{"title":"在低收入和中等收入国家通过能力建设培训教员卫生倡议实现和维持变革:一项系统审查。","authors":"Bobbi Snowden, Shaon Lahiri, Rebecca Dutton, Lindsay Morton","doi":"10.1097/CEH.0000000000000458","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Given the anticipated health challenges, forecasted deficiencies in the global health workforce, and steady demands to work through resource constraints, effective and efficient training approaches to build capacity are direly needed. Although train-the-trainer (T3) is not a new approach, there has been considerable interest in using it to develop and sustain capacity, particularly in low- and middle-income countries. This systematic review aimed to better understand the factors to achieve and sustain change across multiple countries and levels through T3 approaches.</p><p><strong>Methods: </strong>A literature search was conducted of six scholarly, peer-reviewed, and gray literature databases. Data were extracted for the study method, design, characteristics, and implicit or explicit factors related to maximizing the likelihood of achieving and sustaining change. An existing conceptual framework for T3 interventions in global health guided the thematic analysis. The framework consisted of five factors pertinent to capacity building T3 initiatives: Talent, Resources, Alignment, Implementation, and Nurture and Development.</p><p><strong>Results: </strong>Twenty-two studies met the inclusion criteria. The T3 training spanned all geographical regions, but interventions were most prevalent in sub-Saharan Africa (46%). Nearly all studies (68%) quantitatively examined change at the individual level (95%), but some studies also explored change at the organizational (77%) and institutional (23%) levels. Implementation and Nurture/Development were the two most salient factors in achieving and sustaining change. The greatest hindrances involved Resources and Context , an additional theme that the data identified.</p><p><strong>Discussion: </strong>The findings and recommendations from this first systematic review exploring antecedents influencing change through health-related T3 interventions can inform training and capacity-building investments, improve existing T3 initiatives, and steer planning for future approaches.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Achieving and Sustaining Change Through Capacity Building Train-the-Trainer Health Initiatives in Low- and Middle-Income Countries: A Systematic Review.\",\"authors\":\"Bobbi Snowden, Shaon Lahiri, Rebecca Dutton, Lindsay Morton\",\"doi\":\"10.1097/CEH.0000000000000458\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Given the anticipated health challenges, forecasted deficiencies in the global health workforce, and steady demands to work through resource constraints, effective and efficient training approaches to build capacity are direly needed. Although train-the-trainer (T3) is not a new approach, there has been considerable interest in using it to develop and sustain capacity, particularly in low- and middle-income countries. This systematic review aimed to better understand the factors to achieve and sustain change across multiple countries and levels through T3 approaches.</p><p><strong>Methods: </strong>A literature search was conducted of six scholarly, peer-reviewed, and gray literature databases. Data were extracted for the study method, design, characteristics, and implicit or explicit factors related to maximizing the likelihood of achieving and sustaining change. An existing conceptual framework for T3 interventions in global health guided the thematic analysis. The framework consisted of five factors pertinent to capacity building T3 initiatives: Talent, Resources, Alignment, Implementation, and Nurture and Development.</p><p><strong>Results: </strong>Twenty-two studies met the inclusion criteria. The T3 training spanned all geographical regions, but interventions were most prevalent in sub-Saharan Africa (46%). Nearly all studies (68%) quantitatively examined change at the individual level (95%), but some studies also explored change at the organizational (77%) and institutional (23%) levels. Implementation and Nurture/Development were the two most salient factors in achieving and sustaining change. The greatest hindrances involved Resources and Context , an additional theme that the data identified.</p><p><strong>Discussion: </strong>The findings and recommendations from this first systematic review exploring antecedents influencing change through health-related T3 interventions can inform training and capacity-building investments, improve existing T3 initiatives, and steer planning for future approaches.</p>\",\"PeriodicalId\":50218,\"journal\":{\"name\":\"Journal of Continuing Education in the Health Professions\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Continuing Education in the Health Professions\",\"FirstCategoryId\":\"95\",\"ListUrlMain\":\"https://doi.org/10.1097/CEH.0000000000000458\",\"RegionNum\":4,\"RegionCategory\":\"教育学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"EDUCATION, SCIENTIFIC DISCIPLINES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Continuing Education in the Health Professions","FirstCategoryId":"95","ListUrlMain":"https://doi.org/10.1097/CEH.0000000000000458","RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
Achieving and Sustaining Change Through Capacity Building Train-the-Trainer Health Initiatives in Low- and Middle-Income Countries: A Systematic Review.
Introduction: Given the anticipated health challenges, forecasted deficiencies in the global health workforce, and steady demands to work through resource constraints, effective and efficient training approaches to build capacity are direly needed. Although train-the-trainer (T3) is not a new approach, there has been considerable interest in using it to develop and sustain capacity, particularly in low- and middle-income countries. This systematic review aimed to better understand the factors to achieve and sustain change across multiple countries and levels through T3 approaches.
Methods: A literature search was conducted of six scholarly, peer-reviewed, and gray literature databases. Data were extracted for the study method, design, characteristics, and implicit or explicit factors related to maximizing the likelihood of achieving and sustaining change. An existing conceptual framework for T3 interventions in global health guided the thematic analysis. The framework consisted of five factors pertinent to capacity building T3 initiatives: Talent, Resources, Alignment, Implementation, and Nurture and Development.
Results: Twenty-two studies met the inclusion criteria. The T3 training spanned all geographical regions, but interventions were most prevalent in sub-Saharan Africa (46%). Nearly all studies (68%) quantitatively examined change at the individual level (95%), but some studies also explored change at the organizational (77%) and institutional (23%) levels. Implementation and Nurture/Development were the two most salient factors in achieving and sustaining change. The greatest hindrances involved Resources and Context , an additional theme that the data identified.
Discussion: The findings and recommendations from this first systematic review exploring antecedents influencing change through health-related T3 interventions can inform training and capacity-building investments, improve existing T3 initiatives, and steer planning for future approaches.
期刊介绍:
The Journal of Continuing Education is a quarterly journal publishing articles relevant to theory, practice, and policy development for continuing education in the health sciences. The journal presents original research and essays on subjects involving the lifelong learning of professionals, with a focus on continuous quality improvement, competency assessment, and knowledge translation. It provides thoughtful advice to those who develop, conduct, and evaluate continuing education programs.