Access to electronic health information for the public: analysis of fifty-three funded projects

Many projects discovered the importance of pretesting all translated materials and customizing the content to the needs and interests of the targeted community. This was found to be particularly useful when training specific populations. Issues related to cultural competence were particularly significant for projects that targeted non-English-speaking communities. A project targeting the hearing impaired reported that there are many medical terms for which signs are not available in American Sign Language.

Project directors discovered significant variability in trainees' computer skills, and one noted that self-reported data about computer proficiency may not be reliable. Other methods may be needed for ensuring that participants in a session are at a common level of proficiency. For members of a targeted community with limited computer proficiency, it may be necessary to provide training on basic computer skills as a foundation for training on computer-based health information resources.

Web Site Development

The development of Web sites and pages was a major component of thirty-eight projects. Among these projects, several added new Web pages to their organization's existing Web site. Project directors with dedicated information technology (IT) staff reported that this was advantageous for the development of the project's Web presence. Multiple project directors commented on the value of having staff with varied experience to help develop and create the project's Web presence. Project directors also underscored the benefit of identifying a single staff member with primary responsibility for technical difficulties.

As part of the development of a project's Web presence, directors noted the value of ensuring the availability of usage statistics. They also highlighted the value of a simple, streamlined design to enhance a site's usability. Collaborations in developing information for the project's Web presence were noted as particularly helpful. Projects that undertook usability testing reported the benefit of this effort in the site's development.

Publicity and Marketing

All projects were aware of the importance of promoting their program. More than half of the projects developed and distributed project-specific promotional materials. These products included bookmarks, information prescription pads, flyers, posters, displays, videos, and screen sweeps. Promotion through newspapers and newsletters was also popular. Participation in health fairs and exhibits was effective in thirteen projects, and "word of mouth" was considered effective in twelve projects. Word of mouth included communications by phone, staff contacts, personal contacts, and at meetings. Other methods included the use of Web sites, listservs, e-mail, intranet pages, links on local Web sites to the organization's Web site, and announcements in professional journals. Most projects employed more than one marketing approach.

Project Evaluation

A manual published by NN/LM, Measuring the Difference (Burroughs, 2000), provides a six-stage framework for planning and evaluating health information outreach projects: