I NTERNATI ONAL RESEARCH CAPACI TY-BUI LDI NG PROGRAMS FOR NURSES TO STUDY
THE DRUG PHENOMENON I N LATI N AMERI CA: CHALLENGES AND PERSPECTI VES
1Maria da Gloria Miot t o Wright2 Cat h er in e Cau field3 Gen ev iev e Gr ay4 Joanne Olson3
Wr igh t MGM, Cau f ield C, Gr ay G, Olson J. I n t er n at ion al r esear ch capacit y - bu ildin g pr ogr am s f or n u r ses t o st udy t he dr ug phenom enon in Lat in Am er ica: challenges and per spect iv es. Rev Lat ino- am Enfer m agem 2005 n ov em br o- dezem br o; 1 3 ( n ú m er o especial) : 1 0 9 5 - 1 0 1 .
The Fir st I nt er nat ional Resear ch Capacit y- Building Pr ogr am for Nur ses t o St udy t he Dr ug Phenom enon in t h e Am er icas is a r esu lt of a p ar t n er sh ip b et w een t h e I n t er - Am er ican Dr u g Ab u se Con t r ol Com m ission ( CI CAD) of t he Organizat ion of Am erican St at es ( OAS) and t he Facult y of Nursing in t he Universit y of Albert a, wit h financial support from t he Governm ent of Canada. The program was divided int o t wo part s. The first part of t h e pr ogr am w as h eld at t h e Un iv er sit y of Alber t a in Edm on t on , Alber t a, Can ada. I t in v olv ed capacit y -building in research m et hodologies at t he Facult y of Nursing, which lead t o t he preparat ion of four m ult i- cent ric research proposals for drug dem and reduct ion in t he hom e count ries of t he eleven part icipant s in t he program . The second part of t he program was relat ed t o t he im plem ent at ion of m ult i- cent ric research proposals in seven cou n t r ies in Lat in Am er ica an d in Can ad a. Th is p r og r am p r esen t ed ex p er t ise in r esear ch m et h od olog y t o m em ber s of Lat in Am er ican Sch ools of Nu r sin g an d in t r odu ced Lat in Am er ican ex per t ise t o m em ber s of a Canadian Facult y of Nur sing. The I nt er nat ional Resear ch Capacit y - Building Pr ogr am for Nur ses t o St udy t he Dr u g Ph en om en on in t h e Am er icas h as f ost er ed t h e k in d of in t er - cu lt u r al r espect an d m u t u al appr eciat ion necessary t o confront t he global healt h problem of t he abuse of bot h licit and illicit drugs.
DESCRI PTORS: int er nat ional educat ional ex change; t r aining; nur sing r esear ch
PROGRAMAS I NTERNACI ONALES DE CAPACI TACI ÓN EN I NVESTI GACI ÓN PARA ENFERMEROS EN
EL ESTUDI O DEL FENÓMENO DE LAS DROGAS EN AMÉRI CA LATI NA: DESAFÍ OS Y PERSPECTI VAS
El Pr im er Pr ogr am a I nt er nacional de Capacit ación en I nv est igación par a Enfer m er os en el Est udio del Fenóm eno de las Dr ogas en las Am ér icas r esult ó de una colabor ación ent r e la Com isión I nt er am er icana par a el Cont rol del Abuso de Drogas ( CI CAD) de la Organización de los Est ados Am ericanos ( OEA) y la Facult ad de En f er m er ía en la Un iv er sid ad d e Alb er t a, con ap oy o f in an cier o d el Gob ier n o d e Can ad á. El p r og r am a f u e dividido en dos part es. La prim era part e del program a se organizó en la Universidad de Albert a en Edm ont on, Alber t a, Canadá. Abar có la capacit ación en m et odologías de inv est igación en la Facult ad de Enfer m er ía, que llev ó a la pr epar ación de cu at r o pr opu est as de in v est igación m u lt icén t r ica con v ist as a la r edu cción de la dem anda de dr ogas en los países de or igen de los once par t icipant es en el pr ogr am a. La segunda par t e del pr ogr am a est aba r elacionada a la im plem ent ación de pr opuest as de invest igación m ult icént r ica en siet e países de Am ér ica Lat in a y en Can adá. Est e pr ogr am a pr esen t ó con ocim ien t os especializados en m et odologías de i n v e st i g a ci ó n a m i e m b r o s d e Escu e l a s d e En f e r m e r ía l a t i n o a m e r i ca n a s e i n t r o d u j o l o s co n o ci m i e n t o s e sp e ci a l i za d o s l a t i n o a m e r i ca n o s a m i e m b r o s d e u n a Fa cu l t a d d e En f e r m e r ía ca n a d i e n se . El Pr o g r a m a I nt er nacional de Capacit ación en I nv est igación par a Enfer m er os en el Est udio del Fenóm eno de las Dr ogas en las Am éricas est im uló el t ipo de respect o int ercult ural y apreciación m ut ua necesario para confront ar el problem a de salud global del abuso de drogas lícit as e ilícit as.
DESCRI PTORES: int er cam bio educacional int er nacional; capacit ación; inv est igación en enfer m er ía
PROGRAMAS I NTERNACI ONAI S DE CAPACI TAÇÃO EM PESQUI SA PARA ENFERMEI ROS NO
ESTUDO DO FENÔMENO DAS DROGAS NA AMÉRI CA LATI NA: DESAFI OS E PERSPECTI VAS
O Pr im eir o Pr og r am a I n t er n acion al d e Cap acit ação p ar a En f er m eir os n o Est u d o d o Fen ôm en o d as Dr ogas nas Am ér icas é r esult ado de um a par cer ia ent r e a Com issão I nt er am er icana par a o Cont r ole do Abuso d as Dr o g as ( CI CAD) d a Or g an i zação d o s Est ad o s Am er i can o s ( OEA) e a Facu l d ad e d e En f er m ag em d a Un iv er sid ad e d e Alb er t a, com ap oio f in an ceir o d o Gov er n o d o Can ad á. O p r og r am a f oi d iv id id o em d u as part es. A prim eira part e do program a foi realizada na Universidade de Albert a em Edm ont on, Albert a, Canadá. Com preendeu a capacit ação em m et odologias de pesquisa na Faculdade de Enferm agem , que levou à preparação de quat r o pr opost as de pesquisas m ult icênt r icas par a a r edução da dem anda de dr ogas nos países de or igem dos onze par t icipant es no pr ogr am a. A segunda par t e do pr ogr am a est av a r elacionada à im plem ent ação de propost as de pesquisa m ult icênt ricas em set e países da Am érica Lat ina e no Canadá. Est e program a apresent ou ex per t ise em m et odologias de pesquisa a m em br os de Escolas de Enfer m agem lat ino- am er icanas e int r oduziu ex per t ise lat in o- am er ican a a m em br os de u m a Facu ldade de En f er m agem can aden se. O Pr im eir o Pr ogr am a I nt er nacional de Capacit ação par a Enfer m eir os no Est udo do Fenôm eno das Dr ogas nas Am ér icas est im ulou o t ipo de respeit o int ercult ural e apreço m út uo necessário para confront ar o problem a de saúde global do abuso das dr ogas lícit as e ilícit as.
DESCRI TORES: in t er câm bio edu cacion al in t er n acion al; capacit ação; pesqu isa em en fer m agem
1
The opinions expressed in t his art icle are t he sole responsabilit y of t he aut hors and do not in any way represent t he posit ion of t he organizat ion t hey work at or it s adm inist rat ion; 2 PhD, I nt er- Am erican Drug Abuse Cont rol Com m ission/ CI CAD - Organizat ion of Am erican St at es/ OAS/ US; 3 RN, PhD, Universit y of Albert a/ Facult y of Nursing; 4 RN, RM, Universit y of Albert a/ Facult y of Nursing
I NTRODUCTI ON
T
o d a y, n a t i o n s a r o u n d t h e w o r l d a r e recognizing t hat in m at t ers of int ernat ional and globalhealt h, it is not enough t o be concerned wit h t he healt h
st at u s of t h eir ow n p op u lat ion . As w e con t in u e t o
ev olv e in t o a global com m u n it y, on e n at ion ’s pu blic
h ealt h con cer n becom es t h e con cer n of all n at ion s.
We have evidence in t he end of t he XX Cent ur y and
in t he beginning of XXI Cent ur y, t hat t he em er gence
an d con solid at ion of an econ om ic p ar ad ig m , w h ich
g i v e s e m p h a s i s o n d o m e s t i c d e r e g u l a t i o n , a n d
rem oval of barriers t o int ernat ional t rade and finance,
can h av e a d i r ect i m p act o n t h e h eal t h st at u s o f
populat ions( 1 ).
This new paradigm encom passes t he process
o f g l o b a l i z a t i o n , w h i c h i n v o l v e s a n i n c r e a s e d
int egr at ion of differ ent econom ies and societ ies as a
r esult of gr eat er flow s of goods, capit al, people, and
ideas. We have seen t rade and foreign asset ownership
increased t o new highs of world incom e. I nt ernat ional
t r av el i s occu r r i n g at u n p r eced en t ed l ev el s, w h i l e
I n t e r n e t h a s f a ci l i t a t e d l o w - co st co m m u n i ca t i o n s
a r o u n d t h e g l o b e . Th i s i n t e g r a t i o n h a s e co n o m i c
benefit s as w ell as concer ns for healt h and t he dr ug
ph en om en on( 1 - 2 ).
A s a c o n s e q u e n c e o f t h e g l o b a l i z a t i o n
pr ocess, m any public healt h issues hav e com e t o be
seen as af f ect in g all n at ion s. . Var iou s f act or s h av e
dict at ed t hat t he risks affect ing nat ions are no longer
rest rict ed t o t he infect ious diseases, and a new range
of healt h t hr eat s, such as subst ance abuse, t hat go
bey ond nat ional boundar ies hav e em er ged( 3- 4).
Man y o f o u r cu r r en t an d f u t u r e d o m i n an t
healt h problem s will be global, or at least m ult inat ional
o r i n t er n a t i o n a l i n n a t u r e. Gl o b a l i za t i o n i s a k ey
c h a l l e n g e t o p o l i c y - m a k e r s a n d p u b l i c h e a l t h
p r act it ion er s, an d t o m ak in g t h e lin k ag es b et w een
g l o b a l i za t i o n , h e a l t h , a n d t h e d r u g p h e n o m e n o n
becom es v er y com plex( 5 - 6 ).
When healt h is dealt int ernat ionally it can be
inst r um ent al in cr eat ing m or e under st anding am ong
t he nat ions of t he world and cont ribut ing significant ly
t o h u m an d ev elop m en t . I t is n ot on ly t h e st at e of
healt h and healt h out com es t hat concern us, but also
w het her nat ional and int er nat ional act ion has t ak en
i n t o a c c o u n t t h e m a j o r s o c i a l a n d c u l t u r a l
det er m inant s of t hat healt h.
The challenges in healt h care in general, and
d e a l i n g w i t h t h e p r o b l e m s r e l a t e d t o t h e d r u g
p h en om en on sp ecif ically, r eq u ir es p ar t n er sh ip s an d new approaches t o t he educat ion of healt h and ot her p r o f essi o n a l s. Nu r ses a r e i n a u n i q u e p o si t i o n t o pr ov ide leader ship in m eet ing t he healt h challenges
t h at af f ect p op u lat ion s ar ou n d t h e g lob e, in clu d in g healt h challenges t hat r elat ed t o dr ug issues.
Th i s p a p er d escr i b es t h e ex p er i en ce o f a t echnical and financial cooperat ion bet ween t he I nt
er-Am er ican Dr u g Con t r ol Com m ission / CI CAD an d t h e Universit y of Albert a- Facult y of Nursing t o im plem ent t h e “ I I n t e r n a t i o n a l Re s e a r c h Ca p a c i t y - B u i l d i n g Pr ogr am for Nur ses t o St udy t he Dr ug Phenom enon
in Lat in Am er ica”, an d pr esen t s t h e ch allen ges an d per spect iv es for an init iat iv e such as t his one.
JUSTI FI CATI ON
Am ong t he healt h car e pr ofessions, only t he nur sing pr ofession has blended t he bio- phy siological,
psy chosocial, and populat ion per spect iv es t o pr ov ide t h e leader sh ip t h at w ill be n eeded in t h e em er gin g healt h car e sy st em s par t icular ly in t he fight against t he use of illegal dr ugs in all phases of it s pr ocess.
N u r s e r e s e a r c h e r s m a k e u n i q u e , i n d e p e n d e n t cont ribut ions t o t he public ‘s healt h.
Nursing t akes an expanded view of healt h by em p h asizin g act iv it ies r elat ed t o h ealt h p r om ot ion ,
healt h pr ev ent ion, and social int egr at ion, as w ell as, a com m it m en t t o car in g an d com f or t . Th e n u r sin g k n ow led g e b ase of com m u n icat ion s, h ealt h / p at ien t ed u cat ion , t eam b u ild in g , n eg ot iat ion s, com m u n it y
h ealt h , m an agem en t of in t er disciplin ar y in t er act ion , pat ient advocacy, and focus on process m akes nurses especially effect iv e pat ien t adv ocat es.
Nu r si n g r esear ch , f or ex am p l e, f r eq u en t l y
focuses on fost er ing healt hy lifest y les and im pr ov ing h e a l t h o u t c o m e s f o r i n d i v i d u a l s , f a m i l i e s , a n d com m unit ies. Part icularly at t ent ion has been given t o v u l n e r a b l e g r o u p s s u c h a s t h o s e s u s c e p t i b l e t o
su b st a n ce a b u se . Nu r si n g r e se a r ch st u d i e s h a v e dem onst r at ed how nur ses can assist indiv iduals and g r ou p s in sp ecial sit u at ion an d also h ow t h ey can r espond t o healt h and illness ex per iences( 7- 10).
Th e n ew t ran sn at ion al econ om ic or der, an d t he new social and t echnological adv ancem ent s hav e in som e w ay s facilit at ed t he pr oduct ion, com m er ce, and consum pt ion of licit and illicit drugs in t he Am ericas
Hem i sp h er i c St r at eg y,” as a sy m b o l o f co n sen su s achiev ed am ong all m em ber count r ies of t he r egion t oward cont rol of drugs, and also, as a dem onst rat ion of a polit ical det er m inat ion and com m it m ent t o fight
against t he dr ug phenom enon in t he Am er icas. This i n t eg r a t ed a p p r o a ch h a s f a ci l i t a t ed t h e d esi g n o f int ernat ional and nat ional policies of com m on int erest t o r ed u ce t h e su p p ly an d d em an d t o d r u g s in t h e
Region of t he Am ericas. Som e of t he m ain com ponent s of t h e Hem isp h er ic St r at eg y ar e t o: ( i) st r en g t h en t h e j u d i ci a r y a n d l a w - e n f o r ce m e n t sy st e m s; ( i i ) ed u ca t e p r o f essi o n a l s a n d p u b l i c i n g en er a l ; ( i i i )
cr eat e econ om ic alt er n at iv e ap p r oach es t o p er son s in v olv ed w it h pr odu ct ion of illegal dr u gs; ( iv ) of f er t r eat m ent and r ehabilit at ion ser v ices t o per sons w it h a d d i t i o n p r o b l em s; ( v ) d ev el o p i n t er n a t i o n a l a n d
n at ion al coop er at ion ; an d ( v i) cr eat e m u lt i- lat er al ev aluat ion m echanism s ( MEM) t o st udy t he sit uat ion of drug phenom enon in t he Region( 11).
To d a y, a r o u n d t h e w o r l d , n a t i o n a l
g o v e r n m e n t s a r e e m p h a s i z i n g m u c h m o r e t h e im por t ance and dev elopm ent of act iv it ies r elat ed t o d e m a n d r e d u ct i o n , w i t h sp e ci a l a t t e n t i o n t o t h e pr epar at ion of hum an r esour ces t o w or k in t he ar ea
of dem an d r edu ct ion . Tak in g in t o con sider at ion t h is r ecom m en d at ion , in 1 9 9 7 , w it h t h e su p p or t of t h e Gov er nm ent of Japan and lat t er t he Gov er nm ent s of t h e Un it ed St at es an d Can ad a, CI CAD in it iat ed an
exper im ent al pr oj ect w it h som e schools of nur sing in Lat in Am er ica. The obj ect ives w er e t o pr epar e fut ur e nur sing pr ofessionals and nur sing pr ofessionals w it h scient ific know ledge and t echnical abilit ies t o w ork in
t he ar ea of dem and r educt ion w it h act iv it ies r elat ed t o h ea l t h p r o m o t i o n , p r ev en t i o n o f d r u g u se a n d abuse, and social int egr at ion( 12).
Th e CI CAD / OAS i n i t i a t i v e w i t h sch o o l s o f
n u r sin g r ecog n izes t h e im p or t an ce an in t er n at ion al o r g a n i za t i o n a n d t h e Go v e r n m e n t s o f Ja p a n , t h e Unit ed St at es, Canada, and Lat in Am er ica count r ies place on t he nursing profession in relat ion t o t he drug
phenom enon in Lat in Am er ica, w it h special at t ent ion i n t h e a r e a o f d e m a n d r e d u c t i o n . Th e n u r s i n g p r o f essi o n co n st i t u t es t h e l ar g est seg m en t o f t h e h e a l t h c a r e w o r k f o r c e , a n d t h e y a r e t h e
p r of ession als, w h o m ain t ain t h e m ost con t act w it h individuals, fam ilies and com m unit ies, t herefore, t hey are able t o ident ify t he precocit y of problem s relat ed t o drugs licit and illicit .
I n v est m en t in t h e d ev elop m en t of n u r sin g professionals t o work in t he area of dem and reduct ion in Lat in Am er ica r equir es t he design of int er nat ional and nat ional policies t hat will support such init iat ives.
A s w e l l , t h e d e v e l o p m e n t o f n e w m o d e l s o f par t ner ships t o car r y out t he act iv it ies ar e r equir ed.
TECHNI CAL AND FI NANCI AL COOPERATI ON
CI CA D u s e s t h e t e c h n i c a l a n d f i n a n c i a l cooper at ion ( TFC) appr oach t o dev elop n ew m odels
of part nerships wit h universit ies and schools of nursing in t he Am ericas t o prepare nursing facult y and fut ure nur sing pr ofessional t o w or k in t he ar ea of dem and r educt ion. Since 1997, CI CAD has dev eloped sev er al
t echnical and financial cooper at ion w it h t he suppor t o f Go v er n m en t s o f Ja p a n , t h e Un i t ed St a t es a n d Can ad a. Up t od ay, CI CAD h as d ev elop ed TFC w it h si x t e e n u n i v e r si t i e s a n d sch o o l s o f n u r si n g / SON
dist ribut ed in t en count ries of Lat in Am erica: Argent ina ( 2 SON) ; Br azil ( 4 / SON) ; Boliv ia ( 1 / Son) ; Chile ( 1 / SON) ; Colom bia ( 1/ SON) ; Ecuador ( 1/ SON) ; Honduras ( 1 / S O N ) ; M e x i c o ( 3 / S O N ) ; Pe r u ( 1 / S O N ) ; a n d
Venezuela ( 1/ SON) t o im plem ent act ivit ies relat ed t o: ( i) educat ion: dev elopm ent of nur sing cur r icula w it h con t en t of dr u gs; ( ii) ex t en sion: im plem en t at ion of out r each com m unit y act iv it ies w it h dr ug cont ent for
sp eci al g r o u p s an d h i g h r i sk p o p u l at i o n ; an d ( i i i )
research: im plem ent at ion of research st udies on drug issues and r elat ed pr oblem s.
Du r in g 2 0 0 2 an d 2 0 0 3 , CI CAD dev eloped a
special TFC w it h t he Univ er sit y of São Paulo, School of Nu r sin g at Ribeir ão Pr et o/ SP/ Br azil t o im plem en t t h e “ Region al Resear ch Capacit y - Bu ildin g Pr ogr am s f or Nu r ses t o St u dy t h e Dr u g Ph en om en on in Lat in
Am erica” wit h t he support of Governm ent of Japan. A t ot al of t h ir t y t h r ee ( 3 3 ) n u r sin g facu lt y h av e been t rained in t wo years. The first group, a t ot al of eight een ( 18) facult y, has com plet ed t heir research, graduat ed
and published t he first scient ific art icle about t he result s of t heir st udies r elat ed t o dr ugs issues. The second g r ou p , a t ot al of f if t een ( 1 5 ) f acu lt y, h av e alr ead y graduat ed in 2004, and are in process t o publish t he
f ir st scien t if ic ar t icle r elat ed t o t h e r esu lt s of t h eir r e se a r ch st u d i e s. Ba se d i n t h e se t w o su cce ssf u l ex p er ien ces, CI CAD h as d ev elop ed an ot h er sp ecial TFC wit h t he Universit y of Albert a- Facult y of Nursing,
t o im plem ent t he “ I I nt er nat ional Resear ch Capacit y-Bu i l d i n g Pr o g r a m f o r N u r se s t o St u d y t h e D r u g
Phenom enon in Lat in Am er ica”.
Th e d i f f er en ce b et w een t h e Reg i o n a l a n d
I n t er n at ion al Resear ch Cap acit y - Bu ild in g Pr og r am s
i s r el at ed t o t h e m o d al i t y o f r esear ch st u d y. Th e
Re g i o n a l Pr o g r a m g i v e s e m p h a s i s t o i n d i v i d u a l
gives em phasis on m ult i- cent ric research st udies. Bot h
program s ( Regional and I nt ernat ional) provide t raining o n q u al i t at i v e an d q u an t i t at i v e r esear ch m et h o d s
applied t o t he st udy of t he drug phenom enon from an int ernat ional healt h perspect ive. The Regional and t he
I nt ernat ional program s offer a specializat ion cert ificat e for t he part icipant s who have a Mast er Degree, and a
post - doct oral cert ificat e for t hose who have a doct oral d eg r ee. Th e Reg i o n al an d I n t er n at i o n al Pr o g r am s
hav e a durat ion of one year, wit h t wo m ont hs at t he U n i v e r s i t y S ã o Pa u l o ( Re g i o n a l Pr o g r a m ) a n d
Un iv er sit y of Alb er t a ( I n t er n at ion al Pr og r am ) , an d
eigh t m on t h s w it h in t h eir ow n un iv er sit y / cou nt r y t o im plem ent t he r esear ch st udy on dr ug issue.
CI CAD , i n 2 0 0 2 , i n v i t ed t h e Un i v er si t y o f Albert a, Facult y of Nursing t o be a part ner t o im plem ent
t h e “ I I n t e r n a t i o n a l Re s e a r c h Ca p a c i t y - B u i l d i n g Pr ogr am for Nur ses t o St udy t he Dr ug Phenom enon
in Lat in Am erica”, wit h t he support of Governm ent of Canada. The obj ect ives of t he program include: ( i) t o
prepare a group of nursing facult y t o do m ult i- cent ric r esear ch st udies on dr ug issues; ( ii) t o st r engt h t he
gr aduat e nur sing pr ogr am s in Lat in Am er ica; ( iii) t o
cr eat e r esear ch gr oups w it hin t heir ow n Univ er sit ies and Schools of Nur sing t hat w ill suppor t r esear ch on
d r u g p h en om en on ; ( i v ) t o f aci l i t at ed ex ch an g e of facult y and graduat e st udent s am ong t he part icipat ing
Un i v e r si t i e s a n d Sch o o l s o f Nu r si n g ; a n d ( v ) t o pr om ot e t he incr ease of nur sing scient ific k now ledge
in t he dem and r educt ion ar ea in Lat in Am er ica w it h publicat ions at int er nat ional and nat ional lev els.
Th e Facu lt y of Nu r sin g at t h e Un iv er sit y of
Alber t a is t he lar gest nur sing facult y in Canada w it h over 1,000 undergraduat e and 250 graduat e st udent s.
I t st r i v e s t o f u l f i l l i t s m i ssi o n t o b e a ce n t e r o f e x c e l l e n c e i n n u r s i n g f o r t h e a d v a n c e m e n t ,
dissem inat ion, and applicat ion of nur sing k now ledge. Th e facu lt y m em ber s ar e am on g t h e best edu cat ed
in Canada w it h a gr eat er per cent age hav ing doct or al degrees t han any ot her nursing school in t he count ry.
The Univer sit y of Alber t a Facult y of Nur sing is dedicat ed t o t he im provem ent of t he healt h of t he
local an d g lob al com m u n it y, t h r ou g h it s lead er sh ip
t e a c h i n g , r e s e a r c h , a n d c o m m u n i t y s e r v i c e . I ncor por at e in it s m ission is an int ent t o ex t end t he
Facult y’s expert ise t o t he com m unit y locally, nat ionally, and int ernat ionally, in order t o fost er healt h prom ot ion,
h eal t h m ai n t en an ce, an d t h e ad v an cem en t o f t h e n u r sin g pr of ession . I t s f acu lt y m em ber s f ocu s t h eir
r e s e a r c h p r o g r a m s i n f i v e a r e a s o f r e s e a r c h e x c e l l e n c e : Gl o b a l H e a l t h , H e a l t h S y s t e m s a n d
Ser vices, Evidence Based Clinical Pr act ice, I nnovat ive
Lear ning Env ir onm ent s and Populat ion Healt h. Ther e
is a p ar t icu lar em p h asis on k n ow led g e t r an sf er t o
dev elop com pet ence in nur sing pr act ice, st ill a quest
for knowledge, and creat e a sense of professionalism
t hus enabling nur ses t o ut ilize cut t ing edge nur sing
r esear ch t o pr ovide evidence- based car e. The Annual
Repor t for 2002 – 2003 clear ly indicat es a st r at egic
i n i t i a t i v e f o c u s i n g o n d e v e l o p i n g i n t e r n a t i o n a l
p a r t n e r s h i p s . D u r i n g t h a t y e a r, t h e r e w e r e 8
i n t e r n a t i o n a l r e s e a r c h p r o j e c t s a n d 3 0 f a c u l t y
m em ber s pr esent ing at int er nat ional confer ences.
ACADEMI C STRUCTURE OF THE PROGRAM
CI CAD and t he Univer sit y of Alber t a- Facult y
of Nursing select ed eleven nursing facult y from seven
c o u n t r i e s , A r g e n t i n a ( 1 ) ; B r a z i l ( 5 ) ; Ch i l e ( 1 ) ;
Colom bia ( 1) ; Ecuador ( 1) ; Mexico ( 1) ; and Peru ( 1)
t o p a r t i c i p a t e i n t h e “ I I n t e r n a t i o n a l Re s e a r c h
Cap acit y - Bu ild in g Pr ogr am f or Nu r ses t o St u d y t h e
Drug Phenom enon in Lat in Am erica”, held at Edm ont on,
Canada. The program had a t ot al of 810 hours, divided
int o Part I : 310 hours for on- sit e, Facult y of Nursing,
Par t I I : 500 hour s for follow - up m ent or ing dist
ance-learning t echniques, where t he part icipant s went back
t o t heir count ries t o im plem ent t he research st udies;
and Part I I I : com m unicat ion and dissem inat ion of t he
r esu lt s of r esear ch st u d ies, w h er e t h e p ar t icip an t s
pr esent ed t heir r esult s at int er nat ional and nat ional
confer ences w it hin t heir count r ies as w ell as out side
of t h eir cou n t r ies. Th e f acu lt y in v olv ed in clu ded: a
t ot al of 5 f r om t h e Un iv er sit y of Alber t a Facu lt y of
Nur sing; a t ot al of 4 Nat ional Consult ant s; and one
r epr esent at iv e fr om CI CAD, w ho w as r esponsible for
Module I of t he program . The language spoken in t he
Pr o g r a m w a s En g l i s h . Th e Pr o g r a m h a d t w o
c o o r d i n a t o r s : o n e i n t e r n a t i o n a l c o o r d i n a t o r
r epr esent ing CI CAD/ OAS; and one local coor dinat or,
r epr esent ing t he Facult y of Nur sing.
EDUCATI ONAL PROGRAM
Part I of t he Program was com posed of t hree
Modules, w hich em phasized t he follow ing aspect s: ( i)
M o d u l e I – I n t e r n a t i o n a l H e a l t h a n d t h e D r u g
Phenom enon; ( ii) Module I I – The Drug Phenom enon;
Met hods. Par t I I – of t he Pr ogr am w as com posed of
Me n t o r i n g D i s t a n c e - Re s e a r c h Te c h n i q u e s . Ea c h s t u d e n t r e c e i v e d a La p t o p c o m p u t e r a n d
a cco m p a n y i n g so f t w a r e t o co n d u ct d a t a a n a l y si s n eed ed t o im p lem en t h er r esear ch p r oj ect . Facu lt y
m em ber s fr om Lat in Am er ican Univ er sit y Schools of Nur sing w er e w elcom ed t o t he Facult y of Nur sing at
t he Universit y of Albert a as Scholars in Residence. I n or d er t o f acilit at e t h e w or k of t h e Lat in Am er ican
facult y, English as a second language ( ESL) t raining w as pr ov ided. Tw o w eek s of in t en siv e t r ain in g w as
offered from 8: 00- 12: 00 and 14: 00- 17: 00 Monday t o
Friday. The t raining was designed t o assist part icipant s t o furt her develop t heir research skills and t o enhance
t h e i r c a p a c i t y f o r p a r t i c i p a t i o n i n i n t e r n a t i o n a l r esear ch .
The Universit y of Albert a has several libraries an d an ex t en siv e collect ion of h ealt h - r elat ed book s
and j ournals. Borrowing privileges at all of t he libraries an d access t o t h e co m p u t er - b ased cat al o g u e an d
dat abases was grant ed t o t he Lat in Am erican Scholars in Residence. The m em bers of t he Facult y of Nursing
at t he Universit y of Albert a have expert ise in a num ber
of ar eas t hat ar e bot h dir ect ly and indir ect ly r elat ed t o t he drug phenom enon in t he Am ericas. There w as
excellent opport unit y for collaborat ion bet ween facult y an d Sch olar s in Resid en ce f or t h e d ev elop m en t of
m u l t i - c e n t r i c r e s e a r c h s t u d i e s i n d r u g d e m a n d r ed u ct ion .
Sev eral m em ber s of t h e Facu lt y of Nu r sin g co l l a b o r a t e d w i t h g r o u p s o f t h r e e o r f o u r o f t h e
Scholar s in Residence in pr epar ing pr oposals for t he
m u l t i - c e n t r i c r e s e a r c h p r o j e c t s . Fo u r p r o j e c t s e m e r g e d f r o m t h a t c o l l a b o r a t i o n : 1 ) D r u g
Co n su m p t i o n a n d Wo r k p l a ce Vi o l e n ce i n Wo m e n Wo r k er s: A Mu l t i - Cen t r i c St u d y i n La t i n Am er i ca .
Mexico - Peru - Brazil, 2003 - 2004; 2) Healt h Prom ot ion and Qualit y of Life Am ong Mot her s of Pr eadolescent s
in Argent ina, Brazil and Chile: A Focused Et hnography Pr op osal; 3 ) Per cep t ion s of t h e Mot h er in g Role f or
Wom en Liv ing in t he Cont ex t of Dr ugs and Violence; and 4) The Relat ionship bet ween Drug Use and Violent
Behavior in Two Universit ies in Brazil and Ecuador. All
proj ect s were approved by t he Healt h Research Et hics Board of t he Universit y of Albert a and t he appropriat e
et hics r ev iew boar ds in t heir hom e count r ies. At t he conclusion of t he in- count ry port ion of
t he Program , t he Canadian facult y have been available f o r co n su l t a t i o n t h r o u g h d i st a n ce co m m u n i ca t i o n
t e c h n o l o g i e s s u c h a s e m a i l , i n t e r n e t m e e t i n g s , t eleconfer encing, t elephone, and fax .
EVALUATI ON PROCESS
The First I nt ernat ional Program for Nurses t o St u d y t h e Dr u g Ph en om en on in t h e Am er icas w as
evaluat ed t hrough a series of quest ionnaires and in a f o cu s g r o u p w i t h t h e D i r e ct o r o f t h e Ce n t r e f o r I nt ernat ional Nursing at t he Universit y of Albert a. The ov er all pr ogr am w as ev alu at ed by bot h par t icipan t s
a n d f a c u l t y m e m b e r s w h o w e r e i n v o l v e d i n i t. Part icipant s also com plet ed evaluat ions at t he end of each m odu le.
I n e v a l u a t i n g t h e o v e r a l l p r o g r a m ,
par t icipan t s m ost en j oy ed t h e edu cat ion al pr ogr am provided by t he Facult y of Nursing and felt t hat t heir research skills in quant it at ive and qualit at ive m et hods were m arkedly st rengt hened. Part icipant s appreciat ed
t he resources available at t he libraries of t he Universit y of Alber t a. Th e in t er n at ion al in t er ch an ge w it h ot h er pr ofessional nur se academ ics w or k ing in t he ar ea of drug dem and reduct ion was st rongly cit ed as a posit ive
and pr oduct iv e aspect of t he pr ogr am .
Par t icip an t s w ou ld h av e lik ed som e “ d ow n t im e” at t h e begin n in g of t h e pr ogr am t o adapt t o Ed m o n t o n , Ca n a d a a n d t h e Un i v e r si t y o f Al b e r t a
before beginning full- day coursework. They would also hav e lik ed t o spend m or e t im e on less m at er ial.
I n ev aluat ing t he ov er all pr ogr am , Canadian facult y appr eciat ed t he oppor t unit y for int er nat ional
collabor at ion an d f or h ear in g an d sh ar in g ideas on research in com m on areas of int erest . The chart below provides an overview of t he barriers and st rengt hs of t he program as indicat ed by bot h Canadian and Lat in
Am er ican f acu lt y :
s h t g n e r t
S Barriers
l a n o i t a n r e t n i r o f y t i n u t r o p p O n o it a r o b a ll o c d n a e u g o l a i d f o e g a u g n a l n i y t il i b a t n e t s i s n o c n i n o it c u r t s n i d n a g n i d a e r f o e g n a h c x e r o f y t i n u t r o p p o d n a m e d g u r d r o f s a e d i h c r a e s e r n o it c u d e r s n a l p h tl a e h t n e t s i s n o c n i h t o b n i g n i d l i u b -y t i c a p a c h c r a e s e r d o h t e m e v it a t il a u q d n a e v it a t it n a u q g n i d a e r y v a e h o t n i y r t n e e t a i d e m m i n g i e r o f n i s d n a m e d t n e m n g i s s a d n a t n e m n o r i v n e n g i e r o f d n a e g a u g n a l d il o s y ll a c i g o l o d o h t e m g n i n g i s e d s t c e j o r p h c r a e s e r c i r t n e c -it l u m c i r t n e c -i t l u m f o n o i t a t n e m e l p m i s t c e j o r p h c r a e s e r d r a h d n a , r o m u h d o o g , m s a i s u h t n e d e v l o v n i ll a f o k r o w
I MPACTS PRODUCED
Th e oppor t u n it y t o h av e pr of ession als f r om
seven Lat in Am erican count ries involved in t he proj ect ,
int er act ing daily w it h each ot her and t heir Canadian
h o st s, cr ea t ed r i ch i n t er cu l t u r a l a n d p r o f essi o n a l
g r o w t h e x p e r i e n c e s . Th e p r o g r a m c r e a t e d
am ong t he Lat in Am erican facult ies of nursing as well
as w it h t he Univ er sit y of Alber t a, Facult y of Nur sing.
At least one of t he proposals developed by t he groups
r eceiv ed fur t her funding t o be conduct ed in Canada
as w ell as in t he Lat in Am er ican count r ies. Alr eady,
t h er e h av e been oppor t u n it ies f or f acu lt y m em ber s
from t he Lat in Am erican count ries and t hose in Canada
t o p r e s e n t p r e l i m i n a r y r e s e a r c h f i n d i n g s a t
in t er n at ion al con f er en ces.
Man y b r i d g es w er e b u i l t an d m u ch g l o b al
good will was generat ed. Many of t he part icipant s who
hold m ast er s degr ees ex pr essed int er est in pur suing
nursing doct oral educat ion at t he Universit y of Albert a.
The pr ogr am fost er ed a global healt h per spect iv e on
t he drug phenom enon in t he nurses who part icipat ed
i n t h e p r o g r a m . Ea c h p a r t i c i p a n t w i l l t a k e t h i s
ex panded per spect iv e w it h her as she cont inues her
professional work and t his will wit hout doubt enhance
int ernat ional effort s t o reduce t he dem and for drugs.
All elev en par t icipant s hav e alr eady gr aduat ed fr om
t he program and are in process t o prepare t heir first
sci e n t i f i c a r t i cl e t o b e su b m i t t e d f o r p u b l i ca t i o n .
I ndicat ing in t his w ay t he success of t he program .
FI NAL CONSI DERATI ONS
Th e f i r st I n t er n at i on al Resear ch Cap aci t y
-Bu i l d i n g Pr o g r a m f o r N u r se s t o St u d y t h e D r u g
Ph en om en on in t h e Am er icas offer ed at t h e Facu lt y
of Nursing at t he Universit y of Albert a as part of t he
CI CAD Sch ools of Nu r sin g p r oj ect p r esen t ed a r ich
l e a r n i n g e x p e r i e n c e f o r a l l i n v o l v e d . Th i s f i r s t
e x p e r i e n c e i n d e v e l o p i n g p a r t n e r s h i p s b e t w e e n
Can ad i an an d Lat i n Am er i can f acu l t y m em b er s t o
design an d im plem en t r esear ch in t h e ar ea of dr u g
d e m a n d r e d u c t i o n o p e n s t h e d o o r f o r o t h e r
oppor t u n it ies an d ch allen ges. I t w ou ld be h elpf u l if
fut ur e, t hat int er nat ional capacit y - building pr ogr am s
r e q u i r e s a m o r e a d v a n c e d l e v e l o f En g l i s h , a
m an d at or y h ealt h p lan t h at is con sist en t f or each
p ar t i ci p an t , an d a w eek o f ad j u st m en t t i m e af t er
ar r i v i n g i n t h e h o st co u n t r y b ef o r e b eg i n n i n g t h e
p r o g r a m . A f u t u r e co n si d e r a t i o n m i g h t b e co st
ef f ect i v e v i r t u a l ed u ca t i o n f o r r esea r ch ca p a ci t y
-bu ildin g.
ACKNOW LEDGEMENTS
Grat eful acknowledgem ent is ext ended t o t he
Depar t m ent of For eign Affair s of t he Gov er nm ent of
Canada for t he funds provided for t his proj ect and t o
t he Execut iv e Secr et ar iat of t he I nt er - Am er ican Dr ug
Abuse Cont rol Com m ission/ CI CAD of t he Organizat ion
of Am er ican St at es/ OAS for all of t h e h ar d w or k in
planning and im plem ent ing t he proj ect . We also w ish
t o express our deep appreciat ion t o all of t he Direct ors
of Schools of Nur sing inv olv ed in t he pr oj ect , t o all
Canadian and Lat in Am erican facult y, and t o any ot her
person who direct ly or indirect ly support ed t he process
of plan n in g, im plem en t in g, an d ev alu at in g t h e f ir st
I nt er nat ional Resear ch Capacit y - Building Pr ogr am for
N u r s e s t o S t u d y t h e D r u g Ph e n o m e n o n i n t h e
Am er i cas.
Many people cont ribut e behind t he scenes t o
p r od u ce a p r og r am su ch as Th e Fir st I n t er n at ion al
Resear ch Cap acit y - Bu ild in g Pr og r am f or Nu r ses t o
St udy t he Dr ug Phenom enon in t he Am er icas. These
i n c l u d e u n i v e r s i t y s u p p o r t p e r s o n n e l , g r a d u a t e
st u d en t s, an d m an y p eop le f r om t h e in t er n at ion al
of f ices at t h e Un iv er sit y of Alber t a. Sev er al people
con t r ibu t ed qu it e abov e t h e call of du t y : A sin cer e
t h an k y ou is ex t en d ed t o t h e st af f at St . Josep h ’s
College an d t o Ju lie Gilber t f or all of t h e t im e an d
at t ent ion t hey devot ed t o assist ing t he Lat in Am erican
f a cu l t y w i t h m a n y d e t a i l s o f a d j u st i n g t o l i f e i n
Edm ont on, Canada. We also wish t o ext end a special
t hank you t o m em bers of t he Facult y of Nursing who
assist ed w it h host ing our Lat in Am er ican colleagues.
REFERENCES
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8 . Sá n ch e z FM, Fe r r i a n i MGC. Pe r ce p ci ó n d e p a d r e s y pr ofesor es de los fact or es de r iesgos par a el uso de dr ogas licit as y ilícit as en los escolar es. Rev Lat ino- am Enfer m agem m ar ço- ab r il 2 0 0 4 ; 1 2 ( n ú m er o esp ecial) : 3 5 2 - 3 5 8 . 9 . Re b o l l e d o EAO, Me d i n a NMO, Pi l l o n SC. Fa ct o r e s d e Ri e s g o s A s o c i a d o s a l U s o d e d r o g a s e n Es t u d i a n t e s Adolescent es. Rev Lat ino- am Enfer m agem m ar ço- abr il 2004; 1 2 ( n ú m er o esp ecial) : 3 6 9 - 7 5 .
10. Bonifaz RGV, Nak ano AMS. La v iolencia int ra- fam iliar, el uso de drogas en la parej a, desde la perspect iva de la m uj er m a l t r a t a d a . Re v i st a La t i n o - a m En f e r m a g e m m a r ço - a b r i l 2 0 0 4 , 1 2 ( n ú m er o esp ecial) : 4 3 3 - 4 4 .
1 1 . Or g an i zat i o n o f Am er i can St at es/ OAS. I n t er am er i can Dr ug Cont r ol Com isión/ CI CAD. Challenges for a new fut ur e. 1 9 9 9 - 2 0 0 4 . Wash in g t on ( DC) : OAS; 2 0 0 4 .
1 2 . Com isión I n t er am er ican a p ar a o Con t r ol d el Ab u so d e Drogas ( CI CAD) . Proj et o das escolas de enferm agem na área de reducción da dem anda de drogas en Am érica Lat ina. 1997-2 0 0 4 Wash i n g t on ( DC) : CI CAD/ OEA; 1997-2 0 0 4 .
