Département Recherche, Innovation et Santé Publique, Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana.
Foundation for the Advancement of Scientific Research in Suriname (SWOS), Paramaribo, Suriname.
Front Public Health. 2024 Jan 8;11:1306432. doi: 10.3389/fpubh.2023.1306432. eCollection 2023.
An innovative and community-based intervention is implemented in the Guiana Shield to eliminate malaria among people involved in artisanal and small-scale gold mining. The intervention consists of the distribution of malaria self-management kits to goldminers and the presumptive treatment for individuals at risk of carrying hypnozoites. The intervention is possible owing to community health workers (CHWs) who are previously trained to master all intervention procedures, including health education activities and goldmining training. This study aimed to evaluate the training program provided to CHWs in terms of quality and effectiveness.
A training-of-trainers program for CHWs has been developed based on the CDC framework. A mixed-method case study was implemented in two steps between February and March 2023. The evaluation was based on a knowledge survey, satisfaction test, observations, and semi-structured interviews. Quantitative and qualitative data were analyzed and triangulated.
A total of 20 CHWs participated in the training and the first-step evaluation. For the second step, four semi-structured interviews were conducted. The Qualitative data showed that group dynamics and adaptations were central elements of a high-quality training program. Quantitative analysis found that CHWs' satisfaction was elevated (> 4/5 overall), especially regarding format and learning results. Improvements in knowledge level demonstrated good effectiveness (pre-training vs. post-training, < 0.05). Nevertheless, some difficulties persisted regarding tasks of the intervention procedure, such as informed consent and smartphone application procedures (with an inaccuracy rate of 29.2% and 16.7%, respectively). Further on-the-job training permitted to address these issues. The project team's previous experience and the Guiana Shield countries' commitment to the WHO-E-2025-initiative were identified as levers for the quality of the training, while the complexity of the project context was a challenge.
High-quality, effective, and appropriate training programs are required for effective and sustainable interventions involving CHW profiles. Training design is a crucial point to address to accomplish quality and effectiveness. The training-of-trainers model has been shown to allow a high level of satisfaction, good learning results, and satisfactory implementation in the field. Initial and continuing training is an indispensable continuum to sustain good practices in the field and CHWs' motivation. Training evaluation permits standardizing methods and facilitates transferability.
在圭亚那盾地区实施了一项创新的基于社区的干预措施，旨在消除参与手工和小规模采金活动的人们中的疟疾。该干预措施包括向金矿工人分发疟疾自我管理工具包，并对有携带休眠疟原虫风险的个人进行推定治疗。由于社区卫生工作者（CHWs）之前接受过培训，掌握了所有干预程序，包括健康教育活动和金矿开采培训，因此干预措施成为可能。本研究旨在评估针对 CHWs 的培训计划在质量和效果方面的情况。
根据美国疾病控制与预防中心（CDC）的框架，为 CHWs 制定了一项培训培训员计划。2023 年 2 月至 3 月期间，分两步实施了一项基于案例的混合方法研究。评估基于知识调查、满意度测试、观察和半结构化访谈。对定量和定性数据进行了分析和三角剖分。
共有 20 名 CHWs 参加了培训和第一阶段的评估。在第二步中，进行了四次半结构化访谈。定性数据显示，小组动态和适应是高质量培训计划的核心要素。定量分析发现，CHWs 的满意度很高（总体>4/5），尤其是对形式和学习结果的满意度。知识水平的提高表明效果良好（培训前与培训后相比，<0.05）。然而，干预程序的某些任务仍然存在困难，例如知情同意和智能手机应用程序程序（分别存在 29.2%和 16.7%的不准确率）。进一步的在职培训允许解决这些问题。项目团队的先前经验和圭亚那盾国家对世卫组织 E-2025 倡议的承诺被确定为培训质量的推动因素，而项目背景的复杂性则是一个挑战。
需要高质量、有效的培训计划，以支持 CHW 参与的有效和可持续干预措施。培训设计是实现质量和效果的关键点。培训培训员模式已被证明可以在现场实现高水平的满意度、良好的学习效果和令人满意的实施。初始和持续培训是维持现场良好实践和 CHWs 积极性的不可或缺的连续体。培训评估允许标准化方法并促进可转移性。
