Introduction
To mitigate the lack of specialty healthcare, Project ECHO (Extension for Community
Health Outcomes) trains community-based primary care clinicians to better prevent
the progression of, manage, and treat common health conditions. ECHO-Chicago launched
in 2010 as the first urban-centered ECHO program, focusing on safety-net clinicians,
and has trained over 5,175 community clinicians across 34 topic areas. This paper
examines self-efficacy among ECHO-Chicago participants across 11 clinical series,
including a novel use of qualitative themes from self-efficacy questions.
Methods
Five years of baseline and postseries survey data were collected from 2014 to 2019,
resulting in 951 participants. Paired t-tests assessed change from baseline survey to postsurvey, and Cohen's d determined effect size. Change was assessed by individual series, adult or pediatric
focus, participants’ prescription privilege status, and across series by qualitative
question theme. Metrics included total change, any improvement, a 10% target, and
a clinical competency threshold. Analysis occurred from July 2020 to January 2022.
Results
All clinical series achieved statistically significant improvement in self-efficacy,
and most had a large effect size. A total of 88% had any improvement, 65% met the
10% target of 0.7 points, and 52% met the competency threshold of 5.0 in the postsurvey.
Prescribers had a significantly greater increase in their self-efficacy scores than
nonprescribers. With a comparison across series, each theme achieved statistical significance,
with most reaching large effect sizes.
Conclusions
ECHO-Chicago successfully increased participants’ self-efficacy. This inquiry adds
an urban focus, years of data, multiple series, and a novel qualitative theme component
to enable comparisons across rather than solely within the ECHO series.
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Published online: January 10, 2023
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