Global Bridges, Global Connections: The Results of the 2013 Network Survey

When Global Bridges was created, one of our fundamental goals was to foster the creation of a global network of healthcare providers who were trained to provide evidence-based tobacco treatment, who could serve as models for other healthcare providers in their countries and regions, and who would support and encourage policies and practices that would increase implementation of the FCTC’s Article 14.   Initially, three regions received grant funding to begin the process of training healthcare providers, Africa, the Middle East and Latin America.   Later, Europe was also added, with the goal of expanding to the rest of the world.

Every year, the Global Bridges leaders in each region evaluated their training to assess the breadth and scope of their efforts and to understand how the participants would use their new skills. In addition, we implemented a survey in 2013 that was designed to look at the network itself.  More specifically, the survey objectives were to

  1. Describe the Global Bridges network, including specialty expertise, geographic location, and to map the flow of information through the network
  2. Assess Global Bridges performance against objectives, particularly network-building and training;
  3. Identify gaps in the current network
  4. Identify targets for future network building activity
  5. Identification of potential new network members

To achieve these goals, e-mail solicitations, including a link to the online survey, were sent in March 2013 to 526 members who had registered through the Global Bridges website.  The survey remained open in March and April 2013 with weekly reminder e-mails.  In addition, the Global Bridges regional directors disseminated the survey link through their listservs and encouraged participation. The survey was available in both English and Spanish because previous website usage data indicated that the predominant language, besides English, of Global Bridges website users was Spanish.  As a result, a total of 233 responses were received.

We found that 27.5% of the respondents were physicians, and 15.4% were non-physician clinicians (e.g. nurses).  In addition, 13.3% were program coordinators or managers, 12.5% were administrators, and 12% were faculty.  The rest of the respondents were from a variety of disciplines (such as health educators).

Most importantly, 74% of respondents reported ever contacting or collaborating with others on tobacco dependence treatment, and about one quarter of those tobacco dependence treatment ties reported were a result of involvement in Global Bridges.  In addition, 60% of respondents reported ever contacting or collaborating with others on tobacco policy/advocacy, and just under 20% of those tobacco policy/advocacy ties reported were a result of involvement in Global Bridges.  This shows that in just a few years, those who are involved in Global Bridges have developed new involvement in tobacco treatment and tobacco policy.

It is clear from the network map below that the central Global Bridges office is essential for assuring communication and collaboration across the Global Bridges network.  This is just the role that was intended, and it allows for greater communication and coordination as the organization grows.   Once greater communication and collaboration occurs across Regions, it may be possible for the central organization to reduce its role.   Indeed, there are signs of significant collaboration across organizations.  For example, the most central network nodes in the tobacco dependence treatment communication network are organizations, such as the Association for the Treatment of Tobacco Use and Dependence (ATTUD) and the Ethiopian Public Health Association, rather than individuals.  Within specific Regions, there is a relatively great amount of activity in Nigeria within the AFRO region, and a highly centralized network in the EMRO Region.  In the EURO region, which is the latest region added to Global Bridges, there is a great amount of diversity in collaboration and communication, which may be related to the many different languages spoken there.

The expanding linkages and training as a result of involvement in Global Bridges is a very good start, but they are still just a beginning because as the global map shows, Global Bridges has not yet expanded to become truly global.   It is essential for Global Bridges to expand into Asian countries in order to meet the objectives of the initiative.   It is very likely that evolution of Global Bridges in 2014 will result in expanded reach and training globally.

In conclusion, network survey responses show activity and ties directly resulting from participation in Global Bridges activities and training.  The value of those linkages is that those with more ties have multiple ways to get information/resources. It is hoped that the next phase of Global Bridges will expand the network further, and as a result increase the number of healthcare providers who can treat tobacco and play a major role within their respective countries in fostering the implementation of treatment policies and practices as part of the FCTC Article 14.