Adaptation of the CUGH global health competency framework in the Chinese context: a mixed-methods study
Ontology highlight
ABSTRACT:
SUBMITTER: Ding W
PROVIDER: S-EPMC10621075 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BACKGROUND:The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. OBJECTIVE:This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. METHODS:A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. RESULTS:Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. CONCLUSIONS:The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs.
| S-EPMC5974459 | biostudies-literature
Project description:BackgroundOsteoarthritis is a leading cause of pain and disability. Knee osteoarthritis accounts for nearly four-fifths of the burden of osteoarthritis internationally, and 10% of adults in the United Kingdom have the condition. Shared decision-making (SDM) supports patients to make more informed choices about treatment and care while reducing inequities in access to treatment. We evaluated the experience of a team adapting an SDM tool for knee osteoarthritis and the tool's implementation potential within a local clinical commissioning group (CCG) area in southwest England. The tool aims to prepare patients and clinicians for SDM by providing evidence-based information about treatment options relevant to disease stage.ObjectiveThis study aimed to explore the experiences of a team adapting an SDM tool from one health context to another and the implementation potential of the tool in the local CCG area.MethodsA partnership approach using mixed methods was used to respond to recruitment challenges and ensure that study aims could be addressed within time restrictions. A web-based survey was used to obtain clinicians' feedback on experiences of using the SDM tool. Qualitative interviews were conducted by telephone or video call with a sample of stakeholders involved in adapting and implementing the tool in the local CCG area. Survey findings were summarized as frequencies and percentages. Content analysis was conducted on qualitative data using framework analysis, and data were mapped directly to the Theoretical Domains Framework (TDF).ResultsOverall, 23 clinicians completed the survey, including first-contact physiotherapists (11/23, 48%), physiotherapists (7/23, 30%), specialist physiotherapists (4/23, 17%), and a general practitioner (1/23, 4%). Eight stakeholders involved in commissioning, adapting, and implementing the SDM tool were interviewed. Participants described barriers and facilitators to the adaptation, implementation, and use of the tool. Barriers included a lack of organizational culture that supported and resourced SDM, lack of clinician buy-in and awareness of the tool, challenges with accessibility and usability, and lack of adaptation for underserved communities. Facilitators included the influence of clinical leaders' belief that SDM tools can improve patient outcomes and National Health Service resource use, clinicians' positive experiences of using the tool, and improving awareness of the tool. Themes were mapped to 13 of the 14 TDF domains. Usability issues were described, which did not map to the TDF domains.ConclusionsThis study highlights barriers and facilitators to adapting and implementing tools from one health context to another. We recommend that tools selected for adaptation should have a strong evidence base, including evidence of effectiveness and acceptability in the original context. Legal advice should be sought regarding intellectual property early in the project. Existing guidance for developing and adapting interventions should be used. Co-design methods should be applied to improve adapted tools' accessibility and acceptability.
| S-EPMC10357316 | biostudies-literature
Project description:BackgroundThe 2014 outbreak of the Ebola virus disease highlighted the importance of overhauling and transforming healthcare systems in West Africa to improve the ability of individual countries to deal with infectious diseases. As part of this effort, in November 2016 the West African Health Organization (WAHO) began the process of institutionalizing the One Health (OH) approach to health security across the Economic Community of West African States (ECOWAS). The lack of clear metrics and evaluation frameworks to measure the progress of OH implementation in West Africa has been reported as a challenge. Therefore, this study sought to assess and explore whether the existing metrics of global health security frameworks can measure the successful implementation of OH activities, evaluate the progress made since 2016, and identify key areas for improvement in the region.MethodThe study employed predetermined keywords to select indicators from the International Health Regulations (IHR) Monitoring Frameworks, specifically the State Party Self-Assessment Annual Report (SPAR) and Joint External Evaluation (JEE), deemed relevant to the OH approach. In addition, the COVID-19 performance index scores (severity and recovery) for June 2022 were extracted from the Global COVID-19 Index (GCI). The GCI Recovery Index evaluated the major recovery parameters reported daily to indicate how a country performed on the path to recovery from the COVID-19 pandemic compared to other countries. National documents were also analyzed using categorical variables to assess the performance status of OH platforms across implementing countries. A quantitative analysis of these indicators was conducted and supplemented with qualitative data gathered through interviews with key stakeholders. Between March and April 2022, we conducted 18 key informant interviews with purposively selected representatives from regional governmental agencies and international multilateral agencies, including ECOWAS member states. Interviews were conducted online, transcribed, and analysed following the tenets of thematic analysis.ResultsOur quantitative analysis revealed no significant association between the implementation status of OH activities and any of the selected indicators from SPAR and JEE. The descriptive analysis of the JEE scores at the country level revealed that countries with existing OH platforms scored relatively higher on the selected JEE indicators than other countries in the pre-implementation stage. OH implementation status did not significantly affect COVID-19 recovery and severity indices. The qualitative findings with relevant stakeholders revealed noteworthy challenges related to insufficient human capacity, inadequate coordination, and a lack of government funding for the sustainability of OH initiatives. Nonetheless, countries in the ECOWAS region are making progress toward the integration of OH into their health security systems.ConclusionStandardized metrics were used to assess the implementation and efficacy of OH systems in the ECOWAS region. Current indicators for monitoring global health security frameworks lack specificity and fail to comprehensively capture essential OH components, particularly at the sub-national level. To ensure consistency and effectiveness across countries, OH implementation metrics that align with global frameworks such as IHR should be developed.
| S-EPMC11299367 | biostudies-literature
Project description:Academic global health collaborations have the potential to improve joint understanding of health issues in low- and middle-income countries (LMICs). Our objective was to elucidate perceptions of benefits and challenges of academic global health collaborations as well as areas for improving collaborative research conducted in LMICs. This cross-sectional, mixed-methods study surveyed investigators' perceptions of benefits and challenges of pediatric academic global health collaborations. Authors of articles from four pediatric journals reporting pediatric research conducted in LMICs published between 2006 and 2015 were surveyed. Responses of LMIC investigators were compared with those of investigators in high-income countries (HICs). Responses to open-ended questions were analyzed using a combined thematic and content analysis approach. Of 1,420 potential respondents, 252 (17.7%) responded to the survey. Collaborative research with investigators from other countries was perceived as beneficial by 88.5% of respondents (n = 223), although this perception was more common among HIC respondents (n = 110, 94.0%) than LMIC respondents (n = 113, 83.7%) (p = 0.014). Sixty-seven percent (n = 170) of respondents perceived that HIC investigators had set the research agenda in work conducted in a LMIC. Respondents identified several critical factors to improve academic global health collaborations, including research capacity building, communication, and early involvement of LMIC investigators with shared decision-making during study conception and grant writing. Pediatric academic global health collaboration was widely perceived as positive. However, despite calls for capacity building and locally generated research ideas, many respondents felt that HIC investigators set the research agenda for work conducted in LMICs. This study provides suggestions for improving collaboration among pediatric academicians globally.
| S-EPMC7056414 | biostudies-literature
Project description:BackgroundGreater understanding about the prevention and treatment of overweight and obesity in preschool children within public health care is needed. This study assessed the impact of The First Steps module in routine primary health care including mapping of height/weight and diet followed by parental counselling of healthy habits on overweight and obesity in children aged 2 to 7 years. Further, we explored the experiences of public health nurses (PHNs) with the module.MethodsBody weight and height obtained in 2014 and 2016 were extracted retrospectively for 676 children from the health records of children at 2, 4, or 6 years of age in five child health centers in Southern Norway. Sex- and age-adjusted body mass index (BMI) z-scores and weight status classifications were calculated according to the International Obesity Task Force reference values. Impact was assessed as change in mean BMI z-scores for children with under-, normal-, and overweight, respectively, and as proportion of children with overweight and obesity. In focus groups, PHNs described their experiences with the practical application of the module. Focus group transcripts were analyzed using Braun and Clarke's thematic analysis.ResultsMean BMI z-scores decreased from 2014 to 2016 in overweight children (- 0.26) and increased in children with under- (0.63) and normal weight (0.06), whereas the proportion of children with overweight and obesity was stable. PHNs believed that the module provides them with new tools that are useful for addressing the intricacies of childhood obesity. They described counseling sessions with families as "moving upstream in a river" and that overweight and obesity may be one of many complex challenges for these families.ConclusionsMean BMI z-score decreased in children with overweight during the 2 years after initiation of The First Steps module. PHNs considered the module as useful for addressing children's overweight and obesity, which was perceived as one of several complex challenges for most of these families. Specialist and evidence-based support is needed to address overweight and obesity in children in primary care. Further research should focus on integrating the issues relating to overweight and obesity within other family problems.
| S-EPMC8152087 | biostudies-literature
Project description:BACKGROUND:Poor EHR design adds further challenges, especially in the areas of order entry and information visualization, with a net effect of increased rates of incidents, accidents, and mortality in ICU settings. OBJECTIVE:The purpose of this study was to propose a novel, mixed-methods framework to understand EHR-related information overload by identifying and characterizing areas of suboptimal usability and clinician frustration within a vendor-based, provider-facing EHR interface. METHODS:A mixed-methods, live observational usability study was conducted at a single, large, tertiary academic medical center in the Southeastern US utilizing a commercial, vendor based EHR. Physicians were asked to complete usability patient cases, provide responses to three surveys, and participant in a semi-structured interview. RESULTS:Of the 25 enrolled ICU physician participants, there were 5(20%) attending physicians, 9 (36%) fellows, and 11 (44%) residents; 52% of participants were females. On average, residents were the quickest in completing the tasks while attending physician took the longest to complete the same task. Poor usability, complex interface screens, and difficulty to navigate the EHR significantly correlated with high frustration levels. Significant association were found between the occurrence of error messages and temporal demand such that more error messages resulted in longer completion time (p?=?.03). DISCUSSION:Physicians remain frustrated with the EHR due to difficulty in finding patient information. EHR usability remains a critical challenge in healthcare, with implications for medical errors, patient safety, and clinician burnout. There is a need for scientific findings on current information needs and ways to improve EHR-related information overload.
| S-EPMC6584062 | biostudies-literature
Project description:ObjectiveIntegrating best practices for health disparities to adapt evidence-based treatments is imperative to adequately meet the needs of diverse cultures, particularly ones that therapists can apply flexibility across multiple diverse communities.MethodUsing a mixed-methods, community-engaged approach, we examined how a range of community participants (N = 169) defined mental health, perceived barriers to treatment, and used culturally based coping methods to manage their mental health. Phase 1 (n = 49) included qualitative focus group data from five distinct racial/ethnic communities (African immigrants/refugees, Black/African Americans, Hispanics, Pacific Islanders, and American Indians). Phase 2 included quantitative surveys from members of four of these communities (n = 59) and the frontline providers serving them (n = 61).ResultsThe communities and providers highlighted chronic worry and distress related to daily activities as primary treatment concerns. Further, this mixed-methods data informed our proposed best practice treatment adaptation framework using chronic worry as an example.ConclusionThe main aims of this study were to exemplify best practices for addressing mental health inequities in communities of color in terms of (a) conducting health disparities research and (b) applying a treatment adaptation framework for culturally responsive clinical care. Specific features of how this framework was conceived and applied provide a unique and critical view into integrating best practices to address health disparities in diverse communities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
| S-EPMC9747246 | biostudies-literature
Project description:Aims and methodNon-Western literature on the core competencies of mental health peer supporters remains limited. Therefore, we used a three-round Delphi study with peer supporters, service users (i.e. someone using peer support services) and mental health professionals to develop a core competency framework for peer supporters in the Chinese context.ResultsThe final framework included 35 core competencies, the conceptual origins of which were local (14.3%), Western (20%) and both local and Western (65.7%). They were grouped into five categories in ascending peer supporter role specificity: (1) self-care and self-development, (2) general work ethics, (3) work with others, (4) work with service users and (5) peer support knowledge.Clinical implicationsA culturally valid mental health peer support competency framework can minimise role confusion and refine training and practice guidelines. In a Chinese context, peer supporters were valued as generic support companions, whereas functions highlighted in the West, such as role modelling, were perceived as less critical.
| S-EPMC10985733 | biostudies-literature
Project description:BackgroundUrban areas, particularly in developing nations like Uganda, face heightened risks due to poverty, unemployment, and environmental challenges, intensifying the vulnerability of urban youth to poor mental health. This study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 pandemic in Kampala City, Uganda.MethodsWe conducted a cross-sectional survey of 500 adolescents aged 13-19 years residing within the five divisions of Kampala City, Uganda. We utilized standardized psychological assessment tools including the Patient Health Questionnaire, Generalized Anxiety Scale, to assess severity of depression and anxiety levels among the adolescents. A logistic regression model was used to evaluate the correlates associated with depression and generalized anxiety disorders. Variables with a p-value <0.25 in the univariate model were included in the multivariable regression model. Subsequently, we conducted a qualitative study using semi-structured interview guides through focused group discussions, and key informant interviews with teachers, parents, representatives of civil society organizations, and religious leaders. Qualitative data were analyzed using a thematic analysis approach.ResultsThe prevalence of depression was relatively higher among out-of-school adolescents at 21.5% compared to school-going adolescents at 14.0%. Furthermore, out-of-school adolescents had significantly higher anxiety scores when compared to their school-going counterparts (17.5% vs. 10.3%) respectively. Key factors identified associated with poor mental health include loneliness, being out of school, COVID-19, and familial conflicts.DiscussionThis study highlights the impact of the COVID-19 pandemic on the mental well-being of adolescents in Kampala, Uganda. The reported prevalence of depression and anxiety, particularly among out-of-school adolescents, underscores the urgent need for targeted interventions in this vulnerable population. Investing in the mental well-being of Ugandan adolescents is paramount for fostering resilience and ensuring long-term success, especially in marginalized urban settings.
| S-EPMC11891163 | biostudies-literature
Project description:BackgroundNetworks are increasingly regarded as essential in health research aimed at influencing practice and policies. Less research has focused on the role networking can play in researchers' careers and its broader impacts on capacity strengthening in health research. We used the Canadian Coalition for Global Health Research (CCGHR) annual Summer Institute for New Global Health Researchers (SIs) as an opportunity to explore networking among new global health researchers.MethodsA mixed-methods exploratory study was conducted among SI alumni and facilitators who had participated in at least one SI between 2004 and 2010. Alumni and facilitators completed an online short questionnaire, and a subset participated in an in-depth interview. Thematic analysis of the qualitative data was triangulated with quantitative results and CCGHR reports on SIs. Synthesis occurred through the development of a process model relevant to networking through the SIs.ResultsThrough networking at the SIs, participants experienced decreased isolation and strengthened working relationships. Participants accessed new knowledge, opportunities, and resources through networking during the SI. Post-SI, participants reported ongoing contact and collaboration, although most participants desired more opportunities for interaction. They made suggestions for structural supports to networking among new global health researchers.ConclusionsNetworking at the SI contributed positively to opportunities for individuals, and contributed to the formation of a network of global health researchers. Intentional inclusion of networking in health research capacity strengthening initiatives, with supportive resources and infrastructure could create dynamic, sustainable networks accessible to global health researchers around the world.
| S-EPMC3916077 | biostudies-literature