Booklet 1 - Figures

Figure 1: Conducting a Community Assessment

STEP 1: Get Organized

Identify a target community
Assemble a team of advisors
Conduct a literature search
Take an inventory of what you know about your target community
Develop evaluation questions to guide your community assessment
Check organizational policies to determine whether your project will require institutional review

STEP 2: Gather Information

Consult existing data sources (such as publicly accessible statistical databases) to learn about your target community
Use data collection methods such as interviews, focus groups, and surveys to gather additional information to answer your evaluation questions

STEP 3: Assemble, Interpret and Act on Your Findings

Summarize data
Interpret findings and circulate reports to stakeholders
In consultation with your team of advisors, determine if a project in your target community is needed and feasible

Figure 2: Networking Opportunities

The Network of the National Library of Medicine regional office for your area (also known as your Regional Medical Library) can be an excellent source of information about potential partners and ongoing outreach projects. Funding opportunities for health information outreach may even be available. Find information about your Regional Medical Library at https://nnlm.gov/ or call 1-800-338-7657 from within the United States. Here are some other networking opportunities to consider:

If you represent a health sciences or hospital library

Hold exhibits at local events, such as community festivals or health fairs. Take the opportunity to meet and greet other exhibitors from the community.
Make an appointment to meet with school librarians to demonstrate MedlinePlus, especially at high schools with health careers programs. While you provide this service to the school, you can find out about its library and explore opportunities to work together.
Make contact with staffs that provide health education at medical clinics and hospitals, especially those with medically underserved clients. You can help them with their education services and they may ask you to conduct demonstrations for health professionals or patients who would benefit from learning about health information resources.
Get to know public librarians, who often make great community partners. Public libraries provide Internet access to individuals who may not have access at home, school, or work. They also can provide training space and have direct contact with members of diverse age, ethnic, income, and professional groups. They are often looking for affordable ways to expand the resources they can offer to their communities.
Make appointments with community college faculty in health-related disciplines. They may have student internships and community service activities as part of their curricula. They can provide you with contact to professionals-in-training, while you can enhance their health curricula by providing skill-training to their students.
Get to know people in state health departments who are engaged in public health promotion or health education. They often conduct educational programs and services, and can provide access to groups of consumers and patients. In turn, you can contribute to their educational mission by offering demonstrations and training on health information, both to staff and clients.
Get to know people in city or county emergency services organizations. They may be interested in learning about online databases designed for first responders. Some city and county governments also have community outreach staff that teach emergency preparedness to residents and may welcome partnerships with libraries.

If you represent a community-based organization or public library

Visit the library at your local medical school or academic health sciences center and see what types of services are provided to the community. Health sciences libraries may have outreach coordinators who would be interested in partnering with you.
Visit libraries in area hospitals. You may find good resources and potential partners there. Libraries that have consumer health collections are listed on the National Library of Medicine's MedlinePlus Find a Library web page, and many of these are hospital libraries. You can find a listing of other health sciences libraries, including hospital libraries, at https://nnlm.gov/membership

Figure 3: Stakeholders for a Health Information Training Project for Migrant Health Community Health Workers

Health information outreach project: a train-the-trainer project to teach community health workers (paraprofessionals) in a Migrant Health Clinic to provide health information to clinic patients.

Stakeholders

Patients at a Migrant Health Worker clinic
The health educator who trains community health workers and bilingual volunteers
Clinical staff that provides health services to migrant patients
The funding agency for the health information outreach project
Health sciences library staff conducting health information outreach training for community health workers
Administrative staff at the Health sciences library who oversee personnel involved in the health information outreach project

Figure 4: The Innovation-Decision Process

This is the process that individuals go through when adopting a new product, resource or behavior.

Figure 5: Factors That Influence Innovation Adoption

Relative advantage: The innovation is better (i.e., easier to use, more accessible, higher quality) than the product or resource that supersedes it.
Compatibility: The innovation is compatible with existing values, past experiences, or current needs.
Complexity: The resource or product is perceived as simple to use.
Trialability: The user can easily experiment with the product before coming to adoption.
Observability: The results of the innovation are visible to others. (If people can see the results of a peer's use of an innovation, they will talk about it with others.)

Figure 6: Identifying Innovators and Early Adopters

When you demonstrate a website at a site or community event, which visitors seem most enthusiastic about your resource? Who is likely to sign up or request training?
Who in the community needs better access to health information? For example, community health workers and community based organization volunteers may often receive requests from community members for health information but may not have convenient access to the Internet or the search skills necessary for locating health information.
Who currently has values, habits, experience, and needs that are consistent with use of online health information? For instance, you might find a group of clinic staff members who must do patient education. They may find the MedlinePlus tutorials an excellent, efficient way to make presentations to patient groups. Adult literacy educators may need to teach some basic computer skills and would integrate MedlinePlus training into a computer literacy session.
Who in the community has some experience with the technology needed to access your resources? Experienced users will respond more quickly to your innovation. For instance, in many communities targeted by health information outreach, children and teens are often the most experienced with computers.
Who in the community will experience and demonstrate tangible results if they use your health information resources? For example, if health professionals distribute handouts from your databases to patients, they are demonstrating use of your resources. Health information that is customized to the patient's needs is an observable outcome of using your resources.
Who in the community has access to locations where they can practice using the innovation? One of the most troublesome areas of outreach is that many members of typical target communities do not have ready access to the Internet. If your health information outreach involves accessing online health resources, you will want to make sure those you train first will have convenient access to computers.

Figure 7: SWOT (Strengths, Weaknesses, Opportunities, Threats) Analysis for Community Assessment Planning

Team Strengths

What are the strengths that the team possesses to conduct an outreach project with the target community?

Team Weaknesses

What are the team's shortcomings for conducting health information outreach?

Team Unknowns

What do we need to find out about the team before planning an outreach project?

Community Opportunities

What community characteristics, resources, and assets of the community will support the team's project?

Community Threats

What aspects of the community may create challenges or barriers to an outreach project?

Community Unknowns

What do we need to find out about the community before planning an outreach project?

Figure 8: Community Assessment Questions

Listed below are some typical community assessment questions that are based on the Diffusion of Innovation and the experience of the authors.

Key characteristics of the community

Does the community have high percentages of people who belong to populations that are less likely to have access to health information or strong technology skills (e.g., senior citizens or low-income residents)?
Do residents experience health disparities (e.g., are they medically underserved; do many lack health insurance)?
What health problems are prevalent in this community?

Influential community members (authority figures, innovators and early adopters, opinion leaders)

Who helps residents find and assess health information?
Who do community members look to for advice on technology or health issues?
What organizations provide information to community members?
Who are the teachers (paid or informal) in the community?

Current status of health information access

Where do community members get health information now?
How satisfied are they with their current methods of getting health information?
What advantages do your health information resources provide community members over the resources currently available to them?
What are their opinions about online health information (is it usable, credible, helpful)?
What good and bad experiences have community members had in trying to locate online health information?
What type of experiences have community members had with those who provide health information (e.g., librarians; health care providers)?
Are there individual-level or community-level problems that could be addressed through use of your online resources?

Current status of technology use and experience

How technology-literate are members of the target community?
Are community members currently using the technology (e.g., computers, mobile phones) needed to access your health resources?
What type of Internet connectivity (e.g., dial-up, broadband) is most prevalent to the target community?
Will they have to buy any special computer equipment to use your resources?
What are some prevalent health concerns or health information needs within the community?
What health information-related problems could your health resources solve for community members?

Community resources and assets

What popular community events would provide good venues for exhibits and demonstrations?
Are there community-based organizations that may invite you to demonstrate or provide training on your online resources?

Potential collaborators and partners

Are there organizations that hold programs that could incorporate a demonstration, such as community computer classes or English literacy classes?
What publicly accessible computer facilities are available for training sessions? Make sure the computer facilities are available at the times you will need them and have adequate parking.
What media opportunities could be used to promote your resources and outreach activities?

Figure 9: Secondary Data Sources

Note: You can access many of these sources through the Partners in Information Access for the Public Health Workforce (http://phpartners.org/)

Type of information	Sources
Demographic information (e.g., gender, age, income levels, ethnicity)	US Census data http://factfinder2.census.gov/ http://www.census.gov/quickfacts
Health information	County Health Rankings by the Robert Wood Johnson Foundation and the University of Wisconsin http://www.countyhealthrankings.org/ CDC Behavioral Risk Factor Surveillance System http://www.cdc.gov/brfss/ [new link 9 December 2016] HHS Community Health Status Indicators [now CDC, 30 May 2018] https://www.cdc.gov/ophss/csels/dphid/CHSI.html [new link 30 May 2018]
Barriers to health care (e.g., health shortage areas; percent of uninsured residents)	HRSA Health Resources County Comparison Tool https://datawarehouse.hrsa.gov/
Community workforce information (e.g. percent unemployed; job growth)	Local Chambers of Commerce
Information about children	Annie E. Casey Foundation Kids Count Data Center http://www.aecf.org/work/kids-count/ Also check state department of education websites
Listings of local community-based organizations	Local United Way sites, particularly the 2-1-1 United Way referral services. You can find services by using the 2-1-1 Information and Referral Search http://www.211.org/
Information and statistics about public libraries	State Library websites
Information about Healthy People 2020 goals and targets	http://healthypeople.gov

Figure 10: Developing a Data Collection Plan

Evaluation question	How will you collect the information and from whom?	What tools need to be secured or developed?	Who will be responsible for collecting this information?	What is the completion date for data collection?
What community-based organizations serve low income members of the target community?	Review statewide 2-1-1 database	Locate URL for appropriate website	Team leader	2/29/2012
Where do community members go for health information?	Interview recreation center walking group	Focus group question guide	Program team member 1	3/29/2012

Figure 11: Interpreting Your Findings

Describe the target community:

Percentage of community members belonging to vulnerable populations or populations with special information needs
Rates of chronic illness or health risk behavior in the community
Potential for community partnerships that will provide you with access to high percentages of community residents (i.e., show the number of clients that you have the potential to reach through the partnership)

Describe the community characteristics that will help you promote health information resource use by describing values, beliefs, and habits of community residents:

An expressed value of and need for health information
Needs or desires to research specific health issues
Community members' dissatisfaction with the current status of their health information access
Dissatisfaction among local health care providers or community-based organization staff with their access to health information that they can use or provide to their patients or clients

Describe the opportunities available to you to communicate with, teach, and support members of your target community, including:

Well-attended local events or educational programs where you can demonstrate or present your resources
Opportunities to provide some training on online resources
Partner organization that can work with you to reach and serve your target community
Members of the community who may be willing to assist you with your efforts, such as volunteers, community-based organization staff or volunteers
Local organizations willing to offer financial support for your project

Describe potential barriers or challenges that you will have to take into account when planning your outreach project:

Physical barriers that may affect your health information outreach efforts
Social or political barriers you may encounter
Historical issues that may affect project success, such as community members' experiences with previous partnerships

Figure 12: SWOT (Strengths, Weaknesses, Opportunities, Threats) Analysis for Doing Outreach

Helpful

Harmful

Internal

Team Strengths

What are the team's strengths for conducting health information outreach in this community?

Team Weaknesses

What are the team's weaknesses that will have to be addressed to be effective in this community?

External