Project ECHO: a Potential Best-Practice Tool for Training Healthcare Providers in Oral Cancer Screening and Tobacco Cess

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Project ECHO: a Potential Best-Practice Tool for Training Healthcare Providers in Oral Cancer Screening and Tobacco Cessation Suzanne Tanya Nethan 1 & Roopa Hariprasad 1

&

Roshni Babu 2 & Vipin Kumar 1 & Shashi Sharma 3 & Ravi Mehrotra 4

# American Association for Cancer Education 2019

Abstract The oral cancer pandemic and inadvertent tobacco consumption have rendered timely oral cavity screening and tobacco cessation essential, skills which most healthcare providers (HCPs) lack. Project BExtension for Community Healthcare Outcomes^ (ECHO) is a proven best-practice tool for virtual telementoring of primary care providers by experts at academic health centers, in managing complex medical conditions in rural, expert-deficient setups. For the first time, our organization in India has utilized this method for training HCPs in oral cancer screening, across the country and abroad. The program comprised eight, weekly, hour-long sessions, on oral cancer screening and tobacco cessation, hosted online by our Organization (hub) through the Zoom web-conferencing application, with 48 HCPs (spokes) attending from their respective locations (pan-India, n = 47; Libya, n = 1). Each session comprised one expert-led didactic and two participant-led case presentations, culminating with educative discussions. Participants filled out online, program-evaluation (pre and post) questionnaires having 10 similar, multiple-choice questions each (score for every correct response = 1); total responses were later statistically analyzed. Lesser participants completed the post-evaluation questionnaire which could be due to it being optional, their busy schedule, or apprehension of being assessed. The program evaluation results illustrate a significant knowledge gain among participants regarding oral cancer screening and tobacco cessation, i.e., from a mean knowledge score of 6.7 in pre-evaluation to 7.4 in post-evaluation (p < 0.05). Thus, the ECHO model can be utilized as a convenient, cost-effective, large-scale, best-practice, telementoring tool for training HCPs in oral cancer screening and tobacco cessation, especially in populous, resource-deficient countries. Keywords Healthcare providers . Telementoring . Oral cancer screening . Tobacco cessation . Project ECHO

Introduction Oral cancer is one of the most common cancers globally, having a higher incidence among men than in women [1]. Oral cavity and lip cancers are widely prevalent in Southern Asia (examples: India and Sri Lanka) and the Pacific Islands (Papua New Guinea has the highest global incidence rate in both genders). It is also the leading cause of cancer mortality * Roopa Hariprasad [email protected] 1

Clinical Oncology, Indian Council of Medical Research-National Institute of Cancer Prevention and Research (ICMR-NICPR), I-7, Sector 39, Noida, Uttar Pradesh 201301, India

2

NICPR-ECHO, ICMR-NICPR, I-7, Sector 39, Noida, Uttar Pradesh 201301, India

3

Epidemiology & Biostatistics, ICMR-NICPR, I-7, Sector 39, Noida, Uttar Pradesh 201301, India

4

ICMR-NICPR, I-7, Sector 3