scholarly journals Cultural Adaptation of Digital Knowledge Translation Tools on Acute Otitis Media in Low- to Middle-Income Countries: A Mixed-Methods Usability Evaluation (Preprint)

10.2196/13908 ◽  
2019 ◽  
Author(s):  
Salima Meherali ◽  
Lisa Hartling ◽  
Shannon Scott
Keyword(s):  
Mixed Methods ◽  
Knowledge Translation ◽  
Otitis Media ◽  
Cultural Adaptation ◽  
Acute Otitis Media ◽  
Usability Evaluation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Translation Tools ◽  
Digital Knowledge

scholarly journals Cultural adaptation of digital knowledge translation tools to improve child health outcomes in low-middle-income countries: A mixed-methods usability evaluation (Preprint)

2019 ◽  
Author(s):  
Salima Meherali ◽  
Lisa Hartling ◽  
Shannon Scott
Keyword(s):  
Child Health ◽  
Knowledge Translation ◽  
Health Information ◽  
Cultural Adaptation ◽  
Usability Evaluation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Translation Tools ◽  
Low Middle Income Countries ◽  
Digital Knowledge

BACKGROUND Healthcare decisions based on the best available research are crucial for ensuring high quality patient care, optimal health outcomes and quality and safety in health care systems. Healthcare challenges in low-middle income countries (LMICs) have been the focus of many digital or ehealth initiatives that have aimed to improve both the access and the quality of healthcare delivery. Digital interventions have been identified as useful public health tool, particularly in LMICs. A wealth of research evidence is available from developed countries; however much less attention has been paid to how to scale up digital knowledge translation tools to be used by people in LMICs can use it. OBJECTIVE The objective of this research project was to augment digital art and story-based KT tools developed for Canadian parents on acute otitis media (AOM) for parents in Pakistan, a LMIC. In this paper we have presented the usability evaluation conducted to evaluate the usefulness and effectiveness of the digital KT tools for use by parents in Pakistan. METHODS A mixed-methods design (quantitative survey and qualitative focus groups) were used to evaluate the usability of translated digital arts-based KT tools for pediatric AOM. Participants were recruited from a private hospital in Karachi, Pakistan. A total of 47 parents completed the survey forms and 21 parents participated in focus group interviews. RESULTS The usability evaluation of translated digital tools revealed that both of the KT tools (whiteboard video and infographic) are useful and effective in communicating health information to parents. Parents reported that the tools are very usable and they preferred receiving health information in a narrative form in their own language through digital media. This study identified that culturally adapted translated digital KT tools are better than traditional format in transferring health information to parents. CONCLUSIONS Cultural adaptation of the KT tools generated important knowledge that will contribute to the science of KT. Scaling up of digital KT tools for use in a different culture provide the necessary leadership to enable innovative solutions to reach patients and their families in LMICs and can change the trajectory of child health globally.

scholarly journals The development and usability testing of digital knowledge translation tools for parents of children with acute otitis media

2021 ◽  
Author(s):  
Anne Le ◽  
Lisa Hartling ◽  
Shannon D Scott
Keyword(s):  
Otitis Media ◽  
English Language ◽  
Method Development ◽  
Acute Otitis Media ◽  
Usability Testing ◽  
Translation Tools ◽  
Culturally Adapted ◽  
Wide Range ◽  
Development Processes ◽  
Digital Knowledge

Acute otitis media (AOM) is the most common bacterial ear infection affecting up to 80% of children before the age of three. Despite the common occurrence of the illness and the wide range of material available at clinics and online, parents are not always aware of these resources and they are often difficult to understand. We worked with parents to develop and assess the usability of a whiteboard animation video and interactive infographic for AOM in children. Parents rated the tools highly across all usability items, suggesting that creative tools developed using multi-method development processes can be useful, relevant, understandable, and will be used by the intended audience. Following the completion of the English-language products, our team culturally adapted the tools for the Pakistan context and evaluated the usability of these adapted tools. During usability testing, parents indicated that they felt the tools were useful, demonstrating that culturally adapted version of knowledge translations tools are effective in ensuring that parents could understand complex health information.

scholarly journals Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e004213
Author(s):  
Grace McCutchan ◽  
Bahr Weiss ◽  
Harriet Quinn-Scoggins ◽  
Anh Dao ◽  
Tom Downs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Help Seeking ◽  
Middle Income ◽  
Cancer Symptoms ◽  
Middle Income Countries ◽  
Help Seeking Behaviour ◽  
Psychosocial Influences

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.MethodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.ResultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.ConclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

scholarly journals Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-And- Lower Middle-Income Countries

2021 ◽  
Author(s):  
Giuliano Russo ◽  
Tiago Silva Jesus ◽  
Kevin Deane ◽  
Abdinasir Yusuf Osman ◽  
David McCoy
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Premature Deaths ◽  
Trade Offs ◽  
Mother And Child ◽  
New Research ◽  
The Impact

Background: The aim of this research was to synthetise the existing evidence on the impact of epidemic-related lockdown measures on women and children’s health in low-and-lower-middle-income countries. Methods: A mixed-methods systematic review was conducted of qualitative, quantitative and mixed-methods evidence. Between November 1st-10th 2021, seven scientific databases were searched. The inclusion criteria were that the paper provided evidence on the impact of lockdown and related measures, focused on low-and-lower-middle-income countries, addressed impacts on women and child’s health, addressed epidemics from 2000-2020, was peer-reviewed, provided original evidence, and was published in English. The Joanne Briggs Institute’s critical appraisal tools were used to assess the quality of the studies, and the PRISMA guidelines for reporting. The evidence from the papers was grouped by type of lockdown measure and categories of impact, using a narrative data-based convergent synthesis design. Results: The review process identified 46 papers meeting the inclusion criteria from 17 countries whichall focussed on the COVID-19 and Ebola epidemics. The evidence on the decrease of utilisation of health services showed plummeting immunisation rates and faltering use of maternal and perinatal services, which was linked to a growth of premature deaths. Impacts on the mental health of children and women is well-established, with lockdowns associated with surges in depression, anxiety and low life satisfaction. Vulnerability may be compounded by lockdowns, as livelihoods are disrupted, and poverty levels increase. Conclusion: Limitations included that searches were conducted in late-2020 as new research was being published, and that some evidence not published in English may have been excluded. Epidemic-related lockdown measures carry consequences for the health of women and children in lower-income settings. Governments will need to weigh the trade-offs of introducing such measures and consider policies to mitigate their impacts on the most vulnerable.

To explore the barriers to and facilitators of adolescents in Low-Middle-Income- Countries (LMICs) seeking mental health care: Protocol for a Mixed-Methods Systematic Review

2021 ◽  
Author(s):  
Sudha Subhadra Kallakuri ◽  
Pallab K Maulik ◽  
Prachi Kaistha ◽  
Maree Hackett
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mixed Methods ◽  
Study Design ◽  
Critical Appraisal ◽  
Mental Illnesses ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract Background: Adolescence is a very important transitional phase for an individual as they move from childhood to adulthood. In 2007, the World Health Organization reported that 16% of the global burden of disease and injuries occur among adolescents i.e. those aged between 10 and 19 years, most of them starting by the age of 14 years and usually become serious; if left unrecognised or unattended at that point in time. Several risk factors are associated with increases in the mental health disorders. It is pertinent to promote interventions which teach life skills like regulating one’s emotions, building resilience, and dealing with difficult situations with confidence and strength. This mixed-methods systematic review aims to synthesise best available evidence on the barriers and facilitators to help seeking for mental illnesses among adolescents in Low-Middle-Income Countries Methods and Analyses: The systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Systematic searches will be carried out in electronic databases like PubMed,EMBASE, PsychINFO, Sociofile, CINAHL to identify studies relevant to the review question. At the first stage, titles and abstracts of articles retrieved through the searches will be examined against the eligibility criteria. The second stage will involve independent full-text screening of included articles by two reviewers. All qualitative, quantitative, and mixed method research studies which explicitly answer the research questions will be considered in this review. Methodological appraisal (Risk of Bias) will be conducted using the Joanna Briggs Institute's standardized critical appraisal tools or other standardized critical appraisal tools contingent on the study design by two reviewers. Data will be extracted on the aims/purpose, study design, geographical location, study population, study duration, interventions (if applicable) outcomes, and results of included studies. Data analyses will be conducted using the convergent approach to analysis of mixed methods research using JBI guidance. Discussion: The research will help to identify gaps in knowledge and generate evidence for health departments to look more specifically at the mental health of adolescents and challenges of addressing them. Systematic Review Registration: PROSPERO: CRD42020214349

scholarly journals ‘Maybe we can turn the tide’: an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries

2019 ◽  
Author(s):  
Theresa C. Norton ◽  
Daniela C. Rodriguez ◽  
Catherine Howell ◽  
Charlene Reynolds ◽  
Sara Willems
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
Newborn Health ◽  
Mixed Methods Study ◽  
Promising Practices ◽  
Policy And Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Knowledge Brokers ◽  
Low And Middle Income

Background: Little is known about how knowledge brokers (KBs) operate in low- and middle-income countries (LMICs) to translate evidence for health policy and practice. These intermediaries facilitate relationships between evidence producers and users to address public health issues.<br />Aims and objectives: To increase understanding, a mixed-methods study collected data from KBs who had acted on evidence from the 2015 Global Maternal Newborn Health Conference in Mexico.<br />Methods: Of the 1000 in-person participants, 252 plus 72 online participants (n=324) from 56 countries completed an online survey, and 20 participants from 15 countries were interviewed. Thematic analysis and application of knowledge translation (KT) theory explored factors influencing KB actions leading to evidence uptake. Descriptive statistics of respondent characteristics were used for cross-case comparison.Findings: Results suggest factors supporting the KB role in evidence uptake, which include active relationships with evidence users through embedded KB roles, targeted and tailored evidence communication to fit the context, user receptiveness to evidence from a similar country setting, adaptability in the KB role, and action orientation of KBs.<br />Discussion and conclusions: Initiatives to increase evidence uptake in LMICs should work to establish supportive structures for embedded KT, identify processes for ongoing cross-country learning, and strengthen KBs already showing effectiveness in their roles.<br /><br />key messages<br /><br /><ol><li>Little is known about how knowledge brokers mobilise evidence in low- and middle-income countries.</li><br /><li>A multi-country study of knowledge brokers identified promising practices for evidence uptake.</li><br /><li>Embedded brokers who adapted messaging and evidence to context in active relationships worked well.</li><br /><li>Capacity building should use KB promising practices and facilitate multi-country evidence exchange.</li></ol>

scholarly journals Context Matters in Evidence Implementation Globally; Comment on "Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-Country Analysis"

2021 ◽  
Author(s):  
Marie-Pierre Gagnon
Keyword(s):  
Knowledge Translation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stakeholder Perspectives ◽  
Experience Levels ◽  
Country Analysis ◽  
Healthcare Interventions ◽  
Comprehensive Framework ◽  
Study Participants ◽  
Context Features

Context influences the effectiveness of healthcare interventions and should be considered to inform their implementation. However, context remains poorly defined in the knowledge translation (KT) literature. The paper by Squires and colleagues constitutes a valuable contribution to the field of KT as it provides the basis for a comprehensive framework to assess the influence of context on implementation success. In their study, Squires et al. identified 66 context features, grouped into 16 attributes. Their findings highlight a great convergence in the context features mentioned by stakeholders across countries, experience levels and roles in KT. Thus, the proposed framework could eventually transfer to several implementation settings. However, all study participants were from high-income countries. It would therefore be important to replicate this research in low- and middle-income countries. A common understanding of what context means is essential to assessing its influence on the implementation of healthcare interventions globally.

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