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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 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 • 67% Hispanic • 7% Native American • 26% Anglo • 28.2% less than H.S Education
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
Diabetes Wellness Connection • Department of Commerce TIIAP (TOPS) • Technology Demonstration Project • Health Category • 1996-1998
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
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”
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
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”
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
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
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)
Excel Logs • Date • Provider/Consumer • Sex • Age • Search/Topic
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”
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
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
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
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
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