Prevention Insights, Department of Applied Health Science, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, Indiana, USA.
IUPUI ECHO Center & Center for Public Health Practice, Richard M. Fairbanks School of Public Health, Indiana University, Purdue University, Indianapolis (IUPUI), Indiana, USA.
Med Educ Online. 2021 Dec;26(1):1936435. doi: 10.1080/10872981.2021.1936435.
Project ECHO (Extension for Community Healthcare Outcomes) was developed in 2003 as an innovative model to facilitate continuing education and professional development. ECHO emphasizes 'moving knowledge, not people.' To accomplish this, ECHO programs use virtual collaboration and case-based learning to allow practitioners, including those in rural and underserved areas, to receive specialist training. The ECHO model has expanded rapidly and is now used in 44 countries. Preliminary research on ECHO's efficacy and effectiveness has shown promising results, but evidence remains limited and appropriate research outcomes have not been clearly defined. To improve the evidence basis for ECHO, this study of 5 ECHO programs (cancer prevention/survivorship, integrated pain management, hepatitis C, HIV, and LGBTQ+ health care elucidated actionable insights about the ECHO programs and directions in which future evaluations and research might progress. This was a qualitative study following COREQ standards. A trained interviewer conducted 10 interviews and 5 focus groups with 25 unique, purposively sampled ECHO attendees (2 interviews and 1 focus group for each of the 5 programs). Data were transcribed verbatim and analyzed using the general inductive approach, then reviewed for reliability. We identified four major categories (reasons to join ECHO, value of participating in ECHO, ways to improve ECHO, and barriers to participation) composed of 23 primary codes. We suggest that thematic saturation was achieved, and a coherent narrative about ECHO emerged for discussion. Participants frequently indicated they received valuable learning experiences and thereby changed their practice; rigorous trials of learning and patient-level outcomes are warranted. This study also found support for the idea that the ECHO model should be studied for its role in convening communities of practice and reducing provider isolation as an outcome in itself. Additional implications, including for interprofessional education and model evolution, were also identified and discussed.
ECHO 项目（Extension for Community Healthcare Outcomes）于 2003 年作为一种创新模式开发，旨在促进继续教育和专业发展。ECHO 强调“知识的传播，而非人员的流动”。为了实现这一目标，ECHO 项目采用虚拟协作和基于案例的学习方式，使包括农村和服务不足地区在内的从业者能够接受专业培训。ECHO 模式迅速发展，现已在 44 个国家使用。ECHO 功效和效果的初步研究显示出有希望的结果，但证据仍然有限，适当的研究结果也没有明确界定。为了提高 ECHO 的证据基础，本研究对 5 个 ECHO 项目（癌症预防/生存、综合疼痛管理、丙型肝炎、艾滋病毒和 LGBTQ+医疗保健）进行了研究，阐明了关于 ECHO 项目的可操作见解以及未来评估和研究可能取得进展的方向。这是一项遵循 COREQ 标准的定性研究。一名经过培训的访谈者对 25 名具有独特目的抽样的 ECHO 参与者（每个项目进行 2 次访谈和 1 次焦点小组）进行了 10 次访谈和 5 次焦点小组。数据逐字转录并使用一般归纳方法进行分析，然后进行可靠性审查。我们确定了四个主要类别（加入 ECHO 的原因、参与 ECHO 的价值、改进 ECHO 的方法和参与的障碍），由 23 个主要代码组成。我们认为主题达到了饱和度，并且出现了关于 ECHO 的连贯叙述以供讨论。参与者经常表示他们获得了有价值的学习经验，从而改变了他们的实践；有必要对学习和患者水平结果进行严格的试验。这项研究还支持这样一种观点，即应该研究 ECHO 模式在召集实践社区和减少提供者孤立方面的作用本身作为一种结果。还确定并讨论了其他影响，包括跨专业教育和模型演变。
