing organizational tools and systems for research engagement and use and two third of respondents had not been part of any research activities or had any collaboration with researchers. Overall, research use in public health policymaking and evaluation was limited. As a conclusion, we propose that capacity-building interventions for increasing research use and collaboration in EIPM should be context-oriented, measurable, and sustainable in developing individual and organizational competences.

Changes in the availability of medical oxygen and its clinical practice in Ethiopia during a national scale-up program: a time series design from thirty-two public hospitals

BackgroundOxygen therapy is a lifesaving treatment, however, in Ethiopia, oxygen is not readily available in many healthcare facilities. In 2015, the Federal Ministry of Health launched a national roadmap to increase access to oxygen. This study aims to evaluate whether availability of oxygen and its clinical practice in public hospitals of Ethiopia changed during the time the roadmap was being implemented.MethodsBetween December 2015 and December 2019, a multifaceted approach was undertaken to increase access to oxygen in public facilities in Ethiopia. The activities included formation of new policies, development of guidelines, procurement and maintenance of oxygen equipment, and training of healthcare workers. To evaluate whether access and use of oxygen changed during this period, facility-based surveys were conducted between December 2015 to December 2019. Primary data, including medical record reviews, were collected from 32 public hospitals bi-annually. A chi-square test that claimed P < 0.05 used to assess the statistical significance differences.ResultsThe study was conducted in 32 public hospitals of Ethiopia, where capacity building and technical support interventions implemented. Of these 32 facilities, 15 (46.9%) were general hospitals, 10 (31.2%) were referral hospitals, and 7 (21.9%) were primary hospitals. Functional availability of oxygen has shown a statistically significant increase from 62 to 100% in the pediatric in-patient departments of general and referral hospitals (p-value < 0.001). Similarly, functional availability of pulse oximetry has shown a statistically significant increase from 45 to 96%. With regard to clinical practices, the blood oxygen saturation (SpO2) measurement at diagnosis increased from 10.2 to 75%, and SpO2 measurement at admission increased 20.5 to 83%.ConclusionsBased on the intervention results, we conclude that multifaceted approaches targeting policy, healthcare workers’ capacity, increased device procurement, and device maintenance programs with on-site mentorship, can improve the availability of medical oxygen and pulse oximetry, as well as clinical practice of oxygen therapy in health facilities. Therefore, ensuring device availability along with regular technical support and close follow-up of healthcare workers and facilities are critical, and these interventions should be scaled further.

Evaluation of the Impact of Immunization Second Year of Life Training Interventions on Health Care Workers in Ghana.

As part of a suite of training interventions to improve the knowledge and practice of immunization in the second year of life (2YL), training of trainers workshops were conducted with regional and district health management teams (DHMTs) in 15 districts in 3 regions of Ghana. Using adult learning principles, DHMTs implemented several capacity-building activities at the subdistrict and health facility levels, including health facility visits, on-the-job training, and review meetings. The current evaluation investigated whether frontline health care workers (HCWs) reported or demonstrated improvements in knowledge, attitudes, and practices after training interventions. Quantitative and qualitative methods with a utilization-focused approach guided the framework for this evaluation. A systematic random sample of 115 HCWs in 3 regions of Ghana was selected to complete a competency survey before and after training, which focused on 3 core competency areas-Expanded Programme on Immunization (EPI) policy; communication with caregivers; and immunization data management, recording, and use. Interviews and direct observations by data collectors were done to assess HCWs' knowledge, self-reported attitude, and behavior changes in practices. Of 115 HCWs, 102 were surveyed before and 4 months after receiving capacity-building interventions. Modest but not statistically significant improvements were found in knowledge on EPI policy, immunization data management, and communication skills with caregivers. HCWs reported that they had improved several attitudes and practices after the 2YL training. The most improved practice reported by HCWs and observed in all 3 regions was the creation of a defaulter list. Findings of this evaluation provide encouraging evidence in taking the first step toward improving HCW knowledge, attitudes, and practices for 3 core immunization competency areas. The use of learner-focused teaching methods combined with adult learning principles is helpful in solving specific performance problems (such as lack of knowledge of EPI policy).

Relationship Between Research Culture and Research Activity of Medical Doctors: A Survey and Audit.

PurposeTo describe the research capacity and culture, and research activity (publications and new projects) of medical doctors across a health service and determine if the research activity of specialty groups correlated with their self-reported “team” level research capacity and culture.MethodsCross-sectional, observational survey and audit of medical doctors at a tertiary health service in Queensland. The Research Capacity and Culture (RCC) validated survey was used to measure self-reported research capacity/culture at organisation, team and individual levels, and presence of barriers and facilitators to research. An audit of publications and ethically approved research projects was used to determine research activity.ResultsApproximately, 10% of medical doctors completed the survey (n= 124). Overall, median scores on the RCC were 5 out of 10 for organisational level, 5.5 for specialty level, and 6 for individual level capacity and culture; however, specialty-level scores varied significantly between specialty groups (range 3.1–7.8). Over 80% of participants reported lack of time and other work roles taking priority as barriers to research. One project was commenced per year for every 12.5 doctors employed in the health service, and one article was published for every 7.5. There was a positive association between a team’s number of publications and projects and their self-reported research capacity and culture on the RCC. This association was stronger for publications.ConclusionHealth service research capacity building interventions may need a tailored approach for different specialty teams to accommodate for varying baselines of capacity and activity. When evaluating these initiatives, a combination of research activity and subjective self-report measures may be complementary.

Opportunities for Capacity Building to Create Healthy School Communities in the Netherlands: Focus Group Discussions With Dutch Pupils.

Background: To sustainably implement a healthy school community in which stakeholders, including pupils, feel ownership over health-promotion activities, building community capacity is important. Pupils have experiential knowledge that is complementary to professional knowledge, but their perspectives on capacity-building processes are underexposed. This study aims to explore secondary-school pupils' perceptions about key influencers on physical activity and dietary choices and starting points for building community capacity.Methods: Seven focus groups with forty one pupils were held in four secondary schools engaged in a capacity-building intervention. Transcripts were analysed thematically regarding key influencers about choices in the home and school setting and capacity-building strategies (leadership, participation, tailored health-promotion activities and local networks).Results: Parents remained important influencers for making healthy choices, but snacking choices were increasingly made independently from parents based on attractiveness, availability and cost. Choices to engage in physical activity depended on social aspects and opportunities in the physical environment. Pupils considered their influence over the healthy school community limited, desired more involvement, but require this to be facilitated. They identified leaders mainly within formal structures, for example, student councils. They believed health-promotion activities related to the physical environment and project-based activities within the curriculum have the maximum potential to stimulate healthy behaviours in school communities.Conclusion: This study shows that pupils can reflect critically on their physical activity and dietary choices, and on how this can contribute to processes in creating a healthy school community. In order to take an active role, they need to be considered as full partners and leadership roles should be facilitated in existing structures.

Evaluation of the Effects of “USAID- MARKETS” Capacity Building of Farmers on Rice Output in Kebbi State, Nigeria

Poor yield and low quality of locally produced rice despite many capacity building interventions for rice farmers necessitated this study entitled Effects of “USAID- MARKETS” Capacity Building of Farmers on Rice Output in Kebbi State, Nigeria.Taking an empirical survey, the study comparedoutput and income of the project participants against the non-project participants. Using multi stage sampling techniques, primary data were collected from 240 rice farmers who participated in the training and 240 farmers who did not, through semi-structured questionnaire and interview schedule. The study revealed a significant difference between the output of the project participants and the non-participants. In conclusion, “USAID-MARKETS” capacity buildingsignificantly increased farmers’ rice production and income in the study area, however findings from this study also showed that there was a drop in these variables when compared to what was obtained before the capacity building project ended due to inadequate asses to farm inputs, extension services and ready markets. The study strongly recommends the need to scale up the “USAID-MARKETS” capacity building project in a sustainable manner, improve agricultural input sector and extension services in order to strengthen the capacity of rice farmers for increase output and income.

More than just managerial self-efficacy: conceptualizing and predicting top managers' means efficacy about the organization under extreme events

PurposeThis study extends the concept of managerial efficacy to include managerial means efficacy (MME) attributed to the utility and quality of means external to managers for performing a task. Focusing on its antecedents, the authors theorize and empirically test MME sourced from the organization (MMEO) and situate the examination under extreme events.Design/methodology/approachThis study uses a 2016 national survey of 892 top managers in 273 US largest transit agencies covering 82% of the entire population. Participants report their confidence for their organization to perform effectively under various extreme events. The survey data are matched with data from various institutional data sources to capture organizational characteristics, operations and experience with extreme events.FindingsFindings suggest that organizational-level factors influence MMEO. Specifically, organizational slack and relationship management of key jurisdictional stakeholders positively predict MMEO, whereas political fragmentation is negatively associated with MMEO.Practical implicationsOrganizations can bolster MMEO, hence, managerial efficacy through developing organizational slack and engaging in relationships building with jurisdictional stakeholders. Those initiatives have particular importance for those with boundary-spanning service areas.Originality/valueThe study advances understanding of managerial efficacy by directing attention to means external to managers' self. It also brings clarity to the notion of “confident managers” or “managerial confidence” broadly applied in previous studies. Findings provide insights about capacity-building interventions to build managerial efficacy through improving external means, circumventing the need to alter self-efficacy that is typically stable and resistant to change.

Community Capacity Building for HIV and Addiction Service Integration: An Intervention Trial in Vietnam

Scientific findings and policy guidelines recommend integrating HIV and drug addiction prevention and care into community-based settings. Systematic capacity-building efforts are warranted to provide technical support for community health workers and improve their confidence in the integrated service provision. An intervention trial was conducted between 2018 and 2019 with 120 community health workers (CHW) from 60 communes in Vietnam’s four provinces. The 60 intervention CHW received in-person training to enhance their HIV/addiction-related service knowledge and skills. Online support groups were established between trained CHW and local HIV and addiction specialists. The intervention outcomes were assessed using mixed-effects regression models with the data collected at baseline and every 3 months for 1 year. Adjusted analyses showed that intervention CHW reported a significant increase in the interaction with other treatment providers than the control group at 6 months and remained at the 12-month follow-up. The difference in the improvement of confidence in HIV/addiction-related service delivery between the intervention and control groups was significant at 6-month but became insignificant at the 12-month. Male CHW were more confident in providing services than female CHW at baseline, and gender differences in the changing patterns were observed over time. This capacity-building intervention demonstrated promising outcomes on CHW inter-agency collaborations and confidence in service delivery. Gender divides in healthcare professionals should be attended to in future studies.

Abstract 41: International Collaborative Rwanda Endoscopy Week Conferences Demonstrate Feasibility and identify H. pylori Testing as an Important Target for Capacity-Building Interventions

Abstract Purpose: Gastrointestinal (GI) endoscopy is a growing field in Rwanda, a country of 12.6 million with significant GI morbidity and mortality. Endoscopy alongside Helicobacter pylori identification and eradication aids in GI cancer prevention and diagnosis in this population. Our collaborative training-focused endoscopy conference provides preliminary data to focus future training and capacity building programs in Rwanda to improve oncologic outcomes. Methods: Since 2017, ‘Rwanda Endoscopy Week' (REW) is held annually at multiple hospitals throughout Rwanda. It consists of several days of didactic training in endoscopy, oncology and research, followed by a week of endoscopy procedures performed jointly by visiting and hosting endoscopists, and ending with a summary of results of didactic and endoscopic activity. Results: Four (4) hospitals performed 244 training endoscopies in 2017 and 448 cases in 2018. In 2019 this expanded to 668 endoscopies performed at 7 hospitals, including academic, district, and private hospitals. The case distribution remained similar over 3 years at 86.0% (1170/1360) upper endoscopies, 13.2% (180/1360) colonoscopies, and 0.7% (10/1360) endoscopic retrograde cholangiopancreatographies. Thirty-nine (5.8%, 39/668) patients had a tumor finding suspicious for gastric (4.0%, 27/668), colorectal (1.5%,10/668), ampullary (0.1%, 1/668), or gallbladder (0.1%, 1/668) malignancy. 54% of patients receiving endoscopy were tested for H. Pylori (367/669); 38% of those tested had inconclusive results (141/367) and 20% were positive (74). There were 2 non-serious bleeding events. Conclusions: Participation by Rwandan urban, district, public and private hospitals in a cooperative international GI training conference has experienced a nearly three-fold increase in patients and identified malignant pathology while maintaining safe endoscopic care over a three-year period. H. pylori, ubiquitous in this population, is an important risk factor for gastric cancer and gastric diseases. Necessary next steps include increased training and capacity-building interventions to improve the quality of the testing and surveillance of those treated. Citation Format: Nikitha Gangasani, Eric Rutaganda, Felcien Shikama, Steve Bensen, Vincent Dusabejambo, Mary Chamberlin. International Collaborative Rwanda Endoscopy Week Conferences Demonstrate Feasibility and identify H. pylori Testing as an Important Target for Capacity-Building Interventions [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 41.

Assessment of Progress in Capacity Building of HIV/AIDS Supply Chain Workforce in Nigeria

This Study On Assessment Of Progress In Capacity Building Of HIV/AIDS Supply Chain Workforce In Nigeria Included Research Objectives, Questions, And Hypothesis. A Pre-Tested Self-Completion Structured Questionnaire Was Administered To Participants (422) With A Response Rate Of 396 (93.8%). The Reliability Statistics Showed The Questionnaire Is Less Reliable (Α = 0.237). Notable Progress Includes Donor Agencies Interventions Contributing Considerably To Capacity Building Of Government Personnel And Adequate Capacity At The National Level 396 (100.0), The Institutionalization Of Capacity Development At All Levels Through National Product Supply Chain Management Programme, Procurement And Supply Management Technical Working Groups, And Logistics Management Coordinating Unit 292 (73.7) And Demonstrable Capacity In Key Supply Chain Functions 259 (65.4). The Study Revealed Substantial Progress In Capacity Building Of The HIV/AIDS Supply Chain Workforce, Evident With The Institutionalization Of Capacity Building And Demonstrable Capacity In The Key Supply Chain Functions. More So, Master Trainers From The Government Are Not Always Part Of The Facilitators And Involved In Capacity Building, Needs Assessment Does Not Always Precede Capacity Building, The Inadequate Pool Of Master Trainers, Fellowship Training Program Is Not Recognized, And Pre-Service Training Has Not Been Institutionalized. Chi-Square Statistics Revealed That The Extent Of Progress In Capacity Building Is A Significant Factor Of HIV/AIDS Supply Chain Workforce Capacity (P&lt;0.05). There Is A Need To Develop Manuals, Policies, And Procedures To Ensure Sustained Progress In Capacity Building, Needs Assessment Precedes Capacity Building, More Training Conducted To Ensure An Adequate Pool Of Master Trainers In The Public Sector And Their Participation In Future Capacity Building Interventions.

“A Very Noble Crop”: Financial Stability, Agronomic Expertise, and Personal Values Support Conservation in Shade-Grown Coffee Farms

Shade-grown coffee is an important reservoir for tropical biodiversity, but habitat quality hinges on decisions made by farmers. Our research aims to investigate the link between coffee producers’ decisions and outcomes for biodiversity, using epiphytes as our focal group. Using qualitative methods, we interviewed 33 producers in northern Nicaragua to understand how they connect trees and epiphytes on their farms to ecosystem services and how personal values, access to agronomic expertise, labor supply, and financial stability influence decision-making. We used interview responses to construct six producer typologies. Most producers had strong positive attitudes toward trees and associated them with a variety of important ecosystem services. Smallholders were more likely to connect trees with provisioning services, while producers on larger farms and with greater agronomic knowledge emphasized regulating services. Most producers connected epiphytes primarily with aesthetic values. Across demographics, producers emphasized the restorative potential for shade coffee in repairing damage to soil, water, and nutrient cycles caused by other forms of agriculture. The conservation significance and sustainability of this social-ecological system can be maintained and expanded through economic and capacity-building conservation interventions, especially when those can be connected to values already held by farmers.

Building Substance Use Disorder Management Capacity During COVID-19: Outcomes From a Tele-mentoring Program for Community-based Healthcare Professionals

ABSTRACT Objectives: The limited access to addiction services pre-COVID-19 and the increase in substance use disorder support required during COVID has led to a heightened need for virtual addictions care capacity building interventions. We describe the evaluation of Project Extension for Community Healthcare Outcomes™-Ontario Addiction Medicine and Psychosocial Interventions (ECHO-AMPI), a Canadian virtual tele-mentoring program focused on building capacity in community-based addiction care during COVID-19. Methods: We used Moore's multi-level evaluation framework for continuing education. Participants rated their satisfaction on a five-point Likert scale. A pre–post 10-item scale was used to measure self-efficacy. Participants used a binary scale to self-report post-participation whether ECHO changed their practice. Participants also responded to an open-text question around how participation in ECHO has impacted challenges experienced during the pandemic. Results: Seventy-nine healthcare professionals from 62 organizations across Ontario participated in ECHO-AMPI. Mean satisfaction ratings were high (&gt;4.27/5), and a 12% improvement in participants’ addictions care mean self-efficacy scores was observed (P &lt; 0.001). Post-ECHO participation, 77% of participants reported practice change. Analysis of open-text responses highlighted participants felt ECHO fostered an open and supportive community, improved knowledge and skills via the acquisition of new resources, enhanced participants’ interaction with their clients, and reduced professional isolation. Conclusions: ECHO-AMPI demonstrated the ability to engage providers and build addictions care capacity during COVID-19, specifically by improving learning outcomes and supporting practice change. Our data also suggests that this virtual tele-mentoring model can provide a supportive community of practice for addictions care providers during COVID-19. Objectifs: L’accès limité aux services de l’addiction avant le COVID-19 et la croissance de la demande de soutien aux troubles liés à la consommation de substances requis pendant le COVID a conduit à un besoin accru d’interventions de renforcement des capacités en matière de soins de l’addiction virtuels. Nous décrivons l’évaluation du projet ECHO-Ontario Addiction Medicine and Psychosocial Intervention (ECHO-AMPI), un programme canadien de télé-mentorat virtuel axé sur le renforcement des capacités dans les soins de l’addiction en milieu communautaire spécifiquement pendant le COVID-19. Méthodes: Nous avons utilisé le cadre Moore d’évaluation à plusieurs niveaux pour une formation continue. Les participants ont évalué leur satisfaction sur une échelle de Likert en cinq points. Une échelle avant/après à 10 items a été utilisée pour mesurer l’auto-efficacité. Les participants ont utilisé une échelle binaire pour auto-déclarer après leur participation si ECHO avait changé leur pratique. Les participants ont également répondu à une question ouverte sur l’impact de la participation à ECHO sur les défis rencontrés pendant la pandémie. Résultats: 79 professionnels de la santé de 62 organisations de tout l’Ontario ont participé à ECHO-AMPI. Les cotes de satisfaction moyennes étaient élevées (&gt;4.27/5) et une amélioration de 12% des scores d’auto-efficacité des participants aux soins d’addiction a été observée (P &lt; 0.001). Après la participation à ECHO, 77% des participants ont signalé un changement de pratique. L’analyse des réponses en texte ouvert a mis en évidence le sentiment des participants qu’ECHO a favorisé une communauté ouverte et solidaire; amélioration des connaissances et des compétences grâce à l’acquisition de nouvelles ressources, amélioration de l’interaction des participants avec leurs clients et réduction de l’isolement professionnel. Conclusions: ECHO-AMPI a démontré sa capacité à impliquer les prestataires et à renforcer les capacités de prise en charge des dépendances pendant le COVID-19, en particulier en améliorant les résultats d’apprentissage et en soutenant le changement de pratique. Nos données suggèrent également que ce modèle de télé-mentorat virtuel peut fournir une communauté de pratique de soutien pour les fournisseurs de soins de l’addiction pendant le COVID-19.

Developing and Evaluating a Capacity-Building Intervention for Healthcare Providers to Improve Communication Skills and Awareness of Hard of Hearing and D/deaf Populations: Protocol for a Participative Action Research-Based Study.

Background: D/deaf and hard of hearing populations are at higher risk for experiencing physical and mental health problems compared to hearing populations. In addition, they commonly encounter barriers to accessing and benefiting from health services, which largely stem from challenges they face in communicating with healthcare providers. Healthcare providers commonly lack tailored communication skills in caring for D/deaf and hard of hearing populations, which lead to difficulties and dissatisfaction for both staff and D/deaf and hard of hearing communities. This research project aims to develop and evaluate a capacity-building intervention for healthcare providers with the goal of increasing their awareness of D/deaf and hard of hearing individuals' experiences with the healthcare system, their distinct needs, and improving their capacity to communicate effectively with this patient population.Methods: This research project features a participative action research design using qualitative and quantitative methods. Consistent with participative action research, the study will actively involve the target populations, key stakeholders and representative associations. The intervention will be developed and tested through iterative phases. The Integrated Model of Training Evaluation and Effectiveness will guide prospective evaluation of the intervention. The latter will involve qualitative and quantitative assessments in participants before and after the intervention and at 6-months follow-up.Discussion: Results will contribute to research aimed at decreasing barriers to accessing and benefiting from healthcare services for D/deaf and hard of hearing individuals. Findings will be presented to representative associations and political authorities, as well as disseminated at research conferences and in peer-reviewed journals.

Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care \u2013 experiences from Ukraine

BackgroundNon-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care.MethodsA mixed-methods evaluation study was performed in 2018 to analyse the effect of a capacity building intervention carried out for over 10,000 primary care professionals in Ukraine in 2018. Quantitative data were collected from primary health care records of intervention and control areas preceding the intervention and 1.5 to 2 years after the intervention. Altogether 2798 patient records before and 2795 after the intervention were reviewed. In control areas, 1202 patient records were reviewed. Qualitative data were collected carrying out focus group interviews for health professionals, clinic managers and patients. Also, observations of clinical practice and patient pathways were performed.ResultsThe capacity building intervention improved the capacity of professionals in detection and management of non-communicable disease risk factors. Significant improvement was seen in detection rates of both behavioural and biological risk factors and in medication prescription rates in the intervention areas. However, almost similar improvement in prescription rates was also observed in control clinics. Improvements in control of blood pressure, blood glucose and cholesterol were not seen during the evaluated implementation period. Qualitative analyses highlighted the improved knowledge and skills but challenges in changing the current practice.ConclusionsA large scale capacity building intervention improved primary health care professionals’ knowledge, skills and clinical practice on NCD risk detection and reduction. We were not able to detect improvements in treatment outcomes - at least within 1.5 to 2 years follow-up. Improvement of treatment outcomes would most likely need more comprehensive systems change.

A non-formal education approach of medicinal plant sellers

This article reports on the results of a non-formal education intervention program that involved medicinal plant sellers in northern KwaZulu-Natal, South Africa. The study was done in two phases. It identified and explored the prevalent challenges of the medicinal plant-selling businesses. A selected number of medicinal plant sellers were exposed to a capacity-building instructional intervention strategy aimed at addressing the skills and knowledge gaps identified. The principles of education for sustainable development (ESD) were followed as part of the study's theoretical foundation. Data were collected through semi-structured and focus group interviews. The results reveal that the medicinal plant sellers face a number of challenges such as lack of business acumen, and knowledge about processing methods techniques and packaging. They have, for example, poor marketing and pricing skills, low banking esteem and poor record keeping, particularly of stock. This indicates their slow implementation and application of the information and skills as discussed in previous workshops. Positively, there is evidence that some of the medicinal plant sellers had begun revisiting their business practices based on previous discussions. Overall, the processing of medicinal plant materials and packaging needs urgent attention.

Knowledge of malaria control and attitudes towards community involvement among female community volunteers: effect of capacity building in a rural community, southeast Nigeria

Introductioncommunity volunteers have limited skills but are an important link between the community and health facilities. We determined the effect of a capacity building intervention on knowledge of malaria control and attitudes towards community involvement among female community volunteers as part of a larger community-based intervention study on pregnant women and children under five.Methodswe conducted a before and after intervention study (no randomization or controls) among female community volunteers in Amagu community in Abakaliki Local Government Area. The intervention consisted of training sessions on knowledge of malaria and its control. The training took the form of lectures, role plays and practical demonstrations. Supportive supervision by trained community health extension workers was also provided during their field work. We compared pre-training test and post-training test scores after six months interval and analysed the data using paired t test at 5% level of significance with EPI INFO software version 7.2.3.Resultsthe mean age of the participants was 28.5(± 6.0) years. All had a minimum level of secondary education. There was significant improvement in the mean scores of their knowledge of malaria signs and symptoms (p < 0.001), preventive measures (p < 0.001) and appropriate drug treatment (p < 0.001) in the post-training test when compared with the pre-training test. The overall mean knowledge scores pre and posttest were 147.8 and 169.8 respectively (p < 0.001) out of a maximum achievable score of 195. Also there was significant improvement in the perception of the participants on community involvement in promoting referral of pregnant women with fever (p = 0.001), the use of intermittent preventive therapy with sulphadoxine-pyrimethamine (p = 0.048) and funding initiatives to sustain activities (p = 0.037).Conclusioncapacity building of female community volunteers coupled with supportive supervision by trained community health workers improved the female community volunteers´ knowledge of malaria, its control and their perception of community involvement in control activities. It is recommended that the use of community volunteers as a low cost health resource can be explored further for incorporation into existing policies on malaria control in resource constrained environments.

An Evidence-Based Walking Program in Oregon Communities: Step It Up! Survivors.

Physical activity can help mitigate the long-term symptoms and side effects of cancer and its treatment, but most cancer survivors are not active enough to achieve these benefits. An evidence-based strategy to promote physical activity among adults is a community group–based walking program. However, many evidence-based programs do not achieve intended population health outcomes because of the challenges of real-world implementation. We used the Interactive Systems Framework for Dissemination and Implementation to conceptualize implementation of a capacity-building intervention to support delivery of a community group–based walking program. We adapted an evidence-based guide for community group–based walking programs for cancer survivors and their support network. We provided a capacity-building intervention (technical assistance and small-grant funding) and evaluated this implementation intervention. We assessed effectiveness of the intervention by measuring adoption, acceptability, appropriateness, feasibility, fidelity, implementation costs, and penetration through monthly progress reports, site visit observations, interviews, and a final report. Eight organizations received a small grant and technical assistance and implemented Step It Up! Survivors (SIUS). SIUS helped cancer survivors increase their physical activity, establish social connections, and be part of a supportive environment. Despite receiving monthly technical assistance, some grantees experienced challenges in recruiting participants, developing community partnerships, and adhering to the prescribed implementation plan. Implementation facilitators included community partners and specific components (eg, incentives for participants, webinars). Organizations needed different amounts and types of assistance with adaptation and implementation. Overall fidelity to SIUS ranged from 64% to 88%. Some integrated SIUS within existing organizational programming for sustainability. The provision of funding and technical assistance was a successful implementation intervention. Our results suggest a need to better tailor technical assistance while organizations are in the process of adapting, implementing, and sustaining an evidence-based program in their local communities.