# Presentation: 638273

## Getting Started with Information Outreach in Minority Communities 

**Siobhan Champ-Blackwell**
**National Network of Libraries of Medicine**
**siobhan@creighton.edu**

## Board Member	

**Center for Human Diversity**
- <http://www.centerforhumandiversity.org/>
**Presbyterian Outreach Inc**
- <http://www.presbyterianoutreach.com/>

**Notes:**
This is a space holder for listing any organizations you might belong to 

## Who are you?	

**What country were you born in?**
**What language did you first learn?**
**What languages do you speak now?**
**Tell us one home remedy your family used when you were growing up**

**Notes:**
Have 8 1⁄2 x 11 cardstock – fold in half to make name tents. On one side people write their name, on the other side, they answer as many questions as you want. Depending on the size of the class, they either share answers with a neighbor, or if the group is small enough, everyone has a chance to tell the whole group.

## Why are you here?

**Notes:**
Hopefully these answers will lead into the next slide of learning objectives.

## Learning Objectives

**Define cultural competence**
**Apply principles of cultural competence in outreach programs**
**Examine ways to learn about local communities**** **
**Learn about strategic collaboration**
**Outline the steps in developing an outreach plan**

**Notes:**
We are going to go over some core information that I would like to share with you and that I think will help.

Then we are going to look at the steps that you might take in going about your project or activities.

After the break will do some group activities with reporting back that will allow you to discuss aspects of the presentation.

I also want to tell you that there is no substitute for actually going out and doing the work. If you are honest and open about who you are, what you have to offer, and show that you are willing to learn, generally people are very welcoming – or at least receptive. 

## Let’s get started with cultural competency

**What is cultural competency and why is it important?**
**What are the legal and health care guidelines?**
**How do I find community demographics?**
**Where are you in your cultural competency?**

**Notes:**
These are questions we will discuss in the next several minutes

## Cultural Competence

**    ****A set of behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professionals to work effectively in cross-cultural situations**
** ****From: Cross T, Bazron B, Dennis K, and Isaacs M (1989) Towards a Culturally Competent System of Care Volume I.**
**See the Purnell Model for Cultural Competence **
**http://www.tcns.org/society/PurnellModel2.pdf**

**Notes:**
Culture – we are like fish in fishbowl, surround by water (culture) but not aware of it. we interact with others in their own fishbowl, and somehow we have to find ways to communicate with each other

##     Rationale for Cultural Competency

**Perception of illness and disease varies by culture**
**Diverse belief systems exist related to health, mental health, healing, wellness**
**Individual preferences affect approaches to health care**
**Individuals must overcome personal experiences of bias**

**Notes:**
Why should we worry about cultural competence?

People learn and remember best when new information is related to their current knowledge and experience. Therefore, to be most effective, we must relate the health information we provide to our users own experience and knowledge – which may be very different from our own. We must be aware ourselves of our own bias, and approach others openly. 

As we will see, there are laws and standards that make cultural competency a requirement for health care professionals, and as medical librarians we support our providers with our knowledge of those laws and standards.

## Linguistic Competence

**The capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, and individuals with disabilities.**
- From: The National Center for Cultural Competence, Georgetown University Center for Child and Human Development

## Title VI of the Civil Rights Act- 1964

**No person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. ****<http://www.usdoj.gov/crt/cor/coord/titlevistat.htm>**

## The Joint Commission

**Hospitals Language and Culture: A Snapshot of the Nation **_**[http://www.jointcommission.org/PatientSafety/HLC/](http://www.jointcommission.org/PatientSafety/HLC/)**_** **
***	***
***	******The delivery of health care services in a manner that is respectful and appropriate to an individual’s language and culture is more than simply a patient’s right, but is, in fact, a key factor in the safety and quality of patient care (Schyve, 2002). ***** **

**Notes:**
From the website: Research has shown that a lack of sensitivity and responsiveness to cultural and language needs impacts quality, safety, and patient satisfaction. In addition, one-half of the U.S. population lacks the skills to function within the health care system. 

## JCAHO Chapter Six

**Community Engagement**
*	**Outreach activities that may increase diverse populations’ use of hospital services through education and tailoring of services to meet specific population needs is another important element.*

## Finding Demographic Information

**American Fact Finder **_**[http://factfinder.census.gov/](http://factfinder.census.gov/)**_
**US Census Bureau Minority Links **_**[http://www.census.gov/pubinfo/www/hotlinks.html](http://www.census.gov/pubinfo/www/hotlinks.html)**_** **
**Census Bureau State Data Centers **_**[http://www.census.gov/sdc/www/](http://www.census.gov/sdc/www/)**_
**The Modern Language Association Language Map **_**[http://www.mla.org/resources/census_main](http://www.mla.org/resources/census_main)**_
**ZipSkinny **_**[http://www.zipskinny.com/](http://www.zipskinny.com/)**_

**Notes:**
On the American Fact Finder, go to the State Fact sheets. Select a couple of state fact sheets to view based on who is in the room. Ask class for volunteers to to introduce themselves and say something about their state and their particular community – then view the statistics online.

Remind class about the Census Bureau State Data Center. Each state has one center, who’s role it is to provide access to the US Census Bureau data. Contacting someone at your state center can be one way to begin learning about the make up of your community.

MLA Language Map: “The MLA Language Map uses data from the 2000 United States census to display the locations and numbers of speakers of thirty languages and three groups of less commonly spoken languages in the United States.” 

Zip Skinny is a cool site – but when you do a search you will find these cautions in the About Zip Skinny tab: “This site was created as a Web development "hobby" project using Census 2000 data obtained from the Census Website. While every effort has been made to ensure the accuracy of the information, errors and omissions can occur, and visitors are encouraged to use the actual Census site instead of this one for any serious research.”

## Barnga!

## What is Outreach?

-    “In community-based health information outreach, organizations work together to improve peoples’ abilities to find and use health information.”
*Getting Started With Community-Based Outreach*** **_[http://nnlm.gov/evaluation/guides.html#A2](http://nnlm.gov/evaluation/guides.html#A2)_

**Notes:**
If possible, order these books ahead of time so there are enough of the booklets to give each class participant. Read page 1 of the 1st booklet – the Introduction. Lots of good discussion material on effective community based health information outreach.

## The Four R’s:All You Really Need to Know

**Relationships**
**Respect**
**Relevance**
**Repetition**

**Notes:**
This is all you really need to know!

The highest priority is that you must develop relationships – relationships with individuals and relationships with the community

You need to respect the people and the communities with which you are working or planning to work. Don’t approach them with what I call “the lady bountiful” approach. They may take offense at that. Just because people are in a minority, underserved, and/or low socioeconomic group, doesn’t mean that they aren’t smart, educated, organized. This is a partnership of equals you are working toward.

You need to make sure that what you have to offer to them is relevant to the community, their current needs and current situation. You need to respect their identification of what their needs are. 

And “no drive-by” outreach. You need to keep coming back and coming back – over years

## Learning About the Community

**Build the demographic picture**
**What local agencies and resources are in your community?**
**What gaps are there in health status?**
**Is there a role for health information?**

**Notes:**
You have done an initial assessment of the community through the statistical data you have gathered. What else do you need to know about your community? Who is already providing health information and health services, and what gaps are there? 

## Learn More

**Where do people congregate?**
**Where are the social activities?**
**Where are the educational activities?**
**Where do people shop and take care of business?**
**Where to people get their information?**

**Notes:**
Its important to learn where people are, and to bring the information to them, not expect them to come to you. 

## Finding Partners Within the Community

**Network**
**Be consistent**
**Demonstrate your commitment**
- Work with or join, already existing organizations
- Attend health fairs, conferences and other events in your community
- Don’t forget your public library!

**Notes:**
Determine what groups to approach and how
	disease or condition (eg, AIDS workers, breast cancer support group)
	job (e.g., teachers, nurses)

Seize the opportunities
go to health fairs; start volunteering

Try to find out where people currently go for information – friends/TV/radio – see if you can improve those resources

## Selecting Partners

**Seek intermediaries**
- Community leaders
- Early adopters
- Trusted community members
**Work with people of like passion**

**Notes:**
Find people who can run interference for you in the community or who will be your leader
Often these are people who are already leaders or early adopters of new ventures or technology. 

Also look for people or groups who will endorse what you do

Seek out parallel programs such as adult education, health literacy, technology centers – where you might be able to easily insert health information into existing activities rather than have to start independently

## Working Together

## Methods for Strategic Collaboration

**Café to Go**
**Appreciative Inquiry**
**Open Space Technology**
- http://www.triunemilagro.com/methods_for_strategic_collaboration

**Notes:**
These are three different techniques that can be used in groups or partnerships to draw out what already exists in a community, and what needs are still there. They are techniques that draw from the people at the table, so are good strategies to use to create meaningful partnerships that are relevant to each person present. The Next activity uses the Café to Go methodology to demonstrate to the class how easy it is to do.

## Identifying  Health Information Needs

**With your partners:**
**Listen**
**Abandon preconceived ideas**
**Think about language, ethnicities, country of origin**
**Consider other needs – transportation, childcare, medical care**
**Identify potential barriers**
**Café to Go!**

**Notes:**
Find out about existing barriers to access heath information
Use a variety of methods for discovering information needs in terms of topic, level and format
Seek out current materials that match those needs
Where no materials can be found try to arrange for that to be created – this is especially true for creating alternate formats

How would you identify needs – short of a formal needs assessment – enough so that you can approach someone or an organization (think about local newspapers; web sites of local orgs, schools)

Although many libraries try to do a research based approach to needs assessment with a statistically-based sample and a field tested survey instrument, I believe that we have better success in minority communities by taking the practical approach– gain an overall understanding of the community/environment/target group. 

## Café to Go!

## Assess Community Assets

**Level of connectivity**
**Training centers/locations**
**Libraries**
**Educational institutions**
**This can be considered part of community environmental scan**

**Notes:**
Now its time, with your partner to develop a list of assets in the community. 

## Assess Group Assets

**What does the combined partnership bring to the table**
**Appreciative Inquiry!**

## Team Charters

**The American Health Association Team Charter**
**North Carolina Department of Transportation **

**Notes:**
Using Team Charters is an excellent way for a group to make sure they have developed a common mission, understand who will be responsible for specific activities, and add in how the evaluation of the project will take place. The best one I have seen is used by the Tribal Connections Four Corners region and was developed by the University of New Mexico. I can’t find a link to it online at this point, and I’m not sure what the copyright issue is on it.

## Make a Plan!

**Understand your level of cultural competence**
**Begin networking in diverse communities**
**Assess community needs**
**Find like minded community partners **
**Identify needs to collaborate on**
**Assess the groups joint assets**
**Put it all together!**

## What Kinds of Activities Might You Do?

**Notes:**
Promotional - exhibits, brochures, fact sheets
Infrastructure or Logistical – providing equipment, providing document delivery
Educational - Training – direct training
Partnerships - Peer tutor projects  

## Outreach can take you places   you never expected to go!

##     More Information

**Find your local NN/LM **
- http://nnlm.gov
- 800-338-7657
**NN/LM Outreach Evaluation Resource Center http://nnlm.gov/evaluation**
**CE courses**
- Workshops through the NN/LM
- National Online Training Center and Clearinghouse
- MLANET CORE – Center of Research and Education
- Funded by the National Library of Medicine under a Contract No. NO1-LM-6-3504 with the University of Utah Spencer S. Eccles Health Sciences Library

**Notes:**
NNLM workshops
Making a Difference 
Measuring Your Impact 
Planning and Evaluating Health Information Outreach Projects 

## Resources 

**Notes:**
You aren’t alone – there are great resources for finding more information

The Outreach Evaluation Resource Center, not surprisingly, has many useful and practical resources for planning and evaluating any type of outreach. 
Planning and Evaluating Health Information Outreach Projects
Measuring the Difference: Guide to Planning and Evaluating Health Information Outreach