scholarly journals Capacity Building in Cancer Screening Using ECHO (Extension for Community Healthcare Outcomes): Innovative and Cost-Effective Model

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 160s-160s
Author(s):  
R. Hariprasad ◽  
R. Babu ◽  
S. Arora ◽  
R. Mehrotra
Keyword(s):  
Health Care ◽  
Cancer Screening ◽  
Training Program ◽  
Health Care Providers ◽  
Screening Program ◽  
Cost Effective ◽  
Population Based ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Community Healthcare

Background and context: Three most common cancers in India are breast, uterine cervix and oral cavity, together accounting for approximately 34% of all cancers. Ministry of Health and Family Welfare, India has released an operational guidelines for cancer screening last year and has urged all the states to roll out population based cancer screening at various health care levels. As per these guidelines, the existing health care providers (HCPs) at various facilities would be rolling out the population based cancer screening in the country. However, the existing HCPs lack the skills and are not trained in cancer screening. Considering the size of the country, it is neither a feasible nor economically viable to provide in-person training for all cadres of HCPs. The limitation is comprehensively overcome by ECHO (Extension for Community Healthcare Outcomes) model provides a cost effective way to exponentially expand the capacity to mentor and train these HCPs in cancer screening best practices. ECHO as per the motto to “move knowledge rather than patients or doctors”, uses widely available one to many video-conferencing technology, didactic presentations and case based learning techniques to mentor and support HCPs to implement best practices in the field. In teleECHO clinics expert teams at an academic “hub” partner with willing participants to participate in knowledge networks in which all teach and all learn. Aim: To train the health care providers in cancer screening through technology assisted learning. Strategy/Tactics: A structured training program was designed using ECHO platform for all HCPs in separate batches that included, gynecologists, dentists and community health workers (CHWs), by virtual training to address all issues while they roll out cancer screening in their communities. Program/Policy process: A structured course of 20 week-sessions' virtual (online) cancer screening training program for various cadres of health care providers was undertaken. A typical one hour of ECHO session consisted of 25-30 minutes of didactics by the expert followed by 2 case presentations by the spokes. A “Beginner´s program” was well received by the participants who requested us to take it ahead with “Advanced training program” for specialists. Outcomes: 58 participants completed the course in cancer screening. The pre- and posttraining knowledge evaluation demonstrated a significant increase in the knowledge gained by participants. What was learned: In a resource constrained environment it is feasible to develop a basic curriculum in cancer screening program and train and support, all cadres of HCPs. Rolling out a technology enabled model such as ECHO for teaching and training can enable the development of a population based cancer screening program.

scholarly journals Attitudes and Perceptions of Health Care Providers About the Implementation of Population Based Cancer Screening Program in India. A study From Assam

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 53s-53s
Author(s):  
A. Kedar ◽  
R. Hariprasad ◽  
R. Kanan ◽  
R. Mehrotra
Keyword(s):  
Health Care ◽  
Cancer Screening ◽  
Health Care Providers ◽  
Screening Program ◽  
Healthcare Providers ◽  
Population Based ◽  
Care Providers ◽  
Cancer Screening Program ◽  
Attitudes And Perceptions ◽  
Study Participants

Background: India is facing noncommunicable diseases epidemic with cancer as one of the main reasons of mortality. To bring this epidemic under control and as a measure of secondary prevention, government of India has rolled out operational framework for population cancer screening. As cancer screening is a new concept for Indian health care providers, this study focuses on the attitudes and perceptions of HCP from a district in Assam. Aim: To know the attitudes and perceptions of healthcare providers in Assam about the implementation of population based cancer screening program in India. Methods: This study was a part of ongoing Indian Council of Medical Research project at Cachar district, Assam. The study was conducted at Silchar, Assam and the study participants were attendees of the master trainers' workshop which was conducted for the pilot cancer screening program rolled out in Cachar district, Assam. Self-administered questionnaires were used to collect data from the health care providers on the last day of the training. Data were gathered from 58 participants. The participants were medical officers, auxillary nurse midwives (ANM), accredited social health activists (ASHA), staff nurses, nongovernmental organization (NGO) representatives and other health care providers from public health facilities. Results: Majority of the study participants agreed with the concept of screening. Half of the study participants stated that they could conduct screening comfortably along with their other responsibilities. Lack of human resources and an overburdened human resource were the main challenges foreseen in the implementation of the program. 91% of the participants wanted GOI to implement the cancer screening program. Majority of the health personnel were in favor of primary health center (PHC) as the first preferable site of population cancer screening followed by subcenter being second on preference for screening. One-third of study participants opined that screening should be done by specialist doctors. Almost one fifth of participants stated that ASHA should do the screening and almost same number of participants thought that medical officer at PHC should do the screening. Conclusion: This is the first pilot study on the population based cancer screening guidelines released by the government of India. The organized screening program is yet to be rolled out in the country. Though many challenges were foreseen by the healthcare providers in carrying out the population based cancer screening, majority were optimistic for the implementation of this screening program.

scholarly journals Retention of Knowledge Levels of Health Care Providers in Cancer Screening Through Telementoring

2018 ◽  
pp. 1-7 ◽  
Author(s):  
Roopa Hariprasad ◽  
Sanjeev Arora ◽  
Roshani Babu ◽  
Latha Sriram ◽  
Sarita Sardana ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cancer Screening ◽  
Training Program ◽  
Health Care Providers ◽  
Knowledge Level ◽  
Care Providers ◽  
Screening Programs ◽  
Primary Health ◽  
Retention Of Knowledge

Purpose Every year > 450,000 individuals are diagnosed with cancer and approximately 350,000 die of it in India. The Ministry of Health and Family Welfare has released an Operational Framework for the Management of Common Cancers that highlights population-based cancer screening programs in primary health care facilities by health care providers (HCPs) and capacity building of HCPs. The purpose of this study is to present a low-cost training model that is highly suitable for resource-deficient settings, such as those found in India, through Extension for Community Health Outcome (ECHO), a knowledge-sharing tool, to enable high-quality training of HCPs. Materials and Methods An in-person, 3-day training program was conducted for 27 HCPs in the tribal primary health care center of Gumballi in Karnataka, India, to teach the basics of cancer screening in oral, breast, and cervical cancer. The training of HCPs was done using the ECHO platform while they implemented the cancer screening, thus enabling them to build the much needed knowledge and skill set to conduct cancer screening in their respective communities. Results The knowledge level of the HCPs was tracked before the intervention, immediately after the 3-day training program, and 6 months after the ECHO intervention, which clearly showed progressive acquisition and retention of knowledge. A marked improvement in knowledge level score from an average of 6.3 to 13.7 on a 15-point scale was noticed after the initial in-person training. The average knowledge further increased to a score of 14.4 after 6 months as a result of training using the ECHO platform. Conclusion ECHO is an affordable and effective model to train HCPs in cancer screening in a resource-constrained setting.

scholarly journals Grassroots Partnership to See and Treat Cervical Cancer in Rural Uganda

2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 14s-14s
Author(s):  
William Cherniak ◽  
Eben Stern ◽  
Carol Picart ◽  
Sarah Sinasac ◽  
Carolyn Iwasa ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Training Program ◽  
Cervical Cancer Screening ◽  
Health Care Providers ◽  
Care Providers ◽  
Educational Training ◽  
Ministry Of Health ◽  
Southwestern Uganda

Abstract 9 Background: In Uganda, cervical cancer is the leading cause of cancer death, affecting 45 in every 100,000 women annually and killing 25 in every 100,000 annually. To effect change, two Canadian registered charities partnered with a Ugandan nongovernmental organization, a university, and the Ministry of Health to develop a novel screening, treatment, and educational training program. The two major goals of our program were to develop a training program for health care providers in southwestern Uganda for visual inspection of the cervix with acetic acid (VIA) and a cryotherapy see and treat model; and to implement the first cervical cancer screening program of its kind in the Kabale region of southwestern Uganda. Methods: Our program was developed in partnership with Mbarara University of Science and Technology, a grass-roots Ugandan community development organization (Kigezi Healthcare Foundation [KIHEFO]), a Canadian charity that is focused on providing medical and dental care and educational training and infrastructure development (Bridge to Health Medical and Dental), and a Canadian charity that is focused on treatment for advanced cervical cancer (Road to Care). Results: Requisite supplies were obtained by Bridge to Health Medical and Dental and left behind with KIHEFO. A partnership was formed between academia, government, and civil society across Canada and Uganda. Over 5 days, 15 Ugandan health care workers were trained in VIA and cryotherapy, and 96 patients were screened for cervical cancer. Six patients were successfully treated for precancerous lesions. One biopsy was sent for pathology review and analysis. Conclusion: Since the pilot program, KIHEFO has conducted two additional cervical cancer screening programs using VIA and the see and treat approach. A new cervical cancer screening and treatment campaign, along with a quality control and educational training refresher, for the original 15 health care providers is planned for February 2017. Funding: Bridge to Health Medical and Dental and Kigezi Healthcare Foundation in partnership with the Ugandan Ministry of Health. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

scholarly journals Innovative COVID-19 Programs to Rapidly Serve New Mexico

2020 ◽  
Vol 136 (1) ◽  
pp. 39-46
Author(s):  
Joanna G. Katzman ◽  
Laura E. Tomedi ◽  
Karla Thornton ◽  
Paige Menking ◽  
Michael Stanton ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Critical Care ◽  
New Mexico ◽  
General Education ◽  
Health Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Project Echo

Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico is a telementoring program that uses videoconferencing technology to connect health care providers in underserved communities with subject matter experts. In March 2020, Project ECHO created 10 coronavirus disease 2019 (COVID-19) telementoring programs to meet the public health needs of clinicians and teachers living in underserved rural and urban regions of New Mexico. The newly created COVID-19 programs include 7 weekly sessions (Community Health Worker [in English and Spanish], Critical Care, Education, First-Responder Resiliency, Infectious Disease Office Hours, and Multi-specialty) and 3 one-day special sessions. We calculated the total number of attendees, along with the range and standard deviation, per session by program. Certain programs (Critical Care, Infectious Disease Office Hours, Multi-specialty) recorded the profession of attendees when available. The Project ECHO research team collected COVID-19 infection data by county from March 11 through May 31, 2020. During that same period, 9765 health care and general education professionals participated in the COVID-19 programs, and participants from 31 of 35 (89%) counties in New Mexico attended the sessions. Our initial evaluation of these programs demonstrates that an interprofessional clinician group and teachers used the Project ECHO network to build a community of practice and social network while meeting their educational and professional needs. Because of Project ECHO’s large reach, the results of the New Mexico COVID-19 response suggest that the rapid use of ECHO telementoring could be used for other urgent national public health problems.

scholarly journals Evaluation of Sensitization Program on Occupational Health Hazards for Nursing and Allied Health Care Workers in a Tertiary Health Care Setting

2021 ◽  
Vol 9 ◽  
Author(s):  
Manisha Naithani ◽  
Meenakshi Khapre ◽  
Rajesh Kathrotia ◽  
Puneet Kumar Gupta ◽  
Vandana Kumar Dhingra ◽  
...  
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Training Program ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Needlestick Injury ◽  
Incident Reporting ◽  
Health Hazards ◽  
Care Providers ◽  
Care Workers

Background: Occupational health hazard pertaining to health care providers is one of the neglected areas that need serious attention. Any compromise in their safety would result in reduction in workforce, which may affect patient care, keeping in mind the wide gap between the required number and actual health care workers (HCWs) available in the world over.Aim: This study was undertaken to evaluate the change in knowledge through a sensitization training program on occupational health hazards and vaccination for HCWs.Materials and Methods: Participants of the study included nursing and allied HCWs of a tertiary care health institute in Uttarakhand, India. Multiple training sessions, each of around 180 min, were held periodically in small groups with 20–40 participants over 2 years. Participants were assessed with pretest and posttest questionnaires, and feedback was taken. Questionnaires comprised three categories: general safety and ergonomics, biological hazards, and chemical and radiation hazards. Data of incident reporting for needlestick injury from 2017 to 2019 were retrieved. All data were compiled in Excel sheet and analyzed.Results: A total of 352 participants were included in the study. Mean ± SD for pretest and posttest scores were 5.3 ± 2.13 and 11.22 ± 2.15, respectively. There was considerable improvement in knowledge, which was found to be statistically significant with p-value of 0.001 for all categories. Participants in their feedback suggested for inclusion of psychosocial aspect in further training programs.Conclusion: Low baseline knowledge prior to attending the course highlights a need for an intervention through such structured sensitization program to create awareness and educate HCWs on common occupational health hazards and vaccination. Statistically significant improvement in posttest knowledge highlights effectiveness of the training program. A drastic rise in incident reporting for needlestick injury reflects fairly good impact of training program. Regular and appropriate form of training can reduce injuries resulting from occupational hazards and ensure healthy workforce contributing toward a positive impact on national economy.

scholarly journals Has Metal-On-Metal Resurfacing Been a Cost-Effective Intervention for Health Care Providers?—A Registry Based Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165021
Author(s):  
Ruth Pulikottil-Jacob ◽  
Martin Connock ◽  
Ngianga-Bakwin Kandala ◽  
Hema Mistry ◽  
Amy Grove ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cost Effective ◽  
Effective Intervention ◽  
Care Providers ◽  
Metal On Metal

scholarly journals Development and evaluation of a culturally appropriate hypertension education (CAHE) training program for health care providers

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0178468 ◽  
Author(s):  
Jennita G. Meinema ◽  
Joke A. Haafkens ◽  
Debbie A. D. C. Jaarsma ◽  
Henk C. P. M. van Weert ◽  
Nynke van Dijk
Keyword(s):  
Health Care ◽  
Training Program ◽  
Health Care Providers ◽  
Culturally Appropriate ◽  
Care Providers

scholarly journals A Personalized Approach of Patient–Health Care Provider Communication Regarding Colorectal Cancer Screening Options

2018 ◽  
Vol 38 (5) ◽  
pp. 601-613 ◽  
Author(s):  
M. Gabriela Sava ◽  
James G. Dolan ◽  
Jerrold H. May ◽  
Luis G. Vargas
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Medical Decision ◽  
Average Risk ◽  
Care Providers

Background. Current colorectal cancer screening guidelines by the US Preventive Services Task Force endorse multiple options for average-risk patients and recommend that screening choices should be guided by individual patient preferences. Implementing these recommendations in practice is challenging because they depend on accurate and efficient elicitation and assessment of preferences from patients who are facing a novel task. Objective. To present a methodology for analyzing the sensitivity and stability of a patient’s preferences regarding colorectal cancer screening options and to provide a starting point for a personalized discussion between the patient and the health care provider about the selection of the appropriate screening option. Methods. This research is a secondary analysis of patient preference data collected as part of a previous study. We propose new measures of preference sensitivity and stability that can be used to determine if additional information provided would result in a change to the initially most preferred colorectal cancer screening option. Results. Illustrative results of applying the methodology to the preferences of 2 patients, of different ages, are provided. The results show that different combinations of screening options are viable for each patient and that the health care provider should emphasize different information during the medical decision-making process. Conclusion. Sensitivity and stability analysis can supply health care providers with key topics to focus on when communicating with a patient and the degree of emphasis to place on each of them to accomplish specific goals. The insights provided by the analysis can be used by health care providers to approach communication with patients in a more personalized way, by taking into consideration patients’ preferences before adding their own expertise to the discussion.

Knowledge Based Commissioning: Can a National Clinical Effectiveness Policy Be Compatible with Seeking Local Professional Advice?

1996 ◽  
Vol 1 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Peter Littlejohns ◽  
Carol Dumelow ◽  
Sian Griffiths
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Care Providers ◽  
Professional Advice ◽  
Knowledge Based ◽  
Artery Disease ◽  
Health Care Purchasing ◽  
The Right

Objectives: To help develop a means, based on the views of purchasers and providers of health care, of incorporating national research on clinical effectiveness into local professional advisory mechanisms in order to inform health care purchasing and contracting. Methods: Three geographically based multidisciplinary workshops attended by National Health Service (NHS) staff drawn from the principal purchaser and provider groups in one English region were organized around the discussion of three health care purchasing case studies: Coronary artery disease, diabetes and management of clinical depression in general practice. The proceedings were transcribed and analyzed using content analysis methods. Results: 95 people took part. There were major differences between the purchasers' and health care providers' views on the right balance between local and national information and advisory sources for purchasing. In general, providers wanted the provision of advice to purchasers to be local, in which their opinion was sought, either individually or collectively, acted on and the results fed back to them. In contrast, health authority purchasers considered that local professionals were only one source of professional advice, albeit an important one, to be utilized in coming to decisions. General practitioner fundholders as purchasers, however, preferred to rely on their own experiences and contacts with local providers in making purchasing decisions. Conclusions: Professional specialist advisory groups are necessary to inform the purchasing of health care, but should extend beyond advising on the placement of individual contracts. Involving health care providers in all short-term contracting is unlikely to be cost-effective given the time commitment required. The emphasis at purchaser/provider meetings should be on education: Providing an opportunity for purchasers and providers to develop closer relationships to discuss political imperatives and financial constraints; increasing communication and understanding of providers' and purchasers' roles; and providing an environment for professionals and purchasers to share their views on purchasing. As currently presented, elements of the national policies in the NHS advocating the use of both national evidence on clinical effectiveness and local professional advice are contradictory and should be clarified.

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