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PubMed2006

Evaluation of the Outreach School Garden Project: building the capacity of two Indigenous remote school communities to integrate nutrition into the core school curriculum.

ISSUE ADDRESSED: This paper describes the Outreach School Garden Project, which was conducted in two remote Indigenous school communities in north-west Queensland. This project integrated nutrition into the key learning areas of the core school curriculum by using a school-based garden as a nutritional education tool. METHODS: Evaluation was by a descriptive qualitative approach supplemented by some quantitative data consistent with Indigenous research methods. The objectives were linked to the Health Promoting Schools Framework, using concepts of community capacity building, action research, social capital and experiential learning. RESULTS: Nutrition was extensively integrated into the core school curriculum by the teaching staff, who required no specific nutrition knowledge or gardening skills prior to the implementation. Students' knowledge and skills in nutrition and gardening were increased over the six-month period and positive improvements in the physical and social environment at the school were observed. CONCLUSION: A school-based nutrition garden enables the teaching and learning of basic nutrition through the core school curriculum. This concept was an innovative, practical nutritional education tool to engage and build the capacity of Indigenous students, school staff and the broader community in nutrition.

Community-Institutional Relations↗

PubMed2003

Building research capacity. An exploratory model of GPs' training needs and barriers to research involvement.

AIMS: To determine general practitioners' research training needs, and the barriers to involvement in research. METHOD: Semi-structured interviews with 11 GPs in rural and metropolitan South Australia, analysed using a grounded theory approach. RESULTS: General practitioners' perceptions about their research needs were limited by their own experience and focussed at an individual level. Overlapping needs and barriers emerged, categorised as: 'individual issues' (a lack of research training or experience, concepts and attitudes to research, and research interest) and 'systems issues' (funding arrangements for general practice, access to resources, opportunity for publication and the role of The Royal Australian College of General Practitioners [RACGP]). DISCUSSION: Our data provide an exploratory model that may assist in developing suitable strategies for research capacity building programs. General practitioners perceived both individual and systems solutions to building research capacity, including multifaceted interventions.

Attitude of Health Personnel↗

PubMed2006

Building true capacity: indigenous models for indigenous communities.

Within the past 2 decades, community capacity building and community empowerment have emerged as key strategies for reducing health disparities and promoting public health. As with other strategies and best practices, these concepts have been brought to indigenous (American Indian and Alaska Native) communities primarily by mainstream researchers and practitioners. Mainstream models and their resultant programs, however, often have limited application in meeting the needs and realities of indigenous populations. Tribes are increasingly taking control of their local health care services. It is time for indigenous people not only to develop tribal programs but also to define and integrate the underlying theoretical and cultural frameworks for public health application.

Community Participation↗

PubMed2005

Human rights, cultural pluralism, and international health research.

In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry.

Bioethics↗

PubMed2002

Vezimfilho: a model for health sector response to gender violence in South Africa.

Vezimfilho, a model program for the training of health care workers was developed, implemented and evaluated in close collaboration with government and non-government partners in South Africa. It was implemented and evaluated in two districts in the Eastern Cape and Western Cape provinces, respectively. This initiative represents one of the first attempts to build capacity in the health sector to address gender-based violence and has been a leading example of how to address within the South African context. Outputs have been the development of a model for the health sector response to gender violence, a training package Vezimfilho! and a partnership with the Department of Health to address the sustained integration of capacity building in this area.

Adult↗

PubMed2004

Health services research in Australia: an investigation of its current status.

OBJECTIVES: The objectives of this audit were to document the current status of health services research (HSR) in Australia in terms of inputs and outputs. Inputs were defined as the number of organised centres or groups undertaking HSR, the extent to which HSR was being developed and the funding available for HSR. Outputs were measured as the number of peer-reviewed papers. METHODS: Centres or groups were identified via the membership of the HSRAANZ and a web-based search. Information from annual reports and/or other published sources was used to determine the extent of capacity building and available funding. The tables of contents of 21 journals published over a 10-year period were searched for articles reporting Australian HSR. RESULTS: Eighteen groups were identified that undertook HSR as their predominant activity, while twelve were involved in HSR as a collaborative activity. No HSR-specific training (in terms of under- or postgraduate degrees) was identified, although more than 400 postgraduate students were being supervised in the university departments where HSR groups were situated. Between 1998 and 2001, more than 13 million Australian dollars was awarded for HSR, most of it by the National Health and Medical Research Council (NHMRC). Over the past 10 years, 482 articles about Australian health services have been published in the peer-reviewed journals audited. CONCLUSIONS: Although HSR is widespread in Australia, no specific training appears to be available to build capacity. Overall, HSR is not well-funded especially by organisations outside the NHMRC or Australian Research Council. Thus, it is not surprising that the output of Australian HSR, in terms of peer-reviewed articles, is slight.

Australia↗

PubMed1992

Building applied health research capacity in less-developed countries: problems encountered by the ADDR Project.

As governments and other donors renew their support for research scientists in less developed countries, it becomes important to consider new questions about the process of funding scientific research and scientific researchers. This paper argues that research capacity building is a development goal subject to structural constraints and cultural impediments among both donors and recipients. Using data from one specific research capacity building program, the Applied Diarrheal Disease Research Project (ADDR), we describe a set of constraints among donors, recipient institutions, and individual recipients of research grants. We then describe how ADDR supports its investigators, how it has responded to the identified constraints, and what obstacles it still faces. Research capacity building programs in health would be well-served by focusing more attention on research problem identification, and dissemination and application of research findings.

Anthropology, Cultural↗

PubMed2006

Maintaining product-process balance in community antipoverty initiatives.

Antipoverty initiatives strive to improve distressed communities by producing outputs, such as housing, new businesses, and enhanced social services, and by building the capacity of communities to address their own problems. Although crucial for addressing the social and cultural factors contributing to community problems and for the sustainability of initiatives, capacity building is frequently set aside once implementation of initiatives begins. This article explores the funding realities, implementation demands, and power dynamics between stakeholders that result in output production being favored over capacity building. Examples from past and ongoing initiatives illustrate points and drive recommendations to help future initiatives maintain a balance between producing outputs and building capacity.

Community Networks↗

PubMed2005

Building research capacity: the role of partnerships.

What "connections"--a broader term than "partnerships"--need to be made to build research capacity? Connections build capacity to the degree that they augment the skills, knowledge and resources of the focal investigator or investigating entity. We suggest that the goal of capacity building through partnerships/connections is to maximize research utility, i.e., its potential to effect desired changes in targeted systems. Specifically, an investigator or research organization must create connections that will enable: the selection and framing of research questions to address matters of importance to relevant stakeholders, especially and necessarily responding to the needs of people with disabilities; the development of a research design adhering to the highest standards of science; and the translation of new knowledge into messages about the results useful to those who are potential beneficiaries, tailoring the message so that it will be clearly "heard" by each respective target audience (including clinicians, other researchers, administrators and/or people with disabilities and their family members). Utility of research traditionally has not comprised the standard for judging research. However, the current focus in Federal funding appears to be shifting, with a demand to assess outcomes (i.e., utility) of research, thus, bolstering the argument to strengthen research utility through creating appropriate partnerships.

Cooperative Behavior↗

PubMed1997

Critical factors in building local capacity to prevent and control injury: North Carolina's experience.

In fiscal years 1991-1992, a state injury control program awarded $258,000 to 33 local health departments for 50 community-based injury prevention projects. To determine whether this program helped build the capacity of local health departments to prevent injury, project reports were reviewed and project directors were surveyed. For four of six factors developed to assess capacity building, success was demonstrated for all local projects to some degree. However, continued support is necessary to assure that the local health departments can sustain this capacity and continue to develop proficiency in data monitoring and evaluation.

Accident Prevention↗

PubMedDate not supplied

Mapping capacity in the health sector: a conceptual framework.

Capacity improvement has become central to strategies used to develop health systems in low-income countries. Experience suggests that achieving better health outcomes requires both increased investment (i.e. financial resources) and adequate local capacity to use resources effectively. International donors and non-governmental agencies, as well as ministries of health, are therefore increasingly relying on capacity building to enhance overall performance in the health sector. Despite the growing interest in capacity improvement, there has been little consensus among practitioners and academics on definitions of 'capacity building' and how to evaluate it. This paper aims to review current knowledge and experiences from ongoing efforts to monitor and evaluate capacity building interventions in the health sector in developing countries. It draws on a wide range of sources to develop (1) a definition of capacity building and (2) a conceptual framework for mapping capacity and measuring the effects of capacity building interventions. Mapping is the initial step in the design of capacity building interventions and provides a framework for monitoring and evaluating their effectiveness. Capacity mapping is useful to planners because it makes explicit the assumptions underlying the relationship between capacity and health system performance and provides a framework for testing those assumptions.

Delivery of Health Care↗

PubMed2002

Supporting community-based prevention and health promotion initiatives: developing effective technical assistance systems.

As research evidence for the effectiveness of community-based prevention has mounted, so has recognition of the gap between research and community practice. As a result, state and local governments are taking a more active role in building the capacity of community-based organizations to deliver evidence-based prevention interventions. Innovations are taking place in the establishment of technical assistance or support systems to influence the prevention and health education activities of community-based organizations. Several challenges for technical assistance systems are described: (1) setting prevention priorities and allocating limited technical assistance resources, (2) balancing capacity-building versus program dissemination efforts, (3) collaborating across categorical problem areas, (4) designing technical assistance initiatives with enough "dose strength" to have an effect, (5) balancing fidelity versus adaptation in program implementation, (6) building organizational cultures that support innovation, and (7) building local evaluative capacity versus generalizable evaluation findings.

Community Health Services↗

PubMedDate not supplied

Development of multidimensional scales to measure key leaders' perceptions of community capacity and organizational capacity for teen pregnancy prevention.

This study discusses the development of scales to measure key leaders' self-reported involvement in community capacity building, perceptions of organizational capacity for teen pregnancy prevention, and the relationship between capacity and teen pregnancy rates. Data were collected from 1,516 key leaders across a rural southern state. Findings indicate that key leaders' perceptions of organizational capacity are related to their involvement in community capacity building efforts and community capacity is associated with teen pregnancy rates. This research represents progress toward measuring community and organizational capacity and may be used to inform future work focusing on developing quantitative measures of community capacity.

Adolescent↗

PubMed2006

Pursuing scale and quality in STI interventions with sex workers: initial results from Avahan India AIDS Initiative.

BACKGROUND: Migration, population mobility, and sex work continue to drive sexually transmitted epidemics in India. Yet interventions targeting high incidence networks are rarely implemented at sufficient scale to have impact. India AIDS Initiative (Avahan), funded by the Bill and Melinda Gates Foundation, is scaling up interventions with sex workers (SWs) and other high risk populations in India's six highest HIV prevalence states. METHODS: Avahan resources are channelled through state level partners (SLPs) to local level non-governmental organisations (NGOs) who organise outreach, community mobilisation, and dedicated clinics for SWs. These clinics provide services for sexually transmitted infections (STIs) including Condom Promotion, syndromic case management, regular check-ups, and treatment of asymptomatic infections. SWs take an active role in service delivery. STI capacity building support functions on three levels. A central capacity building team developed guidelines and standards, trains state level STI coordinators, monitors outcomes, and conducts operations research. Standards are documented in an Avahan-wide manual. State level STI coordinators train NGO clinic staff and conduct supervision of clinics based on these standards and related quality monitoring tools. Clinic and outreach staff report on indicators that guide additional capacity building inputs. RESULTS: In 2 years, clinics with community outreach for SWs have been established in 274 settings covering 77 districts. Mapping and size estimation have identified 187,000 SWs. In a subset of four large states covered by six SLPs (183,000 estimated SWs, 65 districts), 128,326 (70%) of the SWs have been contacted through peer outreach and 74,265 (41%) have attended the clinic at least once. A total of 127,630 clinic visits have been reported, an increasing proportion for recommended routine check ups. Supervision and monitoring facilitate standardisation of services across sites. CONCLUSION: Targeted HIV/STI interventions can be brought to scale and standardised given adequate capacity building support. Intervention coverage, service utilisation, and quality are key parameters that should be monitored and progressively improved with active involvement of SWs themselves.

Ambulatory Care↗

PubMed2006

Rehabilitation Medicine Summit: building research capacity.

The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: (1) researchers; (2) research culture, environment, and infrastructure; (3) funding; (4) partnerships; and (5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report.

Academies and Institutes↗

PubMed2005

Rehabilitation Medicine Summit: building research capacity.

The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: 1) researchers; 2) research culture, environment, and infrastructure; 3) funding; 4) partnerships; and 5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called for to pursue the agendas outlined in this report.

Cooperative Behavior↗

PubMed2005

Rehabilitation medicine summit: building research capacity.

The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were 1) researchers; 2) research culture, environment, and infrastructure; 3) funding; 4) partnerships; and 5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report.

Biomedical Research↗

PubMedDate not supplied

Rehabilitation medicine summit: building research capacity.

The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The 5 elements of research capacity that guided the discussions were (1) researchers; (2) research culture, environment, and infrastructure; (3) funding; (4) partnerships; and (5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multiorganizational initiative is called to pursue the agendas outlined in this article.

Biomedical Research↗