Project ECHO: a Potential Best-Practice Tool for Training Healthcare Providers in Oral Cancer Screening and Tobacco Cessation

J Cancer Educ. 2020 Oct;35(5):965-971. doi: 10.1007/s13187-019-01549-8.


The oral cancer pandemic and inadvertent tobacco consumption have rendered timely oral cavity screening and tobacco cessation essential, skills which most healthcare providers (HCPs) lack. Project "Extension for Community Healthcare Outcomes" (ECHO) is a proven best-practice tool for virtual telementoring of primary care providers by experts at academic health centers, in managing complex medical conditions in rural, expert-deficient setups. For the first time, our organization in India has utilized this method for training HCPs in oral cancer screening, across the country and abroad. The program comprised eight, weekly, hour-long sessions, on oral cancer screening and tobacco cessation, hosted online by our Organization (hub) through the Zoom web-conferencing application, with 48 HCPs (spokes) attending from their respective locations (pan-India, n = 47; Libya, n = 1). Each session comprised one expert-led didactic and two participant-led case presentations, culminating with educative discussions. Participants filled out online, program-evaluation (pre and post) questionnaires having 10 similar, multiple-choice questions each (score for every correct response = 1); total responses were later statistically analyzed. Lesser participants completed the post-evaluation questionnaire which could be due to it being optional, their busy schedule, or apprehension of being assessed. The program evaluation results illustrate a significant knowledge gain among participants regarding oral cancer screening and tobacco cessation, i.e., from a mean knowledge score of 6.7 in pre-evaluation to 7.4 in post-evaluation (p < 0.05). Thus, the ECHO model can be utilized as a convenient, cost-effective, large-scale, best-practice, telementoring tool for training HCPs in oral cancer screening and tobacco cessation, especially in populous, resource-deficient countries.

Keywords: Healthcare providers; Oral cancer screening; Project ECHO; Telementoring; Tobacco cessation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Early Detection of Cancer / standards*
  • Health Personnel / education*
  • Humans
  • India / epidemiology
  • Mouth Neoplasms / diagnosis*
  • Mouth Neoplasms / prevention & control
  • Program Evaluation
  • Rural Population
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Surveys and Questionnaires
  • Tobacco Use Cessation / methods*