{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:43:35Z","timestamp":1777859015292,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54GM115677"],"award-info":[{"award-number":["U54GM115677"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100021045","name":"Massachusetts Department of Public Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100021045","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction\/Objectives:<\/jats:title>\n                    <jats:p>In the US, reactivation of latent tuberculosis infection (LTBI) accounts for 80% of new cases. In 2016, the US Preventive Services Task Force provided a new recommendation that primary care providers (PCPs) should conduct LTBI screening, whereas in the past, LTBI cases were evaluated and treated by specialty providers. This shift in care revealed knowledge gaps surrounding LTBI treatment among PCPs. This study assessed changes in PCPs\u2019 confidence for performing key aspects of LTBI care before and after participation in an LTBI Extension for Community Healthcare Outcomes (ECHO) course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The ECHO Model\u2122 is an evidence-based telementoring intervention. Participants were primary care team members from clinics throughout Massachusetts who voluntarily enrolled in the ECHO course. In this mixed-methods evaluation, primary outcomes were PCP self-reported confidence changes by pre- and post-course surveys and post-course semi-structured interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty PCPs (43% of registered PCPs) attended at least 3 of the 6 sessions and 24 PCPs (31% of registered PCPs) completed at least one survey. Confidence increased in selecting a test ( P\u2009=\u2009.004), interpreting tuberculosis infection test results ( P\u2009=\u2009.03), and selecting a treatment regimen ( P\u2009=\u2009.004). Qualitative interviews with 3 PCPs revealed practice changes including switching to interferon gamma release assays for testing and using rifampin for treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Use of the ECHO model to train PCPs in LTBI management is feasible and efficacious. For continuing medical education, ECHO courses can be leveraged to reduce health disparities in settings where PCPs\u2019 lack of familiarity about a treatment topic contributes to poor health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319221119942","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T05:25:53Z","timestamp":1661318753000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Expanding Latent Tuberculosis Infection Testing and Treatment in Massachusetts Primary Care Clinics via the ECHO Model"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5864-9011","authenticated-orcid":false,"given":"Daria","family":"Szkwarko","sequence":"first","affiliation":[{"name":"Department of Family Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA"},{"name":"Department of Family Medicine and Community Health, The University of Massachusetts Chan Medical School, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"Urbanowski","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, The University of Massachusetts Chan Medical School, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Thal","sequence":"additional","affiliation":[{"name":"Family Health Center of Worcester, Worcester, MA, USA"},{"name":"Tan Chingfen Graduation School of Nursing, University of Massachusetts Chan Medical School, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Iyer","sequence":"additional","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, The University of Massachusetts Chan Medical School, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liisa M.","family":"Randall","sequence":"additional","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"},{"name":"Department of Medicine, Division of Pulmonary, Allergy, Sleep & Critical Care Medicine, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith A.","family":"Savageau","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, The University of Massachusetts Chan Medical School, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Cochran","sequence":"additional","affiliation":[{"name":"Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"bibr1-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1186\/s41479-016-0018-6"},{"key":"bibr2-21501319221119942","volume-title":"Global tuberculosis report 2020","author":"WHO","year":"2020"},{"key":"bibr3-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt246"},{"key":"bibr4-21501319221119942","volume-title":"CDC Fact Sheet: TB in the United States: A Snapshot","author":"CDC","year":"2018"},{"key":"bibr5-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30216-X"},{"key":"bibr6-21501319221119942","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.12.0823"},{"key":"bibr7-21501319221119942","volume-title":"Implementing the End TB Strategy: The Essentials","author":"WHO","year":"2015"},{"key":"bibr8-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.11046"},{"key":"bibr9-21501319221119942","author":"El Rayess F","year":"2021","journal-title":"Text communication"},{"key":"bibr10-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1370\/afm.139"},{"key":"bibr11-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1002\/chp.20001"},{"key":"bibr12-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009370"},{"issue":"4","key":"bibr13-21501319221119942","first-page":"239","volume":"37","author":"Arora S","year":"2017","journal-title":"J Contin Educ Health Prof"},{"key":"bibr14-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1002\/chp.21210"},{"key":"bibr15-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1210\/js.2017-00361"},{"key":"bibr16-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2015.1129388"},{"key":"bibr17-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2016.005504"},{"key":"bibr18-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001328"},{"key":"bibr19-21501319221119942","doi-asserted-by":"publisher","DOI":"10.1177\/0033354920904084"},{"key":"bibr20-21501319221119942","unstructured":"Rutgers Global Tuberculosis Institute. New England Focus on LTBI. Published 2020. Updated June 27, 2019. Accessed November 1, 2020. http:\/\/globaltb.njms.rutgers.edu\/educationalmaterials\/calendar\/i.php"},{"key":"bibr21-21501319221119942","unstructured":"Washington State Department of Health. TB ECHO TeleHealth Project. Updated November 1, 2020. Accessed November 1, 2020. https:\/\/www.doh.wa.gov\/YouandYourFamily\/IllnessandDisease\/Tuberculosis\/TrainingandEducation\/TBECHO"},{"key":"bibr22-21501319221119942","unstructured":"The University of New Mexico. Project ECHO (Extension for Community Healthcare Outcomes). Published 2020. Updated 2020. Accessed January 16, 2021. https:\/\/hsc.unm.edu\/echo\/"},{"key":"bibr23-21501319221119942","unstructured":"University of Massachusetts Medical School. Project ECHO. 2020. Accessed November 2, 2020. https:\/\/www.umassmed.edu\/echo\/"},{"key":"bibr24-21501319221119942","first-page":"179","volume-title":"Doing Qualitative Research","volume":"2","author":"Borkan J","year":"1999"},{"key":"bibr25-21501319221119942","unstructured":"Centers for Disease Control and Prevention. Interferon-gamma release assays (IGRAs) - blood tests for TB infection. Updated May 4, 2016. Accessed January 10, 2021. https:\/\/www.cdc.gov\/tb\/publications\/factsheets\/testing\/igra.htm"},{"key":"bibr26-21501319221119942","volume":"14","author":"Sterling TR","year":"2020","journal-title":"Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319221119942","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501319221119942","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319221119942","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:23:37Z","timestamp":1777508617000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501319221119942"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":26,"alternative-id":["10.1177\/21501319221119942"],"URL":"https:\/\/doi.org\/10.1177\/21501319221119942","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"article-number":"21501319221119942"}}