Project Echo @ NICPR

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  1. About Us
  2. Project Echo @ NICPR
  3. Pilot Project
  4. Training Program
  5. List of Didactics

echo

Project ECHO (Extension for Community Healthcare Outcomes) originated at the University of New Mexico, USA is a lifelong learning and guided practice model that revolutionizes medical education and exponentially increases workforce capacity to provide best-practice specialty care and reduce health disparities. The heart of the ECHO model is its hub-and-spoke knowledge-sharing networks, led by expert teams who use multi-point videoconferencing to conduct virtual clinics with community providers. In this way, primary care doctors, nurses, and other clinicians learn to provide excellent specialty care to patients in their own communities. The mission of Project ECHO is to develop the capacity to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas, and to monitor outcomes of this treatment. More information on Project ECHO is available at their homepage http://echo.unm.edu/about-echo/model/

Project NICPR ECHO: Empowering with Knowledge and Skills in Cancer Prevention

NICPR ECHO empowers health care providers to update knowledge and skills in the area of cancer prevention. This entails incorporating cancer screening programs using the ECHO model to improve capacity and access to specialty care for rural and underserved populations.

Mission of NICPR ECHO: The mission is to build capacity in the area of cancer screening services among health care providers. This will empower them to carry out screening independently thereby enabling their services to be accessible to every eligible citizen in India.

There is an estimated burden of over 1 million individuals who were diagnosed with cancer in India in 2012. The three most commonly occurring cancers in India are breast, uterine cervix and oral cancers, together accounting for one third of India’s cancer burden. All three are usually detectable at early stages, and malignancies of the oral cavity and cervix have precancerous stages that are amenable to secondary prevention. Therefore, screening and early detection of these three cancers will help to markedly reduce the cancer burden in India.

Gumballi Pilot Study

NICPR-ECHO piloted their community health-worker (CHW) cancer screening training program at Gumballi primary healthcare center (PHC) which is situated in the poorly developed district of Chamarajanagar with a 83% rural population and consisting of significant tribal population too.

A 5-days hands-on training was held from May 26th to 31st, 2015, for a dentist (1), staff nurses (3), ANMs (5), MHWs (3), ASHA’s (20) and a project staff. Cancer screening training in oral, breast and cervical cancer was taught in great detail to cover the significance of screening asymptomatic population, the eligibility of screening in both males and females and the protocol to follow in the case of screen positive cases. In oral cancer screening they were taught the nuances of tobacco cessation counseling. Female trainees such as ANMs and ASHAs were taught clinical breast examination (CBE) as well as self breast examination (SBE). Two screening methods viz. visual inspection by acetic acid (VIA) and visual inspection by Luigol’s iodine (VILI) was taught to them, including the preparation of reagents and sterilization of devices used in these screening tests.

After the 5 days of in-person training, the training continued virtually on the tele-mentoring platform of ECHO through which a session was conducted every week and then every fortnight. The trained CHWs were able to clear their doubts regarding cancer screening during their field visits. Tips on motivating clients for screening were shared, along with the challenges they were facing in counselling for tobacco cessation etc.

After a year of in-person and virtual hand-holding attempts, the CHWs were able to complete cancer screening of the entire population.

ascopubs.org/doi/pdf/10.1200/JGO.2016.004036

Cancer Screening Training Program For Master Trainers(Medical officers/ Physicians/Private Practitioners/ Other Specialists)

National Institute of Cancer Prevention and Research (NICPR), Noida, a division of Indian Council of Medical Research (ICMR), is committed to its mandate of cancer prevention in the country.

We are actively promoting the strategy of prevention and/ or early detection of cancers through a robust screening process in the effort to reduce the burden of cancer treatments in a LMIC like India, as well as to achieve better health outcomes for the patients involved.

In this effort, we are into building the knowledge of medical officers regarding cancer prevention and diagnostic tools, in an attempt to successfully effect screening of the community through them.

We offer our cancer screening training program in two phases:

  • In person, three day training program where knowledge about three most preventable cancers in India will be imparted along with diagnostic tools available in rural areas etc.
  • This will be followed by virtual training program on the ECHO platform, complete with didactics by experts in the field and case presentation following screening of the community. Some of the didactics conducted so far include:
    • The importance of screening communities
    • Diagnostic methods in Oral Malignancies
    • Treatment of Breast Cancer with Centchroman
    • Ablative Methods of Managing CIN etc.

At this point we have a fortnightly ECHO clinic, where oral, breast and cervical cancer are discussed on rotation.

We eventually plan to make this into a weekly (1 hour) program with smokeless tobacco and tobacco cessation component added to it.

The training program is of 6 months duration with about 15 ECHO sessions (5 in each: oral, breast and cervical) of an hour each. Upon the successful completion of this program, the participants will be awarded an institutional (NICPR/ ICMR) certificate. The eligibility for this certificate is the completion of atleast 4 sessions under each category to make it a total of 12. If attending only one area of specialty, then ones needs to attend ALL the sessions in the category. In addition to the attendance at these sessions, doctors are expected to present cases as well. A minimum of 5 cases presentation, if attending sessions only in one are or 6 cases (2 in each area) are necessary towards the successful completion of the course. A pre and post evaluation of knowledge gained and the quality of the sessions will be conducted, in an effort to improve our program and deliver the best to the trainees.

Our hope is that the medical officers will in turn train the community health workers (CHWs) in their communities to assist them in the robust cancer screening of the members of the community they serve.

Concerted efforts like this will inevitably bring down the burden of cancer that has been predicted for our country by many experts in the field.

S. No. Date Time Topic Facilitators
1 30/09/16 11 am to 12 pm Informal  
2 20/10/16 11 am to 12 pm Improving screening covergae  Dr. Roopa Hariprasad
3 17/11/16 11 am to 12 pm Tobaco Cessation  Dr. Shekhar Grover
4 16/12/16 11 am to 12 pm Breast Cancer Screening Dr. Anurag Chaturvedi 
5 12/01/17 2 pm to 3 pm Training for Healthcare Providers  Latha Sriram and Chandresh Verma 
6 31/01/17 11 am to 12 pm Management of CIN1  Dr. Roopa Hariprasad
7 23/02/17 3 pm to 4 pm Leukoplakia Dr. Suzanne Nethan 
8 10/03/17 11 am to 12 pm Breast cancer treatment with centchroman  Dr. Roopa Hariprasad
9 06/04/17 11 am to 12 pm  Ablative Methids in Treatment of CIN D. Pakhee Agarwal
10 27/04/17 11 am to 12 pm Diagnostoc Methods in the Treatment of Oral malignancies  Prof. Dr. Ravi Mehrotra
11 25/05/17 2 pm to 3 pm Mastalgia Dr. Piyush Ranjan
12 08/06/17 11 am to 12 pm Cervical Cancer Screening Guideliens
Dr. Sumita Mehta
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