Providing Internet Based Health Information to Underserved Populations a Promotora Model
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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
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 Existing Health 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 promotingincreased 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