Evidence map›Paper›PMID 37612108›Full record

ArticleBMJ open2023

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

Samah Hassan, Valeria E Rac, Brian David Hodges, Patti Leake, Saul Cobbing, Catharine Marie Gray, Nicola Bartley, Andrea Etherington, Munira Abdulwasi, Hei-Ching Kristy Cheung and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 4 countries.

Samah HassanThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada sam.hassan@mail.utoronto.ca.ORCID 0000-0003-2526-4515
Valeria E RacUniversity Health Network, Toronto, Ontario, Canada.
Brian David HodgesUniversity Health Network, Toronto, Ontario, Canada.
Patti LeakeThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada.
Saul CobbingThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada.
Catharine Marie GrayThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada.
Nicola BartleyUniversity Health Network, Toronto, Ontario, Canada.
Andrea EtheringtonThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada.
Munira AbdulwasiThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada.
Hei-Ching Kristy CheungThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada.
Melanie AndersonLibrary and Information Services, University Health Network, Toronto, Ontario, Canada.ORCID 0000-0001-9786-1656
Nicole N WoodsThe Institute of Education Research, University Health Network, Toronto, Ontario, Canada.
Institute of Education Sciences · USUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFoot 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.

Indexed as

Diabetic FootHealth EquityAmputation, SurgicalCanadaFootHumansReview Literature as TopicDiabetic footEDUCATION & TRAINING (see Medical Education & Training)Health EquityHealth Services Accessibility

Identifiers

PMID37612108
PMCPMC10450069
OpenAlexW4386101789

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.