PROJECT ECHO Reducing Health Disparities in Underserved Communities BY SALLY PARKER
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aunted by memories of war and genocide in their homeland, many of the Cambodian refugees and immigrants who come to the Metta Health Center at the Lowell Community Health Center in Lowell, Massachusetts, deal with depression, anxiety, and post-traumatic stress disorder. These challenges are daunting in their own right. But they also make it harder to maintain habits that combat diabetes, says Sarah Bradshaw, FNP, a primary care provider in the clinic. “Diabetes is an interesting disease in that your lifestyle choices make a difference,” says Bradshaw,
who has a grant through the Massachusetts League of Community Health Centers to improve health outcomes for Cambodian immigrants with the disease. “A lot of [our work] is focused on encouraging people and helping people believe they can make the lifestyle changes they need to control the disease.” To learn how to help patients in complex situations like this, Bradshaw turned to Project ECHO, a video-based mentoring model that brings specialist expertise to frontline medical personnel in underserved communities. The Joslin Diabetes Center Inc., a Project ECHO hub, provided the training.
“Depending on the diagnosis, you are looking into all different avenues and directions, including nutrition and lifestyle habits,” Omer says. “You try so many different things and you get stuck and you say, ‘What would be my second move?’ Experts help you to look into the different angles and figure out how to achieve the goal for a specific patient, because it has to be patient-centered care.” ECHO stands for Extension for Community Healthcare Outcomes. It is the brainchild of Sanjeev Arora, MD, a New Mexico gastroenterologist who in 2003 sought a way to treat a surge in Hepatitis C cases across the state. Troubled that many patients traveled hundreds of miles and waited up
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to eight months to see him, he conceived ECHO to bring specialist knowledge back to the community providers who serve those patients. ECHO is based at the University of New Mexico. More than 400 partner organizations now replicate the model around the world.
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