Extension for Community Health Outcomes (ECHO) Diabetes Program
ECHO
1 other identifier
interventional
32,796
1 country
17
Brief Summary
The Project ECHO model is currently used in 180 countries to address chronic disease care through a provider empowerment, tele-education approach using a "hub" and "spoke" learning model. Few studies have rigorously evaluated the impact of the program on patient outcomes using randomized designs. This study evaluated implementation of an ECHO Diabetes program on patient-level, provider-level, and center-level outcomes in underserved populations receiving diabetes care from primary care providers. Participants: Twenty Federally Qualified Health Centers (FQHCs) and FQHC "look alikes" across CA and FL were recruited to participate as spokes in the ECHO Diabetes trial. A stepped-wedge trial design was used with randomized, phased-in intervention entry for participating health centers (or "spokes"). Interventions: Spokes were provided access to 6-months of tele-education sessions with continuing medical education credits, access to real-time support for complex medical decision making with hub subspecialty teams, and access to a diabetes support coach. Main outcomes and Measures: Participating FQHCs ("spokes") provided aggregate data including Healthcare Effectiveness Data and Information Set (HEDIS) reporting on the % of patients with HbA1c \>9%.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jun 2021
Typical duration for not_applicable
17 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
June 1, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
June 30, 2022
CompletedStudy Completion
Last participant's last visit for all outcomes
December 31, 2023
CompletedFirst Submitted
Initial submission to the registry
August 8, 2024
CompletedFirst Posted
Study publicly available on registry
August 14, 2024
CompletedAugust 14, 2024
August 1, 2024
1.1 years
August 8, 2024
August 13, 2024
Conditions
Outcome Measures
Primary Outcomes (1)
HbA1c
The percent of patients with HbA1c greater than 9 percent
6-months
Study Arms (2)
ECHO Intervention Immediate
EXPERIMENTAL9 FQHC were randomized to start the ECHO program June 2021. The providers at participating FQHCs joined tele-education one hour sessions and received CME for learning about diabetes care-related topics. They attended sessions twice monthly for 6-months
ECHO Intervention Delayed
EXPERIMENTAL11 FQHC were randomized to start the ECHO program in December 2021. The providers at participating FQHCs joined tele-education one hour sessions and received CME for learning about diabetes care-related topics. They attended sessions twice monthly for 6-months
Interventions
A common curriculum was developed that covered best practices in multidisciplinary diabetes care for the primary care setting that was guided by the ADA Clinical Care. guidelines. FQHCs attended one-hour tele-ECHO sessions twice a month for 6-months.
Eligibility Criteria
You may qualify if:
- Age 18 and older
- Seen for routine care at participating FQHC
- Diagnosis of Type 1 Diabetes or Type 2 Diabetes
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (17)
CommuniCare Davis Family Health Center
Davis, California, 95616, United States
St Agnes Medical Center
Fresno, California, 93720, United States
La Clinica
Multiple Locations, California, 94601, United States
Santa Rosa Community Health Centers
Multiple Locations, California, 95403, United States
Shasta Community Health Centers
Multiple Locations, California, 96001, United States
Health Service Alliance
Rancho Cucamonga, California, 91730, United States
Hill Country Community Clinic
Redding, California, 96001, United States
CommuniCare Salud Family Health
West Sacramento, California, 95605, United States
CommuniCare Hansen Family Center
Woodland, California, 95695, United States
Premier Community Health
Dade City, Florida, 33525, United States
Community Health of South Florida (CHI)
Homestead, Florida, 33190, United States
Banyan Health Systems
Miami, Florida, 33134, United States
Borinquen Medical Center
Miami, Florida, 33137, United States
Orange Blossom Family Health
Orlando, Florida, 32805, United States
Evara Health System
Pinellas Park, Florida, 33718, United States
Tampa Family Health Center
Tampa, Florida, 33610, United States
Treasure Coast Community Health
Vero Beach, Florida, 32960, United States
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
David Maahs, PhD, MD
Stanford University
- PRINCIPAL INVESTIGATOR
Michael Haller, MD
University of Florida
- PRINCIPAL INVESTIGATOR
Ashby F Walker, PhD
University of Florida
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Masking Details
- Masking was not used
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- CROSSOVER
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
August 8, 2024
First Posted
August 14, 2024
Study Start
June 1, 2021
Primary Completion
June 30, 2022
Study Completion
December 31, 2023
Last Updated
August 14, 2024
Record last verified: 2024-08
Data Sharing
- IPD Sharing
- Will not share