Building consensus on identifying research mentoring gaps and finding ways of addressing the gap in a Kenyan college of health sciences

Background: The concept of mentoring in clinical practice has traditionally focused on moving graduates from novice to more respectable positions within the clinical practice hierarchy. With the growing emphasis on evidence-based practice, the role of research in generating evidence for practice cannot be overemphasised. Mentoring in clinical operational research for both students and junior members of academic staff in health professionals' training colleges is as important as mentoring for clinical skills. Aim: This study aimed at building consensus on possible ways of enhancing research mentoring for graduate students and members of academic staff in a college of health sciences. Setting: The study was conducted within Moi University College of Health Sciences (MUCHS) in Eldoret, Kenya. Methods: The study population was composed of academic staff members and registered graduate students by the end of 2015. All academic staff and graduate students were eligible to participate. The Delphi technique was used to not only collect individual opinions but also build consensus. During the first iteration, questions were sent for which open-ended responses were needed. Responses from the first round were grouped into patterns and themes that guided the writing of questions for the subsequent rounds.Results: The response rate was 78%. There was consensus in appreciating that mentoring was fundamental for career growth in clinical practice and research and needed for improving and developing formal structure for effective mentoring. It was crucial to establish training programmes for mentors and for accrediting them. Conclusion: Enhancing of current research mentoring in MUCHS was needed and expected by graduate students and academic staff

Home therapy for inherited bleeding disorders in south Africa: results of a modified delphi consensus process

Background. Optimal care of patients with inherited bleeding disorders requires that bleeding episodes are treated early, or still better prevented, through extension of patient care beyond hospital-based treatment to home-based therapy. In South Africa (SA), adoption of home therapy is variable, in part owing to lack of consensus among healthcare providers on what constitutes home therapy, which patients should be candidates for it, how it should be monitored, and what the barriers to home therapy are.Objectives. To conduct a modified Delphi process in order to establish consensus on home therapy among haemophilia healthcare providers in SA.Methods. Treaters experienced in haemophilia care were invited to participate in a consensus-seeking process conducted in three rounds. In round 1, provisional statements around home therapy were formulated as questions and collated in a structured list. In rounds 2 and 3, evolving versions of the questionnaire were administered to participants. Consensus was defined as ≥70% agreement among the participants.Results. The panel composition included an equal number of physicians and non-physicians. The participation rate was 100% through all three consensus rounds. The group reached consensus for 92% of the statements. Consensus of 100% was reached on starting home therapy in paediatric patients, requiring all patients on home therapy to sign informed consent and indemnity, and providing round-the-clock support for patients on home therapy.Conclusions. The home therapy consensus statements in this report have the potential to translate to policy on home therapy and to guide the initiation, practice and evaluation of home therapy programmes in SA

Cultural consensus modelling to understand the reproductive health needs of South African adolescent girls

Background. Cultural consensus modelling (CCM) is an approach whereby individuals define the boundaries regarding a set of knowledge or behaviours shared by a group within a culture using an ethnographic approach. Objectives. To provide an overview of CCM methods and the application of CCM to examine South African adolescent girls' contraceptive and HIV prevention practices. Methods. In phase 1 of a CCM approach, individuals respond to questions about their culture rather than their individual behaviours, allowing individuals to draw upon a shared cultural knowledge. Utilising these identified group beliefs, phase 2 asks individuals to rate the extent to which factors identified in phase 1 are valued. Phase 3 utilises qualitative interviews with key informants from phase 2 to gather in-depth information regarding the identified determinants of the health behaviour. Lastly, phase 4 of this approach conducts a quantitative survey to determine the extent to which cultural consensus model types are associated with differences in actual behaviours. Results. CCM data analytic approaches are described. Frequencies and descriptive statistics for the free listing are conducted. For phase 2, cultural consensus analysis is conducted to examine whether one or several consensus models exist and competence scores are calculated. Standard qualitative analysis approaches are utilised for phase 3. Phase 4 employs regression to examine the association between cultural models and an outcome of interest. Conclusion. CCM provides a novel, culturally sensitive understanding of reproductive health practices among South African adolescent girls; CCM also has broad applicability to other adolescent health research domains