Reaching thousands: Using the internet to improve outreach, collaboration, and information dissemination

The purpose of the New Americans Health Information Access Project is to build upon the success of an earlier National Network of the Libraries of Medicine: Greater Midwest Region-funded project that provided access to quality health information to non-English speaking refugee and immigrant populations in the Chicago area. Eight dedicated health education computers were purchased and installed in seven mutual aid associations and one refugee resettlement agency   Health promoters working for those agencies and part of a health promoter program coordinated by Heartland Health Outreach received training on computer skills and health information website evaluation techniques.  As a result of this project, literally thousands of health information documents were located on the Internet in the more than fifteen languages spoken collectively by the collaborating agencies.  With the help of a student intern, the documents were organized by website, language, name, and hyperlink.  The unanticipated level of success of this project gave rise to a call to share these resources with other agencies in a manner that could be easily accessed and updated.  The result is a webportal (New Americans Health Information Project) hosted by the University of Illinois at Chicago that provides links to thousands of multi-lingual, multi-format health education documents.  These documents have been evaluated by bilingual health promoters according to criteria established by a medical librarian from a collaborating organization, the University of Illinois at Chicago Library of the Health Sciences.  The Internet site also serves as a website for primary health education material developed by Heartland’s Refugee Health Programs.

Heartland Health Outreach:

Heartland Health Outreach (HHO) is the health services partner of Heartland Alliance for Human Needs & Human Rights, a service-based human rights organization with more than a century of experience improving the lives of those threatened by poverty or danger. In the Chicago area, HHO is a leader in meeting the health needs of recently-arrived refugees, including health care, nutrition assessment and education, refugee mental health, treatment for torture survivors, and health education and promotion The New Americans Health Information Access Project taps into the success of Heartland Health Outreach’s health promoter program in making available to the targeted refugee and immigrant communities health information that is both linguistically and culturally appropriate. Since its establishment in July 2004, HHO’s health promoter program has provided training to health promoters from seven mutual aid associations through monthly workshops and periodic outside training opportunities. Recently, health promoters representing newly arrived refugee populations (Burmese and Burundi) have been  hired by HHO to provide health education and counseling on topics as basic as home and traffic safety and cold weather readiness. Health promoters receive formation in topics as varied as nutrition, winter safety, and home hygiene to diabetes, hypertension, and sexually transmitted diseases.  They pass on acquired health information to their communities during home visits, one-on-one counseling, or in group settings.  Some health promoters present during ESL or citizenship classes; others discuss health issues in women’s and men’s groups.  Other settings have been in ethnic churches, mosques, and temples. Access to quality multi-lingual, multi-format health documents is crucial for the health promoters’ outreach.  Newer technology, such as podcasts, have been successfully implemented.

University of Illinois-Chicago Library of the Health Sciences
The Library of the Health Sciences - Chicago (LHSC) serves the faculty, staff, and students of the University of Illinois at Chicago (UIC) as well as members of the general public seeking health information. The LHSC collection of over 500,000 volumes and 5,100 journals supports education, research, and clinical practice in the Colleges of Medicine, Dentistry, Nursing, Applied Health Sciences, Pharmacy, and the School of Public Health; the UIC Medical Center Hospital and Outpatient Care Center, and other affiliated health care institutions. LHSC also serves as the Regional Medical Library for ten Midwestern states under a contract awarded by the National Library of Medicine

Community profile
The 2000 Census documents that 12.3% of the population of Illinois is foreign born, and in the Chicago area, that percentage increases to 21.7%.  Moreover, the percentage of the foreign born living in the Chicago area that entered within the past 10 years is 45.2%.  Of the top ten areas of Cook County that serve as ports-of-entry, the first (Edgewater), second (Albany Park), and tenth (Rogers Park) lie within the area served by Heartland Health Outreach.  The Uptown area of Chicago ranks 17^th and is also part of HHO’s catchment area. The Uptown, Edgewater, Rogers Park, and Albany Park area of Chicago is home to almost 20,000 immigrants who arrived between 1995-2000, according to the 2000 Census.  No data is available for the percentage of immigrants in these areas who describe themselves as speaking little or no English, but for the Chicago metropolitan area, almost 35% of the immigrants admit to limited English skills.

Among the foreign born in the service area are many refugees from Laos, Vietnam, and Cambodia who arrived in great numbers during the late 1970s to early 1980s and continue to operate small businesses in the neighborhood.  More recent arrivals, including Africans from Ethiopia, Somalia, Sudan, and Liberia, Bosnia, the former Soviet Georgia, Afghanistan, Iran, Cuba, and Columbia have made their home in HHO’s catchment area. Nearly 2200 refugees are anticipated to be resettled in Illinois during FFY08, primarily from Birundi, Burma (Myanmar), and Iraq, and settled in the same HHO catchment area.  At Senn High School, the neighborhood high school, over 100 languages are spoken at home reflecting this area of Chicago as one of the most diverse in the country.

Staff and budget
The New Americans Health Information Access Project is a collaboration of seven mutual aid associations, Heartland’s Refugee Health Programs, and the University of Illinois at Chicago Library of the Health Sciences.  The program budget is $35,000 over an 18-month period.  The mutual aid associations receive a quarterly stipend for their assistance in the research and evaluation of health education materials in their language.  The remaining funds are divided between Heartland Alliance and UIC Library of the Health Sciences to cover the cost of administration and technical equipment.  Celine Woznica DrPH, associate director of Heartland’s Refugee Health Programs and Lisa Massengale MLIS, Assistant Information Services Librarian at UIC’s Library of the Health Sciences are the co-investigators of the project.

Innovation and usefulness for outside agencies:
There are various Internet websites that provide multi-lingual, multi-format health information either as a primary source for those documents or as web-portals with links to other websites. However, most of those websites target an English-speaking population with a certain degree of computer skills in order to navigate the website. The New American Health Information Access Project is designed for ease of use by the immigrant and refugee community with limited English and computer skills.  Community-based agencies as well as refugees and immigrants just learning Internet computer skills will appreciate the ease in which multi-lingual and multi-format documents evaluated for their quality and cultural and linguistic appropriateness can be accessed.