Building reproductive health research and audit capacity and activity in the pacific islands (BRRACAP) study: methods, rationale and baseline results

Abstract

BackgroundClinical research and audit in reproductive health is essential to improve reproductive health outcomes and to address the Millennium Development Goals 4 and 5. Research training, mentoring and a supportive participatory research environment have been shown to increase research activity and capacity in low to middle income countries (LMIC). This paper details the methods, rationale and baseline findings of a research program aimed at increasing clinical research activity and audit in the six Pacific Islands of Fiji, Samoa, Tonga, Vanuatu, Cook Islands and the Solomon Islands.MethodTwenty-eight clinician participants were selected by the five Ministries of Health and the Fiji National University to undergo a research capacity building program which includes a research workshop and mentoring support to perform research and audit as teams in their country. Data on the participants’ characteristics, knowledge and experiences were collected from structured interviews, questionnaires, focus groups, and an online survey. The interviews and the two focus groups were audio-recorded and all replies were analysed in a thematic framework.ResultsThe 28 participants included 9 nurses/midwives, 17 medical doctors of whom 8 were specialists in reproductive health and 2 other health workers. Most (24, 86%) were required to perform research as part of their employment and yet 17 (61%) were not confident in writing a research proposal, 13 (46%) could not use an electronic spreadsheet and the same number had not analysed quantitative data. The limited environmental enablers contributed to poor capacity with only 11 (46%) having access to a library, 10 (42%) receiving management support and 6 (25%) having access to an experienced researcher. Barriers to research that affected more than 70% of the participants were time constraints, poor coordination, no funding and a lack of skills.ConclusionBuilding a research capacity program appropriate for the diversity of Pacific clinicians required research evidence and collaborative effort of key stakeholders in the Pacific Islands and the region. The participants had limited research knowledge, skills and experience and would require individualized training and continuous intensive mentorship to realize their potential as clinician researchers for their services in the Pacific.

In-hospital capacity-building in research and management for pediatric professionals

“…In a questionnaire designed to probe the needs before the start of a research and management training program in the Pacific Islands, many physicians and nurses reported that they lacked basic research competencies (research protocol development, use of spreadsheets, critical reading of scientific papers). 24 There is a consensus that traditional short workshops in evidence-based medicine are insufficient to change behaviors, which calls for a comprehensive approach encompassing a multiplicity of levels and dimensions, including basic epidemiology concepts, knowledge transfer, guideline implementation and health policy development. 25,26 In line with this problem, the TEACH (Teaching Evidence Assimilation for Collaborative Health Care) program was developed and implemented in the United States, with a recent 5-year outcome report that highlights, as we do, the richness of multidisciplinary collaboration, process optimization using interactive activities and IT systems, on-the-job counseling to tackle contextspecific problems, and the complexity of assessing the actual impact of these educational interventions.…”

Capacitación hospitalaria de profesionales pediátricos en investigación y gestión

“…24 Existe consenso en que los talleres tradicionales breves de Medicina Basada en la Evidencia son insuficientes para modificar conductas, lo que requiere un enfoque integrado de diversos niveles y dimensiones, desde conceptos epidemiológicos básicos hasta transferencia del conocimiento a la implementación de guías o el desarrollo de políticas sanitarias. 25,26 Con esta orientación, se planificó el TEACH (Teaching Evidence Assimilation for Collaborative Health Care) Program en Estados Unidos, cuyo reciente reporte de resultados a 5 años destaca, como nosotros, la riqueza del trabajo multidisciplinario, la optimización de procesos usando actividades interactivas y sistemas informatizados, la asesoría ulterior en terreno para resolver problemas del propio contexto y la difícil evaluación del impacto real de estas intervenciones educativas.…”

Building Capacity for Research and Audit: Outcomes of a Training Workshop for Pacific Physicians and Nurses

“…The results of the Needs Analysis survey, combined with evidence from the literature were incorporated into designing the workshop curriculum detailed ina previous publication (Ekeroma et al, 2014). The workshop incorporated 48 hours of seminars, lectures and small group work over six days.…”

“…The Pacific Society for Reproductive Health (PSRH), with a large membership of reproductive health workers in thirteen Pacific Island countries, conducted three research workshops (2009, 2011 and 2013) for clinicians in response to the lack of reproductive health research in the region (Ekeroma et al, 2013;World Health Organization, 2007). The Society decided in 2013 to develop a programme called the Building Reproductive Research and Audit Capacity and Activity in the Pacific (BRRACAP) Study (Ekeroma, Kenealy, Shulruf, McCowan, & Hill, 2014) that would include evaluating effectiveness of research workshops. Research workshops form an important primary component of research capacity building programmes and their effectiveness has been measured in knowledge and skills gained (Ajuwon & Kass, 2008;Bates et al, 2007;Goto, Nguyen, Nguyen, & Hughes, 2005).…”

“…There have been no studies that have compared the effectiveness of research workshops on nurses and physicians attending the same workshop. This paper reports on the process and the immediate outcomes of the first research-training workshop within the BRRACAP Study (Ekeroma et al, 2014). We were also interested in the process of devising a research workshop curriculum and how the participants perceived the workshop content and delivery.…”