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. 2025 May 16:14:e60901.
doi: 10.2196/60901.

Providing Education and Training to Health Care Professionals to Address COVID-19 Health Disparities: Protocol for Implementation Project Using Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework

Adati Tarfa  1 , Nada Fadul  2 , Erica Stohs  2 , Jeffrey Wetherhold  3 , Mahelet Kebede  4 , Nuha Mirghani  2 , Muhammad Salman Ashraf  2
Affiliations

Providing Education and Training to Health Care Professionals to Address COVID-19 Health Disparities: Protocol for Implementation Project Using Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework

Adati Tarfa et al. JMIR Res Protoc. .

Abstract

Background: The COVID-19 pandemic has underscored the need for targeted interventions to address health care disparities among specific health care professionals and mitigate the impact of the virus. In response, we developed a comprehensive statewide educational program protocol focused on subject areas of health equity, cultural sensitivity, infection prevention and control (IPC), and quality improvement (QI).

Objective: The project aims to improve health care professionals' knowledge and practice skills in the 4 subject areas, increase their comfort level in implementing health disparities-related QI projects, and facilitate the successful completion of QI projects addressing COVID-19 health disparities within their practice settings.

Methods: The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used in the planning and evaluation of this innovative educational program, which combines the Extension for Community Healthcare Outcomes (ECHO) learning model with one-on-one QI coaching. Participants engage in virtual interactive sessions led by experts and consultants, covering didactic presentations, case discussions, COVID-19 updates, and assessments. QI and health equity coaches provide guidance on developing QI projects targeting COVID-19 and other health disparities. Evaluation surveys are used for baseline, midpoint, and end-of-program assessment for self-reported comfort levels with knowledge and practice-based learning competencies in all 4 subject areas and health disparities-related QI project implementation. The Wilcoxon rank-sum test and Cochran-Armitage trend test will be used to compare pre- and postsurvey responses. Data from semistructured qualitative interviews, which capture insights into participants' application of ECHO training, will be analyzed using an inductive content analysis approach.

Results: A total of 50 ECHO sessions were held between November 2021 and May 2024. Overall, 510 participants attended at least one ECHO session, resulting in 3316 teaching encounters. The pre- and postsurvey data will be analyzed to study project impact and will be ready for publication in June 2026.

Conclusions: By using implementation science methods, an innovative and comprehensive educational protocol was developed that integrates the training curriculum, evaluation metrics, and coaching support, allowing for the translation of the training into actionable community projects focused on addressing health disparities. This model has shown initial promise in terms of feasibility and uptake. Further studies are needed to evaluate the long-term effectiveness of these QI projects in reducing COVID-19 disparities.

International registered report identifier (irrid): DERR1-10.2196/60901.

Keywords: COVID-19; cultural sensitivity; health disparities; healthcare professional education; quality improvement.

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Conflict of interest statement

Conflicts of Interest: MSA has received investigator-initiated study funding from Merck and Co Inc.

References

    1. Nicola M, O'Neill N, Sohrabi C, Khan M, Agha M, Agha R. Evidence based management guideline for the COVID-19 pandemic - review article. Int J Surg. 2020;77:206–216. doi: 10.1016/j.ijsu.2020.04.001. https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(20)30284-3 S1743-9191(20)30284-3 - DOI - PMC - PubMed
    1. Ho P, Chen K, Shao A, Bao L, Ai A, Tarfa A, Brossard D, Brown L, Brauer M. A mixed methods study of public perception of social distancing: integrating qualitative and computational analyses for text data. J Mix Methods Res. 2021;15(3):374–397. doi: 10.1177/15586898211020862. - DOI
    1. Bibbins-Domingo K. This time must be different: disparities during the COVID-19 pandemic. Ann Intern Med. 2020;173(3):233–234. doi: 10.7326/M20-2247. https://www.acpjournals.org/doi/abs/10.7326/M20-2247?url_ver=Z39.88-2003... 2765523 - DOI - PMC - PubMed
    1. Leggat-Barr K, Uchikoshi F, Goldman N. COVID-19 risk factors and mortality among Native Americans. Demogr Res. 2021;45:1185–1218. doi: 10.4054/demres.2021.45.39. - DOI
    1. Mude W, Oguoma VM, Nyanhanda T, Mwanri L, Njue C. Racial disparities in COVID-19 pandemic cases, hospitalisations, and deaths: a systematic review and meta-analysis. J Glob Health. 2021;11:05015. doi: 10.7189/jogh.11.05015. https://europepmc.org/abstract/MED/34221360 jogh-11-05015 - DOI - PMC - PubMed

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