• Sandra J Tilmon, Karen K Lee, Patrick A Gower, Kathryn S H West, Kanika Mittal, Marielle B Ogle, Isa M Rodriguez, and Daniel Johnson.
• Department of Pediatrics, Biological Sciences Division, The University of Chicago, Chicago, Illinois. Electronic address: stilmon@uchicago.edu.
• Am J Prev Med. 2023 Apr 1; 64 (4): 535542535-542.

IntroductionTo mitigate the lack of specialty healthcare, Project ECHO (Extension for Community Health Outcomes) trains community-based primary care clinicians to better prevent the progression of, manage, and treat common health conditions. ECHO-Chicago launched in 2010 as the first urban-centered ECHO program, focusing on safety-net clinicians, and has trained over 5,175 community clinicians across 34 topic areas. This paper examines self-efficacy among ECHO-Chicago participants across 11 clinical series, including a novel use of qualitative themes from self-efficacy questions.MethodsFive years of baseline and postseries survey data were collected from 2014 to 2019, resulting in 951 participants. Paired t-tests assessed change from baseline survey to postsurvey, and Cohen's d determined effect size. Change was assessed by individual series, adult or pediatric focus, participants' prescription privilege status, and across series by qualitative question theme. Metrics included total change, any improvement, a 10% target, and a clinical competency threshold. Analysis occurred from July 2020 to January 2022.ResultsAll clinical series achieved statistically significant improvement in self-efficacy, and most had a large effect size. A total of 88% had any improvement, 65% met the 10% target of 0.7 points, and 52% met the competency threshold of 5.0 in the postsurvey. Prescribers had a significantly greater increase in their self-efficacy scores than nonprescribers. With a comparison across series, each theme achieved statistical significance, with most reaching large effect sizes.ConclusionsECHO-Chicago successfully increased participants' self-efficacy. This inquiry adds an urban focus, years of data, multiple series, and a novel qualitative theme component to enable comparisons across rather than solely within the ECHO series.Copyright © 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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