Background We aimed to assess the adherence of short-term medical missions (STMMs) operating in Latin America and the Caribbean (LAC) to key best practices using the Service Trip Audit Tool (STAT) and to calculate the inter-rater reliability of the data points. This tool was based on a previously published inventory of 18 STMM best practices. Methods Programme administrators and recent volunteers from 335 North American organizations offering STMMs in LAC were invited to complete the STAT anonymously online. Adherence to each of 18 best practices was reported as either ‘yes’, ‘no’ or ‘not sure’. Fleiss’ κ was used to assess inter-rater agreement of the responses. Results A total of 194 individuals from 102 organizations completed the STAT (response rate 30.4%; 102/335 organizations) between 12 July and 7 August 2017. Reported adherence was >80% for 9 of 18 best practices. For 37 non-governmental organizations (NGOs) with multiple raters, inter-rater agreement was moderate to substantial (κ>0.4) for 12 of 18 best practices. Conclusions This is the first study to evaluate adherence to STMM best practices. Such an objective evaluation will be valuable to governments, volunteers and NGO donors who have an interest in identifying high-quality partners. Assessment and monitoring of STMMs through self-audit may be foundational steps towards quality improvement.

Objectives Short-term medical service trips (MSTs) are a controversial modality for addressing the health of marginalized populations. Despite their prevalence, there are no routinely used evaluative frameworks. This study used stakeholder consensus to validate a literature-based framework for MST best practices. Methods A recent systematic review was used to construct a preliminary list of best practices for short-term MSTs. We then recruited a multidisciplinary panel of academics, medical professionals, program coordinators, and non-medical volunteers for a three-round e-Delphi consensus-building exercise to review the list. A 7-point Likert scale was used, with mean scores 4-7 representing rejection, scores \ 2 representing acceptance, and elements scoring in between being redistributed for discussion. ResultsThe literature review identified 30 best practices. Twenty-six stakeholders were recruited for the e-Delphi panel, with 73.1% responding to all three rounds. Eighteen elements were accepted into the final framework. Conclusions This framework identifies essential MST best practices and enables volunteers to compare organizations. Future research should translate this framework into an assessment tool and initiate dialogue between host communities, local clinicians, and sending organizations.

No abstract

No abstract