Understanding Practice Intentions and Barriers Following Pediatric Mental Health ECHO Participation

Abstract

Introduction. A national shortage of mental health professionals has shifted much of youth mental and behavioral health care to primary care professionals (PCPs), who often feel underprepared, especially in Kansas, where most counties are designated mental health shortage areas. Project ECHO provides continuing medical education (CME) to strengthen PCPs’ ability to manage pediatric mental health conditions.

Methods. Authors administered a 10-item survey immediately after ECHO sessions from April 2020 to October 2024. A cross-sectional analysis of 512 CME surveys was conducted, and descriptive statistics were used to summarize responses across eight mental health topics.

Results. Respondents included physicians (n = 346), APRNs (n = 114), nurses (n = 81), PAs (n = 18), and other professionals (n = 157). Survey counts varied by topic: ADHD (n = 92), Anxiety (n = 65), Autism (n = 28), Depression (n = 59), ID/DD (n = 56), Sleep (n = 86), Suicide (n = 41), and Trauma (n = 85). Across topics, 50-71% of PCPs strongly agreed they learned information that could improve patient outcomes. Many respondents (45-70%) reported no barriers to applying new strategies. When barriers were identified, lack of knowledge was the most common (19-30%), except in suicide sessions, where “other” barriers were cited most frequently (17%).

Conclusions. Findings indicate that knowledge gaps remain the primary barrier to implementing pediatric mental health care, underscoring the value of programs such as KSKidsMAP ECHO in improving provider confidence and practice uptake. Participants also reported gaining information they could share with colleagues, suggesting a broader team-level impact.