A Protocol for a Comprehensive Monitoring and Evaluation Framework With a Compendium of Tools to Assess Quality of Project ECHO (Extension for Community Healthcare Outcomes) Implementation Using Mixed Methods, Developmental Evaluation Design.

Smita Ghosh,Bruce B Struminger,Patrick K Moonan,Emmanuel Mtete,Eve Pinsker,Steven Seweryn,Jacob Lusekelo,Brenna M Roth,Irene Massawe

doi:10.3389/fpubh.2021.714081

Abstract

Introduction: The United States Centers for Disease Control and Prevention (CDC), through U.S. President's Emergency Plan for AIDS Relief (PEPFAR), supports a third of all people receiving HIV care globally. CDC works with local partners to improve methods to find, treat, and prevent HIV and tuberculosis. However, a shortage of trained medical professionals has impeded efforts to control the HIV epidemic in Sub-Saharan Africa and Asia. The Project Extension for Community Healthcare Outcomes (ECHOTM) model expands capacity to manage complex diseases, share knowledge, disseminate best practices, and build communities of practice. This manuscript describes a practical protocol for an evaluation framework and toolkit to assess ECHO implementation.Methods and Analysis: This mixed methods, developmental evaluation design uses an appreciative inquiry approach, and includes a survey, focus group discussion, semi-structured key informant interviews, and readiness assessments. In addition, ECHO session content will be objectively reviewed for accuracy, content validity, delivery, appropriateness, and consistency with current guidelines. Finally, we offer a mechanism to triangulate data sources to assess acceptability and feasibility of the evaluation framework and compendium of monitoring and evaluation tools.Expected impact of the study on public health: This protocol offers a unique approach to engage diverse group of stakeholders using an appreciative inquiry process to co-create a comprehensive evaluation framework and a compendium of assessment tools. This evaluation framework utilizes mixed methods (quantitative and qualitative data collection tools), was pilot tested in Tanzania, and has the potential for contextualized use in other countries who plan to evaluate their Project ECHO implementation.

Highlights

The United States Centers for Disease Control and Prevention (CDC), through U.S President’s Emergency Plan for AIDS Relief (PEPFAR), supports a third of all people receiving HIV care globally
A pragmatic formative process evaluation using appreciative inquiry approach [21, 22] will assess stakeholder perceptions of participation, engagement, satisfaction, learning, self-confidence and applying knowledge acquired in ECHO sessions to practice
Review of the ECHO sessions will assess quality of facilitation, content, interactivity during sessions, and applicability of recommendations provided. This comprehensive evaluation framework and compendium of tools will assess quality of an HIV ECHO implementation in routine practice that may be adapted for evaluation of any ECHO program

Summary

Introduction

The United States Centers for Disease Control and Prevention (CDC), through U.S President’s Emergency Plan for AIDS Relief (PEPFAR), supports a third of all people receiving HIV care globally. The Project Extension for Community Healthcare Outcomes (ECHOTM) model expands capacity to manage complex diseases, share knowledge, disseminate best practices, and build communities of practice. This manuscript describes a practical protocol for an evaluation framework and toolkit to assess ECHO implementation. The United States Centers for Disease Control and Prevention (CDC) partners with more than 50 countries to improve methods to find, treat, and prevent HIV and tuberculosis (TB) [1, 2]. The Extension for Community Healthcare Outcomes (ECHOTM) Project aims to address these gaps through a collaborative hub and spoke model to connect a multi-disciplinary team of health professionals and enable virtual communities of practice [9]

Methods

Results

Conclusion