RESUMEN
BACKGROUND: After the fall of the Soviet Union in 1991, the existing process of Continuing Medical Education (CME) was decimated. The Fund for Armenian Relief (FAR) was able to leverage competitive educational fellowship programmes in existence, and harness new knowledge gained by returning fellows thus amplifying the impact on education and patient care in the regions of the republic of Armenia. AIMS: This manuscript describes a replicable novel amplification programme using a "train the trainer" model for CME in the republic of Armenia. We sought to identify challenges specific to physicians from the regions, and to examine the strengths of the CME programme that can serve as a model for programme development and improvement in countries facing similar challenges. METHODS: The manuscript details a descriptive and mixed method study that includes in-depth interviews and focus group discussions from 2015-2016. Conceptual content analysis was used to identify major themes from the transcripts. RESULTS: Challenges facing regional physicians in post-Soviet counties in transition, exemplified by Armenia, are profound. Exploration of themes related to perceived barriers to care in the regions included, physicians' personal financial constraints, lack of up-to-date knowledge and equipment, lack of confidence, fear of criticism and of making incorrect diagnoses. CONCLUSIONS: The FAR/CME programme presents an innovative way to amplify the knowledge of Armenian physicians upon their return from educational programme participation abroad in order to address challenges facing regional physicians.
RESUMEN
OBJECTIVES: : To determine knowledge and attitudes regarding traffic safety devices, measures, and legislation in the general population in Yerevan, Republic of Armenia. METHODS: : We conducted a baseline random digit dial fixed line telephone verbal survey of Yerevan households in April 2009 with a follow-up survey in May 2010. Survey domains included restraint use, motor vehicle crash experiences, and attitudes regarding traffic safety. RESULTS: : In the initial survey, of 2137 numbers dialed, 436 persons were reached and 390 (90%) agreed to participate. Of survey respondents, 90% percent of household cars had seatbelts, while 47% had airbags. Twenty-four percent always or usually wore a seatbelt when driving, 21% wore a belt as a passenger. 39% were unaware of child restraints. Of the 61% who were aware of child restraints, only 32% had ever used one. A follow-up survey was conducted one year later after enforcement efforts were increased. In the follow-up survey, 81% percent always or usually wore a seatbelt when driving, and 69% wore a belt as a passenger. There was no significant increase of awareness or use of child restraints in the follow-up survey. CONCLUSIONS: : Although cars in Yerevan have seat belts, the majority of drivers and passengers prior to the intervention did not use them. Knowledge and use of child restraints was poor. The follow-up survey conducted after an enforcement campaign was underway in Yerevan showed that improved enforcement greatly increased awareness and compliance with current legislation. This study provides vital baseline information for the formulation of future policy. It also highlights the need for a multi-dimensional road traffic safety initiative through public educational campaigns, enforcement of current laws, and development of novel prevention policies and regulations.