Evidence-based harm reduction training via ECHO: A mentor facilitated educational training for behavioral health providers.

Abstract

Background and objectives: Harm reduction strategies are essential to reducing morbidity and mortality associated with substance use disorders (SUD), yet many healthcare providers report limited training, knowledge gaps, and low confidence in implementing these approaches. Project ECHO (Extension for Community Healthcare Outcomes) offers a virtual telementoring model to address workforce education gaps. This study evaluated the educational impact of an ECHO-based harm reduction training program for behavioral health providers.

Methods: Seven harm reduction training sessions were delivered between July and November 2025 through a Project ECHO. Sessions included didactic content and facilitated discussion. Participants completed postsession surveys assessing self-reported knowledge, relevance to clinical practice, intention to apply learning, and instructional balance. Descriptive analyses were conducted using ECHO platform analytics.

Results: A total of 186 participants registered, with 93 attendees across sessions. The audience was multidisciplinary, predominantly physicians. Self-reported knowledge improved following training, with the proportion reporting high knowledge increasing from 37.9% pre-session to 75.9% post-session. Most participants rated the content as very or extremely relevant (82.8%) and reported definite or probable intent to apply learning (93.1%). The majority endorsed an appropriate balance of didactic and interactive components.

Discussion and conclusions: ECHO-based harm reduction training was feasible and associated with meaningful improvements in provider knowledge, relevance, and intention to implement harm reduction strategies.

Scientific significance: This study supports Project ECHO as a scalable model to disseminate harm reduction education and strengthen the behavioral health workforce in community settings.