The Power of ECHO Autism: Improving Confidence and Holistic Care for Autistic Adults

Autistic adults describe difficulties accessing high-quality primary care services. Primary care practitioners (PCPs) report a lack of confidence and knowledge in working with autistic adults. The Extension for Community Healthcare Outcomes (ECHO) model is a longitudinal clinician education program that utilises a 'hub and spoke' model, community-building strategies and peer case-based learning to improve the care of patients with medical complexity.

The present study utilised the ECHO model ('ECHO Autism Adult Healthcare') to train PCPs in how to best care for autistic adults. We used a qualitative approach to examine the PCPs' subjective experiences of participating in the training. We used a qualitative descriptive framework to explore the experiences of 22 PCPs who completed the ECHO Autism Adult Healthcare program. Semi-structured Zoom interviews examined the support and education needs of PCPs and the benefits and challenges of the program. Three researchers worked collaboratively to code transcripts, testing inter-rater reliability to establish reliability and coding consistency.

Four themes were identified: (1) the benefits of hearing from a wide range of perspectives, (2) establishing and supporting an interactive and engaging climate, (3) building a sense of community and (4) the meaningfulness and usability of resources and information. Overall, participants appreciated the multidisciplinary hub team members' expertise, especially those with lived experiences. Several participants enjoyed the ECHO format, as it encourages active discussion and engagement. PCPs indicated that they felt connected with the hub team and participants. They remarked on the usefulness of provided resources and their ability to implement them into clinical care.

These results can guide the development and implementation of future training programs. The ECHO model has the potential to become a best practice for delivering medical education. Broad implementation of the ECHO model shows significant benefits for PCPs and patients with medical complexity compared to more traditional forms of CME.