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PubMed2004

Facilitators and challenges to organizational capacity building in heart health promotion.

The authors describe the facilitators and challenges to a multi-sectoral initiative aiming at building organizational capacity for heart health promotion in Nova Scotia, Canada. The research process was guided by participatory action research. The study included 21 organizations from diverse sectors. Participant selection for the data collection was purposive. The authors collected data through organizational reflection logs and one-to-one semistructured interviews and used grounded theory techniques for the data analyses. Factors influencing organizational capacity for heart health promotion varied, depending on the project stage. Nonetheless, leadership, organizational readiness, congruence, research activities, technical supports, and partnerships were essential to capacity-building efforts. Approaches to organizational capacity building should be multi-leveled, because organizations are influenced by multiple social systems that are not all equally supportive of capacity.

Cardiovascular Diseases↗
PubMed2006

Setting directions for capacity building in primary health care: a survey of a research network.

BACKGROUND: The South Australian Research Network 'SARNet' aims to build research capacity in primary health care, as part of a national government-funded strategy to integrate research into clinical practice. Internationally, research networks have been a fundamental part of research culture change, and a variety of network models exist. The 'SARNet' model uses a whole system, multidisciplinary approach to capacity building and supports individuals and groups. We undertook a descriptive baseline survey in order to understand the background and needs of SARNet members and to tailor network activities towards those needs. METHODS: A questionnaire survey, assessing members' professional background, research experience, and interest in research development and training, was sent to all members who joined the network in its first year. The visual 'research spider' tool was used to ascertain members' experience in ten core research skills, as well as their interest in developing these skills. Individuals were asked to classify themselves into one of four categories of researchers, based on previous research experience. These self-assessment categories ranged from non-participant to academic. RESULTS: Network membership was diverse. Of the 89 survey participants, 55% were general practitioners or allied health professionals. Overall, most survey respondents indicated little to moderate experience in 7 out of the 10 skills depicted in the 'research spider'. In comparison, respondents were generally highly interested in developing their research skills in all areas. Respondents' research skills correlated significantly with their self-assessed category of research participation (Spearman rank correlation, r = 0.82, p < 0.0005). Correlations between research category and publication record (Gamma association, gamma = 0.53, p < 0.0005) or funding record (Gamma association, gamma = 0.62, p < 0.0005) supported the internal validity of the survey instrument. CONCLUSION: Literature describing evaluation of the impact of networks is scarce. Our survey questionnaire could provide a useful instrument for evaluation of both networks and capacity building initiatives. The survey including the 'research spider' tool provided valuable information about members' needs and interest in strategies to develop their research skills. Initial needs analyses as well as on-going evaluation of network activities are important to include into the business plans of research networks, in order to ensure the network's effectiveness and support of its membership.

Adult↗
PubMed2004

Systemic capacity building: a hierarchy of needs.

'Capacity building' is the objective of many development programmes and a component of most others. However, satisfactory definitions continue to elude us, and it is widely suspected of being too broad a concept to be useful. Too often it becomes merely a euphemism referring to little more than training. This paper argues that it is more important to address systemic capacity building, identifying a pyramid of nine separate but interdependent components. These form a four-tier hierarchy of capacity building needs: (1) structures, systems and roles, (2) staff and facilities, (3) skills, and (4) tools. Emphasizing systemic capacity building would improve diagnosis of sectoral shortcomings in specific locations, improve project/programme design and monitoring, and lead to more effective use of resources. Based on extensive action research in 25 States, experience from India is presented to illustrate how the concept of the capacity building pyramid has been put to practical use.

Community-Institutional Relations↗
PubMed2005

A framework to evaluate research capacity building in health care.

BACKGROUND: Building research capacity in health services has been recognised internationally as important in order to produce a sound evidence base for decision-making in policy and practice. Activities to increase research capacity for, within, and by practice include initiatives to support individuals and teams, organisations and networks. Little has been discussed or concluded about how to measure the effectiveness of research capacity building (RCB) DISCUSSION: This article attempts to develop the debate on measuring RCB. It highlights that traditional outcomes of publications in peer reviewed journals and successful grant applications may be important outcomes to measure, but they may not address all the relevant issues to highlight progress, especially amongst novice researchers. They do not capture factors that contribute to developing an environment to support capacity development, or on measuring the usefulness or the 'social impact' of research, or on professional outcomes. The paper suggests a framework for planning change and measuring progress, based on six principles of RCB, which have been generated through the analysis of the literature, policy documents, empirical studies, and the experience of one Research and Development Support Unit in the UK. These principles are that RCB should: develop skills and confidence, support linkages and partnerships, ensure the research is 'close to practice', develop appropriate dissemination, invest in infrastructure, and build elements of sustainability and continuity. It is suggested that each principle operates at individual, team, organisation and supra-organisational levels. Some criteria for measuring progress are also given. SUMMARY: This paper highlights the need to identify ways of measuring RCB. It points out the limitations of current measurements that exist in the literature, and proposes a framework for measuring progress, which may form the basis of comparison of RCB activities. In this way it could contribute to establishing the effectiveness of these interventions, and establishing a knowledge base to inform the science of RCB.

England↗
PubMed1992

Local knowledge: research capacity building in international health.

Processes of building research capacity in international health projects and their implications for anthropology are addressed using examples from the Applied Diarrheal Disease Research project funded by the United States Agency for International Development. Two aspects of training are examined: the way interdisciplinary methods--qualitative and quantitative approaches--are presented to researchers, given the context of international health research culture; and how researchers' local knowledge and local concerns in pursuing health research relevant to policy led them to become interested in anthropology. The consequences for anthropology's place and product in future capacity building efforts in international health research are discussed.

Anthropology, Cultural↗
PubMed2002

Research capacity building in general practice. The new Australian scene.

BACKGROUND: Primary care research needs strengthening. The Commonwealth Government Department of Health and Aged Care has recently funded the university departments of general practice and rural health to build research capacity in primary care. OBJECTIVE: To explore issues surrounding building primary care research capacity, as well as looking at barriers to research capacity building and ways of overcoming them. DISCUSSION: New funding provides many opportunities for increasing research capacity in primary health care areas. Different institutions will select those methods that are best suited to their skills and the requirements of their area.

Academic Medical Centers↗
PubMed2004

Building capacity in health research in the developing world.

Strong national health research systems are needed to improve health systems and attain better health. For developing countries to indigenize health research systems, it is essential to build research capacity. We review the positive features and weaknesses of various approaches to capacity building, emphasizing that complementary approaches to human resource development work best in the context of a systems and long-term perspective. As a key element of capacity building, countries must also address issues related to the enabling environment, in particular: leadership, career structure, critical mass, infrastructure, information access and interfaces between research producers and users. The success of efforts to build capacity in developing countries will ultimately depend on political will and credibility, adequate financing, and a responsive capacity-building plan that is based on a thorough situational analysis of the resources needed for health research and the inequities and gaps in health care. Greater national and international investment in capacity building in developing countries has the greatest potential for securing dynamic and agile knowledge systems that can deliver better health and equity, now and in the future.

Academies and Institutes↗
PubMedDate not supplied

What have we learned? Capacity building for health responses in disasters.

This is a synthesis of the presentations and discussions pertaining to Capacity Building for Health Responses in Disasters of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO), in Phuket, Thailand, 04-06 May 2005. The topics discussed included: (1) Specific goals; (2) Main focal areas, including available training programs, country-specific training programs, targeted technical assistance for training programs, certified training programs, and ensuring that funding is available for training; (3) What has been achieved in building capacity; (4) Challenges; (5) Where capacity building is needed; and (6) Conclusions and recommendations.

Disasters↗
PubMed2003

Closing the gap and widening the scope. New directions for research capacity building in primary health care.

BACKGROUND: Research capacity building initiatives abound within primary health care to increase the research base of the many component health professionals and organisations. Most initiatives aim to close the gaps between research, policy and practice. Many of these approaches have been unable to build the necessary skills among primary health care researchers to fully integrate research evidence into clinical practice, and ultimately to inform policy in this complex arena. OBJECTIVE: To propose a paradigm shift in the content of capacity building as a step toward closing the gaps between research, policy and practice. DISCUSSION: The complexity of the primary health care environment and the concept of development as a means to understanding and operating within primary health care research, policy and practice environments is discussed. A small pilot study was used to identify the underlying skills required in research, evaluation and development. In order to facilitate the paradigm shift an organisational development model was utilised that demonstrated congruency with this skill set. Further research is required to validate and apply this model in a primary health care research capacity building context.

Australia↗
PubMed1998

Field experiences: measuring capacity building efforts in HIV/AIDS prevention programmes.

OBJECTIVE: To present a theoretical and practical means for the evaluation of organizational and institutional development (capacity building) in HIV/AIDS prevention programmes in developing countries. METHODS: Multiple frameworks, methodologies and paradigms for the evaluation of organizational and institutional development were reviewed and synthesized, resulting in this proposed pluralistic model for the measurement of capacity building efforts. Traditional forms of capacity building evaluation (self-assessment, case study, outcome, and impact evaluation) are presented and a framework for their integration at the level of interpretation and inference is provided. The review is based on experiences in measuring capacity building in more than 20 countries and 200 projects, ranging from communications and behavior change initiatives to condom social marketing to sexually transmitted disease/HIV clinical interventions with a range of international and local non-governmental organizations and ministries of health. RESULTS: From this experience, we have found that conducting a mixed method evaluation of capacity building efforts allows for a more insightful assessment of capacity building and a more comprehensive evaluation of HIV prevention programmes. CONCLUSIONS: The capacity building conceptual framework developed (linking strategies, variables and outcomes) provides an instructive paradigm for the evaluation of HIV prevention interventions worldwide.

Benchmarking↗
PubMed2007

Advancing HIV/AIDS prevention among American Indians through capacity building and the community readiness model.

Although HIV/AIDS prevention has presented challenges over the past 25 years, prevention does work! To be most effective, however, prevention must be specific to the culture and the nature of the community. Building the capacity of a community for prevention efforts is not an easy process. If capacity is to be sustained, it must be practical and utilize the resources that already exist in the community. Attitudes vary across communities; resources vary, political climates are constantly varied and changing. Communities are fluid-always changing, adapting, growing. They are "ready" for different things at different times. Readiness is a key issue! This article presents a model that has experienced a high level of success in building community capacity for effective prevention/intervention for HIV/AIDS and offers case studies for review. The Community Readiness Model provides both quantitative and qualitative information in a user-friendly structure that guides a community through the process of understanding the importance of the measure of readiness. The model identifies readiness- appropriate strategies, provides readiness scores for evaluation, and most important, involves community stakeholders in the process. The article will demonstrate the importance of developing strategies consistent with readiness levels for more cost-effective and successful prevention efforts.

Centers for Disease Control and Prevention, U.S.↗
PubMed2005

Building capacity for health promotion--a case study from China.

During the period 1997-2000 a technical assistance project to build capacity for community-based health promotion was implemented in seven cities and one province in China. The technical assistance project formed part of a much larger World Bank supported program to improve disease prevention capabilities in China, commonly known as Health VII. The technical assistance project was funded by the Australian Agency for International Development. It was designed to develop capacity within the Ministry of Health (MOH) and the cities and province in the management of community-based health promotion projects, as well as supporting institutional development and public health policy reform. There are some relatively unique features of this technical assistance which helped shape its implementation and impact. It sought to provide the Chinese MOH and the cities and province with an introduction to comprehensive health promotion strategies, in contrast to the more limited information, education and communication strategies. The project was provided on a continuing basis over 3 years through a single institution, rather than as a series of ad hoc consultancies by individuals. Teaching and learning processes were developmental, leading progressively to a greater degree of local Chinese input and management to ensure sustainability and maintenance of technical support for the project. Based on this experience, this paper presents a model for capacity building projects of this type. It describes the education, training and planning activities that were the key inputs to the project, as well as the limited available evidence on the impact of the project. It describes how the project evolved over time to meet the changing needs of the participants, specifically how the content of the project shifted from a risk-factor orientation to a settings-based focus, and the delivery of the project moved from an expert-led approach to a more participatory, problem based learning approach. In terms of impact, marked differences before and after the implementation of the training activities were identified in key areas for reform, in addition to the self reported positive change in knowledge, and a high level of participant satisfaction. Key lessons are summarized. Technical assistance projects of this kind benefit from continuity and a high level of coordination, the provision of culturally and linguistically appropriate teaching, and a clear understanding of the need to match workforce development with organizational/institutional development.

China↗
PubMed2005

Capacity building for epidemiologic research: a case study in the newly independent state of Azerbaijan.

PURPOSE: Because many emerging economies lack local capacity for scientific research, capacity building has become a priority for many international development organizations. This article describes and critiques an approach used for building local capacity for applied health research in Azerbaijan, one of the newly independent states (NIS) of the former USSR. METHODS: In 2000, environmental epidemiology training courses were conducted in Azerbaijan. Several local participants of these courses received hands-on training in the planning and conduct of a subsequent cancer study as a practical extension of the training exercises. RESULTS: The research demonstrated that international collaboration can not only result in the successful completion of health research in NIS such as Azerbaijan, but also impart research knowledge and experience to local experts. Several practical issues were encountered in the conduct of the training activities that limited their effectiveness. The most desired result (the proposal and conduct of new research by local experts trained through these exercises) has yet to be achieved to the levels expected. CONCLUSIONS: International collaborations such as the approach described here are useful for imparting expertise to researchers in less affluent countries. However, comprehensive capacity building programs providing ongoing professional development, support, and an enabling environment, rather than scientific training alone, are required to achieve long-term sustainability and measurable outcomes.

Azerbaijan↗
PubMed2002

Reorienting health services with capacity building: a case study of the Core Skills in Health Promotion Project.

This paper presents a case study of the application of a framework for capacity building [Hawe, P., King, L., Noort, M., Jordens, C. and Lloyd, B. (2000) Indicators to Help with Capacity Building in Health Promotion. NSW Health, Sydney] to describe actions aimed at building organizational support for health promotion within an area health service in New South Wales, Australia. The Core Skills in Health Promotion Project (CSHPP) arose from an investigation which reported that participants of a health promotion training course had increased health promotion skills but that they lacked the support to apply their skills in the workplace. The project was action-research based. It investigated and facilitated the implementation of a range of initiatives to support community health staff to apply a more preventive approach in their practice and it contributed to the establishment of new organizational structures for health promotion. An evaluation was undertaken 4 years after the CSHPP was established, and 2 years after it had submitted its final report. Interviews with senior managers, document analysis of written reports, and focus groups with middle managers and service delivery staff were undertaken. Change was achieved in the three dimensions of health infrastructure, program maintenance and problem solving capacity of the organization. It was identified that the critically important elements in achieving the aims of the project-partnership, leadership and commitment-were also key elements of the capacity building framework. This case study provides a practical example of the usefulness of the capacity building framework in orienting health services to be supportive of health promotion.

Competency-Based Education↗
PubMed2007

Acción Mutua (Shared Action): a multipronged approach to delivering capacity-building assistance to agencies serving Latino communities in the United States.

Culturally appropriate, theory-based capacity-building assistance can serve a vital role in helping HIV prevention providers remain up-to-date, effective, and responsive to those they serve. Funded by the Centers for Disease Control and Prevention (CDC), AIDS Project Los Angeles, in collaboration with San Francisco State University's César E. Chávez Institute, conducted full-day site visits and qualitative interviews in 2005 with mid-level management staff of CDC-funded community-based organizations delivering HIV prevention services to Latino communities in the western region of the United States. We found that agencies we visited (1) had not yet adapted the evidence-based interventions they were using at the time of our visit and (2) requested technical assistance and training in the areas of program development, evaluation, group facilitation techniques, consumer recruitment, client retention, intervention adaptation, and materials development. Findings from this needs assessment were used to inform our seven-pronged approach to delivering capacity-building assistance entitled "Acción Mutua" (Shared Action). The approach emphasizes strategic partnerships, stakeholder involvement, organizational self-assessment, culturally appropriate materials development, interactive training, tailored onsite technical assistance, and professional networking opportunities. This article describes our approach in detail, the assessment process we used to develop it, and its implications for capacity-building practice.

California↗
PubMed2007

National-level capacity-building assistance model to enhance HIV prevention for Asian & Pacific Islander communities.

OBJECTIVES: Asian & Pacific Islander (A&PI) communities in the United States face increasing risk for HIV, yet have limited access to US culturally competent HIV prevention services. We describe a national HIV prevention capacity-building program for A&PI communities using a multitiered approach addressing systems, institutional, and individual level outcomes. METHODS: The program developed a national network of A&PI HIV and health-focused institutions, and conducts regional-level replication and dissemination of this model to support four areas of capacity building. This network is led by two national organizations coordinating the planning, implementation, and evaluation of the National Capacity-Building Assistance Program. RESULTS: Baseline data are compared with the last 2 years of preliminary data that show increased capacity among community-based organizations and health departments to strengthen culturally competent models of HIV prevention. Systems-level outcomes so far show enhanced leadership skills for HIV-related advocacy efforts, increased ability to leverage the media, and stronger partnerships between peer providers, health departments, and community leaders. CONCLUSION: This program model preliminarily demonstrates that national capacity-building initiatives can foster coalition development, replication of program models, materials sharing, and new leadership that improve HIV-related prevention services for A&PI communities.

Asian↗
PubMedDate not supplied

Outcomes and effectiveness research: capacity building for nurse researchers at the Agency for Healthcare Research and Quality.

Several of AHRQ's priority areas including disease prevention, health promotion, primary care, quality of care, service delivery, and patient safety are particularly relevant to nurse researchers. With much national attention focused on nursing-related issues such as staff shortages, training, mandatory overtime, working conditions, and autonomy, it is mandatory that nursing research be conducted to inform healthcare delivery and policy. Nurses also need to contribute to the health services literature so that an even balance of discipline perspective is represented. AHRQ's mandate is represented by the slogan "quality research for quality health care." Although our understanding has expanded of contributors to and determinants of evidence-based practice and the relationship between clinical care and improved outcomes, we have much to learn. Appreciating how and which components of nursing care influence patient outcomes represents an essential area of research in need of development. While clarifying nursing contributions to improved outcomes is not the sole purview of nurse researchers, it is plausible to assume that a clinical background in nursing combined with strong methodological skills can help policy makers and health system leaders understand how nurses can most effectively contribute to outcomes and quality improvement. AHRQ is clearly interested in capacity building of researchers from all relevant disciplines. Nurses, the largest provider of healthcare, need to build capacity and develop a much stronger presence in the health services research community of scholars.

Health Priorities↗
PubMed1994

Capacity building for health social science: the International Clinical Epidemiology Network (INCLEN) social science program and the International Forum for Social Science in Health (IFSSH).

This paper describes the unfolding of two complementary efforts to build global capacity in health social science. The INCLEN model aims to infuse a genuine transdisciplinary perspective into international health through equipping social scientists to speak a common language with clinical epidemiologists and sensitising clinicians to the ways social sciences contribute to research and policy. Issues are raised pertinent to the model's viability, including recruitment of scholars for fellowships, curriculum substance, and mechanisms for integrating social science fellows when they return home. The future success of the INCLEN program, and comparable donor initiatives, depends upon a wider infrastructure of career supports played out at the international level in which donor and operating agencies nourish the emergence of an expanded body of health social scientists. The International Forum for Social Sciences in Health (IFSSH) has been formed to help build this infrastructure and provide impetus for a viable scientific community of health social scientists. The IFSSH 'global agenda' is portrayed and an illustration is given of how this agenda is being implemented in the Asia and Pacific region.

Career Choice↗