(PS3-94) Economic Cost of Rush University Medical Center’s Early Childhood Projectecho®

Approximately one third of youth from Chicago’s West Side (WS) demonstrate early signs of mental health (MH) concerns. However, systemic inequalities and disproportionate hardship present challenges to accessing childhood MH interventions. Given that many risk factors for MH problems can be targeted early in life, there is an urgent need to design innovative strategies that support early detection and intervention in the places where children routinely spend time. Leveraging early care providers (i.e., day care workers, home visitors) represents a promising approach to addressing this need.  

To facilitate WS early care providers’ competence and confidence in identifying, referring, and intervening on MH concerns, Rush University Medical Center (RUMC) launched a professional development program using ProjectECHO® (Extension for Community Healthcare Outcomes); this framework uses videoconferencing technology to train providers in underserved areas through didactics and case-based learning. RUMC’s Early Childhood (EC) ECHO® was created to mentor and empower early care providers to identify common MH concerns and utilize evidence-based solutions to support families. The program includes twelve 1-hour virtual sessions over 6 months. Sessions are facilitated by a panel of early childhood experts (e.g., clinical psychologists, social workers), with a guest “subject matter expert” providing a didactic at each meeting. Learners receive payments to incentivize participation.  

The goal of this analysis was to describe the economic cost of RUMC’s EC ECHO®. The economic analysis was conducted from the societal perspective, in which all resources associated with the program are incorporated, including time costs of personnel and learners. Data sources included record review and in-depth interviews with personnel to collect costs of establishing and maintaining the program. Across 3 cohorts, the average number of learners was 12, and the average attendance rate was 79%. Most learners were women ( >90%) and worked within either a WS daycare network or WS childhood non-profit agency. Learners were employed professionally as daycare teachers, center directors, parent educators, family support specialists, and doulas.  

The initial fixed cost associated with establishing the program was $21,587, including costs associated with training in the ECHO® model, outreach to community partners to identify potential learners, and program content development. The monthly cost of maintaining the program is $479, involving sustaining relationships with community organizations, updating training content, and ongoing program evaluation. Delivering a round of the program costs on average $5,787, involving the time costs of guest subject matter experts and learners, and participant incentives. The total cost of delivering the model to one cohort over a one-year program period is $33,120. It is expected that the total cost would decrease over a longer program period because fixed costs would be spread out over time. While this is not an insignificant up-front cost, strategic investment in programs like RUMC’s EC ECHO® may serve to save money in the long term and promote optimal outcomes for children and families.