Understanding how and why upskilling programmes for unregulated care providers can support health equity in underserved communities: a realist review protocol.

Autor:	Hassan S; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada sam.hassan@mail.utoronto.ca.; University Health Network, Toronto, Ontario, Canada.; The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada., Rac VE; University Health Network, Toronto, Ontario, Canada.; Program for Health System and Technology Evaluation, Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario, Canada.; Institute of Health Policy, Management, and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto Health Economics and Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario, Canada.; Diabetes Action Canada, CIHR SPOR Network, Toronto, Ontario, Canada., Hodges BD; University Health Network, Toronto, Ontario, Canada.; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Leake P; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada.; The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada., Cobbing S; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada.; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.; Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa., Gray CM; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada.; The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada., Bartley N; University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada., Etherington A; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada., Abdulwasi M; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada.; The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada., Cheung HK; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada.; Wilson Centre, University Health Network, Toronto, Ontario, Canada., Anderson M; Library and Information Services, University Health Network, Toronto, Ontario, Canada., Woods NN; The Institute of Education Research, University Health Network, Toronto, Ontario, Canada.; University Health Network, Toronto, Ontario, Canada.; The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada.; Wilson Centre, University Health Network, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Aug 23; Vol. 13 (8), pp. e072570. Date of Electronic Publication: 2023 Aug 23.
DOI:	10.1136/bmjopen-2023-072570
Abstrakt:	Introduction: Foot ulcers are one of the most devastating complications of diabetes mellitus leading to leg amputations. In Canada, systematically marginalised and racialised populations are more prone to developing foot ulcers and at higher risk of limb amputations. Shortages of regulated healthcare have hindered efforts to provide foot care. Upskilling unregulated care providers (UCPs) to deliver foot screening seems a reasonable solution to reduce limb loss. UCPs can advocate for health equity and deliver appropriate care. There is a need, however, to understand how and why an educational intervention for UCPs providing foot screening for these high-risk groups may or may not work. Methods and Analysis: This realist review will follow the Realist And Meta-narrative Evidence Syntheses: Evolving Standards standards. First, we will develop an initial programme theory (PrT) based on exploratory searches and discussions with experts and stakeholders. Then, we will search MEDLINE, Embase, PsycINFO, ERIC, CINAHL and Scopus databases along with relevant sources of grey literature. The retrieved articles will be screened for studies focusing on planned educational interventions for UCPs related to diabetic foot assessment. Data regarding contexts, mechanisms and outcomes will be extracted and analysed using a realist analysis through an iterative process that includes data reviewing and consultation with our team. Finally, we will use these results to modify the initial PrT. Ethics and Dissemination: Ethical approval is not required for this review. The main output of this research will be an evidence-based PrT for upskilling programmes for UCPs. We will share our final PrT using text, tables and infographics to summarise our results and draw insights across papers/reports. For academic, clinical, social care and educational audiences, we will produce peer-reviewed journal articles, including those detailing the process and findings of the realist review and establishing our suggestions for effective upskilling programmes. Prospero Registration Number: CRD42022369208. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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