Factors impacting the success of research capacity building programs to address diabetes and related chronic diseases
Abstract
Background:
High quality training and networking to buildcapacity for implementation researchis important in low-resource settings to improve the prevention and control of non-communicable diseases (NCDS). This is particularly important in South Asiawhich has the world’s highest burden of NCDs, including diabetes and an ill-equipped health system and research workforce. Health system research and trained research professionals are required to inform and guide the adaptation and implementation ofeffective prevention and control policies and programs that have usually been developed in high income countries. Over the last 5 years, we have implemented and evaluated two research training and capacity building programsin South Asia -the Asian Collaboration for Excellence in NCDs (ASCEND) and Excellence in Non-Communicable disease Research (ENCORE) – to improve the research capacity of early and mid-career researchers in countries in this region. 
Aims:
To identify and describe factors associated with the success of research training programs and networks(ASCEND and ENCORE) to reduce the burden of diabetes and related NCDsin South Asia. 
Method:
We have developed andimplemented two training programs -the ASCEND and ENCORE- to build the evidence-base for prevention and control of NCDsby strengthening chronic disease researchcapacity across South Asia. This goal has been achieved by providing high-quality research training, mentorship and building a regional network ofresearchers and research institutions with a special focus on NCDsprevention. The ASCEND program was delivered to two trainee cohorts, each of 18 months duration. The online platform, GoToMeeting, and Moodle were used for the delivery of online sessions, and for providing lecture notes, assignment submission and other activities. Each trainee undertook a ‘real-world’ NCD research project in their own country and received mentoring from their nominated supervisor(s) and international mentor. All ASCEND trainees were provided ongoing support to attend conferences, mentoring and the opportunity to actively participate in further forums, until the formal completion of the program in mid-2016. TheENCORE program was initiated in 2016and it has focused on providing high-quality training in the new field of implementation science and related areas in order to effectively translate findings from randomized trials to real world practice. ENCORE has hosted three 1-week long training programs in 2016-17, and monthly webinar sessions and research policy workshops.
Results: 
Over the 5 years period (2012-17), ASCEND has provided training and mentorship to 40 young- and mid-career researchers. The trainees have published more than 50 research articles and presented their research work at national and international health forums. 70% and 80% of trainees rated the teaching blocks and online sessions as “high/very high”in terms of relevance and quality, respectively. ENCORE program in the last 1 year has provided training to 26 mid-level researchers and has organized health policy roundtable engaging government, academia, and research institutions to foster future collaborations to achieve better health outcomes. This program resulted in a research network that provides both opportunistic and planned interactions among researchers/academics, program implementers and policymakers through face-to-face and/or virtual interactions. Both of these training programs are proving effective in developing highly skilled future leaders with technical, implementation research and leadership skills. Key factors for the success of such programs include: 1) blended learning programs that incorporate e-learning, 2) remote and face-to-face training on advanced research methods,3) formal mentorships by both national and international faculty and 4) the creation of a strong network with high-level researchers and research institutions. Such programs support trainees to continue working and living in their own countries, rather than having to relocateto a high-income country to undergo their training.
Discussion: 
These findings demonstrate the acceptability of programs and networks like ASCEND/ENCORE to early- and mid-career researchers. . The high-quality research outputs of the trainees are already contributing to the implementation of improved policy and practice in their own countries forthe prevention and control of diabetes and related NCDs.However, it is very challenging to create and sustain such training and capacity building programs beyond the initial funding phase. Efforts to sustain the research collaborations where the training programs have already been implemented could focus on enhancing the trainee-faculty interactions using e-platforms, to achieve the ultimate goals of translating evidence to effective implementation to improve health outcomes.