Partners for Health Information GWUMC Himmelfarb Library APHA October 2001

1. Partners for Health InformationGWUMC Himmelfarb LibraryAPHA October 2001

2. Project Objectives • Primary Objective: • Toreduce disparities in access to and use of health information by staff and patients of safety-net clinics through providing equipment, content, training. • SecondaryObjective: • To engage students in serving the local community for mutual learning.

3. Description of Partners Participants • 14 non-profit clinics of the District of Columbia. • Diversity of services, clients, cultures, capacities, and resources. • Uninsured and low income working class residents of the metropolitan Washington area - primarily Latino and African American residents.

4. Partners Methodology • Attended clinic-based staff meetings • Held library-based workshops • Made weekly and bi-weekly visits • Created bilingual Partners web page • Offered MD Consult to staff • Precepted service learning students • Hosted clinic staff listserv

5. One Size Doesn’t Fit All!Dissemination Models • "Train the Trainer” • Lobby/Waiting RoomAccess and Teaching

6. One Size Doesn’t Fit All!Dissemination Models • HIV Support and Peer Education Teen Groups • Health Educators as Intermediaries

7. Results: Year 1Visits and Workshops • Made 110 visits • Worked with 420 people • Spent 200 hours on-site • 5 Library-based workshops“It was very enlightening. Give instructions to a wise man and he will be yet wiser… Learning is not like eating. You can never have enough.”Patient comment

8. Lessons Learned:Multiple Needs • Address broader social determinants of health: jobs, housing, free exercise programs, educational resources, advocacy organizations. • Plan a long initial start-up time. • Protect staff time to accomplish objectives. • Provide basic training on using the Internet and computers. • Fund technology support in the clinics.

9. Lessons Learned:Electronic Information • Interest and awareness in electronic information: • high levels although most clients had not used it • apparent media influence • Information needs: • range from basic to complex, health and non-health: drugs, coping, alternative therapies, jobs, housing • maintain client centered approach • Information retrieval: • mutual sharing of resources with staff and patients • “teachable” moments

10. Lessons Learned: Information Content • MD Consult • Popular for bilingual patient ed and full-text material • MEDLINEplus: • Very useful • Broaden and balance • Provide top level Spanish • Add community resources • Develop more Interactive Tutorials - very engaging (although n=small)

11. Lessons Learned:Community Orientation • Community and client needs are primary - allow flexibility implementing objectives. Don’t force external goals. • Identify with community goals - attend community meetings and engage in health advocacy efforts. Need to take this on. • Offer resources - provide material resources, access to content experts, student involvement. • Enjoy different cultures and settings - and cherish the new relationships with clients and staff.

12. Lessons Learned:Demands on Project Staff Extremely time consuming and worthwhile to: • Develop learning materials and train consumers. • Maintain a consistent presence and level of support at each site. • Coordinate, train, and nurture student volunteers.“You CANNOT just give community groups a workstation and access to PubMED and think the information bridge has been completed.”

13. Project Weaknesses • Quality of the evaluation - poor validity, low utilization, and questionable generalizability of evaluation instrument • Time lag between visits and one-shot training • Language barriers • Equipment problems

14. One Solution:Directly Fund CBOs • To improve and achieve: • ownership and determination of project goals • better integration of information behaviors • fuller utilization of resources • more valid and complete evaluation data • sustainability.

15. Strategies for Direct Funding • Ask CBOs to contract and partner with librarians • Identify and recruit CBOs through established organizations, such as AHECs, PCAs, Urban League, La Raza, UPOs, local and state Departments of Health • Link CBOs with organizations to help them write proposals

16. Recommendations • Develop a national community-based consumer health outreach program with diverse members, regional or national meetings, CBO funding. • Guarantee frequent on site time by trainers. • Pay community-based trainers (lay health workers model) • Incorporate basic computer training as part of health information education.

17. Partner: Family and Medical Counseling Service Dr. Veronica Jenkins, Ed Robinson, Charles Williams

18. Partners for Health Information Participants George Washington University (contact: Karyn Pomerantz, kpomeran@gwu.edu; SPHHS) Students from the GWU ISCOPES Service Learning Program and the Howard University AmeriCorps. Clinics: Bread for the City Washington Free Clinic Children’s Health Centers SOME Community of Hope Spanish Catholic Center Columbia Road Health Services Upper Cardozo Health Center Community Medical Care Thanks to the support and interest of the National Library of La Clinica del Pueblo Medicine (NLM), especially Angela Ruffin, Janice Kelly, and Mary’s Center Jana Allcock. Max Robinson Center Special thanks to Ed Robinson, Charles Williams, Ana Aponte, Family and Medical Counseling Service and Monica Villalta for this presentation.