Points of entry and other border regions educate, train, and exercise (ETEs) their staff to improve preparedness and response to cross-border health threats. However, no conclusive knowledge of these ETEs’ effectiveness exists. This study aimed to review the literature on ETEs in infectious disease control concerning their methods and effect, with an emphasis on cross-border settings and methods that enlarge ETEs’ reach. We systematically searched for studies in the databases Embase, Medline, Web of Science, PsycInfo, ERIC, and Cinahl. After successively screening titles and abstracts, full-texts, and citations, 62 studies were included using in- and exclusion criteria. Data were extracted using a data-extraction form. Quality assessment was performed. We developed a theoretical framework based on which we analyzed the ETE context (target group, recruitment, autonomy, training needs), input (topic, trainers, development and quality of materials), process (design, duration, interval, goals), evaluation (pre-, post- follow-up tests), and outcome (reaction, learning, behavior, and system). We found a limited number of published evaluations of ETEs in general (n = 62) and of cross-border settings (n = 5) in particular. The quality assessment resulted in seven ETE methodologies and 23 evaluations with a ‘good’ score. Both general studies and those in a cross-border setting contain a low-moderate detail level on context, input, and process. The evaluations were performed on reaction (n = 45), learning (n = 45), behavior (n = 9) and system (n = 4), mainly using pre- and post-tests (n = 22). Online learning methods have a high potential in enlarging the reach and are effective, particularly in combination with offline training. Training-of-trainer approaches are effective for learning; new ETEs were developed by 20–44% of participants until six months after the initial training. Our study reveals a limited number of publications on ETEs in infectious disease control. Studies provide few details on methodology, and use mainly short-term evaluations and low level outcomes. We call for more extensive, higher-level evaluation standards of ETEs, and an easy and sustainable way to exchange evaluations within the workforce of infectious disease control in cross-border settings. The theoretical framework developed in this study could guide future development and evaluation of ETEs in infectious disease control.

中文翻译：

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传染病控制的教育、培训和锻炼，重点是跨境环境：综合审查。

入境点和其他边境地区对其工作人员进行教育、培训和锻炼（ETE），以提高对跨境健康威胁的准备和响应。然而，对于这些 ETE 的有效性尚无定论。本研究旨在回顾有关 ETE 在传染病控制中的方法和效果的文献，重点关注跨境环境和扩大 ETE 影响范围的方法。我们系统地检索了 Embase、Medline、Web of Science、PsycInfo、ERIC 和 Cinahl 数据库中的研究。在连续筛选标题和摘要、全文和引文后，使用纳入和排除标准纳入了 62 项研究。使用数据提取表格提取数据。进行了质量评估。我们开发了一个理论框架，在此基础上我们分析了 ETE 背景（目标群体、招聘、自主权、培训需求）、输入（主题、培训师、材料的开发和质量）、流程（设计、持续时间、间隔、目标）、评估（跟踪前、跟踪后测试）和结果（反应、学习、行为和系统）。我们发现，针对一般 ETE（n = 62）和特别是跨境环境（n = 5）的已发表评估数量有限。质量评估产生了 7 种 ETE 方法和 23 项评估，得分为“良好”。一般性研究和跨境环境中的研究都包含有关背景、输入和过程的低中等详细程度。评估针对反应（n = 45）、学习（n = 45）、行为（n = 9）和系统（n = 4）进行，主要使用前测试和后测试（n = 22）。在线学习方法在扩大覆盖范围方面具有很大潜力并且非常有效，特别是与线下培训相结合。培训师培训方法对于学习是有效的；20-44% 的参与者在初次培训后六个月内开发出了新的 ETE。我们的研究表明，有关 ETE 在传染病控制中的出版物数量有限。研究提供的方法细节很少，并且主要使用短期评估和低水平结果。我们呼吁制定更广泛、更高水平的 ETE 评估标准，以及在跨境环境下传染病控制人员内部交换评估的简单且可持续的方式。本研究建立的理论框架可以指导 ETE 在传染病控制中的未来发展和评估。