Enhancing cancer prevention and survivorship care with a videoconferencing model for continuing education: a mixed-methods study to identify barriers and incentives to participation

Objective 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. Lay Summary Cancer remains the second leading cause of death in the United States, and new methods are needed to support health care professionals in providing both prevention and survivorship care for their patients. To that end, a school of public health introduced an innovative telelearning program to use technology to link frontline health professionals at their locations with experts at the school for regularly scheduled learning sessions. These sessions on a range of cancer prevention and survivorship care topics take place twice a month and feature presentation of current information and discussion of cases. After the program's pilot year, this study sought input from both participants and nonparticipants to identify incentives and barriers to participation. Input was collected via interviews and a survey. Incentives to participate 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 also wanted more adaptability in program timing to fit busy health care provider schedules. The results will be used to expand and improve the program in the future with the aim of enhancing providers' use of cancer prevention strategies and care for survivors.