heath education and literacy project (help) community service. research. education
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Heath Education and Literacy Project (HELP)
Community Service. Research. Education.
Club Mission
HELP is a community service project dedicated to providing health education and increasing health literacy through lessons at local adult education centers.
Additionally, our project seeks to teach medical students how to become advocates for public health and health literacy, as well as proficient counselors on health issues affecting the most vulnerable segments of the population.
The Health Education Literacy Project seeks to foster a spirit of learning by integrating a research component to assess the success of our interventions.
The final goal is to reduce health disparities in underserved communities through education and the publication of scholarly work.
Why HELP?
Educational inequities and health disparities exist.
HELP exists because there are people in the greater NYC area (and country) who lack health education AND have low health literacy.
We are working to improve the health knowledge and health literacy of the learners that we serve.
We also hope to improve student’s understanding of their risk for particular health conditions, and hope to motivate students to seek health services, if necessary.
Health Literacy
“Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” (HHS, 2000; IOM, 2004)
• Stronger predictor of health than age, income, employment, education, and race (JAMA, 1999)
• >1/3 of US adults have low health literacy (2003 NAAL; Kutner 2006)
• Minorities and low SES at increased risk for low health literacy
Health Knowledge
Health knowledge refers to one’s knowledge of specific health topics.
Individuals with low health literacy often lack knowledge or have misinformation about health topics.
Literacy impacts knowledge.
Who We Are
Group of over 50 medical students at NYU
Mostly MS2’s (and now MS1’s), with MS2’s and MS4’s leading our research initiative
Program began in 2009
Has expanded from 12 medical students
What We Do
Designed user-friendly, low literacy lesson plans
Teach lessons at an adult education site in Central Harlem: Nutrition Hypertension Diabetes
Conduct pre- and post- semester surveys
Analyze results at the end of each semester for scholarly purposes, and to assess our effectiveness as teachers
RML Outreach Express Award
Primary Goals: Incorporate technology into instruction Promote access and use of MedlinePlus and
MedlinePlus en Espanol Revise curriculum to include sources for more
information Improve medical student understanding of patient
education and health literacy concepts and resources
Purchases
Two Pocket Projectors
9 iPad 2 – 32 GB with WiFi
Productivity Apps (Keynote and GoodNotes
Help Curriculum
6 Lessons per Class: Diabetes (2x – English and
Spanish) HTN (2x – English and Spanish) Nutrition (2x – English and
Spanish)
RML Grant iPads and portable projectors
New, updated curriculum 15 person collaboration
Hypertension Curriculum• ESL, GED classesCommunity Recruitment
• Demographic information• Current Health Literacy level
• Current hypertension knowledge
Session 1 - Preliminary Questionnaire
• Lesson on reading nutrition facts labelSession 2 - Nutrition
• Scheduling visits to health care providers• Finding a local healthcare facility
Session 3 - Access and Availability of Health
Resources
• Risk factors• Blood pressure scale
Session 4 - Hypertension Education
• Complications of hypertension• Risks for other diseases
Session 5 - Importance of Hypertension Awareness
• Regular monitoring of blood pressure• Dietary modifications, exercise
Session 6 - Lifestyle modifications
Session 7 - Cumulative Review
• Post-intervention level of health literacy• Post-intervention level of hypertension knowledge
Session 8 - Post-Intervention Assessment
Help Curriculum
Sample Lesson #1: PPT Presentation Group Activity Small Group Review
Sample Lesson #2: IRAT/GRAT- Based on information from Lesson #1 Group Activity- Apply knowledge in clinical settings
Outcomes
Spring 2013 – Four classes (six sessions each) taught Two for diabetes and two for hypertension About 15 participants per class – 60 participants overall
Participants enjoyed learning how to use the iPads
Participants liked the interactive modules
Medical students liked having the flexibility and interactivity provided by the technology
Challenges
Hurricane Sandy in Fall 2012
Teaching location closed
Student leaders
New leaders every year
Community contacts New community contacts not as invested
Future Plans
Work with health literacy faculty advisor to re-establish program
Recruit and train new student leaders
Find new community contacts
Thanks!
HELP President 2010-2011: Lauren Antler
Co-Presidents 2011-2012: Alex Dillon and Sue Boddu
Co-Presidents 2012-2013: Kathryn Iwata and Julie Kokinos
AND
NN/LM Middle Atlantic Region
This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00003-C with the University of Pittsburgh, Health Sciences Library System.
A Clinical Information Tool for Community Health Centersfunded by the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00003-C with the University of Pittsburgh, Health Sciences Library System
Charles B. Wessel, John LaDue & Julia DahmHealth Sciences Library System - University of Pittsburgh
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Used with permission National Association of Community Health Centers. 2013. "Community Health Centers at a Glance" Fact Sheet #S0313. Available at: http://www.nachc.org/client/documents/Infographic--CHCs.pdf 18
PROJECT OVERVIEW clinical information tool for community health centers
Develop, evaluate and validate a search tool that maximizes the use of freely available relevant Internet clinical resources
Target audience for the tool Primary care health professionals practicing in
community health care settings Lack access to a medical library Expensive licensed information tools and resources
are cost prohibitive
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PROJECT TEAM–clinical information tool for community health centers
Tool Developme
nt Team
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John LaDueKnowledge Integration
Julia DahmTechnology Services [email protected]
Charlie WesselHead of Research and Reference [email protected]
PROJECT PHASES clinical information tool for community health centers
2012-2013 Feasibility Study
2013-2014 Demonstration and Evaluation Study
2014-2015 Validation Study
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FEASIBILITY STUDY 2012-2013 clinical information tool for community health centers
• NLM• CDC• NHS• WebMD• AHRQ• Cochrane• ARUP• QuestDiagnostics
• AACC• Skyscape
Identified Quality Free Resources • Drug
Information• Patient Education
• Free Medical Resources
• Free PubMed Articles
• Lab Tests• Medical Calculators
• USPTSF Recommendations
Arranged Free Resources
• IBM InfoSphere Data Explorer (formerly Vivisimo Velocity)
• LibGuides
Federated Search Tool
and Web Platform
• Knowledge Integration Librarian [LaDue]
Engineered Search
Strings for Resources
•Content expert (Wessel)
• ADHD• COPD• Bipolar disorder• Osteomyletis• Type 1 diabetes• Diabetes mellitus• Hip replacement• Coronary artery bypass• Influenza• Atrial fibrillation• Migraines• Thyroid nodules• Thyroid cancer• Chemoprevention breast cancer
• Autism• Back pain• Atorvastatin• Evening primrose• Black cohash• menopause• Coumadin• Urinalysis• Anion gap• etc
Analyzed Resource
Performance in Tool
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THE TOOL –FEASIBILITY STUDY 2012-2013 clinical information tool for community health centers
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THE TOOL –FEASIBILITY STUDY 2012-2013 clinical information tool for community health centers
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RESULTS - FEASIBILITY STUDY 2012—2013 clinical information tool for community health centers
Proof of Concept• Technically feasible• Quality “free” clinical resources• Can Integrate “free” resources• Maximize use of NLM resources • Prototype Web site
Barriers• Free clinical resources contain both
consumer/patient & professional content
• Duplication of content• Registration required to access one
selected resource• Viability of access to free content• Querying whole site
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PROJECT PHASES clinical information tool for community health centers
2012-2013 Feasibility Study
2013-2014 Demonstration and Evaluation Study
2014-2015 Validation Study
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DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
Name Tool
• Open Access Clinical: a clinical information tool for community health centers
Adjust Tool
• move tool to content management system
• add auto-complete
• make 508 compliant
Evaluation
• Develop Usability Test Interview
• Recruitment scripts
• IRB approval
• Study participant recruitment partner-Southwest Pennsylvania AHEC, Inc
Interviews
•
Julia Dahm, technology services librarian
• March 2014
• Transcribe recorded interviews
Study Data
• Code
• Analyze
• Interpret
• Results
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THE TOOL –DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
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THE TOOL –DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
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STUDY PARTICIPANTS – 5 CLINICAL EXPERTS –DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
People
Equipment
Locations
Manufacturing
Sales
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USABILITY INTERVIEW TASKS DEMONSTRATION & EVALUATION
STUDY 2013-2014 clinical information tool for community health centers
Task 1: Find the recommended adult dosing for valtrex for herpes zosterAre you able to find the information? Is the content what you expected?
Task 2: Find an article on the management or evaluation of solitary pulmonary nodules
Are you able to find the information? Is the content what you expected?
Task 3: Find information on when to do PSA screening in asymptomatic menAre you able to find the information? Is the content what you expected?
Task 4: You have a patient that was just diagnosed with asthma. Can you find some information on how to use an inhaler for her to read?
Are you able to find the information? Is the content what you expected?
Task 5: Look for information on a clinical topic you are familiar with or locate information on clinical question you
recently looked up.Are you able to find the information? Is the content what you
expected?
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USABILITY INTERVIEW TASKS DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
Unsuccessful TasksDrug Task
Patient Education TaskSuccessful Tasks
Diagnosis TaskDisease Task
Their Clinical Task
Found information to answer most of the clinical usability tasks.
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STUDY PARTICIPANTS –CLINICAL EXPERTS’ SUGGESTIONS –DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
Brand the site
Radiology tests and interpretation
Herbs and dietary supplement
Drug interaction checker
Patient education in foreign languages
ICD-10 look-up tool
Rank results in tiers to speed up the display of Vivisimo search results 33
SUMMATION OF TOOL COMPONENTS – DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
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SUMMATION OF TOOL COMPONENTS–DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
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TEAM QUESTIONS–DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
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1. What was bad or did not work with the site?
2. Are there solutions (fixes) to address #2?
3. If yes what are the solutions?
4. If no, why are there no solutions?
5. Can we move to the next evaluation phase as proposed?
CONCLUSIONS - DEMONSTRATION & EVALUATION STUDY 2013-2014 clinical information tool for community health centers
Open Access Clinical:
Provides free clinical resources of high quality
Can answer primary care providers clinical questions
Will highlight and maximize the use of National of Library of Medicine resources in a clinical setting
Can be deployed and tested using “real” primary care clinical questions through a validation study. 37
2012-2013 Feasibility Study
2013-2014 Demonstration and Evaluation Study
2014-2015 Validation Study
PROJECT PHASES clinical information tool for community health centers
Site Upgrades
Stay Tuned!
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