Institute for Work & Health, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Occup Med (Lond). 2024 Oct 1;74(7):493-500. doi: 10.1093/occmed/kqae067.
Health issues caused and/or exacerbated by work are common in patients seeking primary health care. Yet, primary care providers generally receive little or no training in the assessment and management of occupational injuries and illnesses.
To conduct a pilot project to develop, implement and evaluate a programme to teach occupational and environmental medicine to primary healthcare providers.
We followed the Extensions for Community Healthcare Outcomes (ECHO) model to connect primary healthcare providers with experts in Occupational and Environmental Medicine (OEM). We employed an observational pre-post study design to assess changes in self-efficacy, knowledge, attitudes and beliefs towards OEM.
From September 2021 to June 2022, we offered two cycles of 12 sessions each. Participants came from medicine, nursing, psychology, occupational and physical therapy, chiropractic, kinesiology, social work, and pharmacy. Sixty-seven participants completed both pre- and post-ECHO questionnaires. Self-efficacy and knowledge ratings significantly increased after attendance at ECHO compared to the pre-ECHO responses. Attitudes and beliefs were unchanged in most of the items assessed. Participants rated their satisfaction with ECHO between 59% and 97%.
Our pilot study demonstrated the challenges in implementing the first ECHO OEM in Canada. Findings show acceptability and satisfaction, improved self-efficacy, and small increases in knowledge, but not overall attitudes and beliefs. There is a need to understand barriers to participation and to target participants with less knowledge and experience in occupational and environmental medicine.
在寻求初级保健的患者中,由工作引起和/或加重的健康问题很常见。然而,初级保健提供者通常在职业伤害和疾病的评估和管理方面接受的培训很少或没有。
开展一项试点项目,开发、实施和评估一项向初级保健提供者教授职业和环境医学的方案。
我们遵循社区医疗保健成果扩展(ECHO)模式,将初级保健提供者与职业和环境医学(OEM)专家联系起来。我们采用观察性前后研究设计来评估自我效能感、知识、对 OEM 的态度和信念的变化。
从 2021 年 9 月到 2022 年 6 月,我们提供了两个周期,每个周期有 12 个环节。参与者来自医学、护理、心理学、职业和物理治疗、整脊、运动机能学、社会工作和药学。67 名参与者完成了 ECHO 前后的问卷。与 ECHO 前的反应相比,参加 ECHO 后自我效能感和知识评分显著提高。在评估的大多数项目中,态度和信念没有变化。参与者对 ECHO 的满意度评分为 59%至 97%之间。
我们的试点研究表明在加拿大实施首个 ECHO OEM 面临挑战。研究结果表明可接受性和满意度、自我效能感提高,以及知识略有增加,但总体态度和信念没有变化。有必要了解参与的障碍,并针对在职业和环境医学方面知识和经验较少的参与者。