Davila Evelyn P, Suleiman Zubeda, Mghamba Janneth, Rolle Italia, Ahluwalia Indu, Mmbuji Peter, de Courten Maximilian, Bader Andrea, Zahniser S Christine, Krag Marlene, Jarrar Bassam
Division of Public Health Systems and Workforce Development, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, USA
Field Epidemiology Laboratory Training Program Tanzania, Ministry of Health and Social Welfare, Tanzania.
Int Health. 2015 Sep;7(5):339-47. doi: 10.1093/inthealth/ihu090. Epub 2014 Dec 19.
Non-communicable diseases (NCDs) are increasing worldwide. A lack of training and experience in NCDs among public health workers is evident in low- and middle- income countries.
We describe the design and outcomes of applied training in NCD epidemiology and control piloted in Tanzania that included a 2-week interactive course and a 6-month NCD field project. Trainees (n=14 initiated; n=13 completed) were epidemiology-trained Ministry of Health or hospital staff. We evaluated the training using Kirkpatrick's evaluation model for measuring reactions, learning, behavior and results using pre- and post-tests and closed-ended and open-ended questions.
Significant improvements in knowledge and self-reported competencies were observed. Trainees reported applying competencies at work and supervisors reported improvements in trainees' performance. Six field projects were completed; one led to staffing changes and education materials for patients with diabetes and another to the initiation of an injury surveillance system. Workplace support and mentoring were factors that facilitated the completion of projects. Follow-up of participants was difficult, limiting our evaluation of the training's outcomes.
The applied NCD epidemiology and control training piloted in Tanzania was well received and showed improvements in knowledge, skill and self-efficacy and changes in workplace behavior and institutional and organizational changes. Further evaluations are needed to better understand the impact of similar NCD trainings and future trainers should ensure that trainees have mentoring and workplace support prior to participating in an applied NCD training.
非传染性疾病在全球范围内呈上升趋势。在低收入和中等收入国家，公共卫生工作者在非传染性疾病方面缺乏培训和经验的情况很明显。
我们描述了在坦桑尼亚试点的非传染性疾病流行病学与防控应用培训的设计及成果，该培训包括为期两周的互动课程和为期6个月的非传染性疾病实地项目。学员（初始14人；完成13人）为接受过流行病学培训的卫生部或医院工作人员。我们使用柯克帕特里克评估模型，通过前后测试以及封闭式和开放式问题来评估培训，以衡量反应、学习、行为和结果。
观察到知识和自我报告的能力有显著提高。学员报告在工作中应用了所学能力，主管报告学员的表现有所改善。完成了6个实地项目；其中一个项目导致了人员配置的变化以及为糖尿病患者编写了教育材料，另一个项目启动了伤害监测系统。工作场所的支持和指导是促进项目完成的因素。对参与者进行随访很困难，这限制了我们对培训成果的评估。
在坦桑尼亚试点的非传染性疾病流行病学与防控应用培训受到好评，在知识、技能和自我效能方面有所提高，工作场所行为以及机构和组织方面也发生了变化。需要进一步评估，以更好地了解类似非传染性疾病培训的影响，未来的培训人员应确保学员在参加非传染性疾病应用培训之前获得指导和工作场所支持。
