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Kpokiri EE, McDonald K, Abraha YG, Osorio L, Nath TC, Talavera-Urdanivia VA, Akinwale OP, Manabe YC, Castelnuovo B, Tang W, Yilma D, Mihut M, Ezechi O, Iwelunmor J, Kaba M, Abdissa A, Tucker JD. Health research mentorship in low-income and middle-income countries: a global qualitative evidence synthesis of data from a crowdsourcing open call and scoping review. BMJ Glob Health 2024; 9:e011166. [PMID: 38184299 PMCID: PMC10773352 DOI: 10.1136/bmjgh-2022-011166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/06/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION Research mentorship is critical for advancing science, but there are few practical strategies for cultivating mentorship in health research resource-limited settings. WHO/TDR Global commissioned a group to develop a practical guide on research mentorship. This global qualitative evidence synthesis included data from a crowdsourcing open call and scoping review to identify and propose strategies to enhance research mentorship in low/middle-income country (LMIC) institutions. METHODS The crowdsourcing open call used methods recommended by WHO/TDR and solicited descriptions of strategies to enhance research mentorship in LMICs. The scoping review used the Cochrane Handbook and predefined the approach in a protocol. We extracted studies focused on enhancing health research mentorship in LMICs. Textual data describing research mentorship strategies from the open call and studies from the scoping review were coded into themes. The quality of evidence supporting themes was assessed using the Confidence in the Evidence from Reviews of Qualitative research approach. RESULTS The open call solicited 46 practical strategies and the scoping review identified 77 studies. We identified the following strategies to enhance research mentorship: recognising mentorship as an institutional responsibility that should be provided and expected from all team members (8 strategies, 15 studies; moderate confidence); leveraging existing research and training resources to enhance research mentorship (15 strategies, 49 studies; moderate confidence); digital tools to match mentors and mentees and sustain mentorship relations over time (14 strategies, 11 studies; low confidence); nurturing a culture of generosity so that people who receive mentorship then become mentors to others (7 strategies, 7 studies; low confidence); peer mentorship defined as informal and formal support from one researcher to another who is at a similar career stage (16 strategies, 12 studies; low confidence). INTERPRETATION Research mentorship is a collective institutional responsibility, and it can be strengthened in resource-limited institutions by leveraging already existing resources. The evidence from the crowdsourcing open call and scoping review informed a WHO/TDR practical guide. There is a need for more formal research mentorship programmes in LMIC institutions.
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Affiliation(s)
- Eneyi E Kpokiri
- Clinical Research Department, London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK
| | - Kamryn McDonald
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | | | - Lyda Osorio
- School of Public Health, Universidad del Valle, Cali, Colombia
| | - Tilak Chandra Nath
- Department of Parasitology, Chungbuk National University, Cheongju, Korea (the Republic of)
- Department of Parasitology, Sylhet Agricultural University, Sylhet, Bangladesh
| | | | | | - Yukari Carol Manabe
- Johns Hopkins Medicine, Baltimore, Maryland, USA
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Kampala, Uganda
| | - Barbara Castelnuovo
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Kampala, Uganda
| | - Weiming Tang
- School of Public Health, Southern Medical University, Guangzhou, China
- The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Daniel Yilma
- Department of Internal Medicine, Jimma University, Jimma, Ethiopia
| | - Michael Mihut
- TDR, The Special Programme for Research and Training in Tropical Diseases co-sponsored by UNICEF, UNDP, the World Bank and WHO, WHO, Geneva, Switzerland
| | - Oliver Ezechi
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Juliet Iwelunmor
- Saint Louis University College for Public Health and Social Justice, Saint Louis, Missouri, USA
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Alemseged Abdissa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia, Addis Ababa, Ethiopia
| | - Joseph D Tucker
- Clinical Research Department, London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
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Kaba M, Birhanu Z, Fernandez Villalobos NV, Osorio L, Echavarria MI, Berhe DF, Tucker JD, Abdissa A, Abraha YG. Health research mentorship in low- and middle-income countries: a scoping review. JBI Evid Synth 2023; 21:1912-1970. [PMID: 37461876 DOI: 10.11124/jbies-22-00260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
OBJECTIVE The objective of this scoping review was to explore and synthesize the available literature on health research mentorship in low- and middle-income countries (LMICs). INTRODUCTION Research mentorship is broadly considered a useful strategy to improve research capacities and research outputs. Existing literature and guidance on research mentorship have focused on high-income countries and assumed resource-rich environments. Despite the successful endeavors to improve health research capacity in LMICs, the strategies that work best under different circumstances are poorly understood. There is a need to map and understand the evidence on health research mentorship in the context of LMICs. INCLUSION CRITERIA Sources that reported existing practices, barriers, and mitigation strategies related to health research mentorship in LMICs were included. METHODS We searched for published and unpublished studies and reports written in English, Spanish, or Portuguese. The search strategy was not limited by search dates and the last search was conducted on January 28, 2022. The databases searched included MEDLINE (PubMed), Embase, Web of Science Core Collection, CINAHL (EBSCOhost), Cochrane Database of Systematic Reviews, and JBI Evidence Synthesis . We also searched for gray literature in a selection of websites and digital repositories. The JBI scoping review methodology was used. RESULTS A total of 77 studies and reports were included in the review. The majority of the papers were from Africa (n=28). Others were from the Americas (n=7), South East Asia (n=4), East Mediterranean (n=2), and Western Pacific (n=2). The remaining studies were from LMICs that included at least 2 regional offices. Most of the mentorship projects (n=55) were initiated and funded by institutions from high-income countries. The first authors of 41 papers were primarily affiliated with LMICs. The findings were categorized under a description of research mentorship practices, barriers related to research mentorship, and suggested mitigation strategies. Deliverable-driven training using intensive hands-on mentorship and ongoing peer mentorship programs were some of the non-regular, non-institutionalized approaches used to improve research capacity for junior researchers in LMICs. None of the included papers focused on institutional components of research mentorship in LMICs. The barriers to research mentorship activities in LMICs included lack of clarity on mentorship, cultural variations, unbalanced power dynamics, socio-political influences, language barriers, lack of experienced mentors, and limited local funding. Institutionalizing research mentorship, adapting mentoring methodologies relying on local resources, and addressing and respecting diversity in mentorship programs were among the main strategies identified to effectively implement research mentorship in LMICs. CONCLUSIONS Research mentorship initiatives and practices are limited in LMICs. Few available practices have been introduced by researchers and research institutions from high-income countries and those that have are not yet institutionalized. The identified existing practices, barriers, and facilitators on health research mentorship could help the design, implementation, and evaluation of programs to institutionalize health research mentorship in LMICs. REVIEW REGISTRATION Open Science Framework osf.io/jqa9z/. SUPPLEMENTAL DIGITAL CONTENT A Spanish-language version of the abstract of this review is available as supplemental digital content: http://links.lww.com/SRX/A32.
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Affiliation(s)
- Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zewdie Birhanu
- Department of Health, Behavior and Society, Public Health Faculty, Jimma University, Jimma, Ethiopia
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia
| | | | | | - Maria Isabel Echavarria
- Centro Internacional de Entrenamiento e Investigaciones Medicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Derbew Fikadu Berhe
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Joseph D Tucker
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Yoseph Gebreyohannes Abraha
- Knowledge Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Ethiopian Knowledge Translation Group for Health: a JBI Affiliated Group, The Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Ransing R, Hawk M, McDonald M, Jones J, Bhatia T, Verma V, Shah GD, Brar J, Egan JE, Konsale P, Kaur J, Singh R, Singh H, Dhaliwal RS, Wood J, Nimgaonkar V, Deshpande S, Swaminathan S. A mentored hands-on training model for scaling up implementation and intervention research in India: "connecting the dots". Health Res Policy Syst 2023; 21:33. [PMID: 37131159 PMCID: PMC10153774 DOI: 10.1186/s12961-023-00980-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/05/2023] [Indexed: 05/04/2023] Open
Abstract
Despite the high burden of mental disorders in low- and middle-income countries (LMICs), less than 25% of those in need have access to appropriate services, in part due to a scarcity of locally relevant, evidence-based interventions and models of care. To address this gap, researchers from India and the United States and the Indian Council of Medical Research (ICMR) collaboratively developed a "Grantathon" model to provide mentored research training to 24 new principal investigators (PIs). This included a week-long didactic training, a customized web-based data entry/analysis system and a National Coordination Unit (NCU) to support PIs and track process objectives. Outcome objectives were assessed via scholarly output including publications, awards received and subsequent grants that were leveraged. Multiple mentorship strategies including collaborative problem-solving approaches were used to foster single-centre and multicentre research. Flexible, approachable and engaged support from mentors helped PIs overcome research barriers, and the NCU addressed local policy and day-to-day challenges through informal monthly review meetings. Bi-annual formal review presentations by all PIs continued through the COVID-19 pandemic, enabling interim results reporting and scientific review, also serving to reinforce accountability. To date, more than 33 publications, 47 scientific presentations, 12 awards, two measurement tools, five intervention manuals and eight research grants have been generated in an open-access environment. The Grantathon is a successful model for building research capacity and improving mental health research in India that could be adopted for use in other LMICs.
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Affiliation(s)
- Ramdas Ransing
- Department of Psychiatry, BKL Walwalkar Rural Medical College, Sawarde, Ratnagiri, Maharashtra, 415606, India
| | - Mary Hawk
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, United States of America.
| | - Margaret McDonald
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, United States of America
| | - Jacquelyn Jones
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America
| | - Triptish Bhatia
- National Coordinating Unit ICMR for NMHP Projects, Department of Psychiatry, Centre of Excellence in Mental Health, ABVIMS, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Vijay Verma
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Gyan D Shah
- National Coordinating Unit ICMR for NMHP Projects, Department of Psychiatry, Centre of Excellence in Mental Health, ABVIMS, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Jaspreet Brar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, Community Care Behavioral Health Organization, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America
| | - James Erin Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, United States of America
| | - Prasad Konsale
- University of Pittsburgh School of Medicine, University of Pittsburgh Swanson School of Engineering, VA Pittsburgh Healthcare System, Pittsburgh, PA, 15213, United States of America
| | - Jasmine Kaur
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Ravinder Singh
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Harpreet Singh
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - R S Dhaliwal
- Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Joel Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America
| | - Vishwajit Nimgaonkar
- Psychiatry and Human Genetics, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, PA, United States of America
| | - Smita Deshpande
- Department of Psychiatry, Centre of Excellence in Mental Health, ABVIMS - Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, 110001, India
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Hawcroft C, Rossi E, Tilouche N, d'Oliveira AF, Bacchus LJ. Engaging early career researchers in a global health research capacity-strengthening programme: a qualitative study. Health Res Policy Syst 2023; 21:19. [PMID: 36927776 PMCID: PMC10018921 DOI: 10.1186/s12961-022-00949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/13/2022] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Research capacity-strengthening is recognized as an important component of global health partnership working, and as such merits monitoring and evaluation. Early career researchers are often the recipients of research capacity-strengthening programmes, but there is limited literature regarding their experience. METHODS We conducted a qualitative study as part of an internal evaluation of the capacity-strengthening programme of the international HERA (HEalthcare Responding to violence and Abuse) research group. Semi-structured interviews were conducted with group members, and thematic analysis was undertaken. RESULTS Eighteen group members participated; nine of these were early career researchers, and nine were other research team members, including mid-career and senior researchers. Key themes were identified which related to their engagement with and experience of a research capacity-strengthening programme. We explored formal/planned elements of our programme: mentoring and supervision; training and other opportunities; funding and resources. Participants also discussed informal/unplanned elements which acted as important facilitators and/or barriers to engaging with research capacity-strengthening: English language; open relationships and communication; connection and disconnection; and diversity. The sustainability of the programme was also discussed. CONCLUSIONS Our study gives voice to the early career researcher experience of engaging with a research capacity-strengthening programme in a global health group. We highlight some important elements that have informed adaptations to our programme and may be relevant for consideration by other global health research capacity-strengthening programmes. Our findings contribute to the growing literature and important discussions around research capacity-strengthening and how this relates to the future directions of global health partnership working.
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Affiliation(s)
- Claire Hawcroft
- Bristol Medical School, University of Bristol, 5 Tyndall Ave, Bristol, BS8 1UD, United Kingdom.
| | - Evelina Rossi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Nerissa Tilouche
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Ana Flavia d'Oliveira
- Faculty of Medicine, University of Sao Paulo, Av. Dr. Arnaldo, 455, São Paulo, SP, 01246-903, Brazil
| | - Loraine J Bacchus
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
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McEvoy PM, Horgan B, Eadon OL, Yong MJ, Soraine J, Chiu VW. Development of a research capacity and culture tool for people with lived experience of mental health challenges. Aust N Z J Psychiatry 2022; 57:865-874. [PMID: 36120943 DOI: 10.1177/00048674221125597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study investigated research capacity and culture in people with lived experience of mental health challenges by developing a quantitative tool that measures capacity to engage in research. METHOD A cross-sectional, correlational methodology was employed, which comprised of three phases: lived experience consultations for item development (n = 15), item refinement (n = 20) and tool piloting. Items were adapted from, and extended, an existing research capacity and culture tool for healthcare workers. People (N = 112) with lived experience as mental health consumers, carers, peer workers and/or advocates aged 18-75 years took part in the tool piloting survey. RESULTS Overall, participants rated their individual research capacity and culture skills as moderate (mean = 5.41, standard deviation = 2.04). The most commonly reported barriers to research engagement related to lack of knowledge, familiarity or experience with the research process. The most commonly reported enablers were altruistic, such as using their experiences to improve services and help others. Research capacity and culture significantly correlated with current research activities (rs = 0.25-0.41; ps < 0.05), but not with being a research participant (r = 0.09; p > 0.05), suggesting that building research capacity of people with lived experience requires them to be active members of research teams. CONCLUSION The Lived Experience research capacity and culture tool developed in this study revealed that people with lived experience of mental health challenges are intrinsically motivated to engage in research to improve consumer outcomes. The tool may be useful to assess self, research team and organisational preparedness to conduct genuinely co-designed research, and to assess changes in lived experience research capacities and culture over time.
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Affiliation(s)
- Peter M McEvoy
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia.,enAble Institute, Curtin University, Bentley, WA, Australia.,Centre for Clinical Interventions, North Metropolitan Health Service, Nedlands, WA, Australia
| | - Ben Horgan
- enAble Institute, Curtin University, Bentley, WA, Australia.,Consumer and Community Involvement Program, Western Australian Health Translation Network, Nedlands, WA, Australia.,Department of Health, Research and Innovation Office, Perth, WA, Australia
| | - Olivia L Eadon
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Marcus Js Yong
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Jacqueline Soraine
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Vivian W Chiu
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia.,enAble Institute, Curtin University, Bentley, WA, Australia
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Kalayjian A, Huang K, Sabbour S, Yasin M. Grassroots collaborations to address the trauma of suicide: Establishing the first suicide prevention lifeline in the republic of Armenia. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2022. [DOI: 10.1080/00207411.2022.2083392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A. Kalayjian
- Psychology, Association for Trauma Outreach and Prevention, MeaningfulWorld, Cliffside Park, NJ, USA
| | - K. Huang
- Psychology, Association for Trauma Outreach and Prevention, MeaningfulWorld, Cliffside Park, NJ, USA
| | - S. Sabbour
- Psychology, Association for Trauma Outreach and Prevention, MeaningfulWorld, Cliffside Park, NJ, USA
| | - M. Yasin
- Psychology, Association for Trauma Outreach and Prevention, MeaningfulWorld, Cliffside Park, NJ, USA
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Busse CE, Anderson EW, Endale T, Smith YR, Kaniecki M, Shannon C, August ET. Strengthening research capacity: a systematic review of manuscript writing and publishing interventions for researchers in low-income and middle-income countries. BMJ Glob Health 2022; 7:bmjgh-2021-008059. [PMID: 35165096 PMCID: PMC8845213 DOI: 10.1136/bmjgh-2021-008059] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/04/2022] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Health researchers from low-income and middle-income countries (LMICs) are under-represented in the academic literature. Scientific writing and publishing interventions may help researchers publish their findings; however, we lack evidence about the prevalence and effectiveness of such interventions. This review describes interventions for researchers in LMICs aimed at strengthening capacity for writing and publishing academic journal articles. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to report literature searches in PubMed, Embase, Global Health, Scopus and ERIC. Our keywords included LMICs, low-income and middle-income countries, health research and writing/publication support interventions, with no restrictions on publication date. Our screening process consisted of title screening, abstract review and full-text review. We collected information about the content, implementation and evaluation of each intervention, if included. RESULTS We identified 20 interventions designed to strengthen capacity for scientific writing and publishing. We summarised information from the 14 interventions that reported submitted or published papers as outcomes separately, reasoning that because they provide quantifiable metrics of success, they may offer particular insights into intervention components leading to publication. The writing and publishing components in this 'Publications Reported' group were an average length of 5.4 days compared with 2.5 days in the other group we refer to as 'Other Interventions.' Whereas all 14 Publications Reported interventions incorporated mentors, only two of five in the Other Interventions group incorporated mentors. Across interventions, leaders expressed the importance of a high ratio of mentors to participants, the need to accommodate time demands of busy researchers, and the necessity of a budget for open access fees and high-quality internet connectivity. CONCLUSION Writing and publishing interventions in LMICs are an underutilised opportunity for capacity strengthening. To facilitate the implementation of high-quality interventions, future writing and publishing interventions should share their experiences by publishing detailed information about the approach and effectiveness of the interventions.
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Affiliation(s)
- Clara E Busse
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth W Anderson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Tamrat Endale
- Center for International Reproductive Health Training, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Yolanda Regina Smith
- Center for International Reproductive Health Training, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Marie Kaniecki
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol Shannon
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
| | - Ella T August
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Amarasekera S, Ugo V, Florez V, Patalay P. Research task shifting and youth as drivers of a more global mental health science. Lancet Psychiatry 2021; 8:1027-1029. [PMID: 34710351 DOI: 10.1016/s2215-0366(21)00368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Sonali Amarasekera
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; Department of Health Services and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Victor Ugo
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; Department of Health Services and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; The MHPSS Collaborative, hosted by Save the Children, Copenhagen, Denmark
| | - Valeria Florez
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; Department of Health Services and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, Social Research Institute and Faculty of Population Health Science, University College London, London WC1E 6DH, UK.
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Sensoy Bahar O, Cavazos-Rehg P, Ssewamala FM, Abente B, Peer L, Nabunya P, Soto de Laurido LE, Betancourt TS, Bhana A, Edmond T. Training LEADers to Accelerate Global Mental Health Disparities Research (LEAD) Program: A Research Training Program Protocol. Front Public Health 2021; 9:749627. [PMID: 34858929 PMCID: PMC8631301 DOI: 10.3389/fpubh.2021.749627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: There is a critical need to address mental health needs across the globe, especially in low and middle-income countries where mental health disparities are pervasive, including among children. The global mental health disparities suggest an imperative for culturally and contextually-congruent mental health services models that expand upon the existing services and interventions for these groups. Rigorous research is a key tool in providing the scientific evidence to inform public policy and practice efforts to effectively address these needs. Yet, there is a limited number of researchers, especially those from diverse backgrounds, who study these issues. In this paper, we describe the "TrainingLEADers to Accelerate Global Mental Health Disparities Research" (LEAD) program, a research training program funded by the National Institute on Minority Health and Health Disparities and focused on global mental health disparities research for early career researchers from under-represented minority groups. Methods: The LEAD program is designed as a two-phase training program for advanced pre-doctoral students, postdoctoral fellows, and junior faculty from diverse backgrounds in the U.S., including groups underrepresented in biomedical, behavioral, clinical and social sciences research, interested in global mental health disparities research. Trainees are matched with mentors and participate in an intensive 12-week program. Discussion: The LEAD program seeks to provide a robust platform for the development, implementation and expansion of evidence-based culturally and contextually-congruent interventions and services models addressing global mental health disparities across the life cycle, especially in low-resource communities in the global context. By producing a sustainable network of well-trained investigators from underrepresented backgrounds, LEAD will potentially contribute to the shared lessons and efforts relevant to addressing global mental health disparities and improving care for vulnerable populations in low-resource settings.
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Affiliation(s)
- Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Fred M. Ssewamala
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Betsy Abente
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Laura Peer
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | | | | | - Arvin Bhana
- South African Medical Research Council, Cape Town, South Africa
- Centre for Rural Health-School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Tonya Edmond
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
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Naslund JA, Kalha J, Restivo JL, Amarreh I, Callands T, Chen H, Gomez-Restrepo C, Hamoda HM, Kapoor A, Levkoff S, Masiye J, Oquendo MA, Patel V, Petersen I, Sensoy Bahar O, Shields-Zeeman L, Ssewamala FM, Tugnawat D, Uribe-Restrepo JM, Vijayakumar L, Wagenaar BH, Wainberg ML, Wissow L, Wurie HR, Zimba C, Pathare S. Identifying challenges and recommendations for advancing global mental health implementation research: A key informant study of the National Institute of Mental Health Scale-Up Hubs. Asian J Psychiatr 2021; 57:102557. [PMID: 33561780 PMCID: PMC8082490 DOI: 10.1016/j.ajp.2021.102557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study explored perspectives of researchers working with the National Institute of Mental Health (NIMH) Scale-Up Hubs, consisting of research partnerships for scaling up mental health interventions in low- and middle-income countries (LMICs), to: 1) identify common barriers to conducting impactful research on the implementation of evidence-based mental health services; and 2) provide recommendations to overcome these implementation challenges. METHODS A sequential qualitative approach was employed. First, an open-ended survey was distributed to the 10 Scale-Up Hubs and NIMH program staff asking informants to identify challenges in conducting mental health implementation research in LMICs. Second, survey findings guided an in-person workshop to generate implementation recommendations to inform the field. RESULTS In total, 46 respondents completed surveys, and 101 researchers attended the workshop. The workshop produced implementation recommendations for low-resource settings: 1) identifying impact of research on policy and practice; 2) sustaining careers of early researchers in global mental health; 3) engaging policymakers and donors to value mental health research; 4) supporting the workforce for delivering evidence-based treatments for mental disorders; and 5) promoting sustainability of programs. CONCLUSIONS These findings can strengthen collaboration between researchers and key stakeholders, and highlight important targets for improving mental health implementation research in LMICs.
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Affiliation(s)
- John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
| | - Jasmine Kalha
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Juliana L Restivo
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Ishmael Amarreh
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Tamora Callands
- Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Hongtu Chen
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Carlos Gomez-Restrepo
- Faculty of Medicine, Department of Clinical Epidemiology, Pontificia Universidad Javeriana, Bogota, Colombia; Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Hesham M Hamoda
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Arjun Kapoor
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Sue Levkoff
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | | | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
| | - Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Laura Shields-Zeeman
- Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, Netherlands
| | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | | | | | | | | | - Milton L Wainberg
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
| | - Larry Wissow
- Division of Child and Adolescent Psychiatry, University of Washington School of Medicine, Seattle, USA; Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, USA
| | - Haja Ramatulai Wurie
- Faculty of Nursing, Biochemistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Chifundo Zimba
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
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Langhaug LF, Jack H, Hanlon C, Holzer S, Sorsdahl K, Mutedzi B, Mangezi W, Merritt C, Alem A, Stewart R, Bandawe C, Musesengwa R, Abas M, Chibanda D, Lund C. "We need more big trees as well as the grass roots": going beyond research capacity building to develop sustainable careers in mental health research in African countries. Int J Ment Health Syst 2020; 14:66. [PMID: 32817758 PMCID: PMC7427069 DOI: 10.1186/s13033-020-00388-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There are substantial gaps in our knowledge regarding the aetiology of mental, neurological and substance use disorders in sub-Saharan Africa, and the cost-effectiveness and scalability of interventions to reduce the burden of these conditions on the continent. To address these gaps, international investment has focussed on building research capacity, including funding doctoral students in African countries, to support development of high quality, contextually relevant interventions. Absent, however, is an understanding of how capacity building feeds into research careers. METHODS Within a broader mental health research capacity-building initiative (African Mental Health Research Initiative), we conducted 52 qualitative interviews with early-career researchers, policymakers, academics, and service users from four African countries (Ethiopia, Malawi, South Africa, and Zimbabwe) and with international funders of mental health research. The interview guide focused on the research context, planning, and priorities and how respondents perceive research careers and funding. Thematic analysis was applied to the transcribed interviews. RESULTS Five components of a research career emerged: (i) research positions; (ii) research skills; (iii) funding; (iv) research commitment from African countries; and (v) advocacy. All stakeholders wanted more high-impact African researchers, but few saw a clear, replicable track for developing their careers within universities or their Ministries of Health in their African countries. This stemmed, in part, from the lack of support for infrastructure that enables high-quality research: grants administration, mentorship, university leadership, research culture, and open communication between policymakers and researchers. CONCLUSIONS This study highlights the importance of developing research infrastructure alongside capacity-building efforts. International funders should invest in grant management at African universities which would place them at the centre of research initiatives. African universities should prioritise the creation of a research culture by developing and promoting well-defined research tracks for both clinicians and academics, investing in grant management, and raising the profile of research within their institutions.
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Affiliation(s)
- Lisa F. Langhaug
- African Mental Health Research Initiative (AMARI), Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Helen Jack
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Stefan Holzer
- Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Katherine Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Barbara Mutedzi
- African Mental Health Research Initiative (AMARI), Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Walter Mangezi
- African Mental Health Research Initiative (AMARI), Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Christopher Merritt
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Atalay Alem
- Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Robert Stewart
- Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Chiwoza Bandawe
- Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Rosemary Musesengwa
- African Mental Health Research Initiative (AMARI), Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Melanie Abas
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Dixon Chibanda
- African Mental Health Research Initiative (AMARI), Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Efficacy of psychosocial interventions for mental health outcomes in low-income and middle-income countries: an umbrella review. Lancet Psychiatry 2020; 7:162-172. [PMID: 31948935 DOI: 10.1016/s2215-0366(19)30511-5] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/04/2019] [Accepted: 11/20/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Mental health conditions are leading causes of disability worldwide. Psychosocial interventions for these conditions might have a key role in their treatment, although applicability of findings to poor-resource settings might be a challenge. We aimed to evaluate the strength and credibility of evidence generated in low-income and middle-income countries (LMICs) on the efficacy of psychosocial interventions for various mental health outcomes. METHODS We did an umbrella review of meta-analyses of randomised studies done in LMICs. Literature searches were done in Medline, Embase, PsychINFO, CINAHL, Cochrane Library, and Epistemonikos from Jan 1, 2010, until May 31, 2019. Systematic reviews of randomised studies investigating the efficacy of psychosocial interventions for mental health conditions in LMICs were included. Systematic reviews of promotion, prevention, and protection interventions were excluded, because the focus was on treatment interventions only. Information on first author, year of publication, outcomes, number of included studies, and reported summary meta-analytic estimates was extracted from included meta-analyses. Summary effects were recalculated using a common metric and random-effects models. We assessed between-study heterogeneity, predictive intervals, publication bias, small-study effects, and whether the results of the observed positive studies were more than expected by chance. On the basis of these calculations, strength of associations was assessed using quantitative umbrella review criteria, and credibility of evidence using the GRADE approach. This study is registered with PROSPERO, number CRD42019135711. FINDINGS 123 primary studies from ten systematic reviews were included. The evidence on the efficacy of psychosocial interventions in adults with depression in humanitarian settings (standardised mean difference 0·87, 95% CI 0·67-1·07; highly suggestive association, GRADE: moderate) and in adults with common mental disorders (0·49, 0·36-0·62; highly suggestive association, GRADE: moderate) was supported by the most robust evidence. Highly suggestive strength of association was found for psychosocial interventions in adults with schizophrenia for functional outcomes, in adults with depression, and in adults with post-traumatic stress disorder in humanitarian settings. In children in humanitarian settings, and in children with disruptive behaviour, psychosocial interventions were supported by suggestive evidence of efficacy. INTERPRETATION A relatively large amount of evidence suggests the benefit of psychosocial interventions on various mental health outcomes in LMICs. However, strength of associations and credibility of evidence were quite variable, depending on the target mental health condition, type of population and setting, and outcome of interest. This varied evidence should be considered in the development of clinical, policy, and implementation programmes in LMICs and should prompt further studies to improve the strength and credibility of the evidence base. FUNDING University of Verona.
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Zeinoun P, Akl EA, Maalouf FT, Meho LI. The Arab Region's Contribution to Global Mental Health Research (2009-2018): A Bibliometric Analysis. Front Psychiatry 2020; 11:182. [PMID: 32265754 PMCID: PMC7096372 DOI: 10.3389/fpsyt.2020.00182] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/25/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Mental health research output in the Arab region is increasing, yet little is known about its recent landscape. This study provides a bibliometric analysis of mental health research in all 22 Arab countries over the past decade. Method: We used 760 journals and numerous keywords to search for articles published between 2009 and 2018 by individuals affiliated with institutions located in the Arab region. We analyzed data within Arab countries and between Arab and non-Arab countries. Results: We found that research output in the Arab world has increased by almost 160% in the past ten years, in comparison to 57% for the rest of the world. The quality of publications has also steadily improved, and so did international collaboration. Despite the progress, the number of articles per capita remains remarkably lower for the Arab world compared to the rest of the world. Also, the majority of articles continue to emanate from a limited number of countries (Egypt, Saudi Arabia, and Lebanon) and institutions within these countries. Mental health research topics in the Arab region are similar to those found in low- and middle-income countries of Africa, Asia, Latin America, and the Caribbean. Conclusion: The region needs to invest more in mental health research to close the gap with other medical and healthcare research areas and with the rest of the world. The region also needs to increase its international collaboration and research training to produce higher-quality studies, attract more funding, and publish more in top journals. As the region's population continues to face increasing trauma as a result of war and terrorism, among others, the field is afforded an opportunity to establish a major standing in the healthcare domain. Researchers are uniquely poised to use their body of research evidence to effectively help people reengage with their environments and return to daily life activities.
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Affiliation(s)
- Pia Zeinoun
- Department of Psychology, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon.,Department of Psychiatry, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Health Research Methods, Evidence, and Impact (HE&I), McMaster University, Hamilton, ON, Canada
| | - Fadi T Maalouf
- Department of Psychiatry, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lokman I Meho
- University Libraries, American University of Beirut, Beirut, Lebanon.,Department of Political Studies and Public Administration, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
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