Virtual Care, Outreach, and ECHO Department, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Health Res Policy Syst. 2022 Feb 8;20(1):17. doi: 10.1186/s12961-022-00818-1.
Project ECHO is a virtual education model aimed at building capacity among healthcare providers to support optimal management for a range of health conditions. The expansion of the ECHO model, further amplified by the pandemic, has demonstrated an increased need to evaluate implementation success to ensure that interventions are implemented as planned. This study describes how Proctor et al.'s implementation outcomes (acceptability, adoption, appropriateness, costs, feasibility, fidelity, penetration, and sustainability) were adapted and used to assess the implementation of ECHO Ontario Mental Health (ECHO-ONMH), a mental health-focused capacity-building programme.
Using Proctor et al.'s implementation outcomes, the authors developed an implementation outcomes framework for ECHO-ONMH more generally. Using this, outcome measures and success thresholds were identified for each outcome for the ECHO-ONMH context, and then applied to evaluate the implementation of ECHO-ONMH using data from the first 4 years of the programme.
An ECHO-ONMH implementation outcomes framework was developed using Proctor's implementation outcomes. ECHO-ONMH adapted implementation outcomes suggest that ECHO-ONMH was implemented successfully in all domains except for penetration, which only had participation from 13/14 regions. Acceptability, appropriateness and adoption success thresholds were surpassed for all 4 years, showing strong signs of sustainability. The programme was deemed feasible all 4 years and was found to be more cost-effective. ECHO-ONMH also showed high rates of fidelity to the ECHO model, and high rates of penetration.
This is the first study to use Proctor et al.'s implementation outcomes to describe implementation success for a virtual capacity-building model. The proposed ECHO implementation outcomes framework provides a base for similar interventions to evaluate implementation success, which is an important precursor to understanding learning, service or health outcomes related to the model. Additionally, these findings can act as a benchmark for other international ECHOs and educational programmes.
ECHO 项目是一种虚拟教育模式，旨在提高医疗保健提供者的能力，以支持一系列健康状况的最佳管理。ECHO 模式的扩展，进一步因疫情而放大，表明需要评估实施的成功，以确保干预措施按计划实施。本研究描述了如何改编和使用 Proctor 等人的实施结果（可接受性、采用、适宜性、成本、可行性、保真度、渗透和可持续性）来评估安大略省心理健康 ECHO（ECHO-ONMH）的实施情况，这是一个专注于心理健康的能力建设项目。
使用 Proctor 等人的实施结果，作者为更广泛的 ECHO-ONMH 开发了一个实施结果框架。使用该框架，针对 ECHO-ONMH 背景确定了每个结果的结果衡量标准和成功阈值，然后将其应用于使用该计划头 4 年的数据评估 ECHO-ONMH 的实施情况。
使用 Proctor 的实施结果开发了 ECHO-ONMH 实施结果框架。ECHO-ONMH 改编的实施结果表明，ECHO-ONMH 在所有领域都成功实施，除了渗透率，渗透率仅覆盖了 13/14 个地区。所有 4 年的可接受性、适宜性和采用成功率都超过了成功阈值，显示出很强的可持续性迹象。该计划在所有 4 年内都被认为是可行的，并且发现更具成本效益。ECHO-ONMH 也表现出对 ECHO 模型的高度保真度和高渗透率。
这是第一项使用 Proctor 等人的实施结果来描述虚拟能力建设模型实施成功的研究。拟议的 ECHO 实施结果框架为类似干预措施提供了评估实施成功的基础，这是了解与该模型相关的学习、服务或健康结果的重要前提。此外，这些发现可以作为其他国际 ECHOs 和教育计划的基准。
