Experiences from a community advisory Board in the Implementation of early access to ART for all in Eswatini: a qualitative study
Experiences from a community advisory Board in the Implementation of early access to ART for all in Eswatini: a qualitative study
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DOI：
10.1186/s12910-019-0384-8
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发表时间：
2019-07-16
影响因子：
2.7
通讯作者：
Khumalo, Gavin
中科院分区：
文献类型：
--
作者：
Mlambo, Charmaine Khudzie;Vernooij, Eva;Khumalo, Gavin
背景 低收入和中等收入国家越来越多地采用让社区参与基于社区的卫生研究的做法。使用社区咨询委员会（CAB）是实践社区参与健康研究的一种方法。迄今为止，很少有研究深入说明 CAB 成员用于实践社区参与的策略。我们评估了斯威士兰（以前称为斯威士兰）第一个当地 CAB 的观点、经验和做法，该项目是作为 MaxART 全民早期接受 ART 研究的一部分而实施的。经过方法培训的斯威士兰研究助理对参与 MaxART 研究至少 2.5 年的 CAB 成员进行了两次焦点小组讨论和 13 次半结构化访谈。访谈探讨了CAB的组成和招聘、CAB成员的活动、与社区互动的机制以及他们在角色中面临的挑战。结果MaxART CAB在全民早期接触艺术研究的实施中发挥了积极作用，活动主要集中在：（1）促进道德行为，特别是隐私、同意和保密； (2) 交流和教育，交流研究并教育社区了解艾滋病毒检测和早期获得艾滋病毒治疗的好处； (3) 社区和研究团队之间的联络。与社区互动的策略多种多样，包括参加一般社区会议、参观卫生设施以及参观公共场所，如牛浸泡池、公共汽车、酒吧和教堂。确定了居住在研究区域的 CAB 成员与居住在研究区域外的 CAB 成员在社区参与方法上的差异。结论 斯威士兰第一个 CAB 的经验表明，使用 CAB 进行社区参与是让社区参与实施研究的宝贵机制。可能影响 CAB 运作的考虑因素包括明确定义 CAB 的范围、解决 CAB 独立性问题、CAB 预算、为 CAB 成员提供情感支持以及提供持续培训和能力建设。这些问题应在 CAB 组建的早期阶段得到解决，以优化运作。
BackgroundEngaging communities in community-based health research is increasingly being adopted in low- and middle-income countries. The use of community advisory boards (CABs) is one method of practicing community involvement in health research. To date, few studies provide in-depth accounts of the strategies that CAB members use to practice community engagement. We assessed the perspectives, experiences and practices of the first local CAB in Eswatini (formerly known as Swaziland), which was implemented as part of the MaxART Early Access to ART for All study.MethodsTrained Swazi research assistants conducted two focus group discussions and 13 semi-structured interviews with CAB members who had been part of the MaxART study for at least 2.5years. Interviews explored CAB composition and recruitment, the activities of CAB members, the mechanisms used to engage with communities and the challenges they faced in their role.ResultsThe MaxART CAB played an active role in the implementation of the Early Access to Art for All study, and activities mainly focused on: (1) promoting ethical conduct, in particular privacy, consent and confidentiality; (2) communication and education, communicating about the study and educating the community on the benefits of HIV testing and early access to HIV treatment; and (3) liaising between the community and the research team. Strategies for interacting with communities were varied and included attending general community meetings, visiting health facilities and visiting public places such as cattle dipping tanks, buses, bars and churches. Differences in the approach to community engagement between CAB members living in the study areas and those residing outside were identified.ConclusionThe experiences of the first CAB in Eswatini demonstrate that community engagement using CABs is a valuable mechanism for engaging communities in implementation studies. Considerations that could impact CAB functioning include clearly defining the scope of the CAB, addressing issues of CAB independence, the CAB budget, providing emotional support for CAB members, and providing continuous training and capacity building. These issues should be addressed during the early stages of CAB formation in order to optimize functioning.