Elham Esfandiari, William C Miller, Sheena King, Maureen C Ashe, W Ben Mortenson
A qualitative study of clinicians' and individuals' with lower limb loss perspectives on the development of a novel online self-management program
Disability and rehabilitation
multiple myeloma mm rural western kenya characterized late diagnosis poor longterm outcomes inadequate skilled rural health care teams partly blame extension community healthcare outcomes echo model attempts bridge skills gap linking rural primarysecondary health care teams spokes myeloma experts tertiary care center hub longitudinal training program hub team comprising myeloma experts administrators moi teaching referral hospitalacademic model providing access healthcare assembled spoke sites recruited rural health care facilities across western kenya curriculum developed incorporating input spokes perceived skills gaps myeloma participants joined sessions remotely virtual meeting technology echo sessions consisted spokeled case presentation guided discussion followed expertled lecture endofprogram survey used evaluate participant satisfaction knowledge practice patterns total eight sessions conducted april november 2021 median 40 attendees per session drawn diverse health care disciplines twentyfour spoke sites identified 15 counties across western kenya majority attendees reported satisfaction echo program 25 29 improvement myeloma knowledge 24 29 74 new myeloma diagnoses made hub site 2021 representing 35 increase previous 3year average despite covid19 pandemic suppressed health care access globally pilot echo model successfully implemented myeloma training ruralbased health care teams key attributes included collaborative curriculum development interactive casebased bidirectional learning multidisciplinary engagement