Imagine an online community, built intentionally to share expert public health knowledge and community-level experience with community health workers. What if this community connected rural CHWs with teams of expert CHWs and medical specialists, who mentored and coached them on the best ways to meet the social and health needs of their patients? What if these communities of practice transformed care provision by providing quality, ongoing training that leveraged case-based learning to achieve better patient outcomes for vulnerable populations across the globe? The ECHO model™ (Extension for Community Health Outcomes), developed at the University of New Mexico (UNM), is an example of just such an on-line approach to CHW training and mentorship that is strengthening CHW capabilities and support.
Context: As of 2018, an estimated 53,000 individuals were experiencing homelessness throughout Los Angeles County.i Nearly one-third describe their health as poor, and the American Public Health Association reports that 73% of individuals experiencing homelessness nationwide describe ≥ 1 unmet health need.ii Student-run free clinics (SRFCs) represent one effort to extend healthcare to the homeless community and other vulnerable groups – in fact, the number of SRFCs nationally has more than doubled from 111 in 2005 to 208 in 2014.iii The UCLA Mobile Clinic Project (MCP) is one such SRFC founded approximately 20 years ago to improve the health and wellbeing of homeless and vulnerable individuals in Los Angeles County. True to its name, MCP does not operate out of a building or fixed indoor space; rather, it is an outreach effort providing streetside medical and social services.