{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:47:17Z","timestamp":1785746837124,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007179","name":"University of New Mexico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007179","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"abstract":"Abstract<\/jats:title>\n \n Background and Objectives<\/jats:title>\n India has one of the world's highest burdens of thalassaemia, with 10,000\u201315,000 births annually and a carrier prevalence of 3%\u20134%. Services for prevention and comprehensive care remain fragmented, especially in rural regions. To address gaps in provider knowledge and practice, Extension for Community Healthcare Outcomes (ECHO) India, in collaboration with the Post Graduate Institute of Child Health and state partners, launched a virtual tele\u2010mentoring programme in Maharashtra, Madhya Pradesh and West Bengal.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n We conducted a mixed\u2010methods evaluation using a convergent parallel design. Data included pre\u2010 and post\u2010training knowledge assessments, post\u2010session feedback surveys and hub reflection meetings. A logical model and Moore's framework guided outcome assessment across participation, satisfaction, knowledge, competence and reported changes in practice.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Following a national training\u2010of\u2010trainers workshop in April 2023, state hubs were established and peer\u2010reviewed modules developed. From October 2023 to March 2025, 73 ECHO sessions were conducted across the three state hubs, with curricula tailored to different participant groups (eight modules for medical officers and six for paediatricians). Paediatricians showed a mean knowledge gain of 15.8% (\n p<\/jats:italic>\n \u2009<\u20090.001) and medical officers 11.4% (\n p<\/jats:italic>\n \u2009=\u20090.001). Over 70% rated sessions highly relevant, and over 90% intended to apply learning. Reported behaviour changes included improved interpretation of complete blood counts, more systematic referral and promotion of antenatal screening.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This first multicentre evaluation demonstrates that ECHO tele\u2010mentoring strengthens thalassaemia care in India, improving provider competence and catalysing systemic and policy\u2010level change. The model is scalable for integration into primary health systems across low\u2010 and middle\u2010income countries.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/vox.70343","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:17:14Z","timestamp":1785745034000},"source":"Crossref","is-referenced-by-count":0,"title":["Transforming thalassaemia care in India through virtual capacity building: Evolution of a national training initiative using extension for community healthcare outcomes model"],"prefix":"10.1111","author":[{"given":"Sandeep","family":"Bhalla","sequence":"first","affiliation":[{"name":"Extension for Community Healthcare Outcomes (ECHO) India New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7941-5641","authenticated-orcid":false,"given":"Nita","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology Oncology Post Graduate Institute of Child Health (PGICH), Thalassemia International Federation Collaborating Centre Noida Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paromita","family":"Das","sequence":"additional","affiliation":[{"name":"Extension for Community Healthcare Outcomes (ECHO) India New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8643-4528","authenticated-orcid":false,"given":"Mamta","family":"Manglani","sequence":"additional","affiliation":[{"name":"Brihanmumbai Municipal Corporation CTC, PHO & BMT Center Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpan","family":"Mitra","sequence":"additional","affiliation":[{"name":"Kolkata Municipal Corporation Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9017-3540","authenticated-orcid":false,"given":"Shweta","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Government Medical College Bhopal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5966-2484","authenticated-orcid":false,"given":"Apoorva Karan","family":"Rai","sequence":"additional","affiliation":[{"name":"Extension for Community Healthcare Outcomes (ECHO) India New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"704","article-title":"Inherited haemoglobin disorders: an increasing global health problem","volume":"79","author":"Weatherall DJ","year":"2001","journal-title":"Bull World Health Organ"},{"key":"e_1_2_9_3_1","article-title":"The prevention of thalassemia","volume":"3","author":"Cao A","year":"2013","journal-title":"Cold Spring Harb Perspect Med"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/ijlh.12948","article-title":"The phenotypic and molecular diversity of hemoglobinopathies in India: a review of 15\u2009years at a referral center","volume":"41","author":"Nadkarni AH","year":"2019","journal-title":"Int J Lab Hematol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4103\/0971-6866.64941","article-title":"Frequency of \u03b2\u2010thalassemia trait and other hemoglobinopathies in northern and western India","volume":"16","author":"Madan N","year":"2010","journal-title":"Indian J Hum Genet"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s12098-017-2325-1","article-title":"Thalassemia minor and major: current management","volume":"84","author":"Choudhry VP","year":"2017","journal-title":"Indian J Pediatr"},{"key":"e_1_2_9_7_1","first-page":"507","article-title":"Past, present & future scenario of thalassaemic care & control in India","volume":"134","author":"Verma IC","year":"2011","journal-title":"Indian J Med Res"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1586\/ehm.09.74","article-title":"Global burden, distribution and prevention of \u03b2\u2010thalassemias and hemoglobin E disorders","volume":"3","author":"Colah R","year":"2010","journal-title":"Expert Rev Hematol"},{"key":"e_1_2_9_9_1","volume-title":"National Policy for rare diseases 2021","author":"Ministry of Health and Family Welfare (India)","year":"2021"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.4103\/0971-6866.142841","article-title":"Guidelines for screening, diagnosis and management of hemoglobinopathies","volume":"20","author":"Ghosh K","year":"2014","journal-title":"Indian J Hum Genet"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1002\/hep.23802","article-title":"Expanding access to hepatitis C virus treatment \u2013 Extension for Community Healthcare Outcomes (ECHO) project: disruptive innovation in specialty care","volume":"52","author":"Arora S","year":"2010","journal-title":"Hepatology"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12960-024-00907-y","article-title":"A mixed methods evaluation of the impact of ECHO\u00ae telementoring model for capacity building of community health workers in India","volume":"22","author":"Panda R","year":"2024","journal-title":"Hum Resour Health"},{"key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1186\/s12885-025-13553-x","article-title":"Enhancing cancer care through a knowledge\u2010sharing model: a systematic review of Project ECHO\u00ae programmes in India","volume":"25","author":"Bhuyan S","year":"2025","journal-title":"BMC Cancer"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/chp.20001","article-title":"Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities","volume":"29","author":"Moore DE","year":"2009","journal-title":"J Contin Educ Health Prof"},{"key":"e_1_2_9_15_1","volume-title":"PGICH launch a nationwide capacity building program to address beta thalassemia","author":"ECHO India","year":"2023"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1097\/ACM.0000000000001328","article-title":"The impact of project ECHO on participant and patient outcomes: a systematic review","volume":"91","author":"Zhou C","year":"2016","journal-title":"Acad Med"},{"key":"e_1_2_9_17_1","first-page":"375","article-title":"Prevention and control of haemoglobinopathies","volume":"73","author":"Angastiniotis M","year":"1995","journal-title":"Bull World Health Organ"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1111\/j.1365-2141.2011.08742.x","article-title":"The challenge of haemoglobinopathies in resource\u2010poor countries","volume":"154","author":"Weatherall DJ","year":"2011","journal-title":"Br J Haematol"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3109\/03630269709000664","article-title":"Hemoglobinopathies in Southeast Asia: molecular biology and clinical medicine","volume":"21","author":"Fucharoen S","year":"1997","journal-title":"Hemoglobin"},{"key":"e_1_2_9_20_1","volume-title":"TIF e\u2010academy","author":"Thalassaemia International Federation","year":"2017"},{"key":"e_1_2_9_21_1","volume-title":"Report of the WHO meeting on haemoglobinopathies, Geneva, 2006","author":"World Health Organization","year":"2007"}],"container-title":["Vox Sanguinis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70343","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/vox.70343","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70343","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:17:20Z","timestamp":1785745040000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/vox.70343"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":20,"alternative-id":["10.1111\/vox.70343"],"URL":"https:\/\/doi.org\/10.1111\/vox.70343","archive":["Portico"],"relation":{},"ISSN":["0042-9007","1423-0410"],"issn-type":[{"value":"0042-9007","type":"print"},{"value":"1423-0410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"article-number":"vox.70343"}}