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Providing Internet Based Health Information to Underserved Populations a Promotora Model Barbara Hau RN, MS La Plaza Telecommunity Taos, New Mexico bhau@laplaza.org 505-758-1836 Taos County Rural – Population density 9.8 per Sq Mi Median Household Income $24,831 Tricultural

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Providing internet based health information to underserved populations a promotora model l.jpg

Providing Internet Based Health Information to Underserved Populations a Promotora Model

Barbara Hau RN, MS

La Plaza Telecommunity

Taos, New Mexico

bhau@laplaza.org

505-758-1836


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Taos County

  • Rural – Population density 9.8 per Sq Mi

  • Median Household Income $24,831

  • Tricultural

    • 67% Hispanic

    • 7% Native American

    • 26% Anglo

  • 28.2% less than H.S Education


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La Plaza Telecommunity

  • Community Technology Center established in 1994

  • Mission: To provide rural tri-cultural communities with:

    • Access to information technology resources

    • Education in Computer and Internet technology

    • A Virtual Library of Community Resources

  • Internet Access (ISP) 2200 dial in users

  • 4 public access computer centers

  • Free or low cost classes in Internet technology

  • Local and regional information on website: www.laplaza.org


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Diabetes Wellness Connection

  • Department of Commerce TIIAP (TOPS)

  • Technology Demonstration Project

  • Health Category

  • 1996-1998


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Goals

  • Provide Internet access to 3 rural clinics

    • Taos~Picuris Indian Health Center

    • PMS Questa Health Center

    • HCNNM Penasco Clinic

  • Provide Internet training for health care providers and consumers

  • Provide health content related to diabetes on La Plaza’s Website


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Access

  • Tech assessment (no capacity)

  • 12 months to build technical capacity

  • Installed phone lines and dial up connection

  • Installed computers

    • consumers - 1 desktop on roll cart in clinic lobby available for public access 10 hrs/week

    • Providers - 1 laptop available for “check out”


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Website Content

  • Focus groups:

    • POSITIVE Information re diabetes

    • Culturally sensitive messages

    • Trusted/familiar sources

    • Local resources/programs

    • Nutrition/diet/recipes

    • Exercise information/motivation

    • Emotional support


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Diabetes Wellness Connectionhttp://laplaza.org/health/dwc/

  • Links to National Websites

    • American Diabetes Association

    • Eli Lilly

  • Mark Up of ExistingHealth Education Materials

  • Personal Stories “Living Well with Diabetes”


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Promotora ModelCommunity Outreach Trainers

  • Native residents of respective communities

  • Bilingual (Spanish/Tiwa)

  • Strong desire to learn computer and Internet skills

  • Strong desire to help community members to learn skills


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Train the Trainer Model

  • Conducted 6 computer/Internet trainings with COTs

  • COTs present 10 hours/week at clinic sites (lobby) homes, H&H agencies

  • Logged encounters on Excel spreadsheet

  • Submitted monthly Excel reports of client encounters


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Curriculum

  • Hardware software (unpack, assemble, set up dial up connection)

  • Keyboard/Mouse/Windows

  • WWW navigation, search, bookmarks

  • Email send, receive, address, files, attach

  • MS Word

  • Excel (logs)


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Excel Logs

  • Date

  • Provider/Consumer

  • Sex

  • Age

  • Search/Topic


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Evaluation Data

  • Intervention time - 8 months

  • 1835 hours of Internet access for health providers and COTs

  • Trained 27 health care providers

  • COTs provided 297 individual training encounters in clinics

  • 23,358 website “hits”


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Evaluation Data

% pre % post

  • Seeking health info daily 37 50

  • Using computer daily 42 69

  • Access health info via

    computer 57 75

  • Access to health info good 44 61

  • Comfortable using computer 55 69


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Lessons Learned

  • Perform a technical assessment prior to implementing technology based health education projects

  • Adapt existing health information for website content

  • COT’s effective in introducing Internet based health information to peers AND HCP

  • Personal stories and culturally appropriate health information was most popular

  • Internet information interest broader than “health”

  • Community members desired participation in development of health content


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Recommendations

  • Increase Internet access through wireless broadband microwave radios

  • Increase pubic access computer sites in Taos County - 26

  • Continue the COT Model – 6 COTs

  • Continue to develop locally and culturally appropriate information on La Plaza Website


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Current Health Projects

  • Internet a Change agent for Rural Muticultural Adults

    • NCI 2000-2004

    • Partners

      • AMC Cancer Research Center, Denver

      • University of New Mexico

      • Colorado State University

    • Determine most effective strategies for training rural multicultural adults in using computers and Internet technology

    • Determine efficacy of website promoting

      increased intake of fruits and vegetables among residents of the Upper Rio Grande Valley


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Current Projects cont.

  • CyberYouth Project

    • New Mexico Department of Health

      Holy Cross Hospital

    • Train “at risk” youth in:

      • TUPAC Issues

      • Media Literacy

      • Website Design

    • Create websites addressing TUPAC issues

    • “World Premier” at Taos Talking Picture Film Festival, April 2002


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