Chongyi to SydneyCollaboration in research and translation

Yuan Zhaokang and Mark Harris

What were our initial expectations?最初的期望

In the beginning• Collaboration with an Australian

researcher was a requirement of CAHHF (China-Australia Health and HIV/AIDS Facility) funding.

• MH) saw the collaboration as an opportunity to engage with research in China at a time of health reform.

• YZ saw an opportunity to engage an Australian academic in providing input and support for the work in Chonyi.

开始时• 与澳大利亚研究人员的合作是 CAHHF基金的要求

• Mark教授认为合作是在中国医改时参与相应研究的一个机遇

• 袁兆康把合作视为在崇义县的研究工作中得到澳大利亚学术支持的机会

Collaboration is not static, it evolves合作不是静态的，而是朝前发展的

This changed over time• although the systems and issues

are different, both countries share common problems

• relevant for rural primary health care reform in China and other countries and regions where government resources are limited and a mixed approach involving public and private sector doctors is necessary.

• Both see that our collaboration can foster new ideas and approaches on ways to reform primary health care and opportunities for research.

认识随时间的变化• 尽管体制和面临的问题不同，但是两国可以分享一些共同的问题。

• 本项目与中国及其他国家和地区农村初级卫生保健改革有关，在这些国家和地区政府的卫生资源是有限的，有必要整合公立和私立医疗机构的医务人员。

• 双方均认为彼此之间的合作在初级卫生保健改革的道路上和研究的机遇上能形成新的想法和出路。

Costs and Benefits 投入和收益

• For both the benefits were mostly in the opportunity to learn about each others systems and research and to develop collaborative research.

• The most important cost was time and the competing priorities of our other work.

• 对于双方来说，收益主要是有机会相互了解彼此的体制和研究工作及发展合作研究。

• 投入主要是时间和其它工作优先顺序上的相互冲突。

Barriers and facilitators障碍和促进

• Lack of understanding of each other’s context, system and perspective was the biggest barrier.

• There was also uncertainty about how to collaborate,

These were overcome by first-hand experience – visiting in Jiangxi and Australia together – as well as meeting and discussing the projects.

• 缺乏对彼此研究环境、体制和观点的了解是最大的障碍。

• 对于如何合作也有不确定性。

• 以上障碍都通过中澳互访，共同开会和讨论项目得到克服。

Understanding each other’s context and building trust

• Mark visits to Chongyi and Nanchang

• Yuan visits to Sydney and meetings to discuss the project

Working on papers together共同撰写报告

• Authorship needs to be earned. This was not assumed but needed to based on contribution to analysis, interpreting the findings, writing and editing the papers.

• We sat together to:- – identify the main themes,

messages– clarify the methods and limitations– clarify the key findings, data

analysis and tables etc.– clarify the conclusions, lessons for

policy and practice and further research.

– work to get the text right

• 原创作者需要付出大量的艰辛工作。这不单是一句空话而已，是基于分析解释结果和编辑撰写论文需要作出大量的贡献。

• 我们坐在一起主要讨论以下几个问题：

-明确主题和主要信息 -阐明方法和局限性 -阐明重要发现和数据分析及表格制定

-阐明研究结论、政策和实践的经验教训及下一步的研究打算

-一起撰写科学的报告

What we have written我们已经写的东西

• Paper 1: Development and impact of a model for community health service development in depressed rural areas

• Paper 2: Impact of the model impact on service use and resident satisfaction

• Paper 3 & 4: An evaluation of an intervention to improve use of e-health records in rural village clinics: impact on providers and services, residents satisfaction and service provision.

• 第一篇：经济欠发达农村地区社区卫生服务模式的发展和影响

• 第二篇：模型对卫生服务利用和居民满意度的影响

• 第三篇和第四篇：提高村卫生室电子健康档案使用的干预评价：基于对卫生服务供方、需方、居民满意度及服务规定。

Example: Papers 1 and 2例子：第一篇和第二篇文章

• We clarified the methodology and analysis with some expert statistical advice including doing some extra factor and multilevel analysis to ensure that the analysis was suitable for publication.

• 我们阐明了方法学和分析方法，听取了专家的统计建议，包括做一些多因素分析以确保分析结果适合发表。

Example: Papers 1 and 2例子：第一篇和第二篇文章

We identified the main themes we wanted to get across:

• Why the model was important:- lack of resources and optimally trained health workforce in depressed rural areas required a different approach including a mix of private and public services and providers. It was feasible because it did not require major organisational change, additional funding or personnel.

• How the model was developed: multistage consultative process a county level

• 我们想通过以下内容阐明主题：

• 为什么这种模式是重要的：由于缺乏资源及对卫生人力的有效培训，欠发达农村地区要求一种不同的途径，这种途径包含了公立和私立卫生服机构的服务和提供者。这种模式是可行的，因为它不需要太大的机构改变、额外的人力和资金投入。

• 这模式是怎样形成的：对县级政府多阶段的开发。

Example: Papers 1 and 2例子：第一篇和第二篇文章

• Main features of the model: comprehensive program of public health services and an integrated electronic health record for the whole population at village, township and county levels. This was underpinned by engagement of officials at county level; training and skill development of township and village doctors; improving management and supervision; facilitating access to and funding of public health and curative medicine at village and township levels;

• 这种模式的主要特点是： 县乡村三级水平人群的综合性公共卫生服务和综合性电子医疗记录。在县级水平通过官员的承诺得到支持，对乡村医生进行培训和技能开发，改善管理和监督，在乡村两级促进和经费支持公共卫生和基本医疗。

Example: Papers 1 and 2例子：第一篇和第二篇文章

• This model was feasible to implement and improved the organisation of health facilities, the provision of services at township and village levels (especially public health) and the satisfaction of rural residents and their use of public health services.

这种模式对于改善乡村两级机构的卫生服务（尤其是公共卫生服务）、提高农村居民满意度及增加公共卫生服务利用是可行的。

Example: Papers 1 and 2例子：第一篇和第二篇文章

• While identifying these successes we also identified barriers to the optimal implementation which suggest subsequent research projects including:-– Problems with quality of recording

of clinical information due to delay in data entry by the clinicians and other factors.

– The need to use the information system as a tool to improve the quality of care provided.

• The need to integrate the CHS and hospital information systems.

• 在阐明这些成果的同时，我们也要认识到在有效实施过程中的障碍，从而提出后续研究，包括：

-- 由于临床医生及其他因素导致的数据推迟录入而引起的临床信息记录的质量问题。

--需要利用信息系统当做提高提供服务的质量的工具。

• 需要整合社区卫生服务信息系统和医院信息系统。

Getting published即将发表

A work in progress:• Picking the audience and

journal (email editor to ask if interested)

• Structuring, drafting and editing the paper for the journal style

• Ask a colleague to review the paper

• Being persistent and not letting it slip off the agenda

进展中的工作 :-• 挑选读者和杂志 ( 给编辑发 email,问他对文章是否有兴趣 )

• 按照杂志要求形成文章结构框架、草稿及编辑

• 请同行给文章提意见。

• 定稿，然后及时投递，不要错过了时效。

Conclusion结论

• Working together required building understanding of each others context and trust in our relationship.

• This was largely built on visits to each others settings and person contact and discussion over time.

• The benefit has been not only to develop joint papers for publication in international journals but also future cooperative projects and exchanges (such as exchange of research students and visiting fellowships).

• 一起工作需要建立对彼此研究背景理解和信任的相互关系。

• 这很大程度上建立在整个过程中双方互访、个人接触及共同讨论的基础上。

• 收益不仅是在国际杂志上共同发表学术论文，也包括进一步的项目合作和相互交流（例如研究生和访问学者的交流）

• The most important outcome is improved understanding, ongoing research and development projects and new ideas to inform the reform of primary health care internationally.

最重要的产出是改善了相互了解、不间断的研究和项目的发展，为国际初级卫生保健改革提供了新的思路。

Translation to policy转变成政策

• International peer review provides credibility and puts local innovations and reforms in the context of international health reform agenda

• Discussion with policy makers at local and national levels• Exchange between researchers and policy makers • 国际同行评议，为在国际卫生改革议程的背景中提出局部性的创新和改革提供了可信度。

• 与地方和国家各级决策者讨论。• 研究人员和决策者之间的交流。

What have you enjoyed the most about your collaboration?

在合作中你最大的感受是什么？

What has surprised you the most?

最让你出乎意料的事情是什么？

What brief advice would you give someone starting a collaboration?

对开始合作者的简短忠告

http://benhr.net/Chongyi2Sydney