Barriers and Facilitators to Implementing Project ECHO in Malaysia During the COVID-19 Pandemic
Suzan M. Walters, Wong Pui Li, Rumana Saifi, Iskandar Azwa, Sharifah Faridah Syed Omar, Zachary K. Collier, Asfarina Amir Hassan, Marwan Haddad, Frederick L. Altice, Adeeba Kamarulzaman, Valerie A. Earnshaw
Abstract
Objective: In Malaysia, HIV is concentrated among key populations who experience barriers to care due to stigma and healthcare discrimination. The COVID-19 pandemic has increased barriers to healthcare. Project ECHO (Extension for Community Healthcare Outcomes) is a transformative tele-education strategy that could improve HIV prevention and treatment. Methods: Practicing physicians who were aged 18 years or older and had internet access participated in asynchronous online focus groups. Results: Barriers to Project ECHO were conflicting priorities, time constraints, and technology. Facilitators included content and format, dedicated time, asynchronized flexible programming, incentives, and ensuring technology was available. Conclusion: Project ECHO is a promising intervention that can increase physicians’ knowledge and skill set in specialty medicine during the COVID-19 pandemic. Interventionists in Malaysia in particular, but also in general, should consider these barriers and facilitators when developing Project ECHO as they may aid in developing a more robust program and increase participation.