Aim

The objectives of this scoping review are to (1) determine how capacity-building has been defined, implemented, and evaluated in LMICs and (2) to provide an overview of the effectiveness of capacity-building initiatives in LMICs.

Study design

The proposed scoping review will be conducted in accordance with Arksey and O’Malley framework [12] methodology to assess and synthesize the evidence in published and unpublished literature on capacity-building and rehabilitation in LMICs. The present scoping review protocol has been registered with the Open Science Framework (registration: osf.io/7vgxu) and is being reported in accordance with the reporting guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P) statement [13] (see Additional file 1). The proposed review will be reported in accordance with the reporting guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) [14]. Any amendments made to this protocol when conducting the study will be outlined and reported in the final manuscript.

Eligibility criteria

We used the SPICE Framework [15] to delimit the research question (see Table 1). SPICE builds upon the PICO acronym (Population, Intervention, Comparison, and Outcomes). This framework offers a step-by-step approach to formulating questions for finding evidence in existing research.

Study types

This scoping review will accept experimental and quasi-experimental studies, analytical observational studies, descriptive observational studies, qualitative studies, systematic reviews, and text and opinion papers that meet the inclusion criteria. Studies published in English and Spanish language will be included.

Search strategy

An experienced information specialist will develop and test the search strategy in consultation with the review authors. Keywords and controlled vocabulary terms will be selected to maximise the sensitivity and specificity of the search. The information specialist will be instrumental in choosing and applying search terms to comply with several databases in the health and social sciences. A sample search strategy for one database is provided in Additional file 2. Upon completion, the results from each database will be documented and the references will be de-duplicated manually. References will then be imported to a review software for screening.

We will search all databases from inception to the date of search. We will include a geographical EPOC filter for low- and middle-income countries. This filter, which is based on the World Bank list of countries (2019), classified as low-income, lower-middle-income, or upper-middle-income economies, has been developed by the EPOC Cochrane group in collaboration with the World Health Organization Library and the Campbell Collaboration. As “rehabilitation” is a narrow area to search, we will review the records left behind when the filter is applied. If we find records of interest, we will remove the filter and run the search strategy without it. We will search in the following databases:

Biomedical: PubMed (MEDLINE), Embase Classic+Embase 1947 to present (OVID), Web of Science Core Collection (Clarivate) 1900 to present, Cochrane Library (Wiley) and Epistemonikos.

Rehabilitation: CINAHL (EBSCO) 1937 to present, PEDro (https://www.pedro.org.au/)

Regional: Bireme-Lilacs, Scielo, LA Referencia.

Searching other sources

Gray literature is defined here as all research work not published in (commercial) or official mainstream literature for example conference proceedings, government reports, global health agency reports, and dissertations. For this scoping review, we will:

1.

Search the bibliographies of relevant studies and reviews

2.

Select an a priori set of global health/rehabilitation/capacity-building associations and their associations’ webpage(s) will be screened for annual reports or findings that these associations produce based on their own research which will be retrieved

3.

Sources: OpenGrey, Gray Literature Report, Lens.

Study selection

The selection criteria will be open, with the only restrictions relating to publication year (2000 to present for research reports and 2010 to present for gray literature); articles including a rehabilitation component with reference or implications to the workforce; and capacity-building specific and/or relatable to health rehabilitation. Table 2 presents the criteria we will utilize.

Table 2 Inclusion criteriaExclusion

Records with no abstract or full text available after exhausting all possible sources.

Records written in languages other than English and Spanish.

Date of publication prior to 2000 for research reports and prior to 2010 for gray literature.

Records focusing on an entry-to-practice program (diploma or degree) in an academic setting.

Following the search, the identified records will be collated and uploaded in Zotero bibliographic software [18] for deduplication. The final unique record set of potentially eligible studies will be exported to Qatar Computing Research Institute’s Internet-based software, Rayyan [19], through which screening of records will be carried out. Prior to the screening, reviewers will pilot the eligibility criteria on a random sample of 15 titles/abstracts and full text, with further pilot rounds if necessary. Duplicate reports from the same study will either be combined if they report different results or one will be excluded if the results are the same.

We have developed a preliminary set of screening probes (see Additional file 3). Following a pilot of the screening probes, each title and abstract will be screened by at least two independent reviewers (DD, AJB, JB, EPA). An initial calibration will be conducted on 5 to 10 randomly selected records to ensure high interrater agreement. The full text of selected literature will then be retrieved, uploaded into an Internet archive (Google Drive), and reviewed for eligibility, independently by two members of the team (DD, AJB, JB, EAP) using a priori eligibility criteria. Reasons for exclusion will be provided in an appendix in the final scoping review report. Disagreements between reviewers at this stage will be resolved by consensus or by a third member of the research team. The results of the search will be reported in full in the final report and presented in a PRISMA flow diagram [13] (see Additional file 4).

Data extraction

Data extraction forms will be developed a priori by the first author to capture information on each document included in the review. The forms will be piloted by members of the review team and refined based on feedback from the exercise. Team members (DD, AJB JB, EPA) will carry out data extraction in the following manner: data will be extracted by one reviewer and a second reviewer will verify the data for all records. Disagreements between reviewers will be resolved by consensus. We will use online file sharing (e.g., Drop box, Google Drive) to facilitate collaboration during study selection and data extraction.

For data extraction related to Objective 1, the pdf or text version of the included study will be uploaded into a qualitative analysis tool. We will extract blocks of text from the full-text articles dealing with the definition (concepts, frameworks, or models), description (when, where, what, how), and motives (why) which describe rehabilitation capacity building in LMICs for later coding and qualitative analysis using constant comparative methods.

Table 3 shows data we will extract from included studies/records for objective 2.

Table 3 Data extraction criteria objective 2Data presentation and analysis of results

Objective 1—Qualitative analysis using grounded theory methodology [20] will be conducted using QSR International’s NVivo 12 qualitative software [21]. Qualitative methods (coding, categorizing, conceptual ordering, and theorizing) will be used to develop a synthesized model that incorporates elements of why, when, where, what, and how rehabilitation capacity building in LMIC has been implemented or conceived as described in the included studies and reports [22].

Objective 2—Charts and tables will be used to display the results. Results will be classified based on the key variables: study design, program type, program objectives, program audience, tools used to evaluate outcomes. Data will be aggregated to present an overview of the included studies. We will identify studies for later quality assessment.

Consulting

This stage of the process, which involves engaging consultants who have expertise in the topical area, is classified as optional by experts [9, 15]. If time allows, the preliminary findings will be discussed with an advisory team made up of partners (i.e., rehabilitation providers, administrators, and academics) from Honduras, Colombia, and Canada. This step will help to evaluate the practicality and applicability of interventions. We will consult with our partners regarding potential avenues for knowledge dissemination.

Disseminating the knowledge

Although not part of the Arksey and O’Malley framework [15], we believe it is important to make the content of this scoping review available to those involved in rehabilitation education, educational institutions, professional association involved in rehabilitation in low resources, and local, regional, and national governments. The goal of this dissemination is to increase awareness of the literature and to help make evidence-informed choices for capacity-building of the healthcare rehabilitation workforce in low-resource settings. We will seek out global health and rehabilitation forums as a venue to distribute our results. We will distribute a plain language summary report to groups and organizations working in rehabilitation, disability, and global health in low-resource settings. In addition to presentations at research conferences in Honduras and Colombia (Spanish), we plan to write two scientific publications (one in English and one in Spanish). At this point, we have selected a variety of modes and venues including the following:

Presentation at the Knowledge Translation Poster Day—2022, School of Rehabilitation Science, University of Saskatchewan (English).

Publish summaries (English and Spanish) on the Red de Rehabilitadores de las Americas Network website [23].

Develop teaching material from this scoping review (e.g., case study) to be used in the introduction to research course(s) in occupational therapy program(s) involving undergraduate students at Universidad de Santander.

As part of the RRA-NRWA collaboration with Honduras and Colombia, the results will be shared as part of a researcher-in-residence approach [24] with rehabilitation centers and academic forums like CRILA (rehabilitation center) or the Universidad Autonoma de Honduras functional therapist program representatives.