Claire Loe*, University of Texas Health Science Center, School of Biomedical Informatics, Houston, United States Vickie Nguyen*, University of Texas Health Science Center, School of Biomedical Informatics, Houston, United States J. Franck Diaz Garelli, University of Texas Health Science Center, School of Biomedical Informatics, Houston, United States Track: Research Presentation Topic: Building virtual communities and social networking applications for health professionals Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2013-09-25

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Background: Community health workers (CHWs) are a unique type of healthcare worker that often works solo in the field. In the United States, they are typically lay people who, under the auspices of a community organization, assist people in their communities to overcome barriers to good health and medical services through education and referral. Situated Learning theory maintains that norms and knowledge for a job are created through “legitimate participation” with like others in the field while Social Learning Theory describes self-efficacy for a task to be developed, in part, through vicarious experience. Because CHWs may not work with other CHWs, they have few opportunities to develop job-related practices based on group norms or self-efficacy from others’ experiences. Online technologies such as intranets and knowledge management systems can support interactions of individuals who do the same job, but are otherwise distant from one another. However, many systems are designed as knowledge repositories rather than for group learning and interactions. Furthermore, these applications are rarely designed from the users’ perspective and do not build in motivators for participation. CHWs often come from communities that have barriers to adoption of the latest information and communication technologies which amplifies the need for user-centered design for this population.

Objectives: 1) Design a social learning system for CHWs in Houston, Texas, USA. 2) Facilitate knowledge sharing and collaboration on group norms about handling difficult health topics with clients. 3) Use open-source software that requires minimal technological know-how. (We hope to make our research findings accessible to real communities.)

Methods: User-Centered Design – The TURF Framework (Tasks, Users, Functions, and Representations) guided our design and evaluation with the goal of a useful, useable and satisfying system. 1) User Analysis: Formative data collection included a survey and case study observations. Survey – we conducted a cross-sectional survey of CHWs attending six continuing education workshops. The 40-item self-administered structured questionnaire covered demographics (age, gender, race/ethnicity, employment and state CHW certification status), training content (difficult topics they encounter), CHWs as a group (job titles, training, sources of information, communications with other CHWs), and technology use (cell phones, texting, computers, e-mail, Internet and web-based social networks). Observations – Ethnographic observations were conducted at five CHW work sites to gather data about the context of their work and communications. Each observation was conducted for one half day during a “typical” workday for that CHW. Variables included the site, the clients served (typically and during the observation), potentially difficult topics, communication skills observed, modes of communication, information sources accessed and communications with other CHWs. 2) Intervention: A social learning system was designed using WordPress open-source software and plug-ins including BuddyPress. The graphical user interface and content were developed based on the formative evaluation and best practices in interface design and health promotion and workforce development. CHWs were recruited to participate during a one-month intervention period. 3) Evaluation: Summative evaluation data were collected with a pre- and post-questionnaire, participation data and interviews with high and low users and non-users.

Results: Research in Progress

Conclusions: Research in Progress