The Impact of an Advance RI-CTR Award on Tuberculosis Infection Management in Rhode Island

To evaluate the impact of a Rhode Island (RI) Latent Tuberculosis Infection (TB Infection) Extension of Community Healthcare Outcomes (ECHO) telementoring program on primary care clinicians' self- reported learning and performance.

Utilizing an exploratory, sequential, mixed- methods design, we first conducted 24 qualitative interviews with RI primary care clinicians and nurses to identify TB infection management gaps. These findings informed the curriculum for a six-session RI TB Infection ECHO course launched in 2021. Participant learning and performance were evaluated using pre- and post-course-structured questionnaires and follow-up qualitative interviews.

Qualitative analysis revealed that participating clinicians felt comfortable with TB infection screening but lacked confidence in treatment initiation and selection. Following the ECHO course, participants demonstrated significant increases in self-reported confidence across the majority of TB infection practice areas (P<0.05). Notably, 75% of post-survey respondents reported making specific practice changes, such as adopting shorter treatment regimens and improving newer test interpretation.

The mentored research award was instrumental in the establishment of the first Project ECHO hub at The Warren Alpert Medical School of Brown University. By achieving Level 5 (Performance) on Moore's Educational Framework through documented practice change, the program demonstrated that tele- mentoring can effectively democratize specialized TB infection knowledge. This framework has since scaled to a regional TB infection ECHO program.