Strengthening research capacity: a systematic review of manuscript writing and publishing interventions for researchers in low-income and middle-income countries.

INTRODUCTION: Health researchers from low-income and middle-income countries (LMICs) are under-represented in the academic literature. Scientific writing and publishing interventions may help researchers publish their findings; however, we lack evidence about the prevalence and effectiveness of such interventions. This review describes interventions for researchers in LMICs aimed at strengthening capacity for writing and publishing academic journal articles. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to report literature searches in PubMed, Embase, Global Health, Scopus and ERIC. Our keywords included LMICs, low-income and middle-income countries, health research and writing/publication support interventions, with no restrictions on publication date. Our screening process consisted of title screening, abstract review and full-text review. We collected information about the content, implementation and evaluation of each intervention, if included. RESULTS: We identified 20 interventions designed to strengthen capacity for scientific writing and publishing. We summarised information from the 14 interventions that reported submitted or published papers as outcomes separately, reasoning that because they provide quantifiable metrics of success, they may offer particular insights into intervention components leading to publication. The writing and publishing components in this 'Publications Reported' group were an average length of 5.4 days compared with 2.5 days in the other group we refer to as 'Other Interventions.' Whereas all 14 Publications Reported interventions incorporated mentors, only two of five in the Other Interventions group incorporated mentors. Across interventions, leaders expressed the importance of a high ratio of mentors to participants, the need to accommodate time demands of busy researchers, and the necessity of a budget for open access fees and high-quality internet connectivity. CONCLUSION: Writing and publishing interventions in LMICs are an underutilised opportunity for capacity strengthening. To facilitate the implementation of high-quality interventions, future writing and publishing interventions should share their experiences by publishing detailed information about the approach and effectiveness of the interventions.

Implementing and measuring the impact of a clinical and translational research mentor recognition program.

INTRODUCTION: Research shows incentives can motivate faculty to increase their engagement in mentoring, despite a myriad of institutional barriers. One such incentive may be the implementation of a university-wide mentor award program to promote a culture of mentorship. METHODS: A new mentorship award was created at a research-intensive university and faculty recipients were surveyed to assess their perceptions of the award's impact on their mentoring practices and career. RESULTS: Sixty-two percent of awardees (n=21) completed the survey and felt the recognition incentivized them to engage in further mentoring and participate in formal mentorship training. Most awardees referenced the award in their CVs, performance evaluations, and grant proposals. Additionally, they felt the award effectively promoted mentoring among the broader faculty community. CONCLUSION: Growth of clinical and translational research depends in part on the mentorship received by early career faculty. Therefore, other research universities may benefit from implementing such awards.

Issues in identifying asthma and estimating prevalence in an urban school population.

UNLABELLED: This article first presents salient issues related to identifying children in urban schools who might benefit from asthma services. It discusses a brief questionnaire for identifying cases and problems in estimating asthma prevalence. Subsequently, results of case detection in 14 urban schools are presented and discussed in light of these issues. The questionnaire was employed with parents of 4,653 African-American children in Detroit. Results suggest that determining number, type, and frequency of symptoms may be necessary to ascertain prevalence of asthma. Using only number and type produced a rate of asthma of 25%. Adding frequency provided a more conservative estimate of 19%. About 9% of children exhibiting symptoms of asthma had no physician diagnosis. Only 25% with symptoms reflecting mild persistent, 35% with moderate persistent, and 26% with severe persistent disease had prescriptions for anti-inflammatory medicine. Further, 23% of children with asthma-like symptoms had no prescription for asthma medicine of any type. CONCLUSIONS: (1) low-cost procedures can be used in schools to identify children with suspected undiagnosed and undertreated asthma; (2) prevalence estimates for asthma in the group of urban school children studied are among the highest in the United States; and (3) asthma is undertreated in this sample.

Effects of a comprehensive school-based asthma program on symptoms, parent management, grades, and absenteeism.

STUDY OBJECTIVE: This study assessed the impact of a comprehensive school-based asthma program on symptoms, grades, and school absences in children, and parents' asthma management practices. DESIGN: Randomized controlled trial. SETTING: Fourteen elementary schools in low-income neighborhoods in Detroit, MI. PARTICIPANTS: Eight hundred thirty-five children with asthma in grades 2 through 5 and their parents. INTERVENTION: The intervention entailed six components for children, their parents, classmates, and school personnel to encourage and enable disease management. MEASUREMENTS AND RESULTS: Parents completed telephone interviews and the schools provided data at baseline and 24 months after intervention. At follow-up, treatment children with persistent disease had significant declines in both daytime (14% fewer, p < 0.0001) and nighttime (14% fewer, p < 0.0001) symptoms. Among children with both mild intermittent and persistent disease, those in the treatment group had 17% fewer daytime symptoms (p < 0.0001) but 40% more nighttime symptoms. Treatment children had higher grades for science (p < 0.02) but not reading, mathematics, or physical education. No differences in school absences for all causes between groups were noted in school records. However, parents of treatment group children reported fewer absences attributable to asthma in the previous 3 months (34% fewer, p < 0.0001) and 12 months (8% fewer, p < 0.05). Parents of treatment children had higher scores (2.19 greater, p = 0.02) on an asthma management index. The program may have stimulated attention to symptoms at night by parents of children with mild intermittent disease. Overall, the intervention provided significant benefits, particularly for children with persistent asthma.

Schools' capacity to help low-income, minority children to manage asthma.

This article describes the challenges and strengths of asthma management in 14 low-income, predominantly African American urban elementary schools serving more than 5,000 students. Asthma prevalence was 24.5%. Teachers, school principals, parents, and children described how asthma was managed at school. Data from classmates of students with asthma showed that they had moderate to high levels of information about the disease. Data from teachers indicated the great need for practical instruction on how they might effectively support a child with asthma in the classroom and on the playground. Principals raised concerns about expectations for the functioning of school staff and implementation of school policies especially related to asthma emergencies. Parents reported a range of problems their children face at school. Data from children with asthma showed that 75% believed asthma affected their school work. Findings from this study should be useful to school personnel, health providers, and others who assist children and their families to manage asthma at school. Data suggest that making school nursing services available is warranted, given the impact of asthma on the school community.

Effect of asthma intervention on children with undiagnosed asthma.

OBJECTIVE: To measure the effect of an asthma intervention on the functional status and morbidity of children with undiagnosed asthma. STUDY DESIGN: Data from a randomized trial were used to compare outcomes at baseline and follow-up for children with undiagnosed and diagnosed asthma. We studied 510 symptomatic children with diagnosed asthma (diagnosed) and 299 children with symptoms but no diagnosis (undiagnosed). Baseline functioning and morbidity were similar for undiagnosed and diagnosed patients classified as moderate-severe. RESULTS: There were fewer undiagnosed reported allergies, seasonal symptoms, and other respiratory diagnoses (all P < 0.01). Among the moderate-severe, functional status, for example, symptom-days ( P = .02), symptom-nights ( P < .01), and days of restricted activity ( P < .01), was significantly reduced at follow-up for the undiagnosed in the intervention group but not for undiagnosed control subjects. Findings were similar for children with diagnosed asthma. CONCLUSIONS: Children with undiagnosed asthma were generally nonatopic, although some had symptoms at a level comparable to children with a diagnosis. The intervention successfully improved functional status for children with undiagnosed asthma as well as for children with diagnosed asthma. These results can be applied to ongoing discussions related to case detection.

Influences on childhood asthma in low-income communities in China and the United States.

For comparison of childhood asthma, the same case-finding survey and parent interview questionnaires were used to collect data from 639 children with asthma in 21 elementary schools in Beijing and 835 children with asthma in 14 elementary schools in Detroit, Michigan. Asthma prevalence in Beijing (7.3%) was more than three times lower than in Detroit (24%) despite a high level of smoking among Chinese parents. Body mass index (BMI; weight in kilograms divided by height in meters squared) levels were higher in Detroit but were not associated with persistent asthma in either country. Higher levels of past infection in Beijing and household allergens in Detroit were noted and may be associated with differences in prevalence. Despite less severe disease observed in Beijing, hospitalizations and office visits did not differ from Detroit. This may be partially associated with less use of anti-inflammatory medicine and lower levels of parental asthma management in China.