GETTING STARTED WITH INFORMATION

OUTREACH IN MINORITY COMMUNITIES

Jacqueline Leskovec, MLIS, MA, RNOutreach, Planning & Evaluation Coordinator, NN/LM GMROctober 2012

Let’s Get Started!

Getting to Know You

In what country were you born? What language did you first learn? What languages do you speak now? Describe one home remedy used by your

family when you were growing up.

Why are you here?

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 to develop an outreach plan

What is a minority?

Racial and ethnic minority populations are defined as: Asian American, Black or African American, Hispanic or Latino, Native Hawaiian and Other Pacific Islander, American Indian and Alaska Native. ~CDC

[A] part of a population differing from others in some characteristics and often subjected to differential treatment. ~merriam-webster.com

Getting started with Cultural Competency

What is cultural competency and why is it important?

Are there legal and health care guidelines?

How do I find community demographics? Where are you in your cultural

competency?

Importance of Cultural Competency

What is culture? One definition: Characteristic features, beliefs,

social norms, and way of life shared by a racial, religious, or social group, or by people in a specific place or time

It’s not just about the words! Differences between Western Caucasian and East Asian

facial expressions / - Western emoticons primarily use the mouth ^.^/;_; - Eastern emoticons primarily use the eyes

Culture and Patient Health

• Beliefs about objects, symbols, food, the body, blood, non-traditional medicine, etc.

• Communication styles and norms• Role of relationships• Ways of learning new information• Role of translations and interpreters

Health Disparities

Racial, ethnic, sexual & other minorities Residents of rural areas Women, children, the elderly Persons with disabilities Immigrants, refugees, asylees

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://tcn.sagepub.com/cgi/content/abstract/13/3/193

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

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

Health Literacy

“The degree to which individuals have the capacity to obtain, process and understand basic health information and services need to make appropriate health decisions.” (Healthy People 2010)

Legal Guidelines

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 benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” http://www.usdoj.gov/crt/coord/titlevistat.htm

Legal Guidelines

The Joint Commission Advancing Effective Communication, Cultural

Competence, and Patient-and Family-Centered Care http

://www.jointcommission.org/Advancing_Effective_Communication/

“…more than a patients’ rights issue…critical to safety and quality of care.”*

Chapter 9, Domain 6 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.

Hospitals Language and Culture: A Snapshot of the Nation

[A]lthough barriers to the provision of culturally sensitive care continue to exist, this issue is one that hospitals must address in order to provide safe, patient-centered care now and in the years to come…[f]irst, as a preventative safety measure. We know that communication is essential to safety.

And…

it’s the right thing to do.

Health Equality

[The] attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.

~Healthy People 2020HealthyPeople.gov

Let’s play!

What is Outreach?

“In community-based health information outreach, organizations work together to improve peoples’ abilities to find and use health information.”

Source: Getting Started With Community-Based Outreach http://nnlm.gov/evaluation/guides.html#A2

Resources

The Four Rs

Relationships Respect Relevance Repetition

Learning About the Community

Build the demographic picture Identify local agencies and resources in

the community What gaps are there in health status? Where are the needs for health

information? Resource: Welcome, stranger-- : public

libraries build the global village : toolkit

Finding Demographic Information

United States Census Bureau http://census.gov/ State & County Quick Facts

http://quickfacts.census.gov/qfd/index.html

American Fact Finder http://factfinder2.census.gov/

Minority Links http://www.census.gov/newsroom/minority_links/minority_links.html

State Data Centers http://www.census.gov/sdc/www/

The Modern Language Association Language Map http://www.mla.org/resources/census_main

Learn Even More

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!

Selecting Partners

Seek intermediaries Community leaders Early adopters Trusted community members

Work with people of like passion

Working Together

Methods for Strategic Collaboration

Café to Go (World Café) http://www.theworldcafe.com

Appreciative Inquiry

Open Space Technology (the Unconference)

Source: http://www.triunemilagro.com/methods_for_strategic_collaboration

Identifying Health Information Needs

With your partners: Listen Abandon preconceived ideas – think “outside the

box” Think about language, ethnicities, country of

origin Consider other needs – transportation, childcare,

medical care Identify potential barriers Café to Go!

Café to Go!

“Hosting conversations about questions that matter”

Images from the World Café Image Bank: http://www.theworldcafe.com/ibank.html

Creating the Environment

Set the theme Who are the

participants? What are the

questions? Café setting

Food Tables with toys Table host(s)

Wrap-up Tying it all together to

the theme Next steps?

Café to Go Design Principles

http://www.theworldcafe.com/principles.html

Café Etiquette

Focus on what matters Contribute your thinking Speak your mind and your heart Listen to understand Link and connect ideas Listen together for insights and deeper questions Play, Doodle, Draw!

Appreciative Inquiry

An approach to change that focuses on finding the positive elements in people and places and using those aspects of an organization as a foundation for change. http://www.nickheap.co.uk/articles.asp?ART_ID=211 Appreciations Exercise: http://

www.nickheap.co.uk/articles.asp?ART_ID=206

“AI is intentional inquiry and directed conversation and story-telling that leads to a place of possibility.” (Steinbach, John. Contribution to the AI Listserve, July 2005) http://appreciativeinquiry.case.edu/

Open Space Technology

Facilitated (at some level) Participant-driven Common theme Other names:

Library Camp The Unconference

Principles and Laws

Whoever comes is the right people. Whenever it starts is the right time. Whatever happens is the only thing that

could have happened. When it’s over, it’s over. The Law of Two Feet

Texas Library Association, April 2011: “Information Literacy from Birth to Earth”

http://2011tlaunconference.wiki.zoho.com/HomePage.html

Science, Technology and Engineering Library Leaders in Action! http://denver-stella.pbworks.com/

Health Camp NYC: Using Collective Knowledge to Improve health Literacy and Community Health http://healthcampnyc.wetpaint.com/

Examples

Activity!

Activity Instructions

1. Get together in small groups and select a scenario from the handout.

2. Select a “method” to use to set up a meeting to respond to the scenario.

3. Report highlights to the larger group.

What kinds of activities might you do?

So…….

Interaction

Goal-

shari

ng

HighLow

Low

Hig

h

Cooperation Collaboration

CoordinationNetworking

Strategies for Working Together

NN/LM Outreach

NN/LM Outreach

The goal of our outreach programs is to expand partnerships and implement activities with network members and other institutions and organizations to improve awareness of and access to health information resources for health professionals, the public health workforce, and members of the public.

NN/LM

What is Outreach?

Extend services and expertise to groups, agencies, and institutions beyond traditional reach

“You must leave the parking lot to do outreach.”

Barriers to Locating Health Information

Resources

MedlinePlus/MedlinePlus Español Health topics Drugs & Supplements Demographic Groups

Children and Teenagers Men Population Groups Seniors Women

NIH Senior Health

Basic health and wellness information Topics of concern for seniors

Bones and Joints Cancer Diseases and Conditions Healthy Aging Heart and Lungs Memory and Mental Health Treatments and Therapies Vision and Hearing

RHIN

Refugee Health Information Network http://www.rhin.org Multilingual health information (more

than 80 languages) for health providers, refugees and asylees

Large section on cultural guidance Country Conditions Reports Multiple formats (print, audio, video)

EthnoMed

http://ethnomed.org Merged material from former 24

Languages Project Background information on cultures and

cultural competency Patient education materials

DiversityRx

Improving Health Care for a Diverse World http://www.diversityrx.org Webinars Cultural Competence Conference

http://www.healthyroadsmedia.org/ Multiple languages; multiple formats

Includes iPod video and multimedia

Health Information Translations

http://healthinfotranslations.org/ Health topics include Diagnostic Tests and

Disaster Preparedness Linked to from MedlinePlus!

A friendly place!

http://www.youtube.com/watch?v=bCzCbYz6Vd0

Who we are

Thank you!

Jacqueline Leskovec

leskovec@uic.edu

1.800-DEV-ROKS

NN/LM Outreach Evaluation Resource Center

http://nnlm.gov/evaluation

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-276-2011-00005-C with the University of Illinois at

Chicago.