Using the cascade model to improve antenatal screening for the hemoglobin disorders

Area of Science:

• Public Health
• Genetics
• Medical Education

Background:

• Inherited hemoglobin disorders pose a significant global health challenge.
• A cascade (train-the-trainer) model was employed to equip frontline practitioners with skills for supporting parents during antenatal screening.
• Experienced counselors acted as facilitators to disseminate knowledge and skills.

Purpose of the Study:

• To evaluate the integration of the cascade model into practice.
• To identify factors enabling or hindering effective knowledge transfer.
• To assess the feasibility of incorporating e-learning and gather facilitator feedback on the change process.

Main Methods:

• Qualitative study involving focus groups and interviews with 50 facilitators.
• Thematic analysis was used to interpret the collected data.

Main Results:

• Workplace context (workload, roles, preparation) significantly influenced cascading effectiveness.
• Facilitator confidence and success perceptions varied despite similar training exposure.
• Key enhancements include careful facilitator selection, tailored training needs assessment, and provision of ongoing support.

Conclusions:

• Contextual and individual factors are crucial for successful cascading of training.
• Combining the cascade model with e-learning is feasible.
• Future research should include diverse stakeholder perspectives and cost-effectiveness analysis.