Enhancing cancer prevention and survivorship care with a videoconferencing model for continuing education: a mixed-methods study to identify barriers and incentives to participation

Abstract

Objective To enhance cancer prevention and survivorship care by local health care providers, a school of public health introduced an innovative telelearning continuing education program using the Extension for Community Healthcare Outcomes (ECHO) model. In ECHO’s hub and spoke structure, synchronous videoconferencing connects frontline health professionals at various locations (“spokes”) with experts at the facilitation center (“hub”). Sessions include experts’ didactic presentations and case discussions led by spoke site participants. The objective of this study was to gain a better understanding of the reasons individuals choose or decline to participate in the Cancer ECHO program and to identify incentives and barriers to doing so. Materials and methods Study participants were recruited from the hub team, spoke site participants, and providers who attended another ECHO program but not this one. Participants chose to take a survey or be interviewed. The Consolidated Framework for Implementation Research guided qualitative data coding and analysis. Results We conducted 22 semistructured interviews and collected 30 surveys. Incentives identified included the program’s high-quality design, supportive learning climate, and access to information. Barriers included a lack of external incentives to participate and limited time available. Participants wanted more adaptability in program timing to fit providers’ busy schedules. Conclusion Although the merits of the Cancer ECHO program were widely acknowledged, adaptations to facilitate participation and emphasize the program’s benefits may help overcome barriers to attending. As the number of telelearning programs grows, the results of this study point to ways to expand participation and spread health benefits more widely.

Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review

“…Two of the studies identified were related to the Extension for Community Healthcare Outcome (ECHO) model which involved connecting the health workers at spoke sites with experts at the hub using videoconferencing [ 27 , 28 ]. These studies aimed to assess the educational outcomes of the programme and to gain a better understanding of the reasons individuals choose or decline to participate in the Cancer ECHO programme.…”

“…Two studies followed a mixed methods approach [ 24 , 25 ], four were observational studies [ 23 , 27 , 28 ] and one was a prospective study [ 26 ]. Overall, the studies highlighted that technology can be used for capacity building, providing specialised care in remote areas, and to navigate patients to facilities for diagnosis and treatment.…”

“…Two studies were based on the ECHO model, and both were published in 2022 [ 27 , 28 ]. The programme is aimed at capacity-building and sharing best cancer care practices with health care workers at the spoke sites.…”

An evaluation of an Extension for Community Healthcare Outcomes (ECHO) intervention in cancer prevention and survivorship care

“…A further in-depth investigation into the identified PCP participation issue is warranted before undertaking a full-scale effectiveness and scalability study. The barriers and incentives to PCPs’ participation were the focus of our prior study, which revealed desired adaptations to better meet PCPs’ needs [ 23 ].…”

“…The final questions asked interviewees to compare this program with other continuing medical education, identify barriers to attending, and suggest improvements. (For the full interview guide, see Milgrom et al [ 23 ]).…”