No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study

Research output: Contribution to journalJournal articlepeer-review

Standard

No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study. / Kjærgaard, Jesper; Nissen, Thomas Nørrelykke; Isaeva, Elvira; Quynh, Nguyen Nhat; Reventlow, Susanne; Lund, Stine; Sooronbaev, Talant; Le An, Pham; Østergaard, Marianne Stubbe; Stout, Jim; Poulsen, Anja; Anastasaki, Marilena; Akylbekov, Azamat; Barton, Andy; Bertsias, Antonios; Binh, Pham Duong Uyen; van Boven, Job F.M.; Brakema, Evelyn A.; Burges, Dennis; Cartwright, Lucy; Chatzea, Vasiliki E.; Chavannes, Niels H.; Cragg, Liza; Dang, Tran Ngoc; Dautov, Ilyas; Emilov, Berik; Ferarrio, Irene; van Gemert, Frederik A.; Hedrick, Ben; Hong, Le Huynh Thi Cam; Hopkinson, Nick; Jones, Rupert; de Jong, Corina; van Kampen, Sanne; Katagira, Winceslaus; Kirenga, Bruce; van der Kleij, Rianne Mjj; Kocks, Janwillem; Lan, Le Thi Tuyet; Linh, Tran Thanh Duv; Lionis, Christos; Loan, Kim Xuan; Luan, Nguyen Huy; Mademilov, Maamed; McEwen, Andy; Musinguzi, Patrick; Nantanda, Rebecca; Ndeezi, Grace; Papadakis, Sophia; Pinnock, Hilary; the FRESH AIR collaborators.

In: BMC Health Services Research, Vol. 20, No. 1, 1137, 2020.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Kjærgaard, J, Nissen, TN, Isaeva, E, Quynh, NN, Reventlow, S, Lund, S, Sooronbaev, T, Le An, P, Østergaard, MS, Stout, J, Poulsen, A, Anastasaki, M, Akylbekov, A, Barton, A, Bertsias, A, Binh, PDU, van Boven, JFM, Brakema, EA, Burges, D, Cartwright, L, Chatzea, VE, Chavannes, NH, Cragg, L, Dang, TN, Dautov, I, Emilov, B, Ferarrio, I, van Gemert, FA, Hedrick, B, Hong, LHTC, Hopkinson, N, Jones, R, de Jong, C, van Kampen, S, Katagira, W, Kirenga, B, van der Kleij, RM, Kocks, J, Lan, LTT, Linh, TTD, Lionis, C, Loan, KX, Luan, NH, Mademilov, M, McEwen, A, Musinguzi, P, Nantanda, R, Ndeezi, G, Papadakis, S, Pinnock, H & the FRESH AIR collaborators 2020, 'No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study', BMC Health Services Research, vol. 20, no. 1, 1137. https://doi.org/10.1186/s12913-020-05984-y

APA

Kjærgaard, J., Nissen, T. N., Isaeva, E., Quynh, N. N., Reventlow, S., Lund, S., Sooronbaev, T., Le An, P., Østergaard, M. S., Stout, J., Poulsen, A., Anastasaki, M., Akylbekov, A., Barton, A., Bertsias, A., Binh, P. D. U., van Boven, J. F. M., Brakema, E. A., Burges, D., ... the FRESH AIR collaborators (2020). No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study. BMC Health Services Research, 20(1), [1137]. https://doi.org/10.1186/s12913-020-05984-y

Vancouver

Kjærgaard J, Nissen TN, Isaeva E, Quynh NN, Reventlow S, Lund S et al. No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study. BMC Health Services Research. 2020;20(1). 1137. https://doi.org/10.1186/s12913-020-05984-y

Author

Kjærgaard, Jesper ; Nissen, Thomas Nørrelykke ; Isaeva, Elvira ; Quynh, Nguyen Nhat ; Reventlow, Susanne ; Lund, Stine ; Sooronbaev, Talant ; Le An, Pham ; Østergaard, Marianne Stubbe ; Stout, Jim ; Poulsen, Anja ; Anastasaki, Marilena ; Akylbekov, Azamat ; Barton, Andy ; Bertsias, Antonios ; Binh, Pham Duong Uyen ; van Boven, Job F.M. ; Brakema, Evelyn A. ; Burges, Dennis ; Cartwright, Lucy ; Chatzea, Vasiliki E. ; Chavannes, Niels H. ; Cragg, Liza ; Dang, Tran Ngoc ; Dautov, Ilyas ; Emilov, Berik ; Ferarrio, Irene ; van Gemert, Frederik A. ; Hedrick, Ben ; Hong, Le Huynh Thi Cam ; Hopkinson, Nick ; Jones, Rupert ; de Jong, Corina ; van Kampen, Sanne ; Katagira, Winceslaus ; Kirenga, Bruce ; van der Kleij, Rianne Mjj ; Kocks, Janwillem ; Lan, Le Thi Tuyet ; Linh, Tran Thanh Duv ; Lionis, Christos ; Loan, Kim Xuan ; Luan, Nguyen Huy ; Mademilov, Maamed ; McEwen, Andy ; Musinguzi, Patrick ; Nantanda, Rebecca ; Ndeezi, Grace ; Papadakis, Sophia ; Pinnock, Hilary ; the FRESH AIR collaborators. / No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study. In: BMC Health Services Research. 2020 ; Vol. 20, No. 1.

Bibtex

@article{6e20ae8edc174c8a920af03bfc25c37c,
title = "No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study",
abstract = "Background: Training is a common and cost-effective way of trying to improve quality of care in low- and middle-income countries but studies of contextual factors for the successful translation of increased knowledge into clinical change are lacking, especially in primary care. The purpose of this study was to assess the impact of contextual factors on the effect of training rural healthcare workers in Kyrgyzstan and Vietnam on their knowledge and clinical performance in managing pediatric patients with respiratory symptoms. Methods: Primary care health workers in Kyrgyzstan and Vietnam underwent a one-day training session on asthma in children under five. The effect of training was measured on knowledge and clinical performance using a validated questionnaire, and by direct clinical observations. Results: Eighty-one healthcare workers participated in the training. Their knowledge increased by 1.1 Cohen{\textquoteright}s d (CI: 0.7 to 1.4) in Kyrgyzstan where baseline performance was lower and 1.5 Cohen{\textquoteright}s d (CI: 0.5 to 2.5) in Vietnam. Consultations were performed by different types of health care workers in Kyrgyzstan and there was a 79.1% (CI 73.9 to 84.3%) increase in consultations where at least one core symptom of respiratory illness was asked. Only medical doctors participated in Vietnam, where the increase was 25.0% (CI 15.1 to 34.9%). Clinical examination improved significantly after training in Kyrgyzstan. In Vietnam, the number of actions performed generally declined. The most pronounced difference in contextual factors was consultation time, which was median 15 min in Kyrgyzstan and 2 min in Vietnam. Discussion and conclusion: The effects on knowledge of training primary care health workers in lower middle-income countries in diagnosis and management of asthma in children under five only translated into changes in clinical performance where consultation time allowed for changes to clinical practice, emphasizing the importance of considering contextual factors in order to succeed in behavioral change after training.",
keywords = "Asthma, Contextual factors, Knowledge, Low- and middle-income countries, Pediatrics, Quality of care, Time for consultation, Training",
author = "Jesper Kj{\ae}rgaard and Nissen, {Thomas N{\o}rrelykke} and Elvira Isaeva and Quynh, {Nguyen Nhat} and Susanne Reventlow and Stine Lund and Talant Sooronbaev and {Le An}, Pham and {\O}stergaard, {Marianne Stubbe} and Jim Stout and Anja Poulsen and Marilena Anastasaki and Azamat Akylbekov and Andy Barton and Antonios Bertsias and Binh, {Pham Duong Uyen} and {van Boven}, {Job F.M.} and Brakema, {Evelyn A.} and Dennis Burges and Lucy Cartwright and Chatzea, {Vasiliki E.} and Chavannes, {Niels H.} and Liza Cragg and Dang, {Tran Ngoc} and Ilyas Dautov and Berik Emilov and Irene Ferarrio and {van Gemert}, {Frederik A.} and Ben Hedrick and Hong, {Le Huynh Thi Cam} and Nick Hopkinson and Rupert Jones and {de Jong}, Corina and {van Kampen}, Sanne and Winceslaus Katagira and Bruce Kirenga and {van der Kleij}, {Rianne Mjj} and Janwillem Kocks and Lan, {Le Thi Tuyet} and Linh, {Tran Thanh Duv} and Christos Lionis and Loan, {Kim Xuan} and Luan, {Nguyen Huy} and Maamed Mademilov and Andy McEwen and Patrick Musinguzi and Rebecca Nantanda and Grace Ndeezi and Sophia Papadakis and Hilary Pinnock and {the FRESH AIR collaborators}",
year = "2020",
doi = "10.1186/s12913-020-05984-y",
language = "English",
volume = "20",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study

AU - Kjærgaard, Jesper

AU - Nissen, Thomas Nørrelykke

AU - Isaeva, Elvira

AU - Quynh, Nguyen Nhat

AU - Reventlow, Susanne

AU - Lund, Stine

AU - Sooronbaev, Talant

AU - Le An, Pham

AU - Østergaard, Marianne Stubbe

AU - Stout, Jim

AU - Poulsen, Anja

AU - Anastasaki, Marilena

AU - Akylbekov, Azamat

AU - Barton, Andy

AU - Bertsias, Antonios

AU - Binh, Pham Duong Uyen

AU - van Boven, Job F.M.

AU - Brakema, Evelyn A.

AU - Burges, Dennis

AU - Cartwright, Lucy

AU - Chatzea, Vasiliki E.

AU - Chavannes, Niels H.

AU - Cragg, Liza

AU - Dang, Tran Ngoc

AU - Dautov, Ilyas

AU - Emilov, Berik

AU - Ferarrio, Irene

AU - van Gemert, Frederik A.

AU - Hedrick, Ben

AU - Hong, Le Huynh Thi Cam

AU - Hopkinson, Nick

AU - Jones, Rupert

AU - de Jong, Corina

AU - van Kampen, Sanne

AU - Katagira, Winceslaus

AU - Kirenga, Bruce

AU - van der Kleij, Rianne Mjj

AU - Kocks, Janwillem

AU - Lan, Le Thi Tuyet

AU - Linh, Tran Thanh Duv

AU - Lionis, Christos

AU - Loan, Kim Xuan

AU - Luan, Nguyen Huy

AU - Mademilov, Maamed

AU - McEwen, Andy

AU - Musinguzi, Patrick

AU - Nantanda, Rebecca

AU - Ndeezi, Grace

AU - Papadakis, Sophia

AU - Pinnock, Hilary

AU - the FRESH AIR collaborators

PY - 2020

Y1 - 2020

N2 - Background: Training is a common and cost-effective way of trying to improve quality of care in low- and middle-income countries but studies of contextual factors for the successful translation of increased knowledge into clinical change are lacking, especially in primary care. The purpose of this study was to assess the impact of contextual factors on the effect of training rural healthcare workers in Kyrgyzstan and Vietnam on their knowledge and clinical performance in managing pediatric patients with respiratory symptoms. Methods: Primary care health workers in Kyrgyzstan and Vietnam underwent a one-day training session on asthma in children under five. The effect of training was measured on knowledge and clinical performance using a validated questionnaire, and by direct clinical observations. Results: Eighty-one healthcare workers participated in the training. Their knowledge increased by 1.1 Cohen’s d (CI: 0.7 to 1.4) in Kyrgyzstan where baseline performance was lower and 1.5 Cohen’s d (CI: 0.5 to 2.5) in Vietnam. Consultations were performed by different types of health care workers in Kyrgyzstan and there was a 79.1% (CI 73.9 to 84.3%) increase in consultations where at least one core symptom of respiratory illness was asked. Only medical doctors participated in Vietnam, where the increase was 25.0% (CI 15.1 to 34.9%). Clinical examination improved significantly after training in Kyrgyzstan. In Vietnam, the number of actions performed generally declined. The most pronounced difference in contextual factors was consultation time, which was median 15 min in Kyrgyzstan and 2 min in Vietnam. Discussion and conclusion: The effects on knowledge of training primary care health workers in lower middle-income countries in diagnosis and management of asthma in children under five only translated into changes in clinical performance where consultation time allowed for changes to clinical practice, emphasizing the importance of considering contextual factors in order to succeed in behavioral change after training.

AB - Background: Training is a common and cost-effective way of trying to improve quality of care in low- and middle-income countries but studies of contextual factors for the successful translation of increased knowledge into clinical change are lacking, especially in primary care. The purpose of this study was to assess the impact of contextual factors on the effect of training rural healthcare workers in Kyrgyzstan and Vietnam on their knowledge and clinical performance in managing pediatric patients with respiratory symptoms. Methods: Primary care health workers in Kyrgyzstan and Vietnam underwent a one-day training session on asthma in children under five. The effect of training was measured on knowledge and clinical performance using a validated questionnaire, and by direct clinical observations. Results: Eighty-one healthcare workers participated in the training. Their knowledge increased by 1.1 Cohen’s d (CI: 0.7 to 1.4) in Kyrgyzstan where baseline performance was lower and 1.5 Cohen’s d (CI: 0.5 to 2.5) in Vietnam. Consultations were performed by different types of health care workers in Kyrgyzstan and there was a 79.1% (CI 73.9 to 84.3%) increase in consultations where at least one core symptom of respiratory illness was asked. Only medical doctors participated in Vietnam, where the increase was 25.0% (CI 15.1 to 34.9%). Clinical examination improved significantly after training in Kyrgyzstan. In Vietnam, the number of actions performed generally declined. The most pronounced difference in contextual factors was consultation time, which was median 15 min in Kyrgyzstan and 2 min in Vietnam. Discussion and conclusion: The effects on knowledge of training primary care health workers in lower middle-income countries in diagnosis and management of asthma in children under five only translated into changes in clinical performance where consultation time allowed for changes to clinical practice, emphasizing the importance of considering contextual factors in order to succeed in behavioral change after training.

KW - Asthma

KW - Contextual factors

KW - Knowledge

KW - Low- and middle-income countries

KW - Pediatrics

KW - Quality of care

KW - Time for consultation

KW - Training

U2 - 10.1186/s12913-020-05984-y

DO - 10.1186/s12913-020-05984-y

M3 - Journal article

C2 - 33302935

AN - SCOPUS:85097390267

VL - 20

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

IS - 1

M1 - 1137

ER -

ID: 253880637