workforce development

劳动力发展
  • 文章类型: Journal Article
    背景:武装冲突和战争是公共卫生灾难。公共卫生行动在与冲突有关的紧急情况和康复中以及在预防战争和促进和平中都具有至关重要的作用。将其转化为公共卫生培训和能力刚刚开始出现,尤其是在欧洲。
    方法:我们进行了范围审查,以绘制和确定公共卫生教育和公共卫生人员培训在预防战争和促进和平方面的作用,正如科学文献所反映的那样。我们在PubMed搜索,CINAHL,PsycINFO,Embase,WebofScience核心收藏以及英文收录材料的参考列表,德语和波兰语最初关注欧洲地区,后来我们把搜索扩展到了欧洲以外.
    结果:我们纳入了7篇出版物,从意见到课程和培训的实证评估。教育方案主要是短期和课外研究生课程,面向受冲突影响国家和未受战争直接影响国家的公共卫生专业人员。出版物侧重于战争时期的公共卫生行动,没有说明战争或武装冲突的背景和类型。在紧急情况下,专注于应急响应和多学科合作的能力教学,经常借鉴自然灾害和疾病爆发管理的经验和例子。
    结论:关于战时和促进和平的公共卫生教育能力的科学论述,主要集中在紧急响应行动。预防战争和促进和平是缺失的重点,这需要在公共卫生培训中更加突出。公共卫生教育和培训应确保预防战争与促进和平,以及战争时期的公共卫生行动,包括在他们对公共卫生专业人员的能力中。
    BACKGROUND: Armed conflict and war are public health disasters. Public health action has a crucial role in conflict-related emergencies and rehabilitation but also in war prevention and peace promotion. Translating this into public health training and competencies has just started to emerge, especially in Europe.
    METHODS: We conducted a Scoping Review to map and identify the role of public health education and training of public health workforce relating to the prevention of war and promoting peace, as reflected in the scientific literature. We searched in PubMed, CINAHL, PsycINFO, Embase, Web of Science Core Collections as well as the reference list of included material in English, German and Polish. Focusing initially on the European region, we later expanded the search outside of Europe.
    RESULTS: We included 7 publications from opinion pieces to an empirical assessment of curricula and training. The educational programs were predominantly short-term and extra-curricular in postgraduate courses addressing both public health professionals in conflict-affected countries as well as countries not directly affected by war. Publications focused on public health action in times of war, without specifying the context and type of war or armed conflict. Competencies taught focused on emergency response and multi-disciplinary collaboration during emergencies, frequently drawing on experience and examples from natural disaster and disease outbreak management.
    CONCLUSIONS: The scientific discourse on competences in public health education for times of war and for the promotion of peace, predominately focuses on immediate emergency response actions. The prevention of war and the promotion of peace are missing foci, that need to feature more prominently in public health training. Public Health Education and training should ensure that war prevention and peace promotion, as well as public health action in times of war, are included in their competencies for public health professionals.
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  • 文章类型: Journal Article
    能够实施基因组医学的卫生劳动力需要有效的基因组学教育。在过去的二十年中,为卫生专业开发了基因组学教育干预措施,以及它们的影响,在文献中有不同的描述。为基因组学教育提供评估框架,我们对已发布的需求评估进行了探索性范围审查,和/或评估,2000年至2023年卫生专业人员的基因组学教育干预措施。我们在两次搜索中检索并筛选了4,659条记录,其中363条被选择用于跨学科工作组的全文审查和审议。选择了104篇文章纳入审查-60需求评估,52个基因组学教育评估,和八个描述两者。收录的文章涵盖了所有年份,并描述了30多个国家的教育干预措施。目标受众包括医学专家,护士/助产士,和/或专职卫生专业人员。评价问题,结果,并提取了措施,分类,分类并制成表格,以反复比较基因组学教育评估各阶段的措施:计划(实施前),开发和交付(实施),和影响(立即,中间,或长期结果)。它们与研究设计的描述一起出现在这里。我们记录了用于定义措施的评估方法和术语的广泛差异,并注意到很少有文章考虑了基因组学教育干预的下游(长期)结果。除了基因组学教育的评估框架之外,本范围审查的结果构成了一个工具包的一部分,该工具包旨在帮助教育工作者进行严格的基因组学评估,该评估符合目的,并且可以为基因组学教育在基因组医学实施策略中的贡献提供越来越多的证据基础.
    A health workforce capable of implementing genomic medicine requires effective genomics education. Genomics education interventions developed for health professions over the last two decades, and their impact, are variably described in the literature. To inform an evaluation framework for genomics education, we undertook an exploratory scoping review of published needs assessments for, and/or evaluations of, genomics education interventions for health professionals from 2000 to 2023. We retrieved and screened 4,659 records across the two searches with 363 being selected for full-text review and consideration by an interdisciplinary working group. 104 articles were selected for inclusion in the review-60 needs assessments, 52 genomics education evaluations, and eight describing both. Included articles spanned all years and described education interventions in over 30 countries. Target audiences included medical specialists, nurses/midwives, and/or allied health professionals. Evaluation questions, outcomes, and measures were extracted, categorized, and tabulated to iteratively compare measures across stages of genomics education evaluation: planning (pre-implementation), development and delivery (implementation), and impact (immediate, intermediate, or long-term outcomes). They are presented here along with descriptions of study designs. We document the wide variability in evaluation approaches and terminology used to define measures and note that few articles considered downstream (long-term) outcomes of genomics education interventions. Alongside the evaluation framework for genomics education, results from this scoping review form part of a toolkit to help educators to undertake rigorous genomics evaluation that is fit for purpose and can contribute to the growing evidence base of the contribution of genomics education in implementation strategies for genomic medicine.
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  • 文章类型: Systematic Review
    UNASSIGNED:自2016年以来,已在各个国家/地区组织了联合外部评估(JEE)任务。对JEE报告的系统审查旨在确定世卫组织区域检测的主要挑战(MC)。
    UASSIGNED:我们在WHO网站上访问了JEE报告。挑战被定义为需要改进的检测指标的变量。MC是每个区域和全球至少三分之一国家面临的共同挑战。为了一致性,我们评估了报告中“需要加强的领域/挑战”下报告的挑战。
    未经评估:我们分析了96份JEE报告。非洲区域(91.7%),东地中海地区(80.9%)和东南亚地区(72.7%)的JEE完成率最高。MC在欧洲地区为24,26在地中海地区,30在西太平洋地区,东南亚地区33个,非洲地区34个。在全球范围内确定了24个MC。国家实验室系统和实时监测的MC数量最高。世卫组织所有区域和全球一级共有11个MC。这些包括核心测试确认能力不足,样本转诊系统不足,质量管理体系薄弱,实验室许可和认证中的问题,数据管理薄弱,薄弱的电子报告系统,国际卫生条例与动物卫生联络点之间缺乏/信息交流机制薄弱,卫生专业专家不足,劳动力战略的需要,现场流行病学的需要和劳动力保留能力不足。
    UNASSIGNED:应通过全球方法解决所确定的MC。
    UNASSIGNED: since 2016, Joint External Evaluation (JEE) missions have been organized in various countries. This systematic review of the JEE reports is intended to identify the main challenges (MC) of detection in WHO regions.
    UNASSIGNED: we accessed JEE reports on the WHO website. Challenge was defined as a variable of the indicators of detection where there was a need of improvement. MC was a challenge common to at least one-third of countries in each region and globally. For consistency, we assessed challenges reported under \"Areas which need strengthening/challenges\" in reports.
    UNASSIGNED: we analyzed 96 JEE reports. African Region (91.7%), Eastern Mediterranean Region (80.9%) and South East Asia Region (72.7%) had the highest rates of JEE completion. The MC were 24 in European Region, 26 in Mediterranean Region, 30 in Western Pacific Region, 33 in South East Asia Region and 34 in African Region. 24 MCs were identified at global level. National laboratory system and Real time surveillance had the highest number of MC. Eleven MCs were common to all WHO regions and global level. These include insufficient capacity for core test confirmation, insufficient specimen referral system, weak quality management system, issues in laboratories licensing and accreditation, weak data management, weak electronic reporting system, absence /weak mechanism of information exchange between International Health Regulation and animal health focal points, insufficient health professional specialists, the need of workforce strategy, the need of field epidemiology and insufficient workforce retention capacity.
    UNASSIGNED: the MCs identified should be addressed through a global approach.
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  • 文章类型: Review
    心血管疾病(CVD)和中风是美国慢性病负担的主要原因。尽管中风的患病率很高,90%的中风事件是可以预防的,可以归因于七个关键的可改变的危险因素(MRF)-高血压(BP)。高胆固醇,糖尿病(DM),吸烟,肥胖,不健康的饮食,缺乏体力活动。在美国,由社区卫生工作者(CHW)领导的卒中预防干预措施已被证明在预防MRF发作方面非常有效.我们对CVD和以中风为重点的CHW培训计划中使用的能力评估方法进行了范围审查。我们搜索了六个在线数据库:PubMed,科克伦,CINAHL,Embase,WebofScience,还有哈皮,从所有可用年份到2021年1月。在找到的1774篇初始文章中,我们确定了30篇符合条件的文章纳入审查。其中9项研究使用了以前验证过的仪器,而其余21项研究使用培训课程中的工具或独立开发的工具。这些经过验证的工具中只有五个报告了心理测量特性;它们都不是为CHW人群设计的。我们对文献的范围审查表明,CHW特定的能力评估方法是有限的,很少或没有符合既定测量标准的心血管疾病或中风危险因素领域参考工具。我们得出结论,迫切需要开发一种全面有效的CVD和中风预防评估工具,以评估CHW表现并优化其可信度。代表着将CHW纳入医疗保健系统的重要第一步。
    Cardiovascular disease (CVD) and stroke are major contributors to chronic disease burden in the United States. Despite the high prevalence of stroke, 90% of all stroke events are preventable and can be attributed to seven key modifiable risk factors (MRFs)-high blood pressure (BP), high cholesterol, diabetes mellitus (DM), smoking, obesity, unhealthy diet, and physical inactivity. In the United States, stroke prevention interventions led by community health workers (CHWs) have been proven to be highly effective in preventing the onset of MRFs. We conducted a scoping review of the competency assessment methods used in CVD and stroke-focused CHW training programs. We searched six online databases: PubMed, Cochrane, CINAHL, Embase, Web of Science, and HaPI, from all available years until January 2021. Of the 1,774 initial articles found, we identified 30 eligible articles to be included in the review. Nine of these studies used previously validated instruments, whereas the remaining 21 studies used tools from the training curriculum or independently developed instruments. Only five of these validated tools reported psychometric properties; none of them were designed for the CHW population. Our scoping review of literature revealed that CHW-specific competency assessment methods were limited, with few or no domain-referenced tools on CVD or stroke risk factors that complied with established measurement standards. We conclude that there is an urgent need for the development of a comprehensive and valid assessment instrument in CVD and stroke prevention to evaluate CHW performance and optimize their credibility, representing important first steps toward integrating CHWs into health care systems.
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  • 文章类型: Journal Article
    This review of reviews aimed to identify and synthesise evidence to support the design of learning interventions for non-registered practitioners supporting older people in long-term care (people\'s own homes, hospices or residential/nursing care). Our objectives were to inform the analysis part of the Analysis, Design, Development Implementation and Evaluation framework by finding evidence on the following five components of learning: content, format (teaching strategies and resources/media), structure, contextual factors (barriers and enablers) and measures used when monitoring the effectives of learning. Databases searched included Pro-quest (ASSIA), Scopus, Ovid (PsycINFO, Medline, Embase and Social Policy and Practice), SCIE Online and Cochrane Reviews and reference searching, with the last search being conducted in April 2021. Fifteen papers were identified as eligible for inclusion. Most of the interventions aimed to improve dementia care (n = 10), with others exploring LGBT+ competency (n = 2), or other forms of professional development (n = 3). Common features of effective learning included a multifaceted approach, with in-practice learning being blended with additional implementation strategies (e.g. supervision) and didactic learning/worksheets. An important contextual factor was working within an organisational culture which supported shared learning and reflection. This may also help encourage engagement with training, where staff are unwilling to attend if it may compromise care delivery. Future research should focus on the characteristics of trainers and the structure of learning, with more research being needed in in mental and physical morbidities outside the remit of dementia to improve the overall quality of the social care workforce.
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  • 文章类型: Systematic Review
    经历无家可归的人经常希望就业,但往往难以捉摸。关于包括就业参与在内的主要社会心理结果的现有文献中评估的基于就业的干预措施的范围和有效性知之甚少。心理健康,住房使用权,社区整合和物质使用。为了识别和综合现有的研究,我们使用JoannaBriggs研究所(JBI)根据系统评价和荟萃分析(PRISMA)指南的首选报告项目提出的方法对有效性进行了系统评价.删除重复项之后,我们筛选了13398个标题和摘要,并使用两名独立评估者在全文审查阶段审查了79项研究。共有16项研究符合纳入叙事综合的标准,并接受了严格的评估。大多数研究在美国进行(n=14;87.5%),其他研究在加拿大(n=1;6.3%)和澳大利亚(n=1;6.3%)发表。现有研究中评估的干预措施包括药物使用和职业技能干预措施(n=7;43.8%),支持就业(n=6;37.5%),和综合支持,包括就业部分(n=3;18.8%)。这些干预措施对就业的有效性,心理健康,住房使用权,社区融合,并介绍了物质使用情况。研究结果表明,评估无家可归者的就业干预措施的研究处于发展的早期阶段。研究人员和从业人员可以考虑与有无家可归经历的人和从业人员合作,共同设计和修改现有方法,以更有效地瞄准关键成果。政策制定者可以考虑为这些举措分配资源,以进一步发展旨在支持无家可归的人在无家可归期间和之后获得和维持就业的实践和研究。
    Employment is frequently desired by persons who experience homelessness yet is often elusive. Little is known about the range and effectiveness of employment-based interventions evaluated in existing literature on key psychosocial outcomes including employment participation, mental well-being, housing tenure, community integration and substance use. To identify and synthesise existing studies, we conducted a systematic review of effectiveness using the methodology proposed by the Joanna Briggs Institute (JBI) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Following the removal of duplicates, we screened 13,398 titles and abstracts, and reviewed 79 studies at the full-text review stage using two independent raters. A total of 16 studies met criteria for inclusion in a narrative synthesis and were subjected to critical appraisal. The majority of studies were conducted in the US (n = 14; 87.5%) with other studies published in Canada (n = 1; 6.3%) and Australia (n = 1; 6.3%). Interventions evaluated in existing studies included combined substance use and vocational skills interventions (n = 7; 43.8%), supported employment (n = 6; 37.5%), and integrated supports including an employment component (n = 3; 18.8%). The effectiveness of these interventions on employment, mental well-being, housing tenure, community integration, and substance use is presented. Findings suggest that research evaluating employment interventions for persons who experience homelessness is in an early stage of development. Researchers and practitioners may consider collaborating with persons with lived experiences of homelessness and practitioners in co-designing and modifying existing approaches to target key outcomes more effectively. Policymakers may consider allocating resources to such initiatives to further the development of practice and research aimed at supporting persons who experience homelessness to secure and sustain employment during and following homelessness.
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  • 文章类型: Journal Article
    卫生系统的实力以及最终人口的健康状况在很大程度上取决于卫生工作者的表现。然而,建设支持不足,管理和优化低收入和中等收入国家(LMICs)的卫生人力资源(HRH)导致卫生人力绩效不足,持续存在健康不平等和低质量的卫生服务。
    美国国际开发署资助的2030年卫生人力资源计划(HRH2030)对记录监督增强和改善卫生工作者绩效的方法的研究进行了系统审查,以突出与这些干预措施相关的组成部分。由概念框架构建,对输入进行分类,进程,和结果,该审查评估了自2010年以来约29个低收入国家的57项监督研究.
    在审查的57项研究中描述的成功监督方法中,44人是外部资助的飞行员,这是一个限制。30个侧重于社区卫生工作者(CHW)计划。卫生工作者的监督来自38种方法(67%)的卫生系统数据,22种方法使用了持续质量改进(QI)(39%)。许多成功的方法集成了数字监管技术(例如,智能手机,mHealth应用程序)以支持现有数据系统并补充其他卫生系统活动。很少有研究被改编,缩放,或持续,限制成本效益或影响的报告。
    在审查结果的基础上,为了提高卫生工作者监督的有效性,我们建议:整合循证,QI工具和流程;将数字监督数据集成到监督流程中;在计划监督访问时增加对卫生系统信息和绩效数据的使用,以优先考虑表现最差的区域;跨服务提供区域和地理区域扩展和复制成功的模型;扩展和制度化监督以达到,准备,保护,并支持一线卫生工作者,特别是在卫生紧急情况下;利用国内人力和财力资源过渡和维持监督工作,包括社区,全面的劳动力支持。总之,有效的卫生工作者监督是由卫生系统数据,使用持续质量改进(QI),并将数字技术集成到其他卫生系统活动和现有数据系统中,以实现整个系统的方法。有效监管的加强和创新要更好地结合起来,缩放,并在现有系统内持续进行,以改善获得优质医疗保健的机会。
    The strength of a health system-and ultimately the health of a population-depends to a large degree on health worker performance. However, insufficient support to build, manage and optimize human resources for health (HRH) in low- and middle-income countries (LMICs) results in inadequate health workforce performance, perpetuating health inequities and low-quality health services.
    The USAID-funded Human Resources for Health in 2030 Program (HRH2030) conducted a systematic review of studies documenting supervision enhancements and approaches that improved health worker performance to highlight components associated with these interventions\' effectiveness. Structured by a conceptual framework to classify the inputs, processes, and results, the review assessed 57 supervision studies since 2010 in approximately 29 LMICs.
    Of the successful supervision approaches described in the 57 studies reviewed, 44 were externally funded pilots, which is a limitation. Thirty focused on community health worker (CHW) programs. Health worker supervision was informed by health system data for 38 approaches (67%) and 22 approaches used continuous quality improvement (QI) (39%). Many successful approaches integrated digital supervision technologies (e.g., SmartPhones, mHealth applications) to support existing data systems and complement other health system activities. Few studies were adapted, scaled, or sustained, limiting reports of cost-effectiveness or impact.
    Building on results from the review, to increase health worker supervision effectiveness we recommend to: integrate evidence-based, QI tools and processes; integrate digital supervision data into supervision processes; increase use of health system information and performance data when planning supervision visits to prioritize lowest-performing areas; scale and replicate successful models across service delivery areas and geographies; expand and institutionalize supervision to reach, prepare, protect, and support frontline health workers, especially during health emergencies; transition and sustain supervision efforts with domestic human and financial resources, including communities, for holistic workforce support. In conclusion, effective health worker supervision is informed by health system data, uses continuous quality improvement (QI), and employs digital technologies integrated into other health system activities and existing data systems to enable a whole system approach. Effective supervision enhancements and innovations should be better integrated, scaled, and sustained within existing systems to improve access to quality health care.
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  • 文章类型: Journal Article
    BACKGROUND: Integrated care aims to improve access, quality and continuity of services for ageing populations and people experiencing chronic conditions. However, the health and social care workforce is ill equipped to address complex patient care needs due to working and training in silos. This paper describes the extent and nature of the evidence on workforce development in integrated care to inform future research, policy and practice.
    METHODS: A scoping review was conducted to map the key concepts and available evidence related to workforce development in integrated care.
    RESULTS: Sixty-two published studies were included. Essential skills and competencies included enhancing workforce understanding across the health and social care systems, developing a deeper relationship with and empowering patients and their carers, understanding community needs, patient-centeredness, health promotion, disease prevention, interprofessional training and teamwork and being a role model. The paper also identified training models and barriers/challenges to workforce development in integrated care.
    CONCLUSIONS: Good-quality research on workforce development in integrated care is scarce. The literature overwhelmingly recognises that integrated care training and workforce development is required, and emerging frameworks and competencies have been developed. More knowledge is needed to implement and evaluate these frameworks, including the broader health and social care workforces within a global context. Further research needs to focus on the most effective methods for implementing these competencies.
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  • 文章类型: Journal Article
    目的:本范围审查旨在确定与健康和人类服务(H&HS)劳动力发展相关的领导定义和方法。这篇综述提供了对现有研究文献的潜在规模和范围的初步分析,以告知正在进行的研究,最终目的是告知与领导力发展干预措施有关的未来系统综述。
    方法:遵循Arksey和O\'Malley提出的方法,并使用PRISMA-ScR,使用七个数据库进行了系统搜索(PubMed,健康商业精英,Medline,CINAHL,奥维德,Scopus,和WebofScience)。对文章进行筛选和资格评估。从符合条件的研究中,提取数据进行汇总,整理,并对调查结果进行叙述。
    结果:采用预先选择的标准,共识别了424条记录,并评估了171篇全文.大多数论文是由北美的研究人员进行的研究。35%的文章涉及H&HS行业的领导力。在医院和急性护理环境中,护理和医疗专业的狭窄学科或劳动力领域占主导地位。
    结论:研究结果表明,尽管在卫生系统中对领导力进行了广泛研究,针对更广泛的H&HS行业的领导力发展研究很少。这篇综述强调了进一步研究的必要性,包括对领导力发展干预措施及其在H&HS部门的应用进行更严格的审查。
    OBJECTIVE: This scoping review was undertaken to determine leadership definitions and approaches relevant to health and human service (H&HS) workforce development. This review provides a preliminary analysis of the potential size and scope of available research literature to inform ongoing research with the ultimate aim to inform a future systematic review in relation to leadership development interventions.
    METHODS: Following the methodology proposed by Arksey and O\'Malley and using PRISMA-ScR, a systematic search was conducted using seven databases (PubMed, Health Business Elite, Medline, CINAHL, Ovid, Scopus, and Web of Science). Articles were screened and assessed for eligibility. From eligible studies, data were extracted to summarize, collate, and make a narrative account of the findings.
    RESULTS: Employing pre-selected criteria, a total of 424 records were identified and 171 full-text articles were assessed. The majority of the papers were studies undertaken by researchers based in North America. Leadership in the H&HS sector was addressed in 35% of the articles. The narrow disciplinary or workforce fields of the nursing and medical professions in hospitals and acute care settings dominated the literature.
    CONCLUSIONS: The findings suggest that while leadership has been studied extensively in the health system, there is a paucity of leadership development research specific to the broader H&HS sector. This review emphasises the need for further research, including a more critical examination of leadership development interventions and their application to the H&HS sector.
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  • 文章类型: Journal Article
    BACKGROUND: Issues related to nutrition and health are prominent, yet it is unclear if the dietetics workforce is being used optimally.
    OBJECTIVE: Trends, challenges, opportunities, and future needs of the international dietetic workforce are investigated in this review, which was registered with Open Science Framework (10.17605/OSF.IO/DXNWE).
    METHODS: Eight academic and 5 grey-literature databases and the Google search engine were searched from 2010 onward according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Of 2050 articles screened, 184 were eligible for inclusion.
    METHODS: To chart data, a directed content analysis and a constant comparison technique were used.
    METHODS: The following 13 themes were identified: 1) emerging or expanding areas of practice; 2) skill development; 3) economic considerations; 4) nutrition informatics; 5) diversity within the workforce; 6) specific areas of practice; 7) further education; 8) intrapersonal factors; 9) perceptions of the profession; 10) protecting the scope of practice; 11) support systems; 12) employment outcomes; and 13) registration or credentialing.
    CONCLUSIONS: The dietetics profession is aware of the need to expand into diverse areas of employment. Comprehensive workforce data are necessary to facilitate workforce planning.
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