Exploring Perceptions and Experiences with Research Ethics in Bolivia

Background: In Bolivia, there is increasing interest in the necessity of incorporating research ethics into study designs and procedures, but there is minimal data on the perceptions and experiences of Bolivian health science faculty, researchers, and national health administrators on research ethics. The Touro University California (TUC) Public Health Program is partnering with Bolivian universities to develop a comprehensive Research Education Ethics Program. In 2013, The Universidad Mayor de San Andrés received a National Institute of Health/Fogarty International Center Planning Grant award to develop the program. The two central aims of this program needs assessment are to describe the perceptions of and experiences with research ethics among study participants and to assess the relationship between participants’ professional roles and their perceptions and knowledge of research ethics. Participants’ perceptions of the functions of Research Ethics Committees (protecting human subjects rights, ensuring the social and scientific value of research, etc) and study participants’ ideas for educational/learning needs were also described. The study has been implemented, data collection completed, and data analysis in process. Preliminary results show an immediate need and interest for research ethics capacity building and education in Bolivia. Structure/Method/Design: This is a cross-sectional study using an online survey completed by approximately 200 Bolivian health science faculty, researchers, residents, and health administrators. Survey domains include demographics, perceptions and experiences related to research ethics and the function of research ethics committees, and knowledge of research ethics including course levels, content, and teaching methodologies. Descriptive statistics were used to describe study participant characteristics and the key variables referred to above. Chi-square tests will be used to assess the relationships between participant characteristics and perception and knowledge indicators measured quantitatively using scales. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract): Universidad Mayor de San Andres Universidad Mayor de San Francisco Xavier Universidad Mayor de San Simón Summary/Conclusion: Challenges identified include insufficient knowledge, academic support, expertise, regulation, and funding. Study findings describe the current research ethics needs and practices in Bolivia and facilitate the development of a sustainable research ethics education program

Research Ethics Training of Trainers: Developing Capacity of Bolivian Health Science and Civil Society Leaders

Research and research ethics (RE) capacity is a key element for addressing health priorities of low- and middle-income countries (LMICs). With support from a NIH/FIC Research Ethics Education and Curriculum Development grant, a RE Training of Trainers (TOT) was implemented in Bolivia. The Steering Committee, including representatives from four Bolivian universities and PAHO, developed the RE TOT that included face-to-face, online and practicum components. Twenty trainees including faculty, researchers and community leaders participated. Pre/Posttest results demonstrated significant increases in overall RE knowledge (13.1% improvement, p-value \u3c 0.0001). An evaluation demonstrated participants valued participatory learning strategies and the flexibility of the online component. TOT participants during the practicum component delivered RE workshops to their university and civil society communities in four regions (n= 3,700 people). The goals of the grant were accomplished through the development of a Steering Committee and implementation of the TOT course. Next steps include the design and implementation of a master’s level research ethics education program in Bolivia

Research Ethics Training of Trainers: Developing Capacity of Bolivian Health Science and Civil Society Leaders

Program/Project Purpose: The University of San Andres, Faculty of Medicine in La Paz, Bolivia in collaboration with Touro University California, Public Health Program was awarded a NIH Research Ethics Planning Grant in June, 2013 to develop strategies and processes for implementation of a comprehensive national research ethics program for Bolivia. Although the importance of scientific research based on ethical principles is highlighted in the Bolivian constitution and national health legislation, few Bolivian academics, researchers and health professionals have received formal training in the principles and practices of research ethics. A principle aim of the Planning Grant is to develop and implement a Research Ethics Train the Trainers (TOT) course with the goal of training faculty for future implementation of a national research ethics program. Structure/Method/Design: A Project Directors Committee representing public health science universities from four participating Bolivian Departments/States (La Paz; Santa Cruz, Cochabamba & Chuquisaca) was formed to oversee all project activities including implementation of a three day in-person TOT followed by a 10 week online training. Training modules utilized materials developed by Bolivian academics and scientists and international research ethics programs at PAHO (Pan American Health Organization) and CITI (Collaborative Institutional Training Initiative), University of Miami. TOT University and civil society representatives were selected from each participating Department/State for a total of 26 participants. Upon completion of the training, participants were asked to implement educational research ethics activities in their local communities and institutions. Outcomes & Evaluation: A pre-test/post-test study design was used to assess change in participant knowledge related to research ethics principles and practices. The mean score improved from 73% correct at baseline and 84% at course completion. Participants completed a course evaluation after the in-person and virtual components of the course. Participants highlighted the most useful topics in the course as respect for persons and human rights, principles of bioethics, informed consent and the function of research ethics committees. The most positive aspects of the in-person component of the course were the high level of participation, group work, communication and debate among participants representing different academic disciplines and social sectors. Eighty percent of participants completed the course with five dropping out during the virtual component. Most students reported that the instructions for using the virtual platform were clear and they received sufficient support from the Course Coordinator, however, most stated that some of the teachers provided insufficient academic support. Going Forward: Integrating the group interaction strengths of the in-person TOT component with the flexibility of the virtual component recommends using a mixed methods approach while providing additional training to teachers related to virtual teaching methodologies. Funding: NIH/FIC, International Research Ethics Education and Curriculum Development Award (R25)

Working Conditions, Workplace Violence, and Psychological Distress in Andean Miners: A Cross-sectional Study Across Three Countries

Background: Psychosocial working conditions are well-known determinants of poor mental health. However, studies in mining populations where employment and working conditions are frequently precarious have, to our knowledge, only focused on occupational accidents and diseases. Objectives: The aim of this study was to assess psychosocial working conditions and psychological distress in Andean underground miners. Methods: The study population consisted of 153 Bolivian miners working in a silver mining cooperative, 137 Chilean informal gold miners, and 200 formal Peruvian silver miners employed in a remote setting. High work demands, minimal work control, minimal social support at work, and workplace exposure to violence and bullying were assessed using the Spanish short form of the European Working Condition Survey. A general health questionnaire score >4 was used as cutoff for psychological distress. Associations between psychosocial work environment and psychological distress were tested using logistic regression models controlling for potential confounding and effect modification by country. Findings: Prevalence of psychological distress was 82% in the Bolivian cooperative miners, 29% in the Peruvian formal miners, and 22% in the Chilean informal miners (pχ2 < 0.001). 55% of the miners had suffered violence during the 12-months before the survey. Workplace demands were high (median 12.5 on a scale from 7-14), as was social support (median 5.5 on a scale from 3-6). After adjustment for country and other relevant exposure variables and considering interactions between country and job strain, miners in active (odds ratio [OR], 6.8; 95% confidence interval [CI] 2.1-22.7) and high strain jobs (OR, 7.2; 95% CI, 1.7-29.9) were at increased odds of distress compared with those in low strain jobs. Violence at work also contributed to increased odds of distress (OR, 1.86; 95% CI, 1.1-3.1). Conclusions: Psychological distress is associated with the psychosocial work environment in Andean underground miners. Interventions in mining populations should take the psychosocial work environment into account

Curso para especialistas en seguridad y salud ocupacional de Latinoamérica

Every year millions of workers die due to health and safety hazards at work. This occurs especially in developing countries, where challenges related to the work conditions are oftensimilar. To improve this situation, the Centre of International Health offers an international. Objective: Training course for specialists in Occupational Health and Safety, where they can interact, develop new ideas and generate improvement of the working conditions in their countries. Methodology: The teaching methods of the first three courses included interactive lectures, project-based learning, presentations, group discussions and the setting-up of a protocol-based epidemiological study. Participants from different professions worked together during two weeks, which has contributed to the exchange of new ideas and the enrichment of the multicultural level and diversity of the courses. Results: All of the 80 participants successfully completed the two-week course. They each designed a protocol-based epidemiological research project, the majority of which have already been implemented or are in their implementation phase. In the evaluation survey all of the participants agreed that the mixture of different professional backgrounds was enriching and they also pointed the excellent quality of the tutors out. Consequently a network in Occupational Health and Safety has been created amongst the participants. Conclusions: The three international and interdisciplinary courses “Occupational Health Crossing Borders” were considered to be a very positive experience for the participants, as well as the tutors. Since 2012, these courses are part of the International Master’s in Occupational Health and Safety of the Ludwig-Maximilian-Universität from Munich, Germany.Anualmente fallecen millones de trabajadores debido a accidentes de trabajo y enfermedades profesionales. Esto afecta especialmente a países en vía de desarrollo donde los desafíos muchas veces se parecen. Para mejorar esta situación, el Centro Internacional de la Salud Objetivo: Ofrece cursos internacionales para profesionales de Seguridad y Salud Ocupacional en los cuales los participantes pueden interactuar y desarrollar nuevas ideas generando cambios a nivel local en sus países. Metodología: El método de enseñanza de los primeros tres cursos incluyó clases interactivas, aprendizaje basado en problemas, presentación de pósteres, discusiones grupales y la formulación de un protocolo de estudio de base epidemiológica. Participantes de diferentes profesiones trabajaron conjuntamente durante dos semanas consecutivas, lo cual favoreció el intercambio de ideas y el nivel de multiculturalidad de los cursos. Resultados: Todos los 80 participantes finalizaron exitosamente el curso de dos semanas de duración. Cada uno de ellos redactó un protocolo de investigación de base epidemiológica, los cuales en su mayoría ya han sido implementados o se encuentran en la fase de implementación. En la evaluación, todos los participantes opinaron que la mezcla de profesionales participantes fue enriquecedora destacando también la excelente calidad de los docentes. Consecuentemente, se estableció una red de contactos de SSO entre los participantes. Conclusiones: Los tres cursos internacionales e interdisciplinarios de “Salud Ocupacional Cruzando Fronteras” fueron positivos tanto para participantes como para docentes. Desde el 2012, estos cursos forman parte de la Maestría Internacional en Seguridad y Salud Ocupacional de la Ludwig-Maximilian-Universität de Múnich, Alemania

The impact of the COVID-19 pandemic on the mental health of healthcare workers:study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study

BACKGROUND: Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. METHODS: Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country’s income level. RESULTS: As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. CONCLUSIONS: This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-021-02211-9

Pesquisa ética no treinamento de estagiários: desenvolvendo a capacitação da ciência da saúde boliviana e em líderes da sociedade civil

Research and research ethics (RE) capacity is a key element for addressing health priorities of low - and middle-income countries (LMICs). With support from a NIH/FIC Research Ethics Education and Curriculum Development grant, a RE Training of Trainers (TOT) was implemented in Bolivia. The Steering Committee, including representatives from four Bolivian universities and PAHO, developed the RE TOT that included face-to-face, online and practicum components. Twenty trainees including faculty, researchers and community leaders participated. Pre/Posttest results demonstrated significant increases in overall RE knowledge (13.1% improvement, p-value &lt; 0.0001). An evaluation demonstrated participants valued participatory learning strategies and the flexibility of the online component. TOT participants during the practicum component delivered RE workshops to their university and civil society communities in four regions (n= 3,700 people). The goals of the grant were accomplished through the development of a Steering Committee and implementation of the TOT course. Next steps include the design and implementation of a master&rsquo;s level research ethics education program in Bolivia.La capacidad de investigación y ética de la investigación (EI) es un elemento clave para hacer frente a las prioridades de salud de los países de ingresos bajos y medios (PIBM). Con el apoyo de la subvención de ética de la Investigación de NIH/FIC, una capacitación para capacitadores (CPC) fue implementado en Bolivia. El Comité Directivo, que incluye representantes de universidades y la OPS, desarrolló un CPC en EI que incluía componentes presenciales, virtuales y de práctica. Veinte participantes, incluyendo docentes, investigadores y líderes de la comunidad participaron. Los resultados de la pre/post prueba demostraron aumentos significativos en el conocimiento de EI (13,1% de mejora, valor de p< 0,0001). Una evaluación demostró que los participantes valoraron las estrategias de aprendizaje y la flexibilidad del componente virtual. Durante el componente de prácticas, los participantes hicieron talleres de EI que fueron presentados a sus comunidades universitarias y a la sociedad civil en cuatro regiones (n = 3,700 personas). Los objetivos de la subvención se llevaron a cabo mediante el desarrollo de un Comité Directivo y la implementación del CPC. Los próximos pasos incluyen el diseño e implementación de un programa de educación en ética de investigación a nivel de maestría en Bolivia.Capacitação em pesquisa e ética em pesquisa (RE) de capacidade é um elemento-chave para abordar as prioridades de saúde em países de baixa e média renda (LMICs). Com o apoio de bolsa do NIH / FIC Research Ethics Education and Curriculum Development, uma RE Training of Trainers (TOT) foi implantada na Bolívia. O Comitê Dirigente, incluindo representantes das universidades bolivianas e PAHO, desenvolveu a RE TOT que envolveu modo presencial, online e componentes práticos. Participaram vinte estagiários, incluindo faculdades, pesquisadores e líderes comunitarios. Resultados pré / pós-teste demonstraram aumentos significativos no conhecimento RE geral (melhoria de 13,1%,

Pesquisa ética no treinamento de estagiários: desenvolvendo a capacitação da ciência da saúde boliviana e em líderes da sociedade civil

Research and research ethics (RE) capacity is a key element for addressing health priorities of low - and middle-income countries (LMICs). With support from a NIH/FIC Research Ethics Education and Curriculum Development grant, a RE Training of Trainers (TOT) was implemented in Bolivia. The Steering Committee, including representatives from four Bolivian universities and PAHO, developed the RE TOT that included face-to-face, online and practicum components. Twenty trainees including faculty, researchers and community leaders participated. Pre/Posttest results demonstrated significant increases in overall RE knowledge (13.1% improvement, p-value &lt; 0.0001). An evaluation demonstrated participants valued participatory learning strategies and the flexibility of the online component. TOT participants during the practicum component delivered RE workshops to their university and civil society communities in four regions (n= 3,700 people). The goals of the grant were accomplished through the development of a Steering Committee and implementation of the TOT course. Next steps include the design and implementation of a master&rsquo;s level research ethics education program in Bolivia.La capacidad de investigación y ética de la investigación (EI) es un elemento clave para hacer frente a las prioridades de salud de los países de ingresos bajos y medios (PIBM). Con el apoyo de la subvención de ética de la Investigación de NIH/FIC, una capacitación para capacitadores (CPC) fue implementado en Bolivia. El Comité Directivo, que incluye representantes de universidades y la OPS, desarrolló un CPC en EI que incluía componentes presenciales, virtuales y de práctica. Veinte participantes, incluyendo docentes, investigadores y líderes de la comunidad participaron. Los resultados de la pre/post prueba demostraron aumentos significativos en el conocimiento de EI (13,1% de mejora, valor de p< 0,0001). Una evaluación demostró que los participantes valoraron las estrategias de aprendizaje y la flexibilidad del componente virtual. Durante el componente de prácticas, los participantes hicieron talleres de EI que fueron presentados a sus comunidades universitarias y a la sociedad civil en cuatro regiones (n = 3,700 personas). Los objetivos de la subvención se llevaron a cabo mediante el desarrollo de un Comité Directivo y la implementación del CPC. Los próximos pasos incluyen el diseño e implementación de un programa de educación en ética de investigación a nivel de maestría en Bolivia.Capacitação em pesquisa e ética em pesquisa (RE) de capacidade é um elemento-chave para abordar as prioridades de saúde em países de baixa e média renda (LMICs). Com o apoio de bolsa do NIH / FIC Research Ethics Education and Curriculum Development, uma RE Training of Trainers (TOT) foi implantada na Bolívia. O Comitê Dirigente, incluindo representantes das universidades bolivianas e PAHO, desenvolveu a RE TOT que envolveu modo presencial, online e componentes práticos. Participaram vinte estagiários, incluindo faculdades, pesquisadores e líderes comunitarios. Resultados pré / pós-teste demonstraram aumentos significativos no conhecimento RE geral (melhoria de 13,1%,

The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 health care workers (HEROES) study

Background: Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. Methods: Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country’s income level. Results: As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. Conclusions: This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings.Background: Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. Methods: Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country’s income level. Results: As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. Conclusions: This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings

Curso para especialistas en seguridad y salud ocupacional de Latinoamérica

Anualmente fallecen millones de trabajadores debido a accidentes de trabajo y enfermedades profesionales. Esto afecta especialmente a países en vía de desarrollo donde los desafíos muchas veces se parecen. Para mejorar esta situación, el Centro Internacional de la Salud Objetivo: Ofrece cursos internacionales para profesionales de Seguridad y Salud Ocupacional en los cuales los participantes pueden interactuar y desarrollar nuevas ideas generando cambios a nivel local en sus países. Metodología: El método de enseñanza de los primeros tres cursos incluyó clases interactivas, aprendizaje basado en problemas, presentación de pósteres, discusiones grupales y la formulación de un protocolo de estudio de base epidemiológica. Participantes de diferentes profesiones trabajaron conjuntamente durante dos semanas consecutivas, lo cual favoreció el intercambio de ideas y el nivel de multiculturalidad de los cursos. Resultados: Todos los 80 participantes finalizaron exitosamente el curso de dos semanas de duración. Cada uno de ellos redactó un protocolo de investigación de base epidemiológica, los cuales en su mayoría ya han sido implementados o se encuentran en la fase de implementación. En la evaluación, todos los participantes opinaron que la mezcla de profesionales participantes fue enriquecedora destacando también la excelente calidad de los docentes. Consecuentemente, se estableció una red de contactos de SSO entre los participantes. Conclusiones: Los tres cursos internacionales e interdisciplinarios de “Salud Ocupacional Cruzando Fronteras” fueron positivos tanto para participantes como para docentes. Desde el 2012, estos cursos forman parte de la Maestría Internacional en Seguridad y Salud Ocupacional de la Ludwig-Maximilian-Universität de Múnich, Alemania