This study should alert researchers, managers, and teachers of management to ways that contexts shape Lean implementation and may affect other types of process redesign and quality improvement.

OBJECTIVES: Involving stakeholders in research helps ensure that research is relevant and responsive to stakeholder needs while improving the quality of the research. This research was conducted as part of AHRQ's Community Forum project which was charged with identifying emerging strategies and state of the art methods for engaging stakeholders. METHODS: We developed a conceptual framework for stakeholder engagement that informed this literature scan and assisted in organizing findings. The scan included a search of peer-reviewed literature, using academic databases as well as an Internet search of grey literature and Web sites. Our final review included 23 peer-reviewed articles, 15 grey literature documents, and 43 Web sites related to stakeholder engagement. To supplement our scan, we conducted 11 interviews with individuals experienced in the field of stakeholder engagement. Our technical experts also suggested organizations and Web sites to explore in our literature review. RESULTS: We identified many promising methods of involving stakeholders in research. One example is using online collaborative platforms to enable interactions between an organization and its stakeholders through a virtual space. These allow users to share information, work together, and provide feedback to stakeholders about how their input is being used. Other examples include product development challenges, utilizing existing online communities, and grassroots community organizing. Selected recommended practices from our review include gaining trust of stakeholders before involvement and maintaining throughout; selecting stakeholders for whom the decision or research has important consequences; and educating stakeholders on their roles, their responsibilities, and the topics being discussed. A limitation to our findings is that there are limited evaluation data measuring outcome effectiveness of these methods. CONCLUSIONS: Stakeholder involvement is critical to health care research. This presentation will highlight selected effective and creative approaches to stakeholder engagement. OBJECTIVES:To analyze the profile of care for sexually transmitted infections (STIs) in health centers in border areas of Central America. METHODS: A crosssectional study in a sample of 3357 people received medical care for some STIs in 13 health centers in border areas of Central America, during 2007-2010. Doctors were trained and supplied medicines, condoms and HIV testing (basic package of health care). The sample of users was characterized according to sociodemographic variables and the associated factors with the probability of receiving the basic package of care for STIs were analyzed using additive probit regression models. RESULTS: Of the total users, 66% had 25 to 59 years old, and 93% of users were women. The most frequently diagnosed STI were Candidiasis, Bacterial Vaginosis, Trichomoniasis, Gonorrhea and Syphilis. 60% of prescriptions for these STIs were adhered to the international recommendations. 53.1 % of users received only medicines, 5.8 ...

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