Health Worker Training Program Research Articles

The Chilcapamba-McGill Partnership: Exploring Access to Maternal and Newborn Care in Indigenous Communities of Ecuador.

Based on a participatory research (PR) partnership between Family Medicine at McGill University, Canada and the Andean community of Chilcapamba, Ecuador, a medical student study focused on maternal and newborn health. To evaluate the access to maternal and newborn care and the occurrence of intrafamilial violence in women with children 5 years of age or less in three indigenous communities of Ecuador. A semistructured survey explored the perinatal and intrapartum care as well as intrafamilial violence. All women (N = 30) received prenatal care, 29 received postnatal care from a physician and 77% gave birth at the hospital. Eighty percent of women experienced intrafamilial violence; 73% reported psychological and 53% physical violence. There is good access to maternal and newborn health care, although the reported level of violence is high. Results were shared with the community and will be used in a local community health worker (CHW) training program. Our project highlights the importance of PR to investigate sensitive health challenges.

Evaluation of a community health worker training program in rural Appalachia, USA

Background: Limited support for healthcare services is one reason rural Appalachia is among the unhealthiest regions in the United States.Objective: Evaluate Level 1 of a multi-level community health worker (CHW) training program designed to train CHWs easily so they can affect community health.Methods: 198 CHWs evaluated their training curriculum. CHW activities were tracked for 19 months. Group data were analyzed with t-tests and ANOVA using mean ± SEM comparisons. Correlation coefficients and rank sum difference analyses were used to evaluate ranked variables. Statistical significance was set at p<0.05.Results: Excellent or good rankings were given by 100% of CHWs for their instructor’s knowledge, 100% being treated fairly, 99% overall class rating, 97% fairness of exam, 96% course objectives met, and 92% course manual. CHW test performance did not affect any variable. CHWs were only asked one question every two months they could not answer. CHWs talked to four new people each month, two people a month for multiple visits, and three people a month for follow-up visits.Conclusions: No need to change the CHW curriculum, training materials, or testing procedures. A 15-hour CHW training program is adequate enough to provide valid healthcare service support in rural Appalachia, USA.

Evaluation of a community health worker training program on hypertension and diabetes in Limpopo Province South Africa: Retention of knowledge and application within the community one year later

Evaluation of a community health worker training program on hypertension and diabetes in Limpopo Province South Africa: Retention of knowledge and application within the community one year later

English

ABTRACT Many persons suffering psychotic illnesses, such as schizophrenia, are largely untreated in low income countries. In these settings, most persons with severe mental illness live with their families. Thus, families play a particular critical role in determining whether a person with a psychotic illness will receive treatment and what the quality of treatment. Psychoeducation has proven to be extremely effective in helping families develop the knowledge and skills which is necessary to help their family members. Indonesia has a national policy to integrate the management of mental health problems into the primary health care system. However, in practice, such care does not implemented effectively. A preliminary study in primary health centers in two districts of Bantul and Gunung Kidul regency, Yogyakarta province, showed that there was very little or there is not any training for health care workers on diagnosis and treatment of psychotic disorder. This study was conducted to evaluate the effectiveness of the training program for health workers in three primary health centers in Yogyakarta, Indonesia, to provide psychoeducation to family caregivers for persons with psychotic disorder. A quasi-experimental study with the approach of one group pre and posttest design was performed in this study. Fortythree health workers in 3 primary health centers in Bantul and Gunung Kidul, Yogyakarta were trained every week for a month to provide psychoeducation to family caregivers who live with psychotic disorder patient. Result showed that the baseline score of knowledge of schizophrenia among health workers in 3 primary health centers in Bantul and Gunung Kidul before training were not significantly different (p=0.162). After the psychoeducation training program there were significantly different (p=0.003) of the score of knowledge of schizophrenia among health workers in 3 primary health care centers compared with before training. For conclusion, the training program to provide psychoeducation to family care providers of persons with psychotic disorder for primary health workers was effective to increase their knowledge of schizophrenia.

Assessment of a community health worker training program in the Peruvian Amazon demonstrates effective learning retention: Implications for health care education in a resource-limited setting

Welcome to Annals of Global Health,Annals of Global Health is a peer-reviewed, fully open access, online journal dedicated to publishing high quality articles dedicated to all aspects of global health. The journal's mission is to advance global health, promote research, and foster the prevention and treatment of disease worldwide. Its goals are to improve the health and well-being of all people, advance health equity, and promote wise stewardship of the earth's environment.Annals of Global Health is supported by the Program for Global Public Health and the Common Good at Boston College. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health.Authors of articles accepted for publication in Annals of Global Health will be asked to pay an Article Publication Charge (APC) to cover publication costs. This charge can normally be sourced from your funder or institution. We are committed to supporting authors from all countries to publish their work in Annals of Global Health regardless of national income level, and to achieve this goal, we waive the Article Publication Charge for manuscripts where all authors are from low-income or lower-middle-income countries (as defined by the World Bank). From time to time, Annals of Global Health publishes Special Collections, a series of articles organized around a common theme in global health. Recent Special Collections have included "Human Health and Ocean Pollution", "Building Health Research Capacity in Rwanda; A Multi-Year Journey", and "2020 Year of the Nurse". Global health workers interested in developing a Special Collection are strongly encouraged to contact the Managing Editor in advance to discuss the project.

Awards unbundled: Evidence from a natural field experiment

Organizations often use non-monetary awards to incentivize performance. Awards may affect behavior through several mechanisms: by conferring employer recognition, by enhancing social visibility, and by facilitating social comparison. In a nationwide health worker training program in Zambia, we design a field experiment to unbundle these mechanisms. We find that employer recognition and social visibility increase performance while social comparison reduces it, especially for low-ability trainees. These effects appear when treatments are announced and persist through training. The findings are consistent with a model of optimal expectations in which low-ability individuals exert low effort in order to avoid information about their relative ability.

The effectiveness of an abbreviated training program for health workers in breast cancer awareness: innovative strategies for resource constrained environments

BackgroundBreast cancer is characterized by late presentation and significant morbidity and mortality in developing countries. Breast screening aids in early detection of breast cancer. Nurses are uniquely placed to provide advocacy and screening in a resource limited environment.ObjectivesTo assess the effectiveness of an abbreviated training program in breast cancer awareness on nurses at a tertiary hospital, in a resource constrained environment.MethodsUsing a statistical tool, the Solomon Model, 79 nurses were identified and divided into experimental and control groups. An abbreviated training intervention in breast cancer awareness was administered to the experimental group. Pre and post test questionnaires and objective structured clinical examinations were used to determine nurses’ knowledge and practice skills before and after the abbreviated training intervention.ResultsInitial scores of knowledge and practice skills related to clinical breast examination were low: Mean knowledge scores of 18 out of 25 [72%] and mean practice scores of 12.5 out of 30 [41.6%]. Significant improvement was observed following the abbreviated training intervention in both knowledge and practice skills. Knowledge scores of 22 out of 25 [88%, p = < 0.001] and practice scores of 26 out of 30 [86.6%, p=0.003]. Trained nurses were able to improve their knowledge of breast cancer from fair to good knowledge.ConclusionThere is need to increase breast awareness, both in terms of knowledge and practice skills, in nurses as a means of improving awareness among the general population and early detection of breast cancer. An abbreviated training in breast cancer awareness can improve these skills in nurses.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-2-528) contains supplementary material, which is available to authorized users.

Concepts of health, disease, and treatment in a rural village of Senegal

In order to carry out an efficacious training programme for community health workers (CHWs) in a rural village of Senegal, we considered it useful to conduct a study on the conceptions of health, sickness and treatment of the village community. The study was conducted by four nurses and a physician, with the collaboration of an anthropologist, using the research method of ethno-nursing, with the aid of semi-structured interviews. People in the study areas have integrated conceptions deriving from biomedicine into their local knowledge and practice. Two interpretations are attributed to the concept of health: “individualistic” and those that perceive health as an effect of harmony at a social level; some describe the human body using elements of anatomy and physiology, while others understand it as a means of relating between environment and society; sickness is placed in relation to biological agents, but also to the world of the supernatural. The treatment of sickness is entrusted in part to modern medicine and in part to traditional healers. The training programme for the CHWs should take into account the conceptions of health, sickness and treatment of the village population. The traditional healers could be involved in a more active collaboration.

Developing community health worker diabetes training

We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included pre/post-knowledge outcomes and encounter data from the field. CHWs and their supervisors were interviewed providing qualitative outcome data of the training process and program implementation. There were statistically significant increases in the scores of CHWs' self-reported knowledge in 8 of 15 curricular domains. Qualitative analysis revealed that CHWs preferred skill-based and case-based teaching, shorter training days but more contact hours. CHWs reported that pre-deployment training alone is insufficient for successful integration into care teams. CHW supervisors reported that CHC's readiness to accept CHWs as members of the care team was as important to successful deployment as training. With respect to implementation, supervision by social workers was deemed more successful than nursing supervision. Field data showed that patient encounters lasted less than 30 min and self-management goals focused on appointment keeping, diet, exercise and glucose testing. Integration and analysis of qualitative and descriptive field data provide an opportunity to continuously evaluate the effectiveness of implementation.

Indigenous cultural training for health workers in Australia

Culturally inappropriate health services contribute to persistent health inequalities. This article reviews approaches to indigenous cultural training for health workers and assesses how effectively they have been translated into training programmes within Australia. CINAHL PLUS, MEDLINE, Wiley InterScience, ATSIHealth and ProQuest. The review focuses on the conceptual and empirical literature on indigenous cultural training for health workers within selected settler-colonial countries, together with published evaluations of such training programmes in Australia. Data extraction Information on conceptual models underpinning training was extracted descriptively. Details of authors, year, area of investigation, participant group, evaluation method and relevant findings were extracted from published evaluations. Six models relevant to cultural training were located and organized into a conceptual schema ('cultural competence, transcultural care, cultural safety, cultural awareness, cultural security and cultural respect'). Indigenous cultural training in Australia is most commonly based on a 'cultural awareness' model. Nine published evaluations of Australian indigenous cultural training programmes for health workers were located. Of the three studies that assessed change at multiple points in time, two found positive changes. However, the only study to include a control group found no effect. This review shows that the evidence for the effectiveness of indigenous cultural training programmes in Australia is poor. Critiques of cultural training from indigenous and non-indigenous scholars suggest that a 'cultural safety' model may offer the most potential to improve the effectiveness of health services for indigenous Australians.

A mental health training program for community health workers in India: impact on knowledge and attitudes

BackgroundUnmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities. This study aims to provide a mental health training intervention to community health workers in Bangalore Rural District, Karnataka, India, and to evaluate the impact of this training on mental health literacy.MethodsA pre-test post-test study design was undertaken with assessment of mental health literacy at three time points; baseline, completion of the training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a four day course based on a facilitator's manual developed specifically for community health workers in India.Results70 community health workers from Doddaballapur, Bangalore Rural District were recuited for the study. The training course improved participants' ability to recognize a mental disorder in a vignette, and reduced participants' faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants' faith in recovery following treatment.ConclusionThe findings from this study indicate that the training course demonstrated potential to be an effective way to improve some aspects of mental health literacy, and highlights strategies for strengthening the training course.

Working with people who have been there: the meaningful involvement of mental health service users in curriculum design and delivery

The notion of mental health service user involvement in curriculum design and delivery has become commonplace over recent years. However, concern has been expressed that the rhetoric has not matched the reality. In particular, service user involvement has tended towards either tokenism or over‐sensitivity to the point of near inertia. By contrast, this paper describes a project that took a pragmatic approach and was designed to make involvement in curriculum planning, design and delivery meaningful and worthwhile for service users, students and educators alike. The paper has two principal objectives. In the first instance, it outlines the strategy for involvement that was used to inform curriculum design and delivery at the University of Abertay Dundee. This was grounded in the academic literature. Second, it provides an evaluation of this strategy based on practical experience and identifies some of the difficulties that must be overcome to work in a collaborative manner. In so doing, it examines some of the common concerns of educational staff, service users and students in relation to service user involvement. In conclusion, we provide recommendations for educators seeking to involve mental health service users in a meaningful manner in both the design of training programmes for mental health workers, and in their delivery.

Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India

People with mental disorders experience discrimination as a consequence of stigmatising attitudes that are largely socio-culturally constructed. Thus, there is a need to understand local contexts in order to develop effective programs to change such attitudes. We undertook a mental health literacy survey in rural Maharashtra, India, prior to developing a mental health training program for village health workers (VHWs) in a primary health care setting. A cross-sectional mental health literacy survey was undertaken in late 2007, which involved interviewer-administration of a questionnaire to 240 systematically sampled community members, and 60 purposively sampled VHWs. Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis), and were asked about attitudes towards, and desired social distance from, the people in the vignettes (the latter being a proxy measure for stigma). Linear regression modelling was undertaken to identify predictors of social distance. Although the community was relatively accepting of people with mental disorders, false beliefs and negative attitudes were still evident. Desired social distance was consistently greater for the person depicted in the psychosis vignette compared to the depression vignette. For both vignettes, the main predictor of greater social distance was perceiving the person as dangerous, and the predictors of reduced social distance were being a VHW, and seeing the problem as a sign of personal weakness. For depression, believing the cause to be family tensions also reduced social distance. For psychosis, labelling the disorder as a mind/brain problem, and believing the cause to be lack of control over life or genetic factors increased social distance. The vast majority did not agree that the problems experienced in the vignettes were 'a real medical illness'. Promoting bio-medical explanations for mental disorders in this setting may exacerbate discriminatory attitudes. Provision of contextually relevant mental health training for the VHWs so that they are able to communicate, model and shape more positive attitudes is the next step.

Assessment of Village Health Worker Training Program in Tuguegarao, Philippine

This study was performed to evaluate the effectiveness of 'village health worker training program' which aimed to build community participatory health promotion capacity of community leaders in villages of low developed country and to develop methods for further development of the program. The intervention group were 134 community leaders from 25 barangays (village). Control group were 149 form 4 barangays. Intervention group participated 3-day training program. Questionnaire was developed based on 'Health Promotion Capacity Checklist' which assessed capacity in 4 feathers; 'knowledge', 'skill', 'commitment', and 'resource'. Each feather was assessed in 4 point rating scale. Capacity scores between intervention group and control group were examined to identify changes between the pre- and post-intervention periods. A qualitative evaluation of the program was conducted to assess the appropriateness of the program. The program was conducted in Tuguegarao city, Philippine in January, 2009. The result showed significant increases in the total health promotion capacity and each feather of health promotion capacities between pre and post assessment of intervention group. But there was no significant change in that of control group. Participants marked high level of satisfaction for preparedness, selection of main subjects and education method. Qualitative evaluation revealed that training program facilitated community participatory health promotion capacity of participants. This study suggested that the Village health worker training program is effective for building health promotion capacity of community leaders and it can be a main method for helping low developed countries with further development.

Linking Learning to Community for Indigenous Computing Courses

Abstract Since its inception, Problem-based learning (PBL) as a process for learning and teaching has been used to enhance many skills based courses, including education programs at Bachelor College and the Aboriginal Technical Health Worker training program at the Centre for Appropriate Technology in Alice Springs. While PBL is an approach to learning and teaching which has been designed to provide a more holistic educational process for all students, Foster and Meehane (2007) suggest that many aspects of the courses are ideally suited for Indigenous students. In particular, this approach is useful when introducing students to a subject matter which is new both in being derived from another culture and not being accessible to Indigenous parents in the past. PBL provides a flexible approach to enable motivation and involvement of the students and their community. This paper considers the benefits of PBL for learning Information Technology and presents some course templates developed to support teaching Indigenous students at school.

Effectiveness of a Collaborative Recovery Training Program in Australia in Promoting Positive Views About Recovery

This study examined the impact of a two-day, recovery-based training program for mental health workers on knowledge, attitudes, and hopefulness related to the recovery prospects of people with enduring mental illness.A self-report pre-post training repeated-measures design was used with 248 mental health workers from the community-based government health sector (N=147) and nongovernment organizations (N= 101) in eastern Australia.Staff attitudes and hopefulness improved after training. Trainees significantly increased their knowledge regarding principles of recovery and belief in the effectiveness of collaboration and consumer autonomy support, motivation enhancement, needs assessment, goal striving, and homework use.This preliminary evidence indicates that staff recovery orientation can improve with minimal training.

Effectiveness of a Collaborative Recovery Training Program in Australia in Promoting Positive Views About Recovery

This study examined the impact of a two-day, recovery-based training program for mental health workers on knowledge, attitudes, and hopefulness related to the recovery prospects of people with enduring mental illness. A self-report pre-post training repeated-measures design was used with 248 mental health workers from the community-based government health sector (N=147) and nongovernment organizations (N= 101) in eastern Australia. Staff attitudes and hopefulness improved after training. Trainees significantly increased their knowledge regarding principles of recovery and belief in the effectiveness of collaboration and consumer autonomy support, motivation enhancement, needs assessment, goal striving, and homework use. This preliminary evidence indicates that staff recovery orientation can improve with minimal training.

Aboriginal health in Aboriginal hands: development, delivery and evaluation of a training programme for Aboriginal health workers to promote the musculoskeletal health of Indigenous people living in a rural community

Indigenous Australians living in rural communities suffer from multiple musculoskeletal problems that significantly impair their activities of daily living. They commonly report physical disability and 'having learned to live with their pain'. A pilot, accredited musculoskeletal training program in the form of a sports massage course was designed and implemented in an attempt to address modifiable, commonly-presenting musculoskeletal conditions in this community. Sports massage was taught to 20 participant Aboriginal Health workers (AHWs) and community Elders at Durri Aboriginal Corporation, New South Wales, Australia. Sports massage was chosen as the vehicle for skills development because sport was widely valued in the community. The participants were taught a variety of theoretical and massage skills in the 2 week course using the informal 'round table' techniques developed by Booroongen Djugun College, NSW, Australia. The course was evaluated positively by participants. Because the course was developed according to community guidelines it had high cultural acceptability. Sports massage skills have been adapted for treatment of patients with chronic illness and stress within the community. Development of the course according to community needs was essential for acceptance, as was the active involvement of AHWs in all phases. For sustainability, such courses require appropriate funding.

Improving the knowledge and skills of psychiatric nurses: efficacy of a staff training programme.

Working with people with mental illness is very challenging and mental health workers can have a significant impact on the mental status of their patients. Few studies have been published that describe training programmes for this staff group. This paper aims to describe and evaluate a training programme for generic mental health workers used in the context of a residential unit for 'difficult to place' mentally ill patients. The staff training programme was adapted from a previous programme showing good efficacy. It was conducted over 10 sessions and addressed a wide range of issues relating to the management of mentally ill patients, with the use of a variety of teaching methods. Twenty-nine generic mental health workers participated in the programme. The impact of the programme was examined using a knowledge questionnaire and a semi-structured questionnaire exploring the range and use of management strategies by staff members. Comparison of pre- and post-training measures indicated that the training programme increased staff knowledge of schizophrenia and the use of certain management skills, in particular, systematic strategies to effect change. This included increased use of structured programmes with patients. The training programme was effective in increasing knowledge and skills of staff and could be used with a variety of psychiatric staff. There are numerous limitations to this study, in particular the poor attendance rates which are likely to have decreased the impact of the programme.

Emergency preparedness training for public health nurses: a pilot study.

The Columbia Center for Public Health Preparedness, in partnership with the New York City Department of Health, recently developed an emergency preparedness training program for public health workers. A pilot training program was conducted for a group of school health nurses and evaluated using a pre/posttest design. A surprising finding was that 90% of the nurses reported at least one barrier to their ability to report to duty in the event of a public health emergency. The most frequently cited barriers included child/elder care responsibilities, lack of transportation, and personal health issues. These findings suggest that it may be prudent to identify and address potential barriers to public health workforce responsiveness to ensure the availability of the workforce during emergencies.