e DATA K

Innovation summary

The Computer-based Drug and Alcohol Training Assessment in Kenya (e DATA K) addresses the challenge of integrating screening and core packages of mental health and substance use disorder (SUD) services into routine primary health care through innovative e-learning technologies. The aim of the project is to train large numbers of primary health care workers to successfully identify and treat substance use disorders through high-quality, globally available, free-to-use and low-cost to assemble computer-, peer- and mentor-supported learning offered by NextGenU.org. The innovation is also referred to as a DOOHICHE (a “doohickey” or “gadget”): a Democratically-Open, Outstanding Hybrid of Internet-aided, Computer-aided and Human-aided Education.

NextGenU.org includes the following features:

It is the world’s first portal to free, accredited higher education
It draws on existing, expert-created competencies and computer-based didactic learning experiences
It offers peer and mentored interactions in a local and global community of learners

Impact summary

158 trainees have completed one or more courses related to alcohol, tobacco and other substance use disorders.
More than 30,000 people have been screen for alcohol tobacco and other substance use disorders from those trainees, and more than 1500 have received brief interventions.
ASSIST screening and feedback seems as effective as a fuller ASSIST linked brief intervention, both leading to a reduction in alcohol consumption to a quarter of the original consumption in average in those who drank at moderate to high risk levels.

"NextGenU’s open access to health information should literally save millions of lives and lead to important new discoveries."

-Anne Margulies, former Executive Director, Open Course Ware, Massachusetts Institute of Technology

This innovation is funded by Grand Challenges Canada.

Innovation details

e DATA K features the adaptation and delivery of the NextGenU.org substance use disorder (SUD) training to build capacity to provide SUD screening and core services in primary care. After piloting in Kenya and conducting a randomised control trial in two Kenyan semi-rural districts (Machakos and Makueni), the training will be available world-wide. e DATA K and the research project have three goals:

Create and Test Trainings for Identification and Treatment of Substance Use Disorders

To train large numbers of primary health care workers to successfully identify and treat substance use disorders in their practices through high-quality, globally available, free-to-use and low-cost to assemble computer-, peer and mentor-supported learning offered by NextGenU.org. The trainings cover:

Screening for lay health workers
Brief intervention and co-morbidities of SUD for primary care practitioners (including alcohol,tobacco and other substances)

Create and Test Trainings for Quality Improvement

To train clinical leaders and managers in quality improvement techniques to help implement those new interventions into the routine practice in primary care. This will also be done through computer based learning and exchange through a community of practice of leaders in substance use disorders service inclusion in primary care, again through NextGenU.org.

Evaluate Impact and Patient Outcomes

To evaluate the impact of this training on knowledge, attitudes, and practice, as well as patient outcomes. This will help to improve the training and to understand factors involved in translating trainings into sustainable SUD programmes and expanding them to other mental health conditions.

NextGenU is the world’s first and only portal to unlimited, free, accredited higher education in health sciences. All trainings on www.NextGenU.org contain:

Competency-basis and High Quality

Trainings are reviewed and endorsed by partners in academic, governmental and professional sectors in both low and high income countries. It uses existing, expert-created, published competencies, as well as existing screened resources that are openly posted. This enables all trainings to be provided free of costs, advertisements and carbon.

Use of an Existing, Globally-Used Platform

Moodle is used to provide a free, open source Course Management System to deliver course components such as modules, resources, testing and peer interaction. Moodle supports 7.2 million courses, 1.2 million teachers and 67 million learners in 235 countries. NextGenU’s use of Moodle includes organizing online and face-to-face interaction with mentors and peers, creating worldwide communities of practice where participants learn to share, review and learn from each other’s work.

High Security

High-security online testing is provided as student profiles include exam scores, work products and other accomplishments and metrics of progress.

Global Reach

Students anywhere in the world can enrol in the courses for interest or credit. University instructors can adapt and teach the courses to local groups of students.

Key drivers

First of its Kind

Through NextGenU, this mental health promoting information becomes integrated into the world’s first and only portal to unlimited, free, accredited higher education.

Competency Based and High Quality

All available trainings are competency-based and are reviewed and endorsed by our world-class partners in academic, governmental and professional sectors in low- and high-income countries.

Challenges

Establishing collaborations with training institutions in Kenya for sustained inclusion of the courses during health professional training.
Sustaining the screening and brief interventions in private facilities when the insurance companies in Kenya exclude any claim related to alcohol or other substance use disorders.
Difficulty to leverage on widespread smartphone mobile technology to widen access to the materials.
Delayed accreditation of the courses as part of continuous professional development programs in Kenya.

Continuation

There are plans to scale-up in Kenya and around the world. The innovation can also be expanded to virtually any topic addressed in an accredited institution of higher education.

Other parallel plans and research projects to scale the innovation in other areas include the development of more public health and preventive medicine courses (up to a full master’s degree in public health and a Preventive Medicine Residency program), a Family Medicine residency (being tested with 10,000 physicians in Sudan), and multiple other courses listed on the NextGenU.org webpage.

So far, course uptake shows that it is generalizable and scalable with the appropriate infrastructure support.

eDATA K set a solid foundation for an ongoing program of mental health sciences education for NextGenU and for research in training programs and health system guidance to adopt and implement evidence-based practices. Results will be disseminated to various stakeholders through peer-reviewed publications, policy briefs, social media and other knowledge-exchange mechanisms.

Partners

Africa Mental Health Foundation (Kenya)
CliniX (Kenya)
Ministry of health (Kenya)
County Governments of Makueni and Machakos (Kenya)
NextGenU.org
University of British Columbia (Canada)
Shalom Community Hospital (Kenya)

Funders:

Annenberg Physician Training Program (USA)
Canada Research Chairs (Canada)
Grand Challenges Canada (Canada)
NextGenU
Ulrich and Ruth Frank Foundation for International Health (USA)
University of British Columbia (Canada)

Evaluation methods

eDATA K is evaluated through a mixed–method, qualitative and quantitative, including a pilot study with a developmental evaluation, two randomized control trials, one in public and one in private facilities, and an implementation science study.

Cost of implementation

The innovation is highly cost-effective, enabling mass capacity building at very low cost.

Total Cost of Research

$1,182,885 USD, over three years (21/09/2012 – 21/09/2015) (Grand Challenges Canada)

Additional Support for Innovation Development

$75,000 USD/3 years (in kind contribution by UBC)

$90,000 USD/3 years (in kind contribution by NextGenU)

$90,000 USD/3 years (Annenberg Physician Training Program)

$225,000 CAD over 5 years for fellowship and post-doctoral work.

Impact details

This cost-effective model has made it possible to launch 4 courses, conduct 4 pilot tests, and initiate 132 additional trainings in various stages of development. Unlike any other educational source, all NextGenU courses are provided for credit free of charge, maximizing the program’s potential coverage and effect

As of early December 2013, NextGenU had over 1,700 course registrants in 101 countries.2 substance use disorder courses launched, one practice improvement course for mental health and addiction piloted, and planned to be laughed in 2016, 2 other courses available in other topics.

There were over 3,000 registrants in over 130 countries for NextGenU.

The practice improvement course was effective in supporting continuous implementation of the screening and brief intervention after the randomized control trials.

As stated within the impact summary, there were 158 trainees have completed one or more courses related to alcohol, tobacco and other substance use disorders and more than 30,000 people have been screen for alcohol tobacco and other substance use disorders from those trainees. More than 1500 have received brief interventions.

ASSIST screening and feedback seems as effective as a fuller ASSIST linked brief intervention, both leading to a reduction in alcohol consumption to a quarter of the original consumption in average in those who drank at moderate to high risk levels.

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Country

Kenya