Reducing Global Health Inequalities For A Rare Disorder: Evaluating The International Prader-Willi Syndrome Organisation's Echo® Program

Abstract Background: people with rare disorders face significant global health inequalities, the challenge is how to raise awareness and develop a nucleus of experts in a country who are then able to provide guidance to others in that country. The International Prader-Willi Syndrome Organisation (IPWSO) established Project ECHO® with the aim of facilitating the sharing of knowledge and the building of international partnerships to reduce global health inequalities for a particular rare neurodevelopmental disorder, Prader-Willi Syndrome (PWS). Four different ECHO programmes were established for the following groups: a) Individuals (usually parents) who had taken on a leadership role in their country; b) health professionals interested in PWS; c) professional care providers supporting children and adults with PWS; and d) a Latin American ECHO in Spanish. The programme started in 2020 and an evaluation was undertaken after one year to determine: the extent to which we had been able to recruit and retain individuals globally; the nature and extent of any benefits gained from the sessions; and examples of how individual involvement in the programme had led to local benefits. The methods included analysing routinely kept process indicators and survey data from the attendees of one component of the program (the Leadership ECHO), together with a qualitative analysis of survey data and recorded interviews with attendees from countries of differing socio-economic status.Results: We describe the IPWSO ECHO programme and report on the outcomes from the evaluation of one aspect of the program, the Leadership ECHO. Program attendance was satisfactory, with a mean of 24.7 participants for the Leadership ECHO, with participants attending a mean of 5.67 sessions, i.e., 30% of sessions. There was also good global reach, with individuals attending from 34 countries, although there were notable geographic regions with very limited representation. Feedback and interviews demonstrated the positive impact of the program with some early evidence of positive developments at national level.Conclusions: Families and professionals from countries with a range of expertise and services they offer to people with PWS remained engaged throughout the ECHO program, established networks of support and fostered the development of good practice.