The effectiveness of the ECHO ® model™ for patient navigation capacity building in Malaysia

Abstract

Background

The patient navigation programme (PNP) is an effective health intervention to address barriers in accessing timely and equitable cancer care. However, its expansion in Malaysia for breast cancer care faces challenges due to limited capacity building among nurses and navigators, particularly nurses who are actively involved in the operation of the PNP centres. The Extension for Community Healthcare Outcomes (ECHO^®) model, a tele-mentoring approach, offers a scalable and sustainable solution for capacity building among the nurses and navigators. This study aims to evaluate the feasibility and impact of using the ECHO model to train nurses and navigators on patient navigation competencies focused on improving breast cancer care delivery.

Methods

The study involved nurses in breast cancer care from Ministry of Health (MOH) state referral hospitals in Malaysia and newly recruited nurses and social workers by Cancer Research Malaysia to subsequently be placed as nurse and community navigator for the upcoming new centres. Participants received an ECHO-based training programme comprising bi-weekly virtual sessions of a six-domain curriculum covering 12 topics on patient navigation competencies. Pre- and post-session assessments were conducted to measure satisfaction, knowledge and confidence in conducting patient navigation.

Results

Most participants were within the age range of 31–35 (n = 38; 40.4% [95% CI, 30.5%–50.3%]) with majority being female (n = 87; 92.6% [95% CI, 87.2%–97.9%]) and MOH nurses (n = 71; 75.5% [95% CI, 66.8%–84.2%]). An average of 28 participants attended each session. Participants expressed high level satisfaction while showing improvements in knowledge and confidence with an average increase in mean score of (1.45 [95% CI, 0.84–2.13]; p < .05) and (0.61 [95% CI, 0.51–0.65]; p < .05) respectively following the intervention.

Conclusion

The study demonstrates the feasibility and effectiveness of the ECHO model for patient navigation capacity building among nurses and navigators. Findings support broader implementation of the ECHO model to strengthen breast cancer care delivery.