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Implementing Cancer Screening Programs by Training Primary Care Physicians in India—Findings from the National Institute of Cancer Prevention Research Project ECHO for Cancer Prevention

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Abstract

In 2016, the Government of India launched a national program for screening and prevention of oral, breast, and cervical cancer. In support, the National Institute for Cancer Prevention Research (NICPR) adopted the Project ECHO (Extension for Community Healthcare Outcomes) model for training health care providers in cancer screening. We assess change in knowledge and skills among physicians attending hybrid (i.e., online and in person) NICPR-ECHO trainings and impact on implementation of cancer screening services. Prior to the start of the online phase and upon completion of 14 weeks, trainees answered a 23-item online questionnaire, including visual vignettes. We conducted descriptive and bivariate analysis of pre-post assessments from trainees participating in the online phase and wherever available report on the weekly quizzes and the hands-on workshop assessments. A total of 641 medical officers participated in the trainings from May 2019 to February 2020. Across nine cohorts of trainees, only 116 primary care physicians completed both the pre- and post-assessments. Almost two-thirds completed medical training (69.7%) and 85% were working in government healthcare facilities. Trainees reported statistically significant improvements before and after the online phase, when queried specifically on knowledge and skills using visual vignettes about oral (p < 0.001), breast (p = 0.35), and cervical cancer screening (p < 0.001). Study findings support the effectiveness of Project ECHO in reaching primary care physicians across the country and improving their knowledge and skills related to screening for breast, oral, and cervical cancer, with additional support needed for implementation of clinical cancer screening services.

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Abbreviations

ICMR-NICPR:

Indian Council of Medical Research—National Institute of Cancer Prevention and Research

ECHO:

Extension for Community Healthcare outcomes

MoHFW:

Ministry of Health and Family Welfare

VIA:

Visual inspection with acetic acid

CBE:

Clinical breast examination

OVE:

Oral visual examination

MRI:

Magnetic resonance imaging

FNAC:

Fine needle aspiration cytology

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Funding

Funding was provided by Tata Trusts, (Grant No.: TEDT/MUM/CAN/NIoCPaR/2018-2019/0043/AD/sa)

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Correspondence to Roopa Hariprasad.

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Adsul, P., Nethan, S.T., deCortina, S.H. et al. Implementing Cancer Screening Programs by Training Primary Care Physicians in India—Findings from the National Institute of Cancer Prevention Research Project ECHO for Cancer Prevention. Glob Implement Res Appl 2, 34–41 (2022). https://doi.org/10.1007/s43477-021-00032-1

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  • DOI: https://doi.org/10.1007/s43477-021-00032-1

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