APHA Annual Meeting 2003

1
Multimedia HIV/STD Information Resource Use By
Urban Women

• Kathleen Burr Oliver, MSLS, MPH
• Jeri Mancini, CNM, MS
• Holly Harden, MLIS
• Susan Rohner, MLS
• Johns Hopkins University
• Baltimore, Maryland

2
Proposed Project

• Provide Web-based information on HIV/AIDS to
  supplement HIV counseling
• Add audio information prepared by the clinical
  staff patients
• Offer information guidance

3
Why?

• To meet identified information needs of patients
  perceived as marginally literate
• To explore new ways of integrating patient
  information services into clinical practice

4
How?

• With funding for the project provided by the
  National Library of Medicine
• Gale Dutcher, Project Officer
• Sheila L. Spring, Contract Specialist

5
Where?

• Maternity Center East
• Located in East Baltimore MD for 30 years
• 2 nurse-midwives, a nurse, a clinical social
  worker, lab technicians, and administrative
  support staff
• Prenatal Clinic with 800 visits a year
• Family Planning/Well-woman Clinic with 1600 visits

6
Collaborators

• Librarians from the Johns Hopkins Welch Medical
  Library
• MCE clinical staff
• Clinic patients
• Welch technology staff
• University IT staff

7
Collaborations

• Needs assessment
• Technology, programming Web site development
• Information resource selection
• Information presentation
• Patient recruitment

8
Quantity and Quality of Services

• Services offered for 9 months
• Monday through Thursday afternoons each week
• 103 patients elected to participate

9
(No Transcript)
10
Web Site Selection Criteria

• Accuracy, authority, objectivity, currency
• Relevant to HIV/AIDS
• Representative of user population
• Literacy level, age, race appropriate
• Vernacular

11
Information Scope

• Expanded beyond HIV/AIDS to include
• STDs and STD prevention
• Curable vs. Treatable Disease Specification
• Vaginal Infections
• Pregnancy Prevention
• Statistics

12
Information Resource Choices

• Audio information
• Categorized Web sites
• Transcribed audio-to-print patient handout

13
Link to STD Images
14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
Local Resources

• Identified
• Presented separately
• Web and print version
• Reviewed for currency and accuracy
• Confirmed contact information
• Included hotlines and Web addresses

19
Computing Preferences

• Clinic platform
• iMacs
• Wireless network
• Patient input for Web design
• Color
• Graphics

20
Integrating Information Services into the
Clinical Process

• The nurse midwife offered patients information
  services
• Patients who participated were randomly assigned
  to 1 of 3 groups print, Web site, or Web site
  with audio
• Patients completed an online or print survey to
  evaluate the information

21
Patient Information Services

• In some instances, patients needed computer/mouse
  instruction
• Patients who were in the computer groups were
  guided through the online information by the
  librarians
• Patients had private access to the computers

22
Patient Information Services

• Session length was determined by the patient
• Patients were encouraged to ask questions and use
  the printer for their information requests
• Patients with clinical questions were referred to
  the nurse midwife

23
Patient Information Services

• The handout and Web site were modified
• based on patient and clinician input
• Headings were added to the Web site and handout
  to show curable vs. treatable diseases
• The Pap smear topic was added to the Web audio
  feature
• The MedlinePlus Web address was added to the
  handout

24
Clinical Information Services

• Librarians offered their services to the clinical
  staff to meet reference and statistical needs
• alerted clinicians to a study of nonoxynol-9 and
  HIV transmission
• provided local birth data to MCE clinicians

25
Project Impact

• Question 1 Did you find the information helpful?

1 Percent of surveys completed
 
26
Project Impact

• Question 2 Did you learn anything new?

27
Some Observational Findings

• Pregnant adolescents had too many things
  happening (blood work, sonograms, etc) during
  their clinic appointments and at school to
  participate
• Lack of childcare limited participation
• Pictures were important to this population as
  source of non-text information

28
Did We Accomplish What We Meant To?

• Yes, the data suggest we
• Positively affected some patients infection
  prevention choices
• Provided patients information they found helpful
• Provided patients information that enabled most
  to learn something new
• Engaged librarians in the clinic process and as a
  member of the clinical team

29
Next Steps

• Continue to offer information services to the
  women at MCE
• Seek funding to expand/adapt project to other
  community organizations offering health services

30
Thank you!

• William H. Welch Medical Library
• Maternity Center East
• Johns Hopkins University
• Kate Oliver koliver_at_jhmi.edu
• Jeri Mancini jmancin_at_jhmi.edu
• Holly Harden hharden_at_jhmi.edu
• Susan Rohner srohner1_at_jhmi.edu