Project ECHO Cancer Initiative: a Tool to Improve Care and Increase Capacity Along the Continuum of Cancer Care

Varon, Melissa Lopez; Baker, Ellen; Byers, Emily; Cirolia, Lucca; Bögler, Oliver; Bouchonville, Matthew F.; Schmeler, Kathleen M.; Hariprasad, Roopa; Pramesh, C S; Arora, Sanjeev

doi:10.1007/s13187-021-02031-0

Cited by 19 publications

(17 citation statements)

References 43 publications

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“…The NICPR-ECHO training model is an important first step toward the implementation of cancer screening services in India, as per the national guidelines (Varon et al, 2021). Study findings support the effectiveness of the ECHO model in reaching primary care physicians across the country and improving their knowledge and skills related to screening for breast, oral, and cervical cancer, which are significant public health problems in India and other low-and middle-income countries.…”

Section: Discussionmentioning

confidence: 57%

Implementing Cancer Screening Programs by Training Primary Care Physicians in India—Findings from the National Institute of Cancer Prevention Research Project ECHO for Cancer Prevention

Adsul

Nethan

deCortina

et al. 2022

Glob Implement Res Appl

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In 2016, the Government of India launched a national program for screening and prevention of oral, breast, and cervical cancer. In support, the National Institute for Cancer Prevention Research (NICPR) adopted the Project ECHO (Extension for Community Healthcare Outcomes) model for training health care providers in cancer screening. We assess change in knowledge and skills among physicians attending hybrid (i.e., online and in person) NICPR-ECHO trainings and impact on implementation of cancer screening services. Prior to the start of the online phase and upon completion of 14 weeks, trainees answered a 23-item online questionnaire, including visual vignettes. We conducted descriptive and bivariate analysis of prepost assessments from trainees participating in the online phase and wherever available report on the weekly quizzes and the hands-on workshop assessments. A total of 641 medical officers participated in the trainings from May 2019 to February 2020. Across nine cohorts of trainees, only 116 primary care physicians completed both the pre-and post-assessments. Almost two-thirds completed medical training (69.7%) and 85% were working in government healthcare facilities. Trainees reported statistically significant improvements before and after the online phase, when queried specifically on knowledge and skills using visual vignettes about oral (p < 0.001), breast (p = 0.35), and cervical cancer screening (p < 0.001). Study findings support the effectiveness of Project ECHO in reaching primary care physicians across the country and improving their knowledge and skills related to screening for breast, oral, and cervical cancer, with additional support needed for implementation of clinical cancer screening services.

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Section: Discussionmentioning

confidence: 57%

Implementing Cancer Screening Programs by Training Primary Care Physicians in India—Findings from the National Institute of Cancer Prevention Research Project ECHO for Cancer Prevention

Adsul

Nethan

deCortina

et al. 2022

Glob Implement Res Appl

Self Cite

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“…Similar models in cancer care have already been successfully implemented. For example, the collaboration between Project ECHO (Extension for Community Healthcare Outcomes) and MD Anderson Cancer Center connects clinicians in rural and underserved settings with educational and mentoring resources to empower community clinicians and improve their ability to manage patients with complex presentations [ 46 , 47 ]. Future work should explore the application of similar models to scale up the delivery of CAR-T in community settings.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Collection of Patient-Reported Outcomes and Activity Data during CAR-T Therapy: Feasibility, Acceptability, and Data Visualization

Oswald

Carvajal

et al. 2022

Cancers

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Background: Clinicians must closely monitor patients for toxicities after chimeric antigen receptor T-cell therapy (CAR-T). Patient-reported outcomes (PROs) (e.g., toxicities, quality of life) and activity data (e.g., steps, sleep) may complement clinicians’ observations. This study tested the feasibility and acceptability of collecting PROs and activity data from patients with hematologic malignancies during CAR-T and explored preliminary data patterns. Methods: Participants wore a Fitbit tracker and completed PROs at several timepoints through 90-days post-infusion. Feasibility was assessed with a priori benchmarks for recruitment (≥50%), retention (≥70%), PRO completion (≥70%), and days wearing the Fitbit (≥50%). Acceptability was assessed with participant satisfaction (a priori benchmark > 2 on a 0–4 scale). Results: Participants (N = 12) were M = 66 years old (SD = 7). Rates of recruitment (68%), retention (83%), PRO completion (85%), and days wearing the Fitbit (85%) indicated feasibility. Satisfaction with completing the PROs (M = 3.2, SD = 0.5) and wearing the Fitbit (M = 2.9, SD = 0.5) indicated acceptability. Preliminary data patterns suggested that participants with better treatment response (vs. progressive disease) had a higher toxicity burden. Conclusions: Longitudinal PRO and activity data collection was feasible and acceptable. Data collected on a larger scale may be used to specify risk prediction models to identify predictors of severe CAR-T-related toxicities and inform early interventions.

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“…This has been supported by interventions like teleconsultations where electronic consultations between PCPs and HIV specialists allow PCPs to provide HIV care independently and reduce formal referrals [30]. The project Extension for Community Healthcare Outcomes (ECHO) demonstrates the success of an ongoing tele-mentoring model which allowing PCPs to provide high-quality specialty care including hepatitis C, HIV, diabetes and cancer [31][32][33][34]. Additional resources that can be helpful to PCPs include the dissemination of professional guidelines for cancer survivorship care.…”

Section: Discussionmentioning

confidence: 99%

Identifying the Needs of Primary Care Providers Caring for Breast and Colon Cancer Survivors in the Safety-Net: a Qualitative Study

et al. 2022

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As the number of cancer survivors continues to increase and given the shortage of oncology clinicians in safety net health care settings, primary care providers (PCPs) in these settings will increasingly provide cancer survivorship care. In order to ensure equitable care for low-income and underserved breast and colon cancer survivors, it is essential to understand the safety-net PCPs’ perspective. We conducted semi-structured, in-depth qualitative interviews with 11 PCPs working in a safety-net health care system to identify their needs in caring for cancer survivors. Interviews were audio-recorded and professionally transcribed. Two coders independently coded the interviews and conducted regular meetings until we reached consensus on the results. Analysis was based in grounded theory and performed using the constant comparative method. Thematic analysis identified six themes as follows: (1) Cancer survivorship care can be integrated with the whole person and chronic disease care management that occurs in primary care; (2) PCPs’ perceptions regarding patients’ survivorship care needs and their confidence in meeting those needs; (3) preference for a shared care model; (4) coordination of care; (5) PCPs’ need for survivorship care education and training; and (6) unique issues involved in the care of older cancer survivors. PCPs in the safety-net believe that providing comprehensive survivorship care requires coordination of care through the cancer continuum. Tools like checklists, electronic health records-based communication, and convenient electronic consultations with cancer specialists would enhance the quality of survivorship care. Respondents advocate the inclusion of survivorship care education in medical education. The continuity of care with PCPs means that they play a particularly important role in the care of older cancer survivors.

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Project ECHO Cancer Initiative: a Tool to Improve Care and Increase Capacity Along the Continuum of Cancer Care

Cited by 19 publications

References 43 publications

Implementing Cancer Screening Programs by Training Primary Care Physicians in India—Findings from the National Institute of Cancer Prevention Research Project ECHO for Cancer Prevention

Implementing Cancer Screening Programs by Training Primary Care Physicians in India—Findings from the National Institute of Cancer Prevention Research Project ECHO for Cancer Prevention

Longitudinal Collection of Patient-Reported Outcomes and Activity Data during CAR-T Therapy: Feasibility, Acceptability, and Data Visualization

Identifying the Needs of Primary Care Providers Caring for Breast and Colon Cancer Survivors in the Safety-Net: a Qualitative Study

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