Abstract

Health care providers in rural or tribal areas encounter a wide range of clients; therefore understanding issues relating to the population can prove difficult. Reliable assessment is critical so that the work that needs to be done is on target and focused. This effective practice, submitted by staff with the National Network of Libraries of Medicine in June 2006, shares strategies that have worked for this group as they serve the Native American population in the Four Corners Region.

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Issue

When assessing the health information needs of service providers working with an American Indian population, unique challenges may be encountered. These are due, in part, to access barriers caused by geography, as well as funding and technology limitations, which often exist in these rural communities.

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Action

According to The National Network of Libraries of Medicine (NN/LM), an organization that has served tribal populations since 1997, steps to take when evaluating information needs include:

• Involve someone who has experience in developing and implementing assessment tools. This could be a member of the assessment team or a resource person. NN/LM had an evaluation consultant assist in designing a survey instrument and implementation.
• Know the community being served. Establish relationships in the area before administering the assessment. For the NN/LM, prior visits with healthcare facilities opened doors to allowing the assessment team to come in and conduct the survey.
• Use the healthcare facility administrator as a point of contact. This provides buy-in from a decision maker and increased awareness by the director of the project about the purpose of the survey. Additionally, a health professional can offer access to the facility's staff.
• Schedule all visits to facilities to conduct the surveys on administrative days, i.e., regularly scheduled days when clinical appointments are not made for part of the day. Health care providers use this time for continuing education, administrative meetings and related professional development.
• Determine who it is you will be assessing; for example, what level is their position in the organization? Tailor assessment questions accordingly.
• Prepare the groundwork. A letter was sent to the CEO describing the NN/LM and explaining the intention of administering a health information needs assessment; a copy of the survey instrument and local contact was included in the letter. Scheduling was arranged in a follow-up phone call.
• Know the politics of the system and who has jurisdiction over the facilities. NN/LM knew which agencies were tribal, community, or federal. Since they were surveying Indian Health Service (IHS) healthcare facilities, they didn't need to contact tribal leaders. However, they did obtain permission from the CEO of the only tribally controlled healthcare facility. With this knowledge of jurisdiction, the appropriate agencies were approached for authorization to administer the survey, thus making better use of time involved for NN/LM.
• Test the assessment instrument in a similar facility outside the survey area to be sure it makes sense and provides the kind of data you are looking for.
• Develop a tool that takes into account as many constraints as could possibly be encountered. For example, the use of one-on-one interviews is the most effective way to assess health information needs, but it can take a great deal of time when dealing with large programs.
• Establish a clear understanding of group members' roles and responsibilities from the start. Have an effective communication tool for the group so that when it becomes clear that a method of assessment is not working, a new method can be set up quickly.

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Context

The National Network of Libraries of Medicine (NN/LM) has been serving tribal populations since 1997. An assessment of health information needs was conducted at Indian Health Service affiliated healthcare facilities in the Four Corners regions by NN/LM.

Testing of the instrument took place at a small healthcare facility outside the survey area, but similar demographically to the facilities being assessed.

Use of the face-to-face survey was effective in one healthcare facility. At other healthcare facilities, NN/LM employed a combination of a face-to-face survey and allowed clinic staff to complete parts of the survey on their own while the team member was present. Additionally, the option to fill in the survey at a later time was offered.

The mail in option did not prove to be an effective tool, as no surveys were returned via the mail.

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Outcome

Increased knowledge about administering a needs assessment within the Indian Health Service organization has been gained.

Data is now available for librarians to use for planning services to this population and as justification in grant proposals to funding agencies and foundations.

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Evidence

A final report was produced with usable data.

Participants from NN/LM came to realize that a needs assessment is important when working with any external organization or population.

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Posted On

July 5, 2006

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For More Information

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Related Practices

• Working with tribal populations to increase access to health information

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Related sites

Topic Areas

• Health
• Poverty and low-income needs
• Tribal services
• Evaluation
• Rural
• Capacity building
• Community-Based Organizations
• Nonprofit Organizations
• Tribal Programs
• ACKCO
• Human needs

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