{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:13:12Z","timestamp":1786122792809,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Learning Health System (LHS) concept is gaining traction in high\u2010income countries, yet its implementation in low\u2010 and middle\u2010income countries (LMICs) remains limited with few initiatives offering practical strategies tailored to these contexts. The Leading a Learning Health System (LLHS) Program, grounded in LHS principles, aimed to build leadership capacities among health professionals and leaders from five Asia\u2010Pacific LMICs. This study explored participants' learning experiences and applications in their context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed\u2010method longitudinal study was conducted (13\u2010months), informed by social constructivism and Kirkpatrick's evaluation framework. Surveys and semi\u2010structured interviews were conducted after the intensive course (Survey A and Interview A) and 1 year later (Survey B and Interview B). Quantitative data were analyzed descriptively, and qualitative data were analyzed through inductive content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen participants (13\/20, 65%) completed Survey A. All (100%) rated the program and cross\u2010country network as \u201chigh value.\u201d Eleven participants (11\/20, 55%) completed Survey B. All participants reported applying program learnings regularly on most days (6\/11, 55%) or most weeks (5\/11, 45%). Nine participants (82%) reported influencing team culture and five (45%) reported influencing organizational change. Qualitative analysis of 20 Interview A and 10 Interview B identified four themes: (1) developing a systems leadership identity, (2) translating leadership intent into practice, (3) contextual challenges to applying learnings, (4) resilience via adaptive leadership capacity and programmatic support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates how a longitudinal leadership program based on the LHS framework supported LMIC health professionals to develop systems leadership identity, foster learning culture, and cultivate adaptive, distributed leadership to build resilience in resource\u2010limited settings. The variability of health information systems in LMICs should not be seen as a barrier to implementing LHS, as improvement can begin with the effective use of locally available data. These findings can inform future capacity\u2010building initiatives to advance LHSs in LMICs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70109","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T12:28:59Z","timestamp":1786105739000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Leading Learning Health Systems in the Asia Pacific: A Mixed\u2010Method Evaluation of Health Professionals' Experiences in a Longitudinal Leadership Program"],"prefix":"10.1002","volume":"10","author":[{"given":"Lichin","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"},{"name":"Royal Children's Hospital Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8348-9918","authenticated-orcid":false,"given":"Carolyn","family":"Van Heerden","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"},{"name":"Royal Children's Hospital Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"},{"name":"Royal Children's Hospital Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"K.SheikhandS.Abimbola \u201cLearning Health Systems: Pathways to Progress: Flagship Report of the Alliance for Health Policy and Systems Research \u201dWorld Health Organization 2021 Report No. 9240032215."},{"issue":"7313","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1136\/bmj.323.7313.625","article-title":"The Challenge of Complexity in Health Care","volume":"323","author":"Plsek P. 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