Implementation and evaluation of a Project ECHO for national cancer control plan implementation in low- and middle-income countries

Abstract

Background

The International Cancer Control Partnership (ICCP) ECHO uses a technology-enabled learning model for knowledge exchange on National Cancer Control Plans (NCCP) implementation strategies for low- and middle-income countries. We evaluated the use of this platform to bring together Ministry of Health-led, transdisciplinary teams in monthly, one-hour sessions with experts and peer presentations between 2020 and 2023.

Methods

A pre-post mixed-methods design was used. Baseline and endpoint surveys (41/90, 46 %) measured changes in self-reported knowledge and confidence related to 12 strategies for NCCP implementation based on a four-point Likert scale. Comparisons were done using a paired T-test. Seven post-focus group discussions (FGDs) (6/12 countries, 50 %) captured the perceived utility of ECHO for implementing NCCP priorities. FGDs were audio-recorded, transcribed, double-coded, and underwent thematic analysis.

Results

Respondents reported high satisfaction with the curriculum, presentations, and format of the program; however, internet connectivity was a challenge, and duration was identified as an area for improvement. Average self-reported knowledge of and confidence using all 12 strategies increased significantly between pre- and post-surveys (p < 0.0001). Along with expert presentation, the peer-to-peer learning through case-based discussion enhanced their learning experience and ensured that the content was relevant. Some participants recommended incorporating additional one-on-one technical assistance during the program.

Conclusion

Study findings suggest this interactive, bidirectional knowledge exchange approach can be effective for improving knowledge and capacity for non-clinical, system-focused areas such as cancer control planning and policy implementation. Further study is warranted to understand how cancer planners utilize their learnings.