Abstract Body

Introduction and Objectives: Project ECHO (Extension for Community Healthcare Outcomes) is a tele-education outreach model seeking to democratize specialty knowledge, reduce disparities, and improve outcomes. Limited access to endocrinologists forces many primary care providers (PCPs) to care for patients with T1D without specialty support. Accordingly, an ECHO T1D program was developed and piloted in Florida and California. Our goal was to demonstrate feasibility and improve PCPs’ abilities to manage patients with T1D.

Methods: Health centers (i.e. spokes) were recruited through an innovative approach, focusing on Federally Qualified Health Centers (FQHC) and through identification of high-need catchment areas using the Neighborhood Deprivation Index (NDI) and provider geocoding. Participating spokes received weekly tele-education provided by the University of Florida and Stanford University hub team, real-time support with T1D medical decision making, access to diabetes support coaches, and access to an online repository of resources. Participating PCPs completed pre/post-tests assessing diabetes knowledge and confidence and exit surveys.

Results: In Florida, 12 spoke sites enrolled with 67 clinics serving >1,000 patients with T1D. In California, 11 spoke sites enrolled with 37 clinics serving >900 patients with T1D. During the 6-month intervention, 27 tele-education clinics were offered and n=70 PCPs (22 from Florida, 48 from California) from participating spoke sites completed pre/post-test surveys assessing knowledge and confidence in diabetes care. There was statistically significant improvement in knowledge (p≤0.01) and diabetes confidence (p≤0.01).

Conclusions: ECHO T1D's pilot demonstrated proof of concept for a T1D-specific ECHO program and represents a viable model to reach medically underserved communities.