Simulation-based training in Leprosy: development and validation of a scenario for community health workers.

OBJECTIVES: To build and validate a clinical simulation scenario designed to instruct community health workers (CHWs) in active leprosy case detection. METHODS: Methodological study involving the development of a simulated clinical scenario and content validation by experts. The Content Validity Index (CVI) was used to determine the level of agreement among the judging commitee, and a descriptive analysis of their recommendations was performed. RESULTS: A simulated scenario with a simulated participant was developed - a simulation characterized by low complexity, moderate physical/environmental fidelity, moderate to high psychological fidelity, and high conceptual fidelity, lasting 50 minutes and capable of training up to 10 CHWs simultaneously. The scenario was validated by 14 experts, with a CVI exceeding 80% for all components. CONCLUSIONS: The validated clinical simulation possesses attributes that make it highly reproducible in various national health contexts, thereby contributing to the global "Towards Zero Leprosy" strategy.

Quality of life of transgender people under the lens of social determinants of health: a scoping review protocol.

INTRODUCTION: There is an urgent need for knowledge about the transgender population to inform the development of clinical protocols and training of health professionals on the unique issues affecting this population. Discussing transgender quality of life (QoL) through the lens of social determinants of health (SDOHs) would enable gender-specific health interventions. Here, we aimed to review the evidence on the QoL of transgender people from an SDOH perspective. METHODS AND ANALYSIS: A scoping review (ScR) protocol following the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews statement and guided by the Joanna Briggs Institute was used. MEDLINE/PubMed, Cochrane Library, Embase, PsycINFO, Web of Science, Scopus and registry sites such as ClinicalTrials.gov and WHO ICTRP will be searched. Additional sources to be searched include ProQuest Dissertations/Theses Global, British Library, Google Scholar and Preprints for Health Sciences-medRXiv. Two independent researchers will carry out the selection, data charting and data synthesis. No date restriction will be applied in this ScR. The search will be restricted to articles published in English, Spanish and Portuguese. The results will be presented in tables, narrative summaries and graphs and will be graded on the type of data presented and the results. The search strategy will be updated in April 2023. The expected completion date of this ScR is July 2023. ETHICS AND DISSEMINATION: This ScR protocol does not require ethical approval. Dissemination plans include peer-reviewed publications, conference presentations to be shared with experts in the field, and advisory groups to inform discussions on future research. It is hoped that our findings will be of interest to practitioners, researchers, stakeholders, public and private managers, and the general population concerned with this emerging public health issue. TRIAL REGISTRATION NUMBER: osf.io/9ukz6.

Simulation-based training in Leprosy: development and validation of a scenario for community health workers / Entrenamiento en lepra por simulación: construcción y validación de escenario a agentes comunitarios de salud / Treinamento em hanseníase por simulação: construção e validação de cenário a agentes comunitários de saúde

ABSTRACT Objectives: To build and validate a clinical simulation scenario designed to instruct community health workers (CHWs) in active leprosy case detection. Methods: Methodological study involving the development of a simulated clinical scenario and content validation by experts. The Content Validity Index (CVI) was used to determine the level of agreement among the judging commitee, and a descriptive analysis of their recommendations was performed. Results: A simulated scenario with a simulated participant was developed — a simulation characterized by low complexity, moderate physical/environmental fidelity, moderate to high psychological fidelity, and high conceptual fidelity, lasting 50 minutes and capable of training up to 10 CHWs simultaneously. The scenario was validated by 14 experts, with a CVI exceeding 80% for all components. Conclusions: The validated clinical simulation possesses attributes that make it highly reproducible in various national health contexts, thereby contributing to the global "Towards Zero Leprosy" strategy.

RESUMEN Objetivos: Construir y validar escenario de simulación clínica para enseñar a agentes comunitarios de salud (ACS) acciones de búsqueda activa de la lepra. Métodos: Estudio metodológico de construcción de escenario clínico simulado y de validez de contenido por especialistas. Utilizado el Índice de Validez de Contenido (IVC) para determinar el grado de concordancia entre los jueces y el análisis descriptivo de las recomendaciones. Resultados: Creado una simulación escénica con participante simulado, de baja complejidad, mediana fidelidad física/ambiental, mediana/alta fidelidad psicológica y alta fidelidad conceptual, cuyo tiempo de duración total fue de 50 minutos, capaz de calificar hasta diez ACS simultáneamente. Catorce jueces validaron el escenario, obteniéndose IVC superior a 80% en todos los componentes. Conclusiones: La simulación clínica validada tiene atributos que la transforman altamente replicable en diferentes contextos de salud nacionales, pudiendo, de esa manera, contribuir con la estrategia global "Rumbo al cero lepra".

RESUMO Objetivos: Construir e validar cenário de simulação clínica para ensinar a agentes comunitários de saúde (ACS) ações de busca ativa da hanseníase. Métodos: Estudo metodológico de construção de cenário clínico simulado e de validação de conteúdo por especialistas. Utilizou-se o Índice de Validade de Conteúdo (IVC) para determinar o grau de concordância entre os juízes e a análise descritiva das recomendações. Resultados: Criou-se uma simulação cênica com participante simulado, de baixa complexidade, média fidelidade física/ambiental, média/alta fidelidade psicológica e alta fidelidade conceitual, cujo tempo de duração total é de 50 minutos, capaz de qualificar até dez ACS simultaneamente. Quatorze juízes validaram o cenário, obtendo-se IVC superior a 80% em todos os componentes. Conclusões: A simulação clínica validada tem atributos que a tornam altamente replicável em diferentes contextos de saúde nacionais, podendo, dessa forma, contribuir com a estratégia global "Rumo à zero hanseníase".

Health Policies for Rare Disease Patients: A Scoping Review.

OBJECTIVE: To identify and map the available evidence on the implementation of public health policies directed at individuals with rare diseases, and to compare the implementation of these health policies between Brazil and other countries. METHOD: A scoping review guided by the PRISMA-ScR and JBI checklists. The search for articles was conducted in eight electronic databases, MEDLINE/Pubmed, Embase, Cochrane Library, Web of Science, Scopus, CINAHL, PsycINFO, and LILACS, using controlled descriptors, synonyms, and keywords combined with Boolean operators. All steps of this review were independently conducted by two researchers. The selected studies were classified by evidence hierarchy, and a generic quantitative tool was used for the assessment of the studies. RESULTS: A total of 473 studies were identified, of which 13 which met all the inclusion criteria were selected and analyzed. Of these studies, 61.5% (n = 8) had final scores equal to or greater than 70%, i.e., they were classified by this tool as being well-reported. The comparative analysis of international rare diseases demonstrates that public authorities' priorities and recommendations regarding this topic also permeate and apply to the Brazilian context. CONCLUSIONS: The evaluation and monitoring of public policies directed at rare disease patients are urgent and necessary to improve and implement such policies with less bureaucracy and more determination for this unique population that requires timely and high-quality care.