Abstract
Objective
The Chronic Disease Research Fellowship Program (RFP) aims to build the research capacity of recent medical graduates to support the development of chronic disease control strategies.
Setting
Guatemala is undergoing an epidemiologic transition. However, given the way universities and the health care system are structured, it lacks an environment that fosters research careers and generates the required knowledge to implement sound public health policies and clinical strategies. The RFP was implemented at the Cardiovascular Unit of Guatemala.
Intervention
This 4-year Program recruited two one-year fellows and provided funding to define a research topic, write a protocol and implement the research. Strong emphasis is placed on developing skills in knowledge translation and exchange to bridge the “know-do” gap. Close mentoring relationships between the Principal Investigator and former and current fellows are fostered through the Program.
Outcomes
The mentoring Program has generated strategic data to support the implementation of sound chronic disease control strategies, mainly related to tobacco control. Results have been presented nationally and internationally. Research training has included principles of biostatistics and epidemiology, and a journal club. The Program is increasingly generating interest among medical graduates to pursue further research training abroad and is building local research capacity. Fellows and research assistants have created a research network in Guatemala and abroad. The main obstacle the Program faces is ensuring long-term sustainability.
Conclusions
A mentoring program can lead to an increase in research interest and capacity in a low-income country with little research infrastructure.
Key Words: Developing countries, chronic disease, capacity building
Résumé
Objectif
Le programme des Bourses de recherche sur la lutte contre les maladies chroniques (Guatemala) vise à accroître la capacité de recherche des récents diplômés en médecine pour appuyer l’élaboration de stratégies de lutte contre les maladies chroniques.
Lieu
Le Guatemala est en transition sur le plan épidémiologique. Toutefois, étant donné la façon dont les universités et le système de soins de santé sont structurés, il manque au pays un milieu qui favorise les carrières en recherche et qui génère les connaissances requises pour mettre en œuvre des politiques de santé publique et des stratégies cliniques rationnelles. Le programme de bourses de recherche a été instauré à l’Unité cardiovasculaire de Guatemala.
Intervention
Ce programme de quatre ans a recruté deux boursiers pendant un an chacun et leur a fourni du financement pour définir un sujet de recherche, rédiger un protocole et mettre la recherche en œuvre. Le programme insiste beaucoup sur le développement de compétences en application et en échange des connaissances pour combler le fossé entre le „ savoir ” et le „ faire ”. Il favorise des liens de mentorat étroits entre le directeur des recherches et les boursiers passés et présents.
Résultats
Le programme de mentorat a généré des données stratégiques à l’appui de la mise en œuvre de stratégies rationnelles de lutte contre les maladies chroniques, principalement axées sur la lutte antitabac. Les résultats de recherche sont présentés au pays et à l’étranger. La formation en recherche porte sur les principes de biostatistique et d’épidémiologie et inclut un club de revue d’articles. Le programme incite de plus en plus de diplômés en médecine à pousser leur formation en recherche à l’étranger, et il est en train de créer une capacité de recherche locale. Les boursiers et les adjoints à la recherche ont créé un réseau de chercheurs au Guatemala et à l’étranger. Le principal obstacle est d’assurer la viabilité à long terme du programme.
Conclusions
Un programme de bourses construit sur des bases de mentorat peut mener à une augmentation de l’intérêt pour la recherche et de la capacité de recherche dans un pays à faible revenu possédant peu d’infrastructures de recherche.
Mots Clés: pays en développement, maladie chronique, renforcement des capacités
Footnotes
Acknowledgement: This work was carried out with the aid of a grant from the International Development Research Centre, Ottawa, Canada. Joaquin Barnoya receives additional support from the American Cancer Society and the Foundation for Barnes-Jewish Hospital. Graham A. Colditz also receives additional support from the Foundation for Barnes-Jewish Hospital. We thank Anne Bernard for her contribution to the development of the Performance Monitoring Framework.
Conflict of Interest: None to declare.
References
- 1.Pan American Health Organization. Health in the Americas. Washington, DC: PAHO; 2012. [Google Scholar]
- 2.Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011;377(9775):1438–47. doi: 10.1016/S0140-6736(11)60393-0. [DOI] [PubMed] [Google Scholar]
- 3.Maher D, Sekajugo J. Research on health transition in Africa: Time for action. Health Res Policy Syst. 2011;9:5. doi: 10.1186/1478-4505-9-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Jones AC, Geneau R. Assessing research activity on priority interventions for non-communicable disease prevention in low- and middle-income countries: A bibliometric analysis. Glob Health Action. 2012;5:1–13. doi: 10.3402/gha.v5i0.18847. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.SCImago Research Group. Ranking Iberoamericano SIR 2010. 2010. [Google Scholar]
- 6.Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746–53. doi: 10.1161/hc4601.099487. [DOI] [PubMed] [Google Scholar]
- 7.Secretaria Nacional de Ciencia y Tecnologia. Indicadores de Actividades Cientificas y Tecnologicas, Guatemala 2009. Guatemala: Consejo Nacional de Ciencia y Tecnologia; 2009. [Google Scholar]
- 8.Barreto SM, Miranda JJ, Figueroa JP, Schmidt MI, Munoz S, Kuri-Morales PP, et al. Epidemiology in Latin America and the Caribbean: Current situation and challenges. Int J Epidemiol. 2012;41(2):557–71. doi: 10.1093/ije/dys017. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Healy C, Welchert A. Mentoring relations: A definition to advance research and education. Educ Res. 1990;19:17–21. doi: 10.3102/0013189X019009017. [DOI] [Google Scholar]
- 10.DeAngelis CD. Professors not professing. JAMA. 2004;292(9):1060–61. doi: 10.1001/jama.292.9.1060. [DOI] [PubMed] [Google Scholar]
- 11.ESSENCE Good Practice Documents. Planning, Monitoring and Evaluation. Framework for Capacity Strengthening in Health Research. Geneva: Enhancing Support for Strengthening the Effectiveness of National Capacity Efforts; 2011. [Google Scholar]
- 12.Potter C, Brough R. Systemic capacity building: A hierarchy of needs. Health Policy Plan. 2004;19(5):336–45. doi: 10.1093/heapol/czh038. [DOI] [PubMed] [Google Scholar]
- 13.Leatherdale ST, Viehbeck S, Murphy C, Norman C, Schultz AS. The tobacco control community of tomorrow: A vision for training. Can J Public Health. 2007;98(1):30–32. doi: 10.1007/BF03405381. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Arbuckle MR, Gordon JA, Pincus HA, Oquendo MA. Bridging the gap: Supporting translational research careers through an integrated research track within residency training. Acad Med. 2013;88(6):759–65. doi: 10.1097/ACM.0b013e31828ffacb. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Feldman MD, Steinauer JE, Khalili M, Huang L, Kahn JS, Lee KA, et al. A mentor development program for clinical translational science faculty leads to sustained, improved confidence in mentoring skills. Clin Transl Sci. 2012;5(4):362–67. doi: 10.1111/j.1752-8062.2012.00419.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Kashiwagi DT, Varkey P, Cook DA. Mentoring programs for physicians in academic medicine: A systematic review. Acad Med. 2013;88(7):1029–37. doi: 10.1097/ACM.0b013e318294f368. [DOI] [PubMed] [Google Scholar]
- 17.Gourevitch MN, Jay MR, Goldfrank LR, Mendelsohn AL, Dreyer BP, Foltin GL, et al. Training physician investigators in medicine and public health research. Am J Public Health. 2012;102(7):e39–e45. doi: 10.2105/AJPH.2011.300486. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Dores GM, Chang S, Berger VW, Perkins SN, Hursting SD, Weed DL. Evaluating research training outcomes: Experience from the cancer prevention fellowship program at the National Cancer Institute. Acad Med. 2006;81(6):535–41. doi: 10.1097/01.ACM.0000225216.07584.b0. [DOI] [PubMed] [Google Scholar]
- 19.Sambunjak D, Straus SE, Marusic A. Mentoring in academic medicine: A systematic review. JAMA. 2006;296(9):1103–15. doi: 10.1001/jama.296.9.1103. [DOI] [PubMed] [Google Scholar]
- 20.Ramani S, Gruppen L, Kachur EK. Twelve tips for developing effective mentors. Med Teach. 2006;28(5):404–8. doi: 10.1080/01421590600825326. [DOI] [PubMed] [Google Scholar]
- 21.Leier CV, Auseon AJ, Binkley PF. Selecting a mentor: A guide for residents, fellows, and young physicians. Am J Med. 2011;124(10):893–95. doi: 10.1016/j.amjmed.2011.04.031. [DOI] [PubMed] [Google Scholar]
- 22.Lipscomb R, An S. Mentoring 101: Building a mentoring relationship. J Am Diet Assoc. 2010;110(7):1002–8. doi: 10.1016/j.jada.2010.05.017. [DOI] [PubMed] [Google Scholar]
- 23.Third World Academy of Sciences. Building Scientific Capacity. A TWAS Perspective. Trieste, Italy: Third World Academy of Sciences; 2004. [Google Scholar]
- 24.Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370(9603):1929–38. doi: 10.1016/S0140-6736(07)61696-1. [DOI] [PubMed] [Google Scholar]
- 25.Guise JM, Nagel JD, Regensteiner JG. Best practices and pearls in interdisciplinary mentoring from Building Interdisciplinary Research Careers in Women’s Health Directors. J Womens Health. 2012;21(11):1114–27. doi: 10.1089/jwh.2012.3788. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 26.Simmons K. Growing a successful mentor program. ASAE & The Center for Association Leadership, 1999. 2013. [Google Scholar]
- 27.Barnoya J, Arvizu M, Jones MR, Hernandez JC, Breysse PN, Navas-Acien A. Secondhand smoke exposure in bars and restaurants in Guatemala City: Before and after smoking ban evaluation. Cancer Causes Control. 2011;22(1):151–56. doi: 10.1007/s10552-010-9673-8. [DOI] [PubMed] [Google Scholar]
- 28.de Ojeda A, Barnoya J, Thrasher JF. Availability and costs of single cigarettes in Guatemala. Nicotine Tob Res. 2013;15(1):83–87. doi: 10.1093/ntr/nts087. [DOI] [PubMed] [Google Scholar]
- 29.Viteri E, Barnoya J, Hudmon KS, Solorzano PJ. Smoking cessation medications and cigarettes in Guatemala pharmacies. Tob Control. 2012;21(5):477–81. doi: 10.1136/tc.2011.044040. [DOI] [PubMed] [Google Scholar]
- 30.Corral JE, Cornejo JA, Barnoya J. Bars’ and restaurants’ compliance with the Guatemalan smoke-free law during the 2010 Soccer World Cup: A missed opportunity. Tob Control. 2011;20(6):445–46. doi: 10.1136/tobaccocontrol-2011-050053. [DOI] [PubMed] [Google Scholar]
- 31.Corral JE, Arnold LD, Argueta EE, Ganju A, Barnoya J. Clinical preventive services in Guatemala: A cross-sectional survey of internal medicine physicians. PloS ONE. 2012;7(10):e48640. doi: 10.1371/journal.pone.0048640. [DOI] [PMC free article] [PubMed] [Google Scholar]