Background Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies. Aim The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA. Setting FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA. Methods A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following collation of responses, the relationship between the participants’ CVD prevention knowledge, lifestyle practices and CVD counselling rates was assessed. Results Of the 174 participants (53% response rate), 83% were married, 51% were females and the mean age was 39.2 (standard deviation [SD] 7.6) years. Most of the participants responded accurately to the CVD prevention knowledge items, but few had accurate responses on prioritising care by 10-year risk. Most participants had less than optimal lifestyle practices except for smoking, vegetable or fruit ingestion and sleep habits. Most participants (65%) usually counselled patients on nutrition, but less frequently on weight management, exercise, smoking and alcohol. The region of practice and physicians with poor lifestyle were predictive of patient counselling rates. Conclusion Training on patient counselling and self-awareness for CVD prevention may influence patient counselling practice. Promoting quality training on patient counselling among FPs as well as a healthy self-awareness for CVD prevention is thus needed. The complex relationship between physician lifestyle and patient counselling warrants further study. Keywords family physicians; cardiovascular diseases; lifestyle counselling; sub-Saharan Africa; online survey; family medicine trainee.
Background: To improve the delivery and reach of primary health care, a robust scientific foundation driven by research is needed. However, few family physicians conduct research, especially in sub-Saharan Africa. Early-career and trainee family physicians are a key part of the primary care research pipeline and have an expressed need for research training and mentorship. Objective: AfriWon Research Collaborative (ARC) was an online research training and mentorship pilot program whose objective was to increase research activity among participants from AfriWon Renaissance, the family physician young doctors’ movement of sub-Saharan Africa. Methods: ARC utilized a 10-module online curriculum, supported by peer and faculty e-mentorship, to guide participants through writing a research protocol. The feasibility, acceptability, and scalability of this program was evaluated via a mixed-methods RE-AIM-guided process evaluation using descriptive statistics and inductive/deductive thematic analysis. Findings: The pilot reached participants from Botswana, Democratic Republic of the Congo, Ghana, Nigeria and Sierra Leone and was adopted by mentors from 11 countries across three continents. Four of the 10 pilot participants completed a full research protocol by the end of the six-month core program. Seven out of the 10 participants, and nine out of the 15 mentors, planned to continue their mentorship relationships beyond the core program. The program helped instill a positive research culture in active participants. Some participants’ and mentors’ engagement with the ARC program was limited by confusion over mentorship structure and role, poor network connectivity, and personal life challenges. Conclusions: Online research training and mentorship for trainee and early-career family physicians in sub-Saharan Africa is feasible and acceptable to participants and mentors. Similar programs must pay careful attention to mentorship training and provide a flexible yet clearly organized structure for mentee-mentor engagement. Additional work is needed to determine optimal implementation strategies and ability to scale.
Background: Primary health care systems in sub-Saharan Africa (SSA) need context-specific evidence to address current challenges. Increased family physician (FP) research activity could help fill this gap.Aim: To describe the research activity, facilitators and barriers amongst AfriWon Renaissance members.Setting: An online programme was designed to improve research activity amongst members of AfriWon Renaissance, an organisation of early-career and trainee FPs in SSA. This article provides a baseline description of their research activity.Methods: All AfriWon Renaissance members were invited to participate in an online survey. A content-validated study tool assessed research activity, including participation in research meetings, engagement in research mentorship, number of projects and published articles. Facilitators and barriers were assessed via Likert scales and two open-ended questions. The researchers conducted descriptive statistics using Epi Info 7, a content analysis of open-ended responses and triangulation.Results: Amongst the 77 respondents, 49 (63.6%) were still in training. Over two-thirds (71.4%) had participated in a research discussion in the past month. Whilst more than half (63.5%) reported having a manuscript under development, only 26 (33.8%) reported a recent publication. Nearly all (94.8%) intend to continue research in their FP careers. The most common facilitators were the institutional requirement to conduct research and having supportive peers and mentors. The most predominant barriers were time constraints and a lack of training on analysis.Conclusion: There is a cohort of committed young FP researchers who would benefit from efforts to address identified barriers and support for their ongoing research activity, in order to increase primary care research outputs in SSA.
Background Many family physicians in sub-Saharan Africa are not active in research, partly due to the lack of available mentorship. The professional society for early-career family physicians in sub-Saharan Africa, AfriWon Renaissance, is well-positioned to address this gap. Here, we describe the AfriWon Research Collaborative (ARC), an online research mentorship and training programme for AfriWon Renaissance members in Africa that aims to increase research activity through an e-learning community. This online initiative for physicians in low-resource settings is significant as more medical education moves online due to the COVID-19 pandemic. Methods ARC provided research training via Google classroom over a six-month core programme period. Participants from sub-Saharan Africa were matched with both peer and faculty mentors from sub-Saharan Africa, Europe, and the USA. We used a tiered mentorship structure focused on peer support for participants as they designed primary-care research proposals. A six-month post-programme period consisted of monthly online research work-in-progress meetings. We used an adapted RE-AIM framework to guide a mixed-methods evaluation of the feasibility, acceptability, and effectiveness of ARC. Data from several sources, including programme logs and surveys, were triangulated to conduct both process and outcome evaluations. We conducted post-programme semi-structured individual interviews with participants and mentors stratified by low, medium, and high levels of engagement. We analysed data using descriptive statistics and mixed inductive/deductive qualitative analysis. Findings The programme included 25 family physicians and family medicine trainees who were placed into five mentorship teams, each consisting of two participants, one peer mentor and two faculty mentors. Participants were from Botswana, Democratic Republic of Congo, Ghana, Nigeria and Sierra Leone and mentors were from 11 countries across three continents. Of the 25 individuals, 19 (76%), continued their mentorship relationships into the postprogramme phase. Six of 10 participants completed a full research proposal by the end of the post-programme period, with several mentors reporting increased confidence and competence of their mentees. Surveys and post-programme interviews showed increases in confidence in conducting and understanding of research and a positive research culture amongst active participants. One participant noted: "all of a sudden I'm finding myself asking questions; what can I do to try and improve this? And for me it's a sign that going forward, research will definitely be part of what I do". Work-in-progress meetings facilitated continued research activity. Barriers to engagement with the ARC program included poor network connectivity, time limitations, confusion over mentorship structure and role, and personal life challenges. Over half of the participants who responded to the outcome survey reported internet connectivity as a barrier and 86% also reported time limitations. Interpretation Online r...
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