Mugo Cyrus, Njuguna Irene, Nduati Margaret, Omondi Vincent, Otieno Verlinda, Nyapara Florence, Mabele Elizabeth, Moraa Hellen, Sherr Kenneth, Inwani Irene, Maleche-Obimbo Elizabeth, Wamalwa Dalton, John-Stewart Grace, Slyker Jennifer, Wagner Anjuli D
Department of Research and Programs, Kenyatta National Hospital, PO Box 20723, 00102, Hospital road, Upperhill, Nairobi, Kenya.
Department of Pediatrics and Child Health, University of Nairobi, PO Box 19676, 00202, Ngong road, Upperhill, Nairobi, Kenya.
Health Policy Plan. 2020 Nov 20;35(9):1180-1187. doi: 10.1093/heapol/czaa089.
Stakeholder engagement between researchers, policymakers and practitioners is critical for the successful translation of research into policy and practice. The Counseling and Testing for Children at Home (CATCH) study evaluated a paediatric index case testing model, targeting the children of HIV-infected adults in care in Kenya. Researchers collaborated with stakeholders in the planning, execution and evaluation, and dissemination phases of CATCH. They included a community advisory board, the national HIV programme, County health departments, institutional ethics review bodies, a paediatric bioethics group, facility heads and frontline healthcare workers . Stakeholder analysis considered the power and interest of each stakeholder in the study. All stakeholders had some power to influence the success of the project in the different phases. However, support from institutions with higher hierarchical power increased acceptance of the study by stakeholders lower in the hierarchy. During the planning, execution and evaluation, and dissemination phases, the study benefitted from deliberate stakeholder engagement. Through engagement, changes were made in the approach to recruitment to ensure high external validity, placing recruitment optimally within existing clinic flow patterns. Choices in staffing home visits were made to include the appropriate cadre of staff. Adaptations were made to the consenting process that balanced the child's evolving autonomy and risks of HIV disclosure. Dissemination involved delivering site-specific results in each HIV clinic, local and international conferences and sharing of study tools, resulting in the study approach being scaled up nationally. The deliberate engagement of stakeholders early in intervention development optimized study validity and accelerated adoption of the CATCH approach in nationwide HIV testing campaigns by the Ministry of Health and inclusion of paediatric index-case testing in national HIV testing guidelines. Involving policymakers and frontline healthcare workers throughout the study cycle builds capacity in the implementing team for quick adoption and scale-up of the evidence-based practice.
研究人员、政策制定者和从业者之间的利益相关者参与对于将研究成功转化为政策和实践至关重要。在家对儿童进行咨询和检测（CATCH）研究评估了一种儿科索引病例检测模式，目标是肯尼亚接受治疗的艾滋病毒感染成人的子女。研究人员在CATCH的规划、执行、评估和传播阶段与利益相关者进行了合作。他们包括一个社区咨询委员会、国家艾滋病毒项目、县卫生部门、机构伦理审查机构、一个儿科生物伦理小组、机构负责人和一线医护人员。利益相关者分析考虑了每个利益相关者在研究中的权力和利益。所有利益相关者在不同阶段都有一定权力影响项目的成功。然而，具有较高层级权力的机构的支持增加了层级较低的利益相关者对该研究的接受度。在规划、执行、评估和传播阶段，该研究受益于精心策划的利益相关者参与。通过参与，在招募方法上进行了改变，以确保高外部效度，将招募最佳地置于现有诊所流程模式内。在安排家访人员时做出选择，以纳入合适的工作人员队伍。对同意程序进行了调整，以平衡儿童不断发展的自主权和艾滋病毒披露风险。传播包括在每个艾滋病毒诊所、地方和国际会议上提供针对具体地点的结果以及分享研究工具，从而使该研究方法在全国范围内得到推广。在干预开发早期精心安排利益相关者参与，优化了研究效度，并加速了卫生部在全国艾滋病毒检测活动中采用CATCH方法以及将儿科索引病例检测纳入国家艾滋病毒检测指南。在整个研究周期中让政策制定者和一线医护人员参与，增强了实施团队快速采用和扩大循证实践的能力。
