RESUMO
Objective: The COVID-19 pandemic challenged the Global Outbreak Alert and Response Network's (GOARN) mechanism used to rapidly deploy technical support for international responses and highlighted areas that require strengthened capacity within the Network. GOARN's partners in the World Health Organization's (WHO) South-East Asia and Western Pacific regions were engaged to explore their levels of preparedness, readiness and ability to respond to international public health emergencies. Methods: Consultative discussions were held and a survey was conducted with GOARN's partners from the two WHO regions. Discussion topics included partners' capacity to support and participate in a GOARN deployment, training, research and collaboration. Descriptive and content analyses were conducted. Results: Barriers to engaging in GOARN's international outbreak response efforts included limited numbers of personnel trained to respond to outbreaks; institutional, financial and administrative hurdles; and limited collaboration opportunities. Partners identified innovative solutions that could strengthen their engagement with deployment, such as financial subsidies, mentorship for less experienced staff, and the ability to provide remote support. Discussion: GOARN plays an important role in enabling WHO to fulfil its international alert and response duties during disease outbreaks and humanitarian crises that have the potential to spark disease outbreaks. Yet without systematic improvement to strengthen national outbreak capacity and regional connectedness, support for international outbreak responses may remain limited. Thus, it is necessary to integrate novel approaches to support international deployments, as identified in this study.
Assuntos
COVID-19 , Surtos de Doenças , Organização Mundial da Saúde , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Surtos de Doenças/prevenção & controle , Organização Mundial da Saúde/organização & administração , Sudeste Asiático/epidemiologia , SARS-CoV-2 , Cooperação Internacional , Saúde Global , Fortalecimento Institucional/organização & administração , Pandemias/prevenção & controle , Ilhas do Pacífico/epidemiologiaRESUMO
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic caused significant global disruptions to the healthcare system, which was forced to make rapid changes in healthcare delivery. The pandemic necessitated closer collaboration between the US civilian healthcare sector and the military health system (MHS), resulting in new and strengthened partnerships that can ultimately benefit public health and healthcare for the nation. In this study, we sought to understand the full range of partnerships in which the MHS engaged with the civilian sector during the COVID-19 pandemic and to elicit lessons for the future. METHODS: We conducted key informant interviews with MHS policymakers and advisers, program managers and providers who were affiliated with the MHS from March 2020 through December 2022. Key themes were derived using thematic analysis and open coding methods. RESULTS: We conducted 28 interviews between December 2022 and March 2023. During the pandemic, the MHS collaborated with federal and local healthcare authorities and private sector entities through endeavours such as Operation Warp Speed. Lessons and recommendations for future pandemics were also identified, including investment in biosurveillance systems and integration of behavioural and social sciences. CONCLUSIONS: The MHS rapidly established and fostered key partnerships with the public and private sectors during the COVID-19 pandemic. The pandemic experience showed that while the MHS is a useful resource for the nation, it also benefits from partnering with a variety of organizations, agencies and private companies. Continuing to develop these partnerships will be crucial for coordinated, effective responses to future pandemics.
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COVID-19 , Atenção à Saúde , Pandemias , Saúde Pública , Parcerias Público-Privadas , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Atenção à Saúde/organização & administração , Estados Unidos , Serviços de Saúde Militar , Fortalecimento Institucional/organização & administração , Comportamento CooperativoRESUMO
In their article on "Navigating the Field of Implementation Science Towards Maturity: Challenges and Opportunities," Chambers and Emmons describe the rapid growth of implementation science along with remaining challenges. A significant gap remains in training and capacity building. Formats for capacity building include university degree programs, summer training institutes, workshops, and conferences. In this letter, we describe and amplify on five key areas, including the need to (1) identify advanced competencies, (2) increase the volume and reach of trainings, (3) sustain trainings, (4) build equity focused trainings, and (5) develop global capacity. We hope that the areas we highlight will aid in addressing several key challenges to prioritize in future efforts to build greater capacity in implementation science.
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Fortalecimento Institucional , Ciência da Implementação , Fortalecimento Institucional/organização & administração , HumanosRESUMO
Drawing from collective experiences in our capacity building project: Health Equity Activation Research Team for Inclusion Health, we argue that while community-engaged partnerships tend to focus on understanding health inequities and developing solutions, they can be healing spaces for health professionals and researchers. Data were obtained from a 15-month participatory ethnography, including focus groups and interviews. Ethnographic notes and transcripts were coded and analyzed using both deductive and inductive coding. Practices of radical welcome, vulnerability, valuing the whole person, acknowledging how partnerships can cause harm, and centering lived experience expertise in knowledge creation processes were identified as key characteristics of healing spaces. Ultimately, health professionals and researchers work within the same social, political and economic contexts of populations with the worst health outcomes. Their own healing is critical for tackling larger systemic changes aimed at improving the well-being of communities harmed by legacies of exclusion.
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Pesquisa Participativa Baseada na Comunidade , Humanos , Pesquisa Participativa Baseada na Comunidade/organização & administração , Pesquisadores/organização & administração , Pesquisadores/psicologia , Grupos Focais , Pessoal de Saúde/psicologia , Pessoal de Saúde/organização & administração , Antropologia Cultural , Fortalecimento Institucional/organização & administração , Equidade em Saúde/organização & administraçãoRESUMO
As the world is facing challenges such as pandemics, climate change, conflicts, and changing political landscapes, the need to secure access to safe and high-quality abortion care is more urgent than ever. On 27th of June 2023, the Swedish government decided to cut funding resources available for developmental research, which has played a fundamental role in the advancement of sexual and reproductive health and rights (SRHR) globally, including abortion care. Withdrawal of this funding not only threatens the fulfilment of the United Nations sustainable development goals (SDGS) - target 3.7 on ensuring universal access to SRHR and target 5 on gender equality - but also jeopardises two decades of research capacity strengthening. In this article, we describe how the partnerships that we have built over the course of two decades have amounted to numerous publications, doctoral graduates, and important advancements within the field of SRHR in East Africa and beyond.
Main findings: The two-decade long collaboration between Sweden and East Africa, funded by the Swedish government, has resulted in important partnerships, research findings, and advancements within sexual and reproductive health and rights in East Africa.Added knowledge: The Swedish government is now cutting funding for development research, which jeopardises the progress made so far.Global health impact for policy and action: Governments need to prioritise women's sexual and reproductive health and rights.
Assuntos
Fortalecimento Institucional , Saúde Reprodutiva , Saúde Sexual , Humanos , Fortalecimento Institucional/organização & administração , Saúde Reprodutiva/educação , Saúde Sexual/educação , África Oriental , Pesquisa/organização & administração , Feminino , Desenvolvimento Sustentável , Aborto InduzidoRESUMO
Introduction Through a unique, inter-sectoral and interprofessional initiative, practitioners from education, health and social service sectors were invited to participate in communities of practice, facilitated online. The focus was on building workforce capacity to address the mental health needs of children and youth. Aim This paper explores interprofessional workforce development by translating knowledge from a mental health promotion initiative developed overseas into the Aotearoa New Zealand context. Methods Over a 6-month period, practitioners engaged in an iterative, capacity-building process, where they had access to the initiative materials and resources, shared practice stories, networked, and discussed barriers and facilitators for implementation. Qualitative thematic analysis was used to interpret data. Results Members of the communities of practice engaged in storytelling and made sense of the initiative in relation to their previous knowledge and experiences: practice and thinking were validated. Mental health promotion was positioned as the responsibility of all sectors and the need for effective interprofessional collaboration was deemed essential. Furthermore, translation of the initiative into the bicultural context of Aotearoa New Zealand demanded and deserved sustained attention. Discussion This study contributes interprofessional and inter-sectoral evidence for building workforce capacity to address the mental health needs of children and youth. Further research is warranted to investigate the outcomes for the children and youth served. Interprofessional communities of practice were shown to provide a sustainable mechanism by which knowledge can be received, transformed and translated into practice.
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Promoção da Saúde , Saúde Mental , Pesquisa Qualitativa , Humanos , Nova Zelândia , Promoção da Saúde/organização & administração , Relações Interprofissionais , Fortalecimento Institucional/organização & administração , Criança , Adolescente , Pessoal de Saúde/psicologia , Pessoal de Saúde/educação , Serviços de Saúde Mental/organização & administração , Comunidade de PráticaRESUMO
Youth development researchers and practitioners share an interest in ensuring that youth development programs contribute positively to youth outcomes. Engaging in evaluation and data-informed decision making (DIDM) has the potential to empower practitioners to improve and adapt programs, improving youth outcomes. Yet, not all practitioners are comfortable engaging in evaluation and/or DIDM. Engaging in partnerships and utilizing internal supporters of evaluations (or "champions") have been identified as potential strategies to build evaluation capacity and strengthen DIDM within an organization. However, little research explores how to do so. This study engaged evaluation champions in four states to examine their experience as they partnered with practitioners within their organization. Results suggest that peer groups can be utilized to promote evaluation capacity, especially by utilizing peers that already have an interest in evaluation. Practitioner engagement can also be developed by using less academic jargon in communication, highlighting the practical value of evaluation, and building capacity slowly.
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Desenvolvimento do Adolescente , Fortalecimento Institucional , Tomada de Decisões , Avaliação de Programas e Projetos de Saúde , Humanos , Avaliação de Programas e Projetos de Saúde/métodos , Fortalecimento Institucional/organização & administração , Adolescente , Grupo Associado , Comunicação , Masculino , Feminino , Comportamento CooperativoRESUMO
The Icelandic Prevention Model (IPM) follows a systematic but flexible process of community capacity building, data collection, analysis, dissemination, and community-engaged decision-making to guide the data-informed selection, prioritization, and implementation of intervention strategies in preventing adolescent substance use. This paper describes two new evaluation tools intended to assess the: 1) integrity of IPM implementation, and 2) unique aspects of IPM implementation in different community contexts. These evaluation tools include a: 1) five-phase IPM Evaluation Framework for Assessing Value Across Communities, Cultures, and Outcomes (IPM-EF); and 2) 10-Step IPM Implementation Integrity and Consistency Assessment (IPM-IICA) that utilizes both quantitative (scored) and qualitative (narrative) data elements to characterize implementation integrity and consistency at both community coalition and school community levels. The IPM-EF includes five phases. Phase 1: Describe the Intervention Context; Phase 2a: Document the Extent to Which the 10 Steps of the IPM were Implemented (using the IPM-IICA scored); Phase 2b: Document the Unique Community-Specific Methods Used within the 10 Steps of the IPM to Tailor Local Intervention Delivery (using the IPM-IICA narrative); Phase 3: Measure Changes in Community Risk and Protective Factors; Phase 4: Measure the Outcomes Associated with the IPM; and Phase 5: Investigate Multiple Full Cycles Over Time.
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Avaliação de Programas e Projetos de Saúde , Transtornos Relacionados ao Uso de Substâncias , Humanos , Islândia , Avaliação de Programas e Projetos de Saúde/métodos , Adolescente , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Fortalecimento Institucional/organização & administração , Coleta de Dados/métodos , Coleta de Dados/normasRESUMO
Despite the millions of dollars awarded annually by the United States Department of Education to build implementation capacity through technical assistance (TA), data on TA effectiveness are severely lacking. Foundational to the operationalization and consistent research on TA effectiveness is the development and use of standardized TA core competencies, practices, and structures. Despite advances toward a consistent definition of TA, a gap still exists in understanding how these competencies are used within an operationalized set of TA practices to produce targeted outcomes at both individual and organizational levels to facilitate implementation of evidence-based practices. The current article describes key insights derived from the evaluation of an operationalized set of TA practices used by a nationally funded TA center, the State Implementation & Scaling Up of Evidence Based Practices (SISEP) Center. The TA provided by the Center supports the uptake of evidence-based practices in K-12 education for students with disabilities. Lessons learned include: (1) the need to understand the complexities and dependencies of operationalizing TA both longitudinally and at multiple levels of the system (state, regional, local); (2) the relative importance of building general and innovation-specific capacity for implementation success; (3) the value of using a co-design and participatory approach for effective TA delivery; (4) the need to develop TA providers' educational and implementation fluency across areas and levels of the system receiving TA; and (5) the need to ensure coordination and alignment of TA providers from different centers. Gaining an understanding into optimal TA practices will not only provide clarity of definition fundamental to TA research, but it will also inform the conceptual framing and practice of TA.
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Prática Clínica Baseada em Evidências , Humanos , Estados Unidos , Prática Clínica Baseada em Evidências/organização & administração , Assistência Técnica ao Planejamento em Saúde/organização & administração , Fortalecimento Institucional/organização & administração , Pessoas com Deficiência , Avaliação de Programas e Projetos de Saúde/métodosRESUMO
Recent implementation science frameworks highlight the role of training and technical assistance (TTA) in building workforce capacity to implement evidence-based practices (EBPs). However, evaluation of TTA is limited. We describe three case examples that highlight TTA by three regional centers in the national Mental Health Technology Transfer Center (MHTTC) network. Each MHTTC formed Learning Communities (LCs) to facilitate connections among behavioral health professionals with the goals of sharing implementation strategies, discussing best-practices, and developing problem solving techniques. Data on outcomes were collected through a combination of self-report surveys and qualitative interviews. LC participants reported strong connectedness, gains in knowledge and skills, improvements in implementation capacity, and intentions to advocate for organizational and systems-level change. Furthermore, across the case examples, we identified LC characteristics that are associated with participant perceptions of outcomes, including tailoring LC content to workforce needs, providing culturally relevant information, engaging leaders, forming connections among participants and trainers, and challenging participants' current workplace practices. These findings are interpreted through the lens of the Interactive Systems Framework, which focuses on how TTA, such as LCs, can facilitate connections between the theoretical and empirical foundations of interventions and the practices of implementing interventions in real-world settings to advance workforce capacity.
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Prática Clínica Baseada em Evidências , Humanos , Prática Clínica Baseada em Evidências/organização & administração , Feminino , Masculino , Pessoal de Saúde/educação , Fortalecimento Institucional/organização & administração , Ciência da Implementação , Adulto , Pesquisa Qualitativa , Aprendizagem , Internet , Educação a Distância/organização & administraçãoRESUMO
OBJECTIVE: This study developed, implemented, and evaluated the feasibility of executing an organizational capacity building intervention to improve bus driver safety and well-being in a Chilean transportation company. Method: Through an implementation science lens and using a pre-experimental mixed methods study design, we assessed the feasibility of implementing a participatory organizational intervention designed to build organizational capacity. Result: We identified contextual factors that influenced the intervention mechanisms and intervention implementation and describe how the company adapted the approach for unexpected external factors during the COVID-19 pandemic and social and political unrest experienced in Chile. Conclusions: The intervention enabled the organization to create an agile organizational infrastructure that provided the organization's leadership with new ways to be nimbler and more responsive to workers' safety and well-being needs and was robust in responding to strong external forces that were undermining worker safety and well-being.
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COVID-19 , Fortalecimento Institucional , Estudos de Viabilidade , Saúde Ocupacional , SARS-CoV-2 , COVID-19/prevenção & controle , COVID-19/epidemiologia , Humanos , Chile , Fortalecimento Institucional/organização & administração , Meios de Transporte , Gestão da Segurança/organização & administração , Pandemias , LiderançaRESUMO
DRIVING FORCES: Many states with high rates of cardiovascular disease (CVD) lack statewide quality improvement (QI) infrastructure (for example, resources, leadership, community) to address relevant health needs of the population. Academic health centers are well positioned to play a central role in addressing this deficiency. This article describes early experience and lessons learned in building statewide QI infrastructure through the Tennessee Heart Health Network (Network). APPROACH: A statewide, multistakeholder network composed of primary care practices (PCPs), health systems, health plans, QI organizations, patients, and academic institutions was led by the University of Tennessee Health Science Center (UTHSC), an academic health center, to improve cardiovascular health by supporting dissemination and implementation of patient-centered outcomes research (PCOR) evidence-based interventions in primary care. PCPs were required to select and implement at least one of three interventions (health coaching, tailored health-related text messaging, and pharmacist-physician collaboration). OUTCOMES AND KEY INSIGHTS: Thirty statewide organizational partners joined the Network in year one, including 18 health systems representing 77 PCPs (30.0% of 257 potentially eligible PCPs identified) with approximately 300,000 patients. The organizational partners share EHRs for the ongoing tracking and reporting of key health metrics, including hypertension control and delivery of tobacco cessation counseling. Of the 77 PCPs, 62 continue participation after year two (80.5% retention). Main barriers to participation and reasons for discontinuing participation included reluctance to share data and changes in leadership at the health system level. These 62 PCPs selected the following interventions to implement: health coaching (41.9%), tailored health-related text messages (48.4%), and pharmacist-physician collaboration (40.3%). CONCLUSION AND WHAT'S NEXT: Academic health centers have broad reach and high acceptability by diverse stakeholders. Tennessee's experience illustrates how academic health centers can serve as platforms for building a statewide infrastructure for disseminating, implementing, and sustaining QI interventions at the practice level. Assessment of Network impact is ongoing.
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Doenças Cardiovasculares , Equidade em Saúde , Atenção Primária à Saúde , Melhoria de Qualidade , Melhoria de Qualidade/organização & administração , Humanos , Tennessee , Equidade em Saúde/organização & administração , Doenças Cardiovasculares/terapia , Doenças Cardiovasculares/prevenção & controle , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/normas , Fortalecimento Institucional/organização & administração , Comportamento Cooperativo , Centros Médicos Acadêmicos/organização & administração , LiderançaAssuntos
Fortalecimento Institucional , Relações Comunidade-Instituição , National Cancer Institute (U.S.) , Pesquisa Translacional Biomédica , Humanos , Pesquisa Translacional Biomédica/organização & administração , Estados Unidos , Fortalecimento Institucional/organização & administração , Neoplasias/terapia , Institutos de Câncer/organização & administraçãoRESUMO
Southern community-based organizations often lack adequate resources to implement high-quality, culturally appropriate HIV programs and services. Shared learning communities (SLCs) combine in-depth training, tailored coaching, and peer-to-peer learning to strengthen HIV programs and services. This paper describes five SLCs, participant characteristics, and their capacity-building components.
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Infecções por HIV , Humanos , Infecções por HIV/prevenção & controle , Infecções por HIV/etnologia , Aprendizagem , Fortalecimento Institucional/organização & administração , Liderança , Feminino , Masculino , Grupo AssociadoAssuntos
Negro ou Afro-Americano , Infecções por HIV , Hispânico ou Latino , Humanos , Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Infecções por HIV/epidemiologia , Hispânico ou Latino/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Epidemias/prevenção & controle , Fortalecimento Institucional/organização & administraçãoRESUMO
Capacity-building in trauma-informed care and harm reduction approaches with Southern HIV service organizations must be implemented in ways that foster trust and spur organizational change. Using an equity-centered implementation science framework, this study examines implementation strategies of the SUSTAIN COMPASS Coordinating Center's person-centered care (PCC) capacity-building interventions. METHODS: Fifty-eight (58) in-depth qualitative interviews with staff (N=116) who received PCC capacity-building were analyzed using modified grounded theory. RESULTS: Analysis identified four factors of equity-centered implementation that facilitated PCC capacity-building implementation. 1) Innovation factors: SUSTAIN models PCC approaches when implementing PCC capacity-building. 2) Inner factors: SUSTAIN employs PCC approaches. 3) Outer factors: SUSTAIN highlights socio-political factors that may influence PCC implementation. 4) Bridging factors: SUSTAIN facilitates partnerships to promote PCC learning and sustainability. CONCLUSION: SUSTAIN PCC capacity-building advances health equity through operationalizing personcentered care in capacity-building implementation.
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Fortalecimento Institucional , Infecções por HIV , Assistência Centrada no Paciente , Humanos , Fortalecimento Institucional/organização & administração , Infecções por HIV/terapia , Infecções por HIV/prevenção & controle , Assistência Centrada no Paciente/organização & administração , Equidade em Saúde/organização & administração , Pesquisa Qualitativa , Entrevistas como Assunto , Inovação OrganizacionalRESUMO
Effectively combating HIV will require southern HIV Service Organizations (SHSOs) to support Black staff while they navigate traumas related to structural racism driving the epidemic. HIV organizational capacity-building research lacks effective community-led approaches to anti-racist organizational change centered on Black people's experiences. This participatory case study examines "Showing Up for Black Power, Liberation and Healing," an organizational capacity-building initiative that leads to individual and organizational change, developed and implemented by the SUSTAIN, an intermediary purveyor organization (IPO). Evaluation data include participant observation notes and in-depth, open-ended evaluation reports analyzed using interpretive phenomenological analysis. The intervention consisted of a two-part shared learning collaborative. Qualitative impact themes highlighted: 1) the power of defining and valuing Black-centered spaces to address trauma; 2) reframing self-care from an individualistic responsibility to an institutionally supported, communal means of healing; and 3) the role of the intervention in spurring organizational changes related to dismantling White supremacy work culture in SHSOs.
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Negro ou Afro-Americano , Infecções por HIV , Estudos de Casos Organizacionais , Racismo , Humanos , Negro ou Afro-Americano/psicologia , Infecções por HIV/etnologia , Fortalecimento Institucional/organização & administração , Cultura Organizacional , Inovação OrganizacionalAssuntos
COVID-19/epidemiologia , Fortalecimento Institucional/organização & administração , Prioridades em Saúde/tendências , Alocação de Recursos para a Atenção à Saúde , Acessibilidade aos Serviços de Saúde/normas , Acessibilidade aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Alocação de Recursos/organização & administração , SARS-CoV-2 , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Building local surgical capacity in low-income and middle-income countries is critical to addressing the unmet global surgical need. Visiting educator programs can be utilized to train local surgeons, but the quantitative impact on surgical capacity has not yet been fully described. The authors' objective was to evaluate the effectiveness of training utilizing a visiting educator program on local reconstructive surgical capacity in Vietnam. METHODS: A reconstructive surgery visiting educator program was implemented in Vietnam. Topics of training were based on needs defined by local surgeons, including those specializing in hand surgery, microsurgery, and craniofacial surgery. A retrospective analysis of annual case numbers corresponding to covered topics between the years 2014 and 2019 at each hospital was conducted to determine reconstructive surgical volume and procedures per surgeon over time. Direct costs, indirect costs, and value of volunteer services for each trip were calculated. RESULTS: Over the course of 5 years, 12 visiting educator trips were conducted across three hospitals in Vietnam. Local surgeons subsequently independently performed a total of 2018 operations corresponding to topics covered during visiting educator trips, or a mean of 136 operations annually per surgeon. Within several years, the hospitals experienced an 81.5 percent increase in surgical volume for these reconstructive clinical conditions, and annual case volume continues to increase over time. Total costs were $191,290, for a mean cost per trip of $15,941. CONCLUSIONS: Surgical capacity can be successfully expanded by utilizing targeted visiting educator trips to train local reconstructive surgeons. Local providers ultimately independently perform an increased volume of complex procedures and provide further training to others.