A qualitative study of health care providers’ uptake of the Project Extension for Community Health Outcomes (ECHO) for chronic pain
Qualitative inquiry of Project ECHO chronic pain
Article [Accepted Manuscript]
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Lippincott, Williams and WilkinsAuthor(s)
Affiliation
Abstract(s)
Introduction: There is an enormous need for pain education among all health care professions before and after licensure. The
study goal was to explore generic and chronic pain–specific factors that influenced uptake of a continuous education program for
chronic pain, the Project Extension for Community Health Outcomes (ECHO) CHUM Douleur chronique.
Methods: The study team conducted 20 semistructured virtual interviews among participants of the program. Interviews were
transcribed verbatim, and two analysts used a reflexive thematic analysis approach to generate study themes.
Results: Five aspects facilitating engagement, continued participation, and uptake of the Project ECHO were identified: rapid
access to reliable information, appraising one’s knowledge, cultivating meaningful relationships, breaking the silos of learning and
practice, and exponential possibilities of treatment orchestrations for a complex condition with no cure. Although participants’
experiences of the program was positive overall, some obstacles to engagement and continued participation were identified:
heterogeneity of participants’ profiles, feelings of powerlessness and discouragement in the face of complex incurable pain
conditions, challenges in applying recommendations, medical hierarchy, and missed opportunity for advocacy.
Discussion: Many disease-specific and contextual factors contributed to an increased motivation to participate in the ECHO
program. Some elements, such as the complexity of diagnosis and treatment, and the multidisciplinary requirements to manage
cases were identified as elements motivating one’s participation in the program but also acting as a barrier to knowledge uptake.
These must be understood in the broader systemic challenges of the current health care system and lack of resources to access
allied health care.
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