Development of Technical Assistance Support as Part of the Salud en Mis Manos Dissemination and Implementation Assistance (SEMM-DIA) Multicomponent Implementation Support Strategy; the SEMM-DIA Project ECHO Program
Introduction
Salud en Mis Manos (SEMM) is a community health worker (CHW)-delivered evidence-based intervention (EBI) that effectively increases cervical and breast cancer screening among medically underserved Latinas. Despite successful adoption and implementation in community settings, its use in clinical settings is limited. To address this, the UTHealth Houston CDC-funded Prevention Research Center developed SEMM-Dissemination and Implementation Assistance (SEMM-DIA), an online implementation support system. Based on the technical support strategy Project ECHO (Extension of Community Healthcare Outcomes), we designed the SEMM-DIA ECHO series which accompanies the SEMM-DIA implementation support system, to provide a virtual collaborative learning community and ongoing technical assistance to clinic implementers of SEMM.
Methods
SEMM-DIA ECHO curriculum and evaluation tools were created in collaboration with an expert advisory group (n=6) comprising CHWs, patient navigators, community-based organization (CBO) directors, and Texas Breast and Cervical Cancer Services stakeholders. An overview of SEMM-DIA, the ECHO model, and SEMM-DIA ECHO goals preceded concept development on (1) critical session topics, (2) session sequence, (3) methods for peer-to-peer engagement (e.g., case study and narrative brainstorming), and (4) session evaluation. Stakeholders reviewed the SEMM-DIA ECHO design for content validity and acceptability.
Results
The SEMM-DIA ECHO implementation strategy comprises 8 one-hour monthly Zoom sessions. Core content includes assessing clinic needs and aligning resources, preparing for SEMM, supporting SEMM implementation, and EHR reporting best practices. Session structure follows (1) didactic presentations by subject matter experts including CBO partners, (2) stakeholder case studies, and narratives from the field (e.g., practical advice and tips), and (3) post-session evaluation surveys assessing attendee satisfaction, knowledge, balance of methods (presentation vs. peer-to-peer interaction), and confidence in applying learned content. SEMM-DIA ECHO design was rated as credible, acceptable, useful, and motivational (100% agreement).
Conclusion
Development of the SEMM-DIA ECHO implementation strategy serves as a model for developing virtual mentoring and technical assistance platforms to support the implementation of EBIs. Ongoing evaluation of SEMM-DIA ECHO will inform future research into salient elements of the Project ECHO model (e.g., using virtual platforms to create knowledge networks, sharing best practices, and case-based learning), to support implementation and reach of EBIs in clinic settings.