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Browsing by Author "Janota, Andrea D."
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Item Enhancing cancer prevention and survivorship care with a videoconferencing model for continuing education: a mixed-methods study to identify barriers and incentives to participation(Oxford University Press, 2022-02-12) Milgrom, Zheng Z.; Severance, Tyler S.; Scanlon, Caitlin M.; Carson, Anyé T.; Janota, Andrea D.; Burns, John L.; Vik, Terry A.; Duwve, Joan M.; Dixon, Brian E.; Mendonca, Eneida A.; Epidemiology, School of Public HealthObjective: To enhance cancer prevention and survivorship care by local health care providers, a school of public health introduced an innovative telelearning continuing education program using the Extension for Community Healthcare Outcomes (ECHO) model. In ECHO's hub and spoke structure, synchronous videoconferencing connects frontline health professionals at various locations ("spokes") with experts at the facilitation center ("hub"). Sessions include experts' didactic presentations and case discussions led by spoke site participants. The objective of this study was to gain a better understanding of the reasons individuals choose or decline to participate in the Cancer ECHO program and to identify incentives and barriers to doing so. Materials and methods: Study participants were recruited from the hub team, spoke site participants, and providers who attended another ECHO program but not this one. Participants chose to take a survey or be interviewed. The Consolidated Framework for Implementation Research guided qualitative data coding and analysis. Results: We conducted 22 semistructured interviews and collected 30 surveys. Incentives identified included the program's high-quality design, supportive learning climate, and access to information. Barriers included a lack of external incentives to participate and limited time available. Participants wanted more adaptability in program timing to fit providers' busy schedules. Conclusion: Although the merits of the Cancer ECHO program were widely acknowledged, adaptations to facilitate participation and emphasize the program's benefits may help overcome barriers to attending. As the number of telelearning programs grows, the results of this study point to ways to expand participation and spread health benefits more widely.Item An evaluation of an Extension for Community Healthcare Outcomes (ECHO) intervention in cancer prevention and survivorship care(BMC, 2022-05-17) Milgrom, Zheng Z.; Severance, Tyler S.; Scanlon, Caitlin M.; Carson, Anyé T.; Janota, Andrea D.; Vik, Terry A.; Duwve, Joan M.; Dixon, Brian E.; Mendonca, Eneida A.; Pediatrics, School of MedicineTo improve cancer care in Indiana, a telementoring program using the Extension for Community Healthcare Outcomes (ECHO) model was introduced in September 2019 to promote best-practice cancer prevention, screening, and survivorship care by primary care providers (PCPs). The aim of this study was to evaluate the program's educational outcomes in its pilot year, using Moore's Evaluation Framework for Continuing Medical Education and focusing on the program's impact on participants' knowledge, confidence, and professional practice. We collected data in 22 semi-structured interviews (13 PCPs and 9 non-PCPs) and 30 anonymous one-time surveys (14 PCPs and 16 non-PCPs) from the program participants (hub and spoke site members), as well as from members of the target audience who did not participate. In the first year, average attendance at each session was 2.5 PCPs and 12 non-PCP professionals. In spite of a relatively low PCP participation, the program received very positive satisfaction scores, and participants reported improvements in knowledge, confidence, and practice. Both program participants and target audience respondents particularly valued three features of the program: its conversational format, the real-life experiences gained, and the support received from a professional interdisciplinary community. PCPs reported preferring case discussions over didactics. Our results suggest that the Cancer ECHO program has benefits over other PCP-targetted cancer control interventions and could be an effective educational means of improving cancer control capacity among PCPs and others. Further study is warranted to explain the discrepancies among study participants' perceptions of the program's strengths and the relatively low PCP participation before undertaking a full-scale effectiveness study.Item Prison Health is Community Health: The Indiana Peer Education Program(Research Square, 2022-07-06) Janota, Andrea D.; Hibbard, Patrick F.; Meadows, Meghan E.; Cocco, John P.; Carr, Abigail L.; Nichols, Deborah; Chapman, Erika; Maupomé, Gerardo; Duwve, JoanBackground: Concerning health inequities have been found in incarcerated populations, which likely impact broader community health. This paper evaluates the Indiana Peer Education Program (INPEP ECHO), an initiative that aims to improve health knowledge using the Project ECHO (Extension for Community Healthcare Outcomes) model to train people incarcerated in Indiana prisons (USA) as peer health educators inside prisons. Peer educators undergo a 40-hour training and then facilitate 10-hour long health education workshops inside their facilities over several days. Methods: We assessed the changes observed in pre- and post-session survey responses to estimate the impact this program had on peer educators and those they teach via multivariate regression analysis. We also examined peer educator qualitative data for emergent themes and confirmation of survey findings. Results: Findings from the 10-hour workshops showed improved knowledge scores and post-release behavior intentions. Peer educator surveys indicated increases in knowledge, health attitudes, and self-efficacy scores. Qualitative analysis affirms the latter finding and points toward peer educators acquiring expertise in the content they teach and how to teach it and that positive results likely expand beyond participants to others in prison, their families, and the communities to which they return. Further, peer educators shared they felt new purpose and hope tied to their participation in INPEP ECHO. Although these survey results show positive change in the short term, such improvements have been shown in other research to lead to improved middle- and long-term outcomes. Conclusions: Though preliminary, results indicate this type of public health intervention, training incarcerated individuals as peer educators on health topics, appears to increase important health knowledge and behavior intentions, which will likely lead to improvements in personal and public health outcomes. Results also point toward specific improvements associated with peers providing the education, and not external sources. The skills participants attain, as well, seem to increase their sense of purpose and self-efficacy, which have been shown to precede desistance from crime. While more work is necessary, the high costs associated with treating diseases like hepatitis C point toward an urgent need for programs like INPEP.Item The continuing evolution of a cancer prevention, screening, and survivorship ECHO: A second year of implementation(Wiley, 2023) Etling, Mary Ann; Vik, Terry A.; Janota, Andrea D.; Liang, Kaley L.; Kryder-Reid, Caroline L.; Robertson, Mary; Scanlon, Caitlin; Carson, Anyé; Agley, Jon; Severance, Tyler S.; Pediatrics, School of MedicineIntroduction: An estimated 39,010 Indiana residents were diagnosed with cancer in 2021. To address the cancer burden, Project ECHO (Extension Community Healthcare Outcomes) was launched in 2019 in Indiana to build specialty healthcare capacity among non-specialists. Due to positive outcomes from the pilot year, the Cancer Prevention, Screening, and Survivorship ECHO was implemented for a second year. The purpose of this study was to measure the participation and regional impact of this ECHO. Methods: ECHO sessions occurred twice monthly from October 2020 to October 2021. Changes were implemented in response to feedback from the pilot year, including making the curriculum more practical for learners and adding accreditation opportunities. Participant information and feedback was extracted from electronic surveys for review. Results: There were 24 ECHO sessions with 213 unique participants, increased from 140 unique participants in the pilot year. An average of 23.5 individuals attended each session, increased from 15.5 individuals per session. Enrolled participants served in a diverse set of roles and represented 247 zip codes, 30 Indiana counties, and 32 states across the United States, each of which increased from the pilot year. Discussion: In this second year, this ECHO expanded to reach more participants with increased attendance and a more diverse distribution of roles within healthcare, which may be attributed to feedback-driven curriculum design. Cancer care is multi-disciplinary, with health educators, nurses, and administrators, each acting within the cancer care continuum. As a result, this ECHO has been adapted to serve an increasingly broad distribution of professionals. Conclusion: The second year of the Cancer Prevention, Screening, and Survivorship ECHO displayed increased overall enrollment and participation, greater diversity among participant roles, and a wider reach across Indiana and the United States.