Enhancing Hepatitis B Care Competency through Project ECHO: A Program Evaluation

Abstract

Background: Despite the availability of evidence-based testing and treatment guidelines for hepatitis B virus (HBV), there is a substantial gap in their use. As a result, chronic HBV is considerably underdiagnosed and undertreated in the US. Methods: This study examines the impact of a hepatitis B provider-training program to improve the knowledge and competence of primary care providers (PCPs) in managing hepatitis B (HBV). Project ECHO (Extension for Community Health Outcomes) seeks to bridge knowledge gaps by connecting PCPs with expert-guided education on HBV care. The HBV Project ECHO program offers monthly educational webinars focusing on key aspects of HBV care including testing, treatment, prevention, and complications. Participants self-assessed their competence in key aspects of HBV care via pre-and post-session surveys. The assessed topics included: identifying patients for screening, identifying treatment candidates, assessing liver damage, managing HBV patients, and educating others about HBV. Results: Analysis indicates a positive shift in the perceived abilities in all five areas assessed. The findings emphasize the established role of the ECHO model in decentralizing HBV management and empowering PCPs to improve their clinical practices. Ultimately, our findings suggest the program has been successful in its aim to enhance the care of patients with HBV. As the HBV landscape evolves in the US, the flexible and adaptive nature of the ECHO model proves vital in meeting the educational needs of PCPs. This study underscores the importance of continuous evaluation. Contributions to the Literature• There is limited research on effective models for hepatitis B provider training programs globally, that work to decentralize hepatitis B service delivery. • This program evaluation demonstrates the clear successes, impact and need for expansion of Project ECHO models in educating providers at the primary care level on hepatitis. • The World Health Organization's (WHO) elimination goals call for improved testing and management for hepatitis B, to improve testing, care delivery services should be expanded, and decentralization of care should also be expanded. Project ECHO is an opportunity to help work towards these WHO elimination goals.• Study findings highlight the importance and impact of Project ECHO for hepatitis B provider training programs.