Engagement With Project ECHO to Increase Medication-Assisted Treatment in Rural Primary Care

Psychiatr Serv. 2019 Dec 1;70(12):1157-1160. doi: 10.1176/appi.ps.201900142. Epub 2019 Aug 22.

Abstract

Objective: The purpose of this study was to understand the barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement medication-assisted treatment (MAT) in primary care settings.

Methods: A 12-session weekly curriculum was delivered to participating primary care providers and clinic staff (N=24 participants from 13 clinics). Participants completed attendance logs and a qualitative interview in order to identify factors that influence engagement in the ECHO sessions and the potential integration of MAT.

Results: Primary care providers and staff valued the ECHO sessions, but overall attendance was low and variable. Participants generally valued the didactic and interactive nature of the sessions but identified system-level constraints that limited engagement. Major barriers to participation included competing demands in patient care and the low degree of endorsement by clinic leadership.

Conclusions: This brief report identifies key systematic challenges that may directly limit primary care providers' engagement in telementoring models such as Project ECHO.

Keywords: Alcohol and drug abuse; Clinical and translational research; Primary care; Recruitment; Substance use.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Community Health Services / methods*
  • Curriculum
  • Education, Medical, Continuing*
  • Health Personnel / education*
  • Humans
  • New Mexico
  • Opiate Substitution Treatment
  • Opioid-Related Disorders / drug therapy*
  • Primary Health Care / methods*
  • Rural Health Services*
  • Telemedicine