Addressing Disparities in Health Information through an FQHC-Library Partnership

描述(由申请人提供)： 卫生信息的不平等导致了卫生保健的不平等，并最终导致 健康差距。利用互联网获取与保健决策和慢性病自我管理有关的健康信息方面的数字鸿沟是国家对解决卫生保健差距这一国家目标的重大挑战。人们越来越多地使用“网络”获取健康信息，这增加了这样一种可能性，即数字鸿沟将转化为贫富之间的健康鸿沟。社会劣势，包括低教育程度、低收入、黑人、拉丁裔或美国印第安人，以及年龄较大的人，都与较少使用网络搜索健康信息有关。不平等群体成员很难获得可靠和准确的健康信息，这阻碍了有效的健康和保健决策，并加剧了健康差距。患者获取基于网络的健康信息的障碍包括身体接触(缺乏计算机和/或互联网连接)、态度(技术恐惧症或兴趣有限)、知识和技能(缺乏关于高质量网站的知识以及较低的计算机和网络素养)、社交网络，以及忙碌的医疗保健提供者在护理地点未能使用高质量的健康信息。对于如何更好地解决卫生信息中的这一数字鸿沟，或者如何改善通过国家医学图书馆(NLM)提供的丰富资源的获取，人们知之甚少。我们建议通过领先的联邦合格健康中心(FQHC)和主要健康科学图书馆之间的独特合作伙伴关系来解决患者之间的健康信息差异。具体地说，安东尼·乔丹健康中心将与罗切斯特大学医学院的爱德华·G·米纳图书馆合作，实施一项全国性示范项目，以改善未得到充分服务的患者获得NLM卫生信息资源的机会。据我们所知，这个项目将是FQHC和健康科学图书馆之间的第一次合作，专门设计用于在护理点向患者提供基于Web的NLM资源。该项目由国家公认的差异研究人员菲斯塞拉博士领导，将通过一项简单、多管齐下的战略，针对造成卫生信息数字鸿沟的关键障碍，确保在护理地点获得相关卫生信息。我们的三个相互关联的目标解决了关键障碍 使用其他人容易复制的可行方法。它们是：1)在联邦合格的卫生中心内改善贫困/少数族裔患者获得高质量卫生信息的网络途径；2)提高患者从网上获得卫生信息的相关知识、态度和技能；3)改善患者在护理地点获得有针对性的高质量信息的机会。我们将根据患者和工作人员对健康信息的使用情况以及患者对信息需求的满意度来评估我们在实现项目目标方面的成功。我们将通过现有的网络和关系在FQHC中传播我们的发现和经验。

DESCRIPTION (provided by applicant): Disparities in health information contribute to healthcare disparities and ultimately contribute to health disparities. The digital divide in use of internet to obtain health information relevant to health care decision making and chronic disease self management represents a critical national challenge to the national goal of addressing health care disparities. Growing use of "The Web" for health information raises the prospect that the digital divide will be converted into a health chasm between the haves and have nots. Social disadvantage, including low educational attainment, low income, being Black, Latino or American Indian, and older age are associated with lower use of The Web to seek health information. Poor access to reliable and accurate health information by members of disparity groups impedes effective health and health care decision making and contributes to health disparities. Patient barriers to Web-based health information include physical access (lack of computer and/or internet connection), attitude (technophobia or limited interest), knowledge and skills (lack of knowledge about high quality sites and low computer and Web literacy), social networks, and failure by busy health care providers to use high quality health information at the point of care. Little is known in how to bet address this digital divide in health information or to improve access to the rich resources offered through the National Library of Medicine (NLM). We propose to address disparities in health information among patients through a unique partnership between a leading Federally Qualified Health Center (FQHC) and a major health sciences library. Specifically, the Anthony Jordan Health Center which delivers primary care to 30,000 largely poor and minority patients, will partner with the Edward G Miner Library at the University of Rochester Medical School to implement a national demonstration project to improve access to NLM health information resources among underserved patients. To our knowledge, this project will represent the first collaboration between an FQHC and a health sciences library explicitly designed to make Web-based NLM resources available to patients at point of care. The project, directed by a nationally recognized disparity researcher, Dr Fiscella, will target key barriers that contribute to the digitl divide in health information through a simple, multipronged strategy that will ensure access to relevant health information at the point of care. Our three inter-related aims address key barriers using feasible methods that can be readily replicated by others. These are: 1) Improve web-access to high quality health information for poor/minority patients within a federally qualified health center; 2) Improve patients' knowledge, attitude and skills relevant to accessing health information from the Web; and 3) Improve patient access to targeted high quality information at the point of care. We will evaluate our success in achieving our project aims based on patient and staff use of health information and patient satisfaction with information needs. We will disseminate our findings and experience among FQHCs through existing networks and relationships.