Using the project ECHOâ„¢ model to teach mental health topics in rural Guatemala: An implementation science-guided evaluation

Francisco Javier de la Garza Iga, Marinés Mejía Alvarez, Joshua D Cockroft, Julia Rabin, Ana Cordón, Dina Maria Elias Rodas, Maria del Pilar Grazioso, Maria Espinola, Christine O’Dea, Charles Schubert and Shanna D Stryker

International Journal of Social Psychiatry, 2023, vol. 69, issue 8, 2031-2041

Abstract: Background: Mental health (MH) disorders are major causes of disability in Guatemala. Unfortunately, limited academic training and funding resources make MH care inaccessible to most people in rural Guatemala. These disparities leave many indigenous populations without care. Project ECHOâ„¢ is an educational model used globally to deliver virtual training for providers in rural/ underserved communities. The aim of this project was to implement and evaluate a Project ECHOâ„¢ program bridging MH training gaps for providers who serve rural communities in Guatemala. Methods: The Project ECHOâ„¢ curriculum was implemented through a partnership between educational and nonprofit institutions in Guatemala City and the United States. Participants were primary care physicians and nurses working in rural Guatemala as well as medical/nursing/psychology students. Evaluation of its implementation was guided by a RE-AIM framework. Reach, effectiveness, adoption, fidelity, sustainability, acceptability, feasibility, and appropriateness were evaluated using a mixed-methods approach, using a pre-post survey and semi-structured focus groups. Results: Forty unique participants attended the five sessions. Attitudes about mental health did not change quantitatively but self-efficacy improved in four of five modules. High quality fidelity scores were noted in two of five sessions. Sustainability scores across multiple domains were highly rated. Scores on instruments measuring acceptability, feasibility, and appropriateness were high. Focus groups showed two main themes: the curriculum filled a gap in education and further adaptation of the model might help improve the experience. Conclusion: Implementation of the Project ECHOâ„¢ educational model appeared to have good reach/adoption, showed improvements in self-efficacy, illuminated facilitators and barriers to sustainability, and was felt to be acceptable, feasible, and appropriate. Qualitative analysis supported these conclusions. Future directions would include ongoing evaluation and monitoring of further Project ECHOâ„¢ curricular experiences through this partnership and adaptation of this project to other learners and settings in Latin America.

Keywords: Virtual; Latin America; depression; primary care; indigenous; medical education; nurse; alcohol; women’s mental health; stress (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:69:y:2023:i:8:p:2031-2041

DOI: 10.1177/00207640231188038

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