Implementation research training for learners in low- and middle-income countries: evaluating behaviour change after participating in a massive open online course

Abstract Background Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programs and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of a massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization on the topic of IR with a focus on infectious diseases of poverty. This study followed Kirkpatrick’s Model to evaluate training programs with a specific focus on post-training changes in behavior. Methods MOOC participants were invited to take part in an anonymous online survey examining their IR knowledge and how they applied it in their professional practice approximately 1-1.5 years after completing the MOOC. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded. Results A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents’ IR knowledge had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently. Respondents most often cited changes in their conceptual understanding of IR and understanding of the research process as substantial areas of change influenced by participating in the MOOC. Conclusions These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and in contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.

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Implementation Research Training for Learners in Low- and Middle-Income Countries: Evaluating Behavior Change after Participating in A Massive Online Open Course

10.21203/rs.3.rs-63059/v1 ◽

2020 ◽

Author(s):

Pascal Launois ◽

Dermot Maher ◽

Edith Certain ◽

Bella Ross ◽

Michael J. Penkunas

Keyword(s):

Professional Practice ◽

Implementation Research ◽

Online Survey ◽

Training Programs ◽

Research Training ◽

Critical Role ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Background: Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programs and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of a massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization on the topic of IR with a focus on infectious diseases of poverty. This study followed Kirkpatrick’s Model to evaluate training programs with a specific focus on post-training changes in behavior.Methods: MOOC participants were invited to take part in an anonymous online survey examining their IR knowledge and how they applied it in their professional practice approximately 1-1.5 years after completing the MOOC. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded.Results: A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents’ IR knowledge had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently. Respondents most often cited changes in their conceptual understanding of IR and understanding of the research process as substantial areas of change influenced by participating in the MOOC.Conclusions: These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and in contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.

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Implementation Research Training for Learners in Low- and Middle-income Countries: Evaluating Behavior Change After Participating in a Massive Online Open Course

10.21203/rs.3.rs-78226/v1 ◽

2020 ◽

Author(s):

Pascal Launois ◽

Dermot Maher ◽

Edith Certain ◽

Bella Ross ◽

Michael J. Penkunas

Keyword(s):

Professional Practice ◽

Implementation Research ◽

Online Survey ◽

Training Programs ◽

Research Training ◽

Critical Role ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Background: Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programs and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of a massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization on the topic of IR with a focus on infectious diseases of poverty. This study followed Kirkpatrick’s Model to evaluate training programs with a specific focus on post-training changes in behavior.Methods: MOOC participants were invited to take part in an anonymous online survey examining their IR knowledge and how they applied it in their professional practice approximately 1-1.5 years after completing the MOOC. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded.Results: A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents’ IR knowledge had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently. Respondents most often cited changes in their conceptual understanding of IR and understanding of the research process as substantial areas of change influenced by participating in the MOOC.Conclusions: These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and in contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.

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Implementation Research Training for Learners in Low- and Middle-income Countries: Evaluating Behavior Change After Participating in a Massive Online Open Course

10.21203/rs.3.rs-118969/v1 ◽

2020 ◽

Author(s):

Pascal Launois ◽

Dermot Maher ◽

Edith Certain ◽

Bella Ross ◽

Michael J. Penkunas

Keyword(s):

Professional Practice ◽

Implementation Research ◽

Online Survey ◽

Training Programs ◽

Research Training ◽

Critical Role ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Background: Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programs and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of a massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization on the topic of IR with a focus on infectious diseases of poverty. This study followed Kirkpatrick’s Model to evaluate training programs with a specific focus on post-training changes in behavior.Methods: MOOC participants were invited to take part in an anonymous online survey examining their IR knowledge and how they applied it in their professional practice approximately 1-1.5 years after completing the MOOC. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded.Results: A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents’ IR knowledge had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently. Respondents most often cited changes in their conceptual understanding of IR and understanding of the research process as substantial areas of change influenced by participating in the MOOC.Conclusions: These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and in contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.

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Evaluation of a massive open online course for just-in-time training in resource-limited settings: evidence from a COVID-19 course for healthcare workers (Preprint)

10.2196/preprints.26815 ◽

2020 ◽

Author(s):

Matthew Charles Strehlow ◽

Kelly Zhang Aluri ◽

Jamie Sewan Johnston ◽

Charles G Prober ◽

Peter Corrigan Acker ◽

...

Keyword(s):

Public Health ◽

Online Courses ◽

Course Completion ◽

Online Course ◽

Massive Open Online ◽

Final Exam ◽

Middle Income ◽

Middle Income Countries ◽

Massive Open Online Course ◽

The Impact

BACKGROUND The COVID-19 pandemic created an urgent global need for healthcare worker (HCW) training. Initial COVID-19-related online courses focused primarily on training public health workers and physicians caring for patients in intensive care units (ICUs). However, in resource-constrained settings, nurses and general practitioners are responsible for providing most COVID-19 patient medical care, typically lacking the training and equipment necessary to manage complex, critically ill patients. In these environments, early recognition and interventions to prevent patient deterioration are essential to optimizing outcomes. We developed a massive open online course (MOOC) for HCWs in resource-constrained settings aimed at training bedside providers caring for patients with COVID-19. OBJECTIVE This study evaluates the impact of this MOOC by assessing HCW course engagement, knowledge, confidence in caring for COVID-19 patients, and user experience. METHODS From May thru June of 2020, the course was rapidly developed by a team of physicians, educators, medical illustrators, and education technology staff, and was subsequently launched on two online platforms in July 2020. The approximately 4-hour course comprises 6 video-based modules with accompanying handouts. Student knowledge was assessed using pre- and post-module quizzes and a final exam, while demographics and user experience were evaluated by pre- and post-course surveys and data collected through the platforms. RESULTS From July 17th to September 24th, 30,859 students enrolled, 18,818 started, and 7,101 completed the course. Most participants worked in healthcare (86%) and resided in lower middle- (36%) or upper middle- (21%) income countries. Higher course completion rates were observed among learners who were from upper middle-income (aOR 1.152 [95% CI 1.019-1.303]) and lower middle-income countries (aOR 1.229 [95% CI 1.104-1.368]). Significant knowledge gains were observed from pre-module (mean 56% [SD 17%]) to post-module quizzes (80% [SD 15%], P<.001), and from pre-module quizzes to the final exam (78% [SD 17%], P<.001). After course completion, participants reported increased self-efficacy regarding the course objectives, with a 0.63 mean increase on a 4-point scale (95% CI [0.60,0.66]). Overall, there was high satisfaction with the course experience, with 93% of participants reporting they would recommend the course to others. CONCLUSIONS This study demonstrates the potential of MOOCs to rapidly provide access to emerging medical knowledge during a public health crisis, particularly for HCWs in high- and middle-income countries. Further research is required to understand the impact of such online courses on patient care and how to better reach learners in low-income countries.

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Designing the next generation of implementation research training for learners in low- and middle-income countries

Globalization and Health ◽

10.1186/s12992-021-00714-3 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Michael J. Penkunas ◽

Shiau Yun Chong ◽

Emma L. M. Rhule ◽

Evangelia Berdou ◽

Pascale Allotey

Keyword(s):

Implementation Research ◽

Research Training ◽

Training Model ◽

Learning By Doing ◽

Health Interventions ◽

System Level ◽

High Quality Research ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

AbstractEfficacious health interventions tested through controlled trials often fail to show desired impacts when implemented at scale. These challenges can be particularly pervasive in low- and middle-income settings where health systems often lack the capacity and mechanisms required for high-quality research and evidence translation. Implementation research is a powerful tool for identifying and addressing the bottlenecks impeding the success of proven health interventions. Implementation research training initiatives, although growing in number, remain out of reach for many investigators in low- and middle-income settings, who possess the knowledge required to contextualize challenges and potential solutions in light of interacting community- and system-level features. We propose a realigned implementation research training model that centers on team-based learning, tailored didactic opportunities, learning-by-doing, and mentorship.

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Noncommunicable Diseases in Low- and Middle-Income Countries: A Strategic Approach to Develop a Global Implementation Research Workforce

Global Heart ◽

10.1016/j.gheart.2018.05.001 ◽

2018 ◽

Vol 13 (2) ◽

pp. 131 ◽

Cited By ~ 7

Author(s):

Michael M. Engelgau ◽

Joshua P. Rosenthal ◽

Bradley J. Newsome ◽

LeShawndra Price ◽

Deshiree Belis ◽

...

Keyword(s):

Implementation Research ◽

Noncommunicable Diseases ◽

Middle Income ◽

Middle Income Countries ◽

Strategic Approach ◽

Research Workforce ◽

Low And Middle Income

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A systematic review of employment outcomes from youth skills training programmes in agriculture in low- and middle-income countries

Nature Food ◽

10.1038/s43016-020-00172-x ◽

2020 ◽

Vol 1 (10) ◽

pp. 605-619 ◽

Cited By ~ 1

Author(s):

W. H. Eugenie Maïga ◽

Mohamed Porgo ◽

Pam Zahonogo ◽

Cocou Jaurès Amegnaglo ◽

Doubahan Adeline Coulibaly ◽

...

Keyword(s):

Systematic Review ◽

Grey Literature ◽

Skills Training ◽

Urban Migration ◽

Youth Engagement ◽

Middle Income ◽

Middle Income Countries ◽

Positive Effects ◽

Training Programmes ◽

Low And Middle Income

Abstract Engagement of youth in agriculture in low- and middle-income countries may offer opportunities to curb underemployment, urban migration, disillusionment of youth and social unrest, as well as to lift individuals and communities from poverty and hunger. Lack of education or skills training has been cited as a challenge to engage youth in the sector. Here we systematically interrogate the literature for the evaluation of skills training programmes for youth in low- and middle-income countries. Sixteen studies—nine quantitative, four qualitative and three mixed methods—from the research and grey literature documented the effects of programmes on outcomes relating to youth engagement, including job creation, income, productivity and entrepreneurship in agriculture. Although we find that skills training programmes report positive effects on our chosen outcomes, like previous systematic reviews we find the topic to chronically lack evaluation. Given the interest that donors and policymakers have in youth engagement in agriculture, our systematic review uncovers a gap in the knowledge of their effectiveness.

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Barriers and facilitators to implementation of oral rehydration therapy in low- and middle-income countries: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0249638 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249638

Author(s):

Obidimma Ezezika ◽

Apira Ragunathan ◽

Yasmine El-Bakri ◽

Kathryn Barrett

Keyword(s):

Systematic Review ◽

Implementation Research ◽

Oral Rehydration Therapy ◽

Barriers And Facilitators ◽

World Health ◽

Successful Implementation ◽

Middle Income ◽

Oral Rehydration ◽

Middle Income Countries ◽

Low And Middle Income

Background Oral rehydration therapy (ORT) is an effective and cheap treatment for diarrheal disease; globally, one of the leading causes of death in children under five. The World Health Organization launched a global campaign to improve ORT coverage in 1978, with activities such as educational campaigns, training health workers and the creation of designate programming. Despite these efforts, ORT coverage remains relatively low. The objective of this systematic review is to identify the barriers and facilitators to the implementation of oral rehydration therapy in low and middle-income countries. Methods A comprehensive search strategy comprised of relevant subject headings and keywords was executed in 5 databases including OVID Medline, OVID Embase, OVID HealthStar, Web of Science and Scopus. Eligible studies underwent quality assessment, and a directed content analysis approach to data extraction was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR) to facilitate narrative synthesis. Results The search identified 1570 citations and following removal of duplicates as well as screening according to our inclusion/exclusion criteria, 55 articles were eligible for inclusion in the review. Twenty-three countries were represented in this review, with India, Bangladesh, Egypt, Nigeria, and South Africa having the most representation of available studies. Study dates ranged from 1981 to 2020. Overarching thematic areas spanning the barriers and facilitators that were identified included: availability and accessibility, knowledge, partnership engagement, and design and acceptability. Conclusion A systematic review of studies on implementation of ORT in low- and middle-income countries (LMICs) highlights key activities that facilitate the development of successful implementation that include: (1) availability and accessibility of ORT, (2) awareness and education among communities, (3) strong partnership engagement strategies, and (4) adaptable design to enhance acceptability. The barriers and facilitators identified under the CIFR domains can be used to build knowledge on how to adapt ORT to national and local settings and contribute to a better understanding on the implementation and use of ORT in LMICs. The prospects for scaling and sustaining ORT (after years of low use) will increase if implementation research informs local applications, and implementers engage appropriate stakeholders and test assumptions around localized theories of change from interventions to expected outcomes. Registration A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD420201695).

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