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Abstract Background While there is an expectation to demonstrate evidence-informed public health there is an ongoing need for capacity development. The purpose of this paper is to provide a description of a tailored knowledge translation intervention implemented by knowledge brokers (KBs), and reflections on the factors that facilitated or hindered its implementation. Methods The 22-month knowledge translation intervention, implemented by two KBs, sought to facilitate evidence-informed public health decision-making. Data on outcomes were collected using a knowledge, skills and behavioural assessment survey. In addition, the KBs maintained reflective journals noting which activities appeared successful or not, as well as factors related to the individual or the organisation that facilitated or hindered evidence-informed decision-making. Results Tailoring of the knowledge translation intervention to address the needs, preferences and structure of each organisation resulted in three unique interventions being implemented. A consistent finding across organisations was that each site needed to determine where evidence-informed decision-making ‘fit’ within pre-existing organisational processes. Components of the intervention consistent across the three organisations included one-to-one mentoring of teams through rapid evidence reviews, large group workshops and regular meetings with senior management. Components that varied included the frequency of the KB being physically onsite, the amount of time staff spent with the KB and proportion of time spent one-to-one with a KB versus in workshops. Key facilitating factors for implementation included strong leadership, influential power of champions, supportive infrastructure, committed resources and staff enthusiasm. Conclusions The results of this study illustrate the importance of working collaboratively with organisations to tailor knowledge translation interventions to best meet unique needs, preferences, organisational structures and contexts. Organisational factors such as leadership, champions and supportive infrastructure play a key role in determining the impact of the knowledge translation interventions. Future studies should explore how these factors can be fostered and/or developed within organisations. While KBs implemented the knowledge translation intervention in this study, more research is needed to understand the impact of all change agent roles including KBs, as well as how these roles can be maintained in the long-term if proven effective.

Abstract Thailand’s transition to high middle-income country status has been accompanied by demographic changes and associated shifts in the nation’s public health challenges. These changes have necessitated a significant shift in public health focus from the treatment of infectious diseases to the more expensive and protracted management of non-communicable diseases (NCDs) in older adults. In 2010, in response to this shift in focus, the University of Michigan and colleagues at the Praboromarajchanok Institute for Health Workforce Development in Thailand began work on a broad-based multi-institutional programme for NCD research capacity-building in Thailand. To begin to build a base of intervention research we paired our programme’s funded Thai postdoctoral fellows with United States mentors who have strong programmes of intervention research. One direct impact of the programme was the development of research ‘hubs’ focused upon similar areas of investigative focus such as self-management of cancer symptoms, self-management of HIV/AIDS and health technology information applications for use in community settings. Within these hubs, interventions with proven efficacy in the United States were used as a foundation for culturally relevant interventions in Thailand. The programme also aimed to develop the research support structures necessary within departments and colleges for grant writing and management, dissemination of new knowledge, and ethical conduct of human subject research. In an effort to capitalise on large national health datasets and big data now available in Thailand, several of the programme’s postdoctoral fellows began projects that use data science methods to mine this asset. The investigators involved in these ground-breaking projects form the core of a network of research hubs that will be able to capitalise on the availability of lifespan health data from across Thailand and provide a robust working foundation for expansion of research using data science approaches. Going forward, it is vitally important to leverage this groundwork in order to continue fostering rapid growth in NCD research and training as well as to capitalise upon these early gains to create a sustaining influence for Thailand to lead in NCD research, improve the health of its citizens, and provide ongoing leadership in Southeast Asia.

With growing pressure to contribute to their region's development, universities are increasingly called upon to engage dynamically in innovation policy-making and governance activities. Previous studies suggest in their collaboration with local and regional government that universities can emerge as animateurs, providing guidance, consolidating networks, and ultimately activating institutional and human agency. This is especially important in the context of less-developed regions, where the unlocking of innovative potential may rest on those factors. This paper provides an extended perspective on universities’ engagement in innovation policy processes and, in a broader sense, on the collaboration between these higher education institutions and local and regional government. Through an analysis of the partnership between two Portuguese institutions, the University of Aveiro and the intermunicipal community of the region of Aveiro, this study explores the potential implications on regional innovation policy and the activation of institutional agency in a less-developed context. Policy documents, reports and interview data from 18 academics, top managers, policy-makers and other stakeholders show that while institutional expectations differ, collaborative interplays have boosted the formation and growing effectiveness of regional innovation networks, crucial for the development of less-developed regions.

Abstract Background Evidence-informed Decision-making in Nutrition and Health (EVIDENT) is an international partnership that seeks to identify information needs in nutrition and health in Africa and build local capacity in knowledge management to help translate the best available evidence into context-appropriate recommendations aligned to the priorities of decision-makers. This study evaluates the extent to which EVIDENT achieved its intended activities, documents the lessons learned and draws on these lessons learned to inform future activities of EVIDENT, as well as in evidence-informed decision-making (EIDM) in nutrition overall. Methods Purposive and snowball sampling were used to identify participants that were either directly or indirectly involved with EVIDENT. An analytical framework of five key elements was developed to guide data collection from EVIDENT’s documentation, in-depth interviews (n = 20), online surveys (n = 26) and a participatory discussion. Interviews were transcribed verbatim and coded in NVivo 11, using deductive thematic content analysis and a phenomenological approach. Online surveys were analysed using Stata 14. Data were triangulated to address both objectives under each element of the analytical framework. Results EVIDENT succeeded in establishing a collaborative partnership, within which it delivered four short courses in EIDM. This capacity complemented case study activities in four partner African countries where EIDM processes were implemented and assessed. Identified barriers to these processes included little experience in EIDM, difficulties in engaging stakeholders, challenging local environments (e.g. donor influence, bureaucracy, inaccessibility to scientific research, poor internet connectivity), and limited time and funding. However, EVIDENT activities were driven by a local need for EIDM, a sheer interest and commitment to the cause, and the opportunity for the Global North and South to work together and build relationships. Future activities of EVIDENT, and EIDM in nutrition overall, should focus on sustained capacity-building in EIDM processes, leadership and functional skills across the Global South, investment in stakeholder engagement, context-specific EIDM, enhanced communication and linking, and strengthening relationships with existing stakeholder organisations. Conclusions In its first 3 years, EVIDENT developed and strengthened partnership, capacity and visibility on EIDM in Africa. Innovative and long-term capacity-building, dedicated leadership, further stakeholder engagement and sustainable financing, are needed for future activities of EVIDENT and EIDM in nutrition.

Abstract This article describes a twinning relationship between the Canadian Association of Midwives (CAM) and the Tanzania Midwives Association (TAMA). It argues that the twinning relationship strengthened both associations. The article briefly reviews the existing literature on professional associations and association strengthening to demonstrate that professional associations are a vital tool for improving the performance of healthcare workers and increasing their capacity to contribute to national and international policy-making. It then suggests that midwifery associations are particularly significant given the frequent professional marginalization of midwives. The article then describes in depth the relationship between CAM and TAMA, highlighting the accomplishments of the twinned partners, and analyzing the factors that contributed to the success of the relationship. The findings demonstrate that twinning can successfully strengthen associations, increasing their ability to support their membership, care for the public, and shape national policy-making. The article therefore proposes twinning as a successful and cost-effective model for encouraging the growth of the midwifery profession.

Low- and middle-income countries (LMIC) are increasing investments in early childhood development programs, including early childhood education. As programs reach scale, there is increasing demand for evidence on impacts of investments. Little work to date has examined capacity required to effectively use data at scale in LMIC, including opportunities and barriers to integrating data into ongoing program implementation and tracking child development and quality of services at scale. Below, we outline the rationale and approach of the Consortium for Pre-primary Data and Measurement in Sub-Saharan Africa, focused on building capacity for data-driven decision-making in early childhood systems. Themes from the first phase include the importance of building diverse groups of stakeholders to define priorities for data and measurement, the need for coordinated and strategic investments in data and measurement, and the value of long-term investments in government/civil society/university partnerships to generate locally relevant data on early childhood education.

Health promotion capacity-building (HPCB) emerged in the public health literature in the 1990s. The objective of this study was to examine the origins and show the developments of the concept in the twenty years following the seminal work. Citation network consisting of 230 texts was constructed in two phases. Texts identified in Phase A were articles with all of the words health, promotion, capacity, and building in their title (n = 79). In Phase B all texts that were cited by more than one phase A text (n = 151) were added to the population. Three quantitative methods - main-path analysis, k-core decomposition, and community detection - were used to identify the strongest path, the core of the network and distinct cliques within the network, respectively. The intellectual source was traced to the diffusion of innovations theory. All dimensions of HPCB could be traced back to the seminal work on the adoption of innovations in organizations. The single strongest path of more recent applications focused on global level HPCB. However, the majority of the more recent texts highlighted in the analyses were associated with community capacity-building. Other recent developments detected were organizational development, workforce development, health promoting schools, and a German Kapazitätsentwicklung application. These results suggest that HPCB has on the one hand given birth to a global-level core competencies approach, while on the other hand it has mostly focused on community capacity-building. As a consequence, other scenarios have received considerably less attention. [ABSTRACT FROM AUTHOR]

After decades of conflict with Indonesia, Timor-Leste is gradually rebuilding its education infrastructure and reclaiming its identity as an independent country. In the first decade post-independence the education sector faced many challenges, including a lack of school buildings and resources, the need to replenish and upskill the Timorese teacher workforce, and inappropriate curriculum. In more recent years, a locally written child-centred curriculum has been rolled out and a systematic and ongoing school leadership and teacher professional development programme has gradually been established. The programme requires school leaders to support ongoing teacher professional development, and to participate in regular mentor visits. The underlying change model focuses on school leader capacity building, so principals work with their teachers to improve their classroom skills, with resultant impact on student learning. This article provides details of the leadership programme and reports some results for the school regions initially involved regarding leader and teacher skills improvement and student learning outcomes. The results provide early indications of the value for developing countries of a leadership capacity-building and school-based teacher professional development programme which involves a whole-of-system approach and ongoing mentor support and monitoring. [ABSTRACT FROM AUTHOR]

This paper reviews recent policy understandings of research capacity in teacher education in the UK. It then draws on a case study from Wales to suggest a conceptualisation of research capacity-building in teacher education that encompasses individual, organisational and systemic levels while remaining sensitive to the particulars of professional practice in teacher education. We argue that a healthy ecology of research-rich teacher education practice and policy includes teacher educators based in universities, schools, colleges or other settings, teachers and other education practitioners, students, school management, governors, local authorities, policy makers, research funders, publishers. We recommend a principled approach to public investment in capacity-building initiatives that embraces a vision of collaborative research-rich professional practice and professional development along all career stages, and commits to sustaining more expansive understandings of research culture in organisations, matched by appropriate recognition mechanisms. [ABSTRACT FROM AUTHOR]

Background. A systems mindset is the ability to see problems in their wider context and in terms of their underlying structure. This research describes how a systems mindset was understood and applied by prevention practitioners in a large-scale community-based initiative that employed a systems thinking approach. Method. This qualitative research included 31 primary semistructured interviews. Deductive thematic analysis was based on Braun and Clarke's analysis framework and was guided by Senge and Scharmer's knowledge-creating system. Results. The practitioners had been introduced to systems theory and were aware of complex problems and the need for equally sophisticated solutions. Their knowledge was not in-depth, although this may be adequate, as a theoretical overview seemed to be sufficient to support practice. A range of tools was available to practitioners to guide their systems mindset; however, none were preferred. Practitioners' awareness of the tools varied, as did their feelings toward them as some found them helpful and others did not. A narrower focus on tools could have benefited those who had not yet grasped systems theory. The use of projects within a systems approach confused some practitioners, yet others saw them as platforms to leverage change from. Implications for practice. With a systems mindset practitioners are able to develop systemic solutions to difficult problems. To do this, they require an overview of complex adaptive systems theory, an applied understanding of systems tools, and an experiential learning opportunity to shift their knowledge into practical know-how. [ABSTRACT FROM AUTHOR]

Continuing professional development (CPD) in low- and middle-income countries (LMICs) can build capacity of health professionals in infant and young child feeding (IYCF). However, travel to in-person workshops can be time-consuming and expensive. Thus, we developed a free online course to provide training in IYCF to health professionals globally; the course received overwhelmingly high numbers of registrations. Our aim was to conduct a program evaluation to assess course satisfaction, learning, and application using surveys administered postcourse and 9 months later. Response rates were 99% (n = 835) and 55% (n = 312), respectively. Among those who only partially completed the course, reasons for noncompletion were assessed (response rate 29%, n = 72). Data within a 1-year period were analyzed. Respondents worked in multiple settings and organizations worldwide. Nearly all (99%) reported postcourse that they learned "a lot" or "some" from all topics, and over 70% applied "a lot" of or "some" information 9 months later. In open-ended questions, respondents reported improved knowledge, skills, and competence to conduct their work; they also desired more similar training courses. Many who did not complete the course reported "not enough time" as the main reason (74%), and most (94%) wanted to continue it. The positive response to the course suggests there is an unmet need for CPD for health professionals in LMICs. Our evaluation found that online training was feasible, acceptable, and increased professionals' knowledge and application of IYCF concepts in nutrition programming. Increased use of online CPD offers the potential for global capacity-building in other health-related topics. [ABSTRACT FROM AUTHOR]

Mentoring is important for improving capacity development in population and public health research in sub-Saharan Africa. A variety of experiences have been documented since Consortium for Advanced Research Training in Africa (CARTA) admitted the first cohort in 2011. However, the experience of mentoring opportunities in CARTA has not been studied. Our study focused on the perceptions, experiences and challenges of mentoring among CARTA fellows. We adopted a descriptive design based on data collected from the fellows using an online semi-structured questionnaire. Out of 143 fellows in the programme, a total of 52 fellows from seven cohorts completed the questionnaire. Fifty-three percent of the respondents were females, more than half belonged to the health sciences while 35% were in the social sciences. Fellows received mentoring from CARTA graduates and experienced researchers in the CARTA network, but they also engaged in peer-mentoring with one another. Teaching, publishing, conference attendance and grant application were considered particularly important in mentoring, but mentors and mentees highlighted personal and social issues such as networking, work-family life balance, and managing stress and time, as challenges. There is a need for more formalised but flexible mentorship initiative in the CARTA fellowship to facilitate enduring relationships for career development. [ABSTRACT FROM AUTHOR]

Lay Abstract: The current demand for autism diagnostic services exceeds the ability of the workforce to assess and diagnose children in a timely manner. One solution may be to equip primary care providers (PCPs) with the tools and expertise needed to diagnose autism within their practice. PCPs are often trusted professionals who have many touchpoints with children during early development, in which they can identify early signs of autism. Recent initiatives have focused on bolstering PCPs' diagnostic capabilities; however, no studies have examined how the rates of autism diagnosis in primary care have changed over time. We aimed to evaluate whether autism diagnosis in primary care has changed over time and how diagnosis in primary care relates to a child's age at the time of diagnosis. We found that the likelihood of a child being diagnosed by a PCP decreased by about 2% with every passing year from 2004 to 2019 when accounting for demographic characteristics. In our sample, PCPs diagnosed children approximately 1 year earlier than non-PCPs (e.g., psychologists and psychiatrists). Further research is needed to understand why the proportion of children diagnosed by PCPs decreases over time. However, this decrease suggests more work is needed to get capacity-building initiatives into community primary care practice. Though we must continue to find effective ways to build community PCPs' ability to diagnose autism, the present findings support the crucial role PCPs can play in early autism diagnosis., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Despite advances in the sexual violence (SV) prevention field, practitioners still face challenges with identifying indicators to measure the impact of their prevention strategies. Public data, such as existing administrative and surveillance system data, may be a good option for organizations to examine trends in indicators for the purpose of program evaluation. In this article, we describe a framework and a process for identifying indicators with public data. Specifically, we present the SV Indicator Framework and a five-step indicator review process, which we used to identify indicators for a national SV prevention program. We present the findings of the indicator review and explain how the process could be used by evaluators and program planners within other developing topic areas. Tracking indicators with public data, in conjunction with other evaluation methods, may be a viable option for state-level program evaluations. We discuss limitations and implications for practice and research. [ABSTRACT FROM AUTHOR]

Using effective models for continuing teacher and school leader education in developing countries is essential for long-term improvement of the education system and student outcomes. Instructional leadership approaches have been used to capacity-build school leaders, improving leader skills in working with teachers on classroom practices and also focusing on ongoing monitoring of student academic progress. Foreign aid frequently supports such initiatives concerned with turning around school systems in developing countries, with local ownership and integration within national frameworks being essential to ensure sustainability. This paper outlines a leadership programme and processes for Kiribati. Early findings and challenges are outlined within the context of instructional leadership models, as well as strategies used to address issues. The programme has relevance for other continuing education programmes in developing countries, especially within foreign aid situations. [ABSTRACT FROM AUTHOR]

This article extends existing knowledge of performance management use by examining intergovernmental (IG) efforts as drivers of local government use. A capacity-building framework is proposed with IG strategies that (1) increase local leaders' awareness and commitment to performance management; (2) provide technical assistance for increasing local government capacities; (3) incentivize local governments to take performance management seriously; (4) institutionalize local efforts that deepen and broaden performance management practice. Using audit assessments, field study, and survey research, this article empirically examines a comprehensive national IG effort that promotes performance management use in local governments. Results show that IG strategies, separately and combined, increase performance management use. This article makes recommendations for increasing IG practices that promote performance management use by subnational governments. [ABSTRACT FROM AUTHOR]

The Nimrud Rescue Project is a collaborative project to recover fragments of Neo-Assyrian sculptures bombed by the Islamic State of Iraq and Syria (ISIS) in 2015–2016, and to develop a long-term plan for the preservation and use of the site and its architectural remains through capacity-building and support of Iraqi heritage professionals. The Smithsonian Institution has been working with colleagues from the Nineveh Provincial Office of the Iraqi State Board of Antiquities and Heritage (SBAH) since early 2017. The project is one of many managed through a partnership with the Iraqi Institute for the Conservation of Antiquities and Heritage (IICAH) in Erbil, Iraq. The Smithsonian has approached recovery and preservation of the site in partnership with Iraqi stewards. Together with the SBAH Nineveh Directorate, the Smithsonian worked to define site needs and develop the skills required by the cadre of local archaeologists (called the 'Nimrud Rescue Team', or NRT) to recover and protect stone sculpture fragments scattered across the site. A purpose-built storage facility has been completed and the NRT has begun the process of recovery using the 'First Aid to Cultural Heritage in Times of Crisis' (FAC) methodology developed by ICCROM and others for organized recovery of cultural heritage objects after a disaster. [ABSTRACT FROM AUTHOR]

The rapidly changing security environment in the Euro-Mediterranean region has made it imperative for international, regional, and state actors to engage in strategic and operational cooperation way beyond the traditional law enforcement fields. Risks arising from terrorism, trafficking in human beings, cybercrime, firearms trafficking, and drug trafficking are increasingly shared by both the EU and South Partner Countries. These challenges have brought about the firm willingness of affected EU and MENA countries to work together to enhance citizen's security by reinforcing law enforcement cooperation through joint capacity-building efforts under the aegis of the Euromed Police projects. This paper thus aims to shed light on and disseminate good practices related to the particular approach and tangible results of the EU-funded Euromed Police IV project. In early 2020, the project came to the end of its 4th phase, which makes it an influential law enforcement actor in the Euro-Mediterranean region. [ABSTRACT FROM AUTHOR]

Coastal acidification in southeastern U.S. estuaries and coastal waters is influenced by biological activity, run-off from the land, and increasing carbon dioxide in the atmosphere. Acidification can negatively impact coastal resources such as shellfish, finfish, and coral reefs, and the communities that rely on them. Organismal responses for species located in the U.S. Southeast document large negative impacts of acidification, especially in larval stages. For example, the toxicity of pesticides increases under acidified conditions and the combination of acidification and low oxygen has profoundly negative influences on genes regulating oxygen consumption. In corals, the rate of calcification decreases with acidification and processes such as wound recovery, reproduction, and recruitment are negatively impacted. Minimizing the changes in global ocean chemistry will ultimately depend on the reduction of carbon dioxide emissions, but adaptation to these changes and mitigation of the local stressors that exacerbate global acidification can be addressed locally. The evolution of our knowledge of acidification, from basic understanding of the problem to the emergence of applied research and monitoring, has been facilitated by the development of regional Coastal Acidification Networks (CANs) across the United States. This synthesis is a product of the Southeast Coastal and Ocean Acidification Network (SOCAN). SOCAN was established to better understand acidification in the coastal waters of the U.S. Southeast and to foster communication among scientists, resource managers, businesses, and governments in the region. Here we review acidification issues in the U.S. Southeast, including the regional mechanisms of acidification and their potential impacts on biological resources and coastal communities. We recommend research and monitoring priorities and discuss the role SOCAN has in advancing acidification research and mitigation of and adaptation to these changes.

Abstract Background There is a need to identify strategies that enhance the implementation of evidence-based school wellness intervention programs in real-world settings. The present study evaluates the feasibility of empowering school wellness leaders to deliver an evidence-based, childhood obesity-prevention program called Switch ™. We specifically evaluated the feasibility of a new implementation framework, based on the robust Healthy Youth Places framework, to increase capacity of school leaders to lead school wellness programming. Methods The SWITCH (School Wellness Integration Targeting Child Health) implementation process was evaluated in a convenience sample of eight Iowa elementary schools. Teams of three leaders from each school attended an in-person school wellness conference followed by five online webinar sessions delivered by two SWITCH team members. The capacity-building and quality improvement process was designed to empower schools to lead wellness change using methods and concepts from the original 16-week Switch ™ program. School wellness leaders completed checklists on two occasions to assess overall school-level implementation as well as setting-level changes in physical education, classrooms, and the lunchroom. Student acceptability of SWITCH was evaluated by the degree of behavior tracking using an online SWITCH Tracker system that promoted self-monitoring. School acceptability and practicality were assessed through an exit survey completed by school leaders. Results All school staff reported satisfaction with the SWITCH implementation process. Reports of school- and setting-level implementation were relatively high (2.0 to 2.8 on a 3-point scale) but student engagement, based on use of the online tracking system, varied greatly over time and across schools. Three high implementation schools had average tracking rates exceeding 70% (range: 72–90%) while three low implementation schools had rates lower than 30% (range = 0–23%). Conclusions This feasibility study supports the utility of the new implementation framework for promoting school and student engagement with SWITCH. Further testing regarding effectiveness and scale-up of this evidence-based school wellness intervention program is warranted.

Abstract Background If there is one universal recommendation to countries wanting to make progress towards Universal Health Coverage (UHC), it is to develop the learning capacities that will enable them to ‘find their own way’ – this is especially true for countries struggling with fragmented health financing systems. This paper explores results from a multi-country study whose main aim was to assess the extent to which UHC systems and processes at country level operate as ‘learning systems’. Method This study is part of a multi-year action-research project implemented by two communities of practice active in Africa. For this specific investigation, we adapted the concept of the learning organisation to so-called ‘UHC systems’. Our framework organises the assessment around 92 questions divided into blocks, sub-blocks and levels of learning, with a seven scale score in a standardised questionnaire developed during a protocol and methodology workshop attended by all the research teams. The study was implemented in six francophone African countries by national research teams involving researchers and cadres of the ministries involved in the UHC policy. Across the six countries, the questionnaire was administrated to 239 UHC actors. Data were analysed per country, per blocks and sub-blocks, by levels of learning and per question. Results The study confirms the feasibility and relevance of adapting the learning organisation framework to UHC systems. All countries scored between 4 and 5 for all the sub-blocks of the learning system. The study and the validation workshops organised in the six countries indicate that the tool is particularly powerful to assess weaknesses within a specific country. However, some remarkable patterns also emerge from the cross-country analysis. Our respondents recognise the leadership developed at governmental level for UHC, but they also report some major weaknesses in the UHC system, especially the absence of a learning agenda and the limited use of data. Conclusion Countries will not progress towards UHC without strong learning systems. Our tool has allowed us to document the situation in six countries, create some awareness at country level and initiate a participatory action-oriented process.

Starting from a perception of cross-border territories being sub-systems, created by the respective national politico-administrative partners involved, the paper asses how cross-border cooperation in Europe can be improved by a new approach of integrated capacity-building. Based on both the achievement but also central challenges that all cross-border territories in Europe are facing in practice, two central fields are interpreted in this regard: training/facilitating and cross-border institution building. The paper concludes that a more effective cross-border policy-making of the future depends on approaches of systemic capacity-builduing and suggests “horizontal subsidiarity” as a new operating principle, to be developed as part of a multi-level governance approach.

Abstract Background Health policy-making can benefit from more effective use of research. In many policy settings there is scope to increase capacity for using research individually and organisationally, but little is known about what strategies work best in which circumstances. This review addresses the question: What causal mechanisms can best explain the observed outcomes of interventions that aim to increase policy-makers’ capacity to use research in their work? Methods Articles were identified from three available reviews and two databases (PAIS and WoS; 1999–2016). Using a realist approach, articles were reviewed for information about contexts, outcomes (including process effects) and possible causal mechanisms. Strategy + Context + Mechanism = Outcomes (SCMO) configurations were developed, drawing on theory and findings from other studies to develop tentative hypotheses that might be applicable across a range of intervention sites. Results We found 22 studies that spanned 18 countries. There were two dominant design strategies (needs-based tailoring and multi-component design) and 18 intervention strategies targeting four domains of capacity, namely access to research, skills improvement, systems improvement and interaction. Many potential mechanisms were identified as well as some enduring contextual characteristics that all interventions should consider. The evidence was variable, but the SCMO analysis suggested that tailored interactive workshops supported by goal-focused mentoring, and genuine collaboration, seem particularly promising. Systems supports and platforms for cross-sector collaboration are likely to play crucial roles. Gaps in the literature are discussed. Conclusion This exploratory review tentatively posits causal mechanisms that might explain how intervention strategies work in different contexts to build capacity for using research in policy-making.

The contemporary Extension 4-H program is focused on positive youth development, providing experiences that increase the likelihood of enhanced wellbeing and optimal development for 4-H participants. Despite the longevity, reach, and success of the 4-H program, however, with few notable exceptions, there has been relatively little attention paid to elucidating the underlying program theory and the actions that put the theory into motion. As a result, no one model or framework guides the program uniformly across the 4-H system, resulting in numerous ways of describing and measuring the impact of the 4-H program on young people. This paper proposes a 4-H program model that connects the 4-H program context to youth developmental outcomes through the mediating process of youth thriving. The model is based on a synthesis of extensive research conducted in the field of youth development and elucidates the processes that facilitate developmental change in youth. Implications for model use as well as professional development are considered.

Compliance of states with multilateral environmental agreements (MEAs) is the objective of these agreements. To this end, a number of measures have to be taken which mainly are called “implementation” as ex-ante as well as “enforcement” as ex-poste initiatives and measures. Such initiatives and measures, prevent member-states from non-compliance, and, in case of breaching environmental obligations, make these defaulting member-states fulfill such obligations and bringing them back into the state of compliance with such multilateral environmental agreements. Exchange of information is an important factor for “implementation” and “enforcement” of environmental obligations. “Non-compliance procedures”, “capacity-building” “Pollutant Release and Transfer Register (PRTR)”, and “Integrated Pollution Prevention and Control (IPPC)” are instances of “implementation” and ex-ante actions in which exchange of information plays an important role. Also, exchange of information facilitates identifying violators of environmental obligations and makes it possible to start proceedings against such offenders, as an instance of “enforcement” and ex-poste measure.

Developing sustainable efforts to address the psychosocial consequences of complex emergencies is often a challenge. There is a limit to what humanitarian efforts can achieve, even with the best of intentions. Locally based tertiary education programmes are needed to provide conceptual frameworks and to develop and sustain professional psychosocial support programmes both during and after the emergency. In Afghanistan, over 30 years of armed conflict and its sequelae have placed an extraordinary emotional strain on every member of the population, affecting not only individuals but also families and communities. The Ministry of Higher Education has therefore taken the initiative to develop two new academic programmes in counselling psychology in its public university system. These programmes are designed to prepare a new generation of academics who can come to understand the specific Afghan context of psychosocial suffering and prepare appropriate interventions to support transformation on an individual and communal level. They are also poised to educate a new generation of qualified practitioners to serve individuals, families, communities and the society itself. In this article, the authors describe a partnership programme with the two universities designed to provide external support for their efforts.

• FETPs build a global workforce that significantly enhances global health security. • FETPs have trained tens of thousands of disease detectives around the world. • More work is needed to strengthen field epidemiology workforce capacity through FETP. • A new global partnership has launched to ensure progress for the FETP Enterprise. • FETP should remain a model for global public health workforce capacity building. [ABSTRACT FROM AUTHOR]

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Background: The field of rural health research is critical for informing health improvement in rural places but it involves researching in small teams and distributed sites that may have specific sustainability challenges. We aimed to evaluate this to inform how to sustain the field of rural health research.Methods: We conducted In-depth semi-structured interviews of 50-70 minutes with 17 rural early career researchers who were from different research sites across rural Australia. Data were thematically coded.Results: Seven sustainability challenges were noted, namely recognition, workload, networks, funding and strategic grants, organisational culture, job security, and career progression options. Rural researchers were poorly recognised for their work and researchers were not extended the same opportunities enjoyed by staff at main campuses. Unpredictable and high workloads stemmed from community demand and limited staff. Strategic grant opportunities failed to target the generalist, complex research in this field and the limited time researchers had for grant writing due to their demands within small academic teams. Limited collaboration with other sites increased dissatisfaction. In the face of strong commitment to rural 'places' and their enthusiasm for improving rural health, fixed-term contracts and limited career progression options were problematic for researchers and their families in continuing in these roles.Conclusion: A comprehensive set of strategies is needed to address the sustainability of this field, recognising its value for rural self-determination and health equity. Hubs and networks could enable more cohesively planned, collaborative research, skills sharing, senior academic supervision and career development. Targeted funding, fit to the context and purpose of this field, is urgent. Inaction may fuel regular turnover, starting after a researcher's first years, losing rich academic theoretical and contextual knowledge that is essential to address the health of rural populations. [ABSTRACT FROM AUTHOR]

Background: Health research is important for the achievement of the Sustainable Development Goals. However, there are many challenges facing health research, including securing sufficient funds, building capacity, producing research findings and using both local and global evidence, and avoiding waste. A WHO initiative addressed these challenges by developing a conceptual framework with four functions to guide the development of national health research systems. Despite some progress, more is needed before health research systems can meet their full potential of improving health systems. The WHO Regional Office for Europe commissioned an evidence synthesis of the systems-level literature. This Opinion piece considers its findings before reflecting on the vast additional literature available on the range of specific health research system functions related to the various challenges. Finally, it considers who should lead research system strengthening.Main Text: The evidence synthesis identifies two main approaches for strengthening national health research systems, namely implementing comprehensive and coherent strategies and participation in partnerships. The literature describing these approaches at the systems level also provides data on ways to strengthen each of the four functions of governance, securing financing, capacity-building, and production and use of research. Countries effectively implementing strategies include England, Ireland and Rwanda, whereas West Africa experienced effective partnerships. Recommended policy approaches for system strengthening are context specific. The vast literature on each function and the ever-growing evidence-base are illustrated by considering papers in just one key journal, Health Research Policy and Systems, and analysing the contribution of two national studies. A review of the functions of the Iranian system identifies over 200 relevant and mostly national records; an analysis of the creation of the English National Institute for Health Research describes the key leadership role played by the health department. Furthermore, WHO is playing leadership roles in helping coordinate partnerships within and across health research systems that have been attempting to tackle the COVID-19 crisis.Conclusions: The evidence synthesis provides a firm basis for decision-making by policy-makers and research leaders looking to strengthen national health research systems within their own national context. It identifies five crucial policy approaches - conducting situation analysis, sustaining a comprehensive strategy, engaging stakeholders, evaluating impacts on health systems, and partnership participation. The vast and ever-growing additional literature could provide further perspectives, including on crucial leadership roles for health ministries. [ABSTRACT FROM AUTHOR]

Background: Implementation research is increasingly being recognised as an important discipline seeking to maximise the benefits of evidence-based interventions. Although capacity-building efforts are ongoing, there has been limited attention on the contextual and health system peculiarities in low- and middle-income countries. Moreover, given the challenges encountered during the implementation of health interventions, the field of implementation research requires a creative attempt to build expertise for health researchers and practitioners simultaneously. With support from the Special Programme for Research and Training in Tropical Diseases, we have developed an implementation research short course that targets both researchers and practitioners. This paper seeks to explain the course development processes and report on training evaluations, highlighting its relevance for inter-institutional and inter-regional capacity strengthening.Methods: The development of the implementation research course curriculum was categorised into four phases, namely the formation of a core curriculum development team, course content development, internal reviews and pilot, and external reviews and evaluations. Five modules were developed covering Introduction to implementation research, Methods in implementation research, Ethics and quality management in implementation research, Community and stakeholder engagement, and Dissemination in implementation research. Course evaluations were conducted using developed tools measuring participants' reactions and learning.Results: From 2016 to 2018, the IR curriculum has been used to train a total of 165 researchers and practitioners predominantly from African countries, the majority of whom are males (57%) and researchers/academics (79.4%). Participants generally gave positive ratings (e.g. integration of concepts) for their reactions to the training. Under 'learnings', participants indicated improvement in their knowledge in areas such as identification of implementation research problems and questions.Conclusion: The approach for training both researchers and practitioners offers a dynamic opportunity for the acquisition and sharing of knowledge for both categories of learners. This approach was crucial in demonstrating a key characteristic of implementation research (e.g. multidisciplinary) practically evident during the training sessions. Using such a model to effectively train participants from various low- and middle-income countries shows the opportunities this training curriculum offers as a capacity-building tool. [ABSTRACT FROM AUTHOR]

STEP-UP is a capacity building and training programme for HIV community activists in Europe and Central Asia, led by the European AIDS Treatment Group (EATG). The programme aims to empower a new cohort of HIV activists each year to engage more deeply in HIV activism at local and national levels addressing key themes such as HIV treatment literacy, prevention technologies, living with HIV, project development, clinical trials, patient participation, advocacy and policy landscapes. The expected outcome of the project is that trainees become activists with knowledge of both policy and science who advocate for change to policy and or practice. To assess the impact of the programme on individual graduates, their organisations and the communities they work with, EATG conducted an evaluation of the programme for the period of 2013–2017. The methods used during the assessment were: a desk review of information about the programme; interviews with implementers and trainees; a focus group with trainees; inputs from national and regional networks, activists and references given by trainees; and an online survey of trainees. This article evaluates the lessons learnt and forms a set of recommendations to implement in the design of future editions of STEP-UP. [ABSTRACT FROM AUTHOR]

Background: Many countries are currently rethinking their global health research funding priorities. When resources are limited, it is important to understand and use information about existing research strengths to inform research strategies and investments and to drive impact. This study describes a method to rapidly assess a country's global health research expertise and applies this method in the Canadian context.Methods: We developed a three-pronged rapid environmental scan to evaluate Canadian global health research expertise that focused on research funding inputs, research activities and research outputs. We assessed research funding inputs from Canada's national health research funding agency and identified the 30 Canadian universities that received the most global health research funding. We systematically searched university websites and secondary databases to identify research activities, including research centres, research chairs and research training programmes. To evaluate research outputs, we searched PubMed to identify global health research publications by Canadian university-affiliated researchers. We used these three perspectives to develop a more nuanced understanding of Canadian strengths in global health research from different perspectives.Results: Canada's main global health research funder, the Canadian Institutes of Health Research, invested a total of $314 M from 2000 to 2016 on global health research grants. This investment has contributed to Canada's wealth of global health research expertise, including 12 training programmes, 27 Canada Research Chairs, 6 research centres and 30 WHO Collaborating Centres across 27 universities. Research activities were concentrated in Canada's biggest cities and most commonly focused on health equity and globalisation issues. Canadian-affiliated researchers have contributed to a research output of 822 unique publications on PubMed. There is an opportunity to build global health expertise in regions not already concentrated with research activity, focusing on transnational risks and neglected conditions research.Conclusions: Our three-pronged approach allowed us to rapidly identify clear geographic and substantive areas of strength in Canadian global health research, including urban regions and research focused on health equity and globalisation topics. This information can be used to support research policy directives, including to inform a Canadian global health research strategy, and to allow relevant academic institutions and funding organisations to make more strategic decisions regarding their future investments. [ABSTRACT FROM AUTHOR]

Background: Improving civil registration and vital statistics (CRVS) systems requires strengthening the capacity of the CRVS workforce. The improvement of data collection and diagnostic practices must be accompanied by efforts to ensure that the workforce has the skills and knowledge to assess the quality of, and analyse, CRVS data using demographic and epidemiological techniques. While longer-term measures to improve data collection practices must continue to be implemented, it is important to build capacity in the cautious use of imperfect data. However, a lack of training programmes, guidelines and tools make capacity shortages a common issue in CRVS systems. As such, any strategy to build capacity should be underpinned by (1) a repository of knowledge and body of evidence on CRVS, and (2) targeted strategies to train the CRVS workforce.Main Text: During the 4 years of the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne, an extensive repository of knowledge and practical tools to support CRVS system improvements was developed for use by various audiences and stakeholders (the 'CRVS Knowledge Gateway'). Complementing this has been a targeted strategy to build CRVS capacity in countries that comprised two approaches - in-country or regional training and a visiting Fellowship Program. These approaches address the need to build competence in countries to collect, analyse and effectively use good quality birth and death data, and a longer-term need to ensure that local staff in countries possess the comprehensive knowledge of CRVS strategies and practices necessary to ensure sustainable CRVS development.Conclusion: The Knowledge Gateway is a dynamic, useful and long-lasting repository of CRVS knowledge for countries and development partners to use to formulate and evaluate CRVS development strategies. Capacity-building through in-country or regional training and the University of Melbourne D4H Fellowship Program will ensure that CRVS capacity and knowledge is developed and maintained, facilitating improvements in CRVS data systems that can be used by policymakers to support better decision-making in health. [ABSTRACT FROM AUTHOR]

This paper seeks to critically reflect on inclusive education in Ireland 2020 exploring whether Ireland is at a crossroads of inclusive education. Matters regarding legislation, policy and classroom practices are outlined and critically discussed. A host of changes in the field of Special Educational Needs (SEN) provision are detailed, including the move from a medical to a biopsychosocial model of SEN and the use of person-first language. Furthermore, the recent advancements in Ireland from integration to inclusion and towards a capacity-building model are discussed, in light of the new model for special education teacher allocation (Department of Education and Skills, 2017a). While these present as significant advancements, there are also many challenges to inclusive education in Ireland that still need to be considered. Such challenges relate to the role of special schools and special classes in our system and the dichotomy between differentiation and a Universal Design for Learning framework within classrooms. Moving forwards, suggestions are outlined related to using formative assessment in the classroom, a more flexible model for educational placement and a greater focus on capacitybuilding within school settings. [ABSTRACT FROM AUTHOR]

Evaluating anti-corruption programmes is difficult because of the complexity and hidden nature of corruption, its political sensitivity, and the ability of corrupt networks to adapt. We show how a theory-based evaluation can elaborate a set of intermediate outcomes for the evaluation of anti-corruption programmes, and showcase purpose-built tools for evaluating capacity building. We discuss learning from two evaluations of Anti-Corruption programmes in the Caribbean to demonstrate how anti-corruption theory is translated into law enforcement practice through both economic models of criminals as rational actors whose behaviour can be changed by altering incentives and social norms models which emphasise local contextualisation. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse and test a theoretical generic health promotion capacity-building framework with empirical data on primary health care. The framework consists of seven dimensions: commitment, management, monitoring and needs assessment, resources, common practices, participation and other core functions. The data were collected in 2014 from all the health centres in Finland, of which 156 (99%) submitted their data. The data were scored by the quality of activities on a scale from 0 to 100, where 100 stands for desirable quality. Individual indicators were nested into subdimensions, which in turn were nested into the dimensions of the theoretical framework. Variables were clustered using the dimensions and subdimensions as initial partitions. The internal consistency of dimensions and subdimensions was tested with standardized Cronbach's alpha both before and after the clustering analysis. The results showed that although the internal consistency of the dimensions was high in the initial classification, it is possible to get even more consistent dimensions. The internal consistency of the initial classification varied from 0.62 in participation to 0.93 in common practices. In the clustering analysis, 45 out of 203 indicators were assigned to a dimension different from the initial partition. The biggest gain in internal consistency was achieved in the subdimension of systematic mass communications by relocating two indicators. This study suggests that it is possible to assess the health promotion capacity-building of organizations in a coherent way with comparable and objective indicators. These analyses also show that the number of indicators can be reduced. It would be interesting to see how the framework works in other governmental structures or political contexts. [ABSTRACT FROM AUTHOR]

Maritime security capacity-building is a growing field of international activity. It is an area that requires further study, as a field in its own right, but also as an archetype to develop insights for capacity-building and security sector reform in other arenas. This article is one of the first to analyse this field of activity. Our empirical focus is on the Western Indian Ocean (WIO) region. Here, international actors have launched multiple capacity-building projects, initially in response to Somali piracy. We document the significance, extent and variety of capacity-building activities in this region and examine the ways in which capacity-building at sea has incorporated innovative characteristics that develop and expand the capacity-building agenda as traditionally understood. Our conclusion highlights the need to pay more attention to the maritime domain in international security and development studies and considers ways in which the maritime capacity-building experience may offer important lessons for other fields of international policy. [ABSTRACT FROM AUTHOR]

Abstract Background Strategies are central to the National Institutes of Health’s definition of implementation research as “the study of strategies to integrate evidence-based interventions into specific settings.” Multiple scholars have proposed lists of the strategies used in implementation research and practice, which they increasingly are classifying under the single term “implementation strategies.” We contend that classifying all strategies under a single term leads to confusion, impedes synthesis across studies, and limits advancement of the full range of strategies of importance to implementation. To address this concern, we offer a system for classifying implementation strategies that builds on Proctor and colleagues’ (2013) reporting guidelines, which recommend that authors not only name and define their implementation strategies but also specify who enacted the strategy (i.e., the actor) and the level and determinants that were targeted (i.e., the action targets). Main body We build on Wandersman and colleagues’ Interactive Systems Framework to distinguish strategies based on whether they are enacted by actors functioning as part of a Delivery, Support, or Synthesis and Translation System. We build on Damschroder and colleague’s Consolidated Framework for Implementation Research to distinguish the levels that strategies target (intervention, inner setting, outer setting, individual, and process). We then draw on numerous resources to identify determinants, which are conceptualized as modifiable factors that prevent or enable the adoption and implementation of evidence-based interventions. Identifying actors and targets resulted in five conceptually distinct classes of implementation strategies: dissemination, implementation process, integration, capacity-building, and scale-up. In our descriptions of each class, we identify the level of the Interactive System Framework at which the strategy is enacted (actors), level and determinants targeted (action targets), and outcomes used to assess strategy effectiveness. We illustrate how each class would apply to efforts to improve colorectal cancer screening rates in Federally Qualified Health Centers. Conclusions Structuring strategies into classes will aid reporting of implementation research findings, alignment of strategies with relevant theories, synthesis of findings across studies, and identification of potential gaps in current strategy listings. Organizing strategies into classes also will assist users in locating the strategies that best match their needs.

Abstract Background The Demand-Driven Evaluations for Decisions (3DE) programme was piloted in Zambia and Uganda in 2012–2015. It aimed to answer evaluative questions raised by policymakers in Ministries of Health, rapidly and with limited resources. The aim of our evaluation was to assess whether the 3DE model was successful in supporting and increasing evidence-based policymaking, building capacity and changing behaviour of Ministry staff. Methods Using mixed methods, we compared the ex-ante theory of change with what had happened in practice, why and with what results (intended and unintended), including a qualitative assessment of 3DE’s contribution. Data sources included a structured quality assessment of the five impact evaluations produced, 46 key informant interviews at national and international levels, structured extraction from 170 programme documents, a wider literature review of relevant topics, and a political economy analysis conducted in Zambia. Results We found that 3DE had a very limited contribution to changing evidence-based policymaking, capacity and behaviour in both countries as a result of having a number of aspirations not all compatible with one another. Co-developing evaluation questions was more time-consuming than anticipated, Ministry evidence needs did not fit neatly into questions suitable for impact evaluations and constricted timeframes for undertaking trials did not necessarily produce the most effective results and value for money. The evaluation recommended a focusing of objectives and a more strategic approach to strengthening evaluative demand and capacity. Conclusions Lessons emerge that are likely to apply in other low- and middle-income settings, such as the importance of supporting evaluative thinking and capacity within wider institutions, of understanding the political economy of evidence use and its uptake, and of allowing for some flexibility in terms of programme targets. Fixating on one type of evidence is unhelpful in the context of institutions like ministries of health, which require a wide range of evidence to plan and deliver programmes. In addition, having success tied to indicators, such as number of ‘policy decisions made’, provides potentially perverse incentives and neglects arguably more important aspects such as incremental programmatic adjustments and improved implementation.

Abstract Background There is a critical gap between needs and available resources for mental health treatment across the world, particularly in low- and middle-income countries (LMICs). In countries committed to increasing resources to address these needs it is important to conduct research, not only to assess the depth of mental health needs and the current provision of public and private mental health services, but also to examine implementation methods and evaluate mental health approaches to determine which methods are most effective in local contexts. However, research resources in many LMICs are inadequate, largely because conventional research training is time-consuming and expensive. Adapting a hackathon model may be a feasible method of increasing capacity for mental health services research in resource-poor countries. Methods To explore the feasibility of this approach, we developed a ‘grantathon’, i.e. a research training workshop, to build capacity among new investigators on implementation research of Indian government-funded mental health programmes, which was based on a need expressed by government agencies. The workshop was conducted in Delhi, India, and brought together junior faculty members working in mental health services settings throughout the country, experienced international behavioural health researchers and representatives of the Indian Council for Medical Research (ICMR), the prime Indian medical research funding agency. Pre- and post-assessments were used to capture changes in participants’ perceived abilities to develop proposals, design research studies, evaluate outcomes and develop collaborations with ICMR and other researchers. Process measures were used to track the number of single-or multi-site proposals that were generated and funded. Results Participants (n = 24) generated 12 single- or multi-site research grant applications that will be funded by ICMR. Conclusion The grantathon model described herein can be modified to build mental health services research capacity in other contexts. Given that this workshop not only was conceptualised and delivered but also returned results in less than 1 year, this model has the potential to quickly build research capacity and ultimately reduce the mental health treatment gap in resource-limited settings.