Bhuyan Sangeeta, Yadav Shikha, Verma Amit, Bhati Shama, Anand Ankit, Bhalla Sandeep, Rai Apoorva Karan
ECHO India, New Delhi, India.
BMC Cancer. 2025 Feb 3;25(1):193. doi: 10.1186/s12885-025-13553-x.
Cancer poses a life-threatening public health challenge, particularly impacting low- and middle-income countries (LMICs). This study focuses on India, where the cancer burden is substantial, with approximately 1.2 million new cancer cases recorded in 2020, emphasising the urgent need for effective prevention, early detection, treatment, and support services. The lack of local workforce capacity in rural areas exacerbates this challenge, necessitating collaborative efforts. The nonprofit organization Extension for Community Healthcare Outcomes (ECHO) employs the 'Hub and Spoke' model in India to bridge gaps in cancer care. The review aimed to assess the scale and impact of ECHO's initiatives, evaluate findings, examine the model's implementation, and assess its acceptability among healthcare professionals (HCPs) in preventing and treating cancer.
This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight studies, comprising six quasi-experimental and two observational studies, employing the ECHO Model for cancer care training programmes were identified. The quality of the selected articles was assessed using a standardized critical appraisal tool developed by the Joanna Briggs Institute (JBI).
The findings reveal that ECHO India actively collaborates with experts and institutions, conducting programmes and webinars in 12 states/Union Territories to enhance professionals' expertise in cancer care. Published literature, though limited, emphasises ECHO's training impact, with knowledge gains ranging from 7% to 51%. The model's adoption, retention, and reach are evident through 24 institutes/hubs implementing ECHO programmes in oncology. However, challenges such as low pre post assessment response rate and internet connectivity were observed.
ECHO India's work in cancer care is substantial, addressing gaps in workforce capacity. The systematic review highlights the need for more publications to capture ECHO's impact comprehensively. The findings contribute valuable insights to ongoing efforts to reduce India's cancer burden and improve the well-being of its population.
癌症构成了危及生命的公共卫生挑战，对低收入和中等收入国家（LMICs）影响尤甚。本研究聚焦于印度，该国癌症负担沉重，2020年记录的新增癌症病例约达120万，凸显了对有效预防、早期检测、治疗及支持服务的迫切需求。农村地区缺乏本地劳动力能力加剧了这一挑战，因此需要各方共同努力。非营利组织社区医疗成果推广组织（ECHO）在印度采用“中心辐射”模式来弥合癌症护理方面的差距。本综述旨在评估ECHO举措的规模和影响，评估研究结果，审视该模式的实施情况，并评估其在预防和治疗癌症方面在医疗专业人员（HCPs）中的可接受性。
本系统综述按照系统评价与Meta分析的首选报告项目（PRISMA）指南进行。共识别出八项研究，其中包括六项准实验研究和两项观察性研究，这些研究采用ECHO模式开展癌症护理培训项目。使用乔安娜·布里格斯研究所（JBI）开发的标准化批判性评估工具对所选文章的质量进行评估。
研究结果显示，印度ECHO与专家和机构积极合作，在12个邦/联邦属地开展项目和网络研讨会，以提高专业人员在癌症护理方面的专业知识。尽管已发表的文献有限，但强调了ECHO的培训影响，知识增益范围从7%至51%。通过24个在肿瘤学领域实施ECHO项目的机构/中心可以明显看出该模式的采用、保留和覆盖范围。然而，也观察到了诸如前后评估回应率低和网络连接等挑战。
印度ECHO在癌症护理方面的工作意义重大，弥补了劳动力能力方面的差距。该系统综述强调需要更多出版物来全面了解ECHO的影响。这些研究结果为当前减轻印度癌症负担和改善民众福祉的努力提供了宝贵的见解。
