Tarfa Adati, Fadul Nada, Stohs Erica, Wetherhold Jeffrey, Kebede Mahelet, Mirghani Nuha, Ashraf Muhammad Salman
School of Medicine, Yale University, New Haven, CT, United States.
Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States.
JMIR Res Protoc. 2025 May 16;14:e60901. doi: 10.2196/60901.
The COVID-19 pandemic has underscored the need for targeted interventions to address health care disparities among specific health care professionals and mitigate the impact of the virus. In response, we developed a comprehensive statewide educational program protocol focused on subject areas of health equity, cultural sensitivity, infection prevention and control (IPC), and quality improvement (QI).
The project aims to improve health care professionals' knowledge and practice skills in the 4 subject areas, increase their comfort level in implementing health disparities-related QI projects, and facilitate the successful completion of QI projects addressing COVID-19 health disparities within their practice settings.
The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used in the planning and evaluation of this innovative educational program, which combines the Extension for Community Healthcare Outcomes (ECHO) learning model with one-on-one QI coaching. Participants engage in virtual interactive sessions led by experts and consultants, covering didactic presentations, case discussions, COVID-19 updates, and assessments. QI and health equity coaches provide guidance on developing QI projects targeting COVID-19 and other health disparities. Evaluation surveys are used for baseline, midpoint, and end-of-program assessment for self-reported comfort levels with knowledge and practice-based learning competencies in all 4 subject areas and health disparities-related QI project implementation. The Wilcoxon rank-sum test and Cochran-Armitage trend test will be used to compare pre- and postsurvey responses. Data from semistructured qualitative interviews, which capture insights into participants' application of ECHO training, will be analyzed using an inductive content analysis approach.
A total of 50 ECHO sessions were held between November 2021 and May 2024. Overall, 510 participants attended at least one ECHO session, resulting in 3316 teaching encounters. The pre- and postsurvey data will be analyzed to study project impact and will be ready for publication in June 2026.
By using implementation science methods, an innovative and comprehensive educational protocol was developed that integrates the training curriculum, evaluation metrics, and coaching support, allowing for the translation of the training into actionable community projects focused on addressing health disparities. This model has shown initial promise in terms of feasibility and uptake. Further studies are needed to evaluate the long-term effectiveness of these QI projects in reducing COVID-19 disparities.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/60901.
2019冠状病毒病（COVID-19）大流行凸显了采取针对性干预措施的必要性，以解决特定医疗保健专业人员之间的医疗保健差异，并减轻该病毒的影响。作为回应，我们制定了一项全州范围的综合教育计划方案，重点关注健康公平、文化敏感性、感染预防与控制（IPC）以及质量改进（QI）等主题领域。
该项目旨在提高医疗保健专业人员在这4个主题领域的知识和实践技能，增强他们实施与健康差异相关的质量改进项目的舒适度，并促进在其实践环境中成功完成解决COVID-19健康差异的质量改进项目。
在该创新教育计划的规划和评估中使用了“普及、有效性、采用、实施和维持”（RE-AIM）框架，该计划将社区医疗保健成果扩展（ECHO）学习模式与一对一的质量改进指导相结合。参与者参加由专家和顾问主持的虚拟互动课程，内容包括理论讲座、病例讨论、COVID-19最新情况和评估。质量改进和健康公平教练为制定针对COVID-19和其他健康差异的质量改进项目提供指导。评估调查用于项目基线、中点和结束时的评估，以自我报告在所有4个主题领域以及与健康差异相关的质量改进项目实施方面基于知识和实践的学习能力的舒适度。将使用Wilcoxon秩和检验和Cochran-Armitage趋势检验来比较调查前后的回答。来自半结构化定性访谈的数据，这些数据捕捉了参与者对ECHO培训应用的见解，将使用归纳性内容分析方法进行分析。
2021年11月至2024年5月期间共举办了50次ECHO课程。总体而言，510名参与者至少参加了一次ECHO课程，产生了3316次教学互动。将对调查前后的数据进行分析以研究项目影响，并将于2026年6月准备好发表。
通过使用实施科学方法，开发了一种创新的综合教育方案，该方案整合了培训课程、评估指标和指导支持，从而能够将培训转化为专注于解决健康差异的可操作社区项目。该模式在可行性和接受度方面已显示出初步前景。需要进一步研究来评估这些质量改进项目在减少COVID-19差异方面的长期有效性。
国际注册报告识别码（IRRID）：DERR1-10.2196/60901。
