Building Complex Care Capacity in Primary Care: An Educational Evaluation of Project ECHO Ontario Integrated Mental and Physical Health

Background: Project Extension for Community Health-care Outcomes (ECHO) is a virtual training and capacity building model that uses videoconferencing to link expert interdisciplinary teams with primary care clinicians in local communities. In this study, we evaluated ECHO Ontario Integrated Mental and Physical Health (ECHO-IMPH). This is the first consultation-liaison psychiatrist-led Project ECHO explicitly designed to support health care providers (HCPs) within primary care in delivering better care for patients with co-occurring mental and physical health needs. We assessed the impact of ECHO-IMPH on HCP engagement, learning, and practice change. Methods: Using Moore's Evaluation Framework, we used attendance logs and weekly surveys to investigate HCP engagement and satisfaction with ECHO-IMPH, as well as questionnaires to assess impact on their learning, self-efficacy, and practice change with respect to patient care. A pre-post design was used to assess change in the latter. Results: A total of 322 HCPs participated in ECHO-IMPH across five cycles. High mean ratings were observed for satisfaction across all five cycles (4.35 +/- 0.59). Precycle and postcycle questionnaires were available for 145 participants, allowing for paired comparison. Mean self-efficacy scores were significantly higher after the cycle than that before (64.26 +/- 15.63 to 78.15 +/- 11.44; t(144) = 11.61, P , 0.001, d = 1.03). Over 80% of participants reported changes in their professional practice post ECHO-IMPH. Conclusions: This is the first study to describe the impact of a Project ECHO led by consultation-liaison psychiatrists focused on integrated mental and physical health care and to demonstrate that this can be effective in changing HCP professional practice and self-efficacy, with high engagement and satisfaction.

Automated summary

The study evaluated the impact of ECHO-IMPH led by consultation-liaison psychiatrists on primary care providers in delivering care for patients with co-occurring mental and physical health needs. Results showed that ECHO-IMPH helped increase HCP engagement, learning, and practice change, with over 80% of participants reporting changes in their professional practice post-project.