DOI: 10.4103/indianjpsychiatry_525_24 ISSN: 0019-5545

Evaluating the impact of Extension of Community Healthcare Outcome (ECHO) telementoring on enhancing knowledge and perceived skills in alcohol use disorders among the nonmedical District Mental Health Programme healthcare providers in Karnataka

Prabhat K. Chand, Channaveerachari Naveen Kumar, Rajani Parthasarathy, Pratima Murthy, Sanjeev Arora
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ABSTRACT

Background:

Alcohol use disorder (AUD) is a public health problem. In India, about 5.2% of the population aged 10–75 years, that is, approximately 5.7 crore individuals, need help for their alcohol use problems, and around 20 lakhs from Karnataka. As per the studies, among people dependent on alcohol who tried quitting, about 75% did not receive any treatment. One potential approach to reducing this gap is enhancing the knowledge and skills of the existing District Mental Health Programme (DMHP) Health Care Providers (HCPs) on a large scale by integrating a case-based tele-ECHO (Extension of Community Healthcare Outcome) mentoring model.

Aim:

This study evaluates the effectiveness of the ECHO telementoring in improving knowledge and perceived skills related to AUD among nonmedical HCPs in Karnataka’s DMHP.

Methods:

A digital-driven curriculum of the Foundation of Alcohol Management was designed and implemented with 84 DMHP healthcare providers (44 ECHO group, 40 waitlist) from 26 districts in Karnataka. The ECHO intervention comprised 27 weekly telementoring sessions over 9 months, combining case-based learning with didactic presentations. Knowledge and perceived skills were assessed at baseline and 3, 6, and 9 months using semistructured questionnaires apart from engagement and satisfaction.

Results:

At baseline, both groups showed comparable knowledge levels (ECHO: 5.84 ± 1.89, waitlist: 6.65 ± 2.67, P = .110). The ECHO group demonstrated significantly higher knowledge scores at 3 months (8.41 ± 2.84 vs 6.35 ± 2.07, P < .001) and 9 months (9.31 ± 2.48 vs 6.13 ± 1.82, P < .001). Self-perceived skills similarly improved in the ECHO group, showing significant enhancement from baseline (20.25 ± 5.62) to 9 months (25.10 ± 4.52, P = .004), with a large effect size (Cohen’s d = 1.040). Program engagement was high, with 42 participants attending more than 60% of sessions, and 104 cases were discussed during tele-ECHO sessions. The waitlist group showed no significant improvements in either domain.

Conclusion:

The ECHO telementoring program effectively improves the knowledge and perceived skills of the DMHP nonmedical HCPs in AUD. The ECHO model can be a valuable tool for exponential enhancement in capacity in addictive disorder, especially in low-resource settings, by leveraging technology.

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