National Network of Libraries of Medicine

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Dragonfly

Fall 2003 -- Volume 34, Number 4

Network Librarians Conclude Outreach Projects. Part III: Health Information for Elders

by Mary Devlin, MAT, MLS
Oregon Health and Sciences University, Medical Informatics

More elders are using the Internet all the time. Looking for health information is one of the most common activities on the Internet. This project was a result of these two trends. The purpose was to develop an easy-to-use web site with quality health information for elders, including links to local and national resources.

Visit The Prepared Caregiver at http://www.ohsu.edu/healthyaging/caregiving

Key project participants were Mary Devlin, MAT, MLS (OHSU, Medical Informatics), Project Manager; Andrea Drury, MLS (RareHeron Web Design), Information Architect; Kayo Parsons-Korn (RareHeron Web Design), Designer; and Dolores Judkins, MLS (OHSU Library), Project Coordinator.

Based on interviews with Oregon Health & Science University (OHSU) School of Nursing faculty and on suggestions from Marna Flaherty-Robb, the project's original liaison person with the School and the Center for Healthy Aging, the content of the site was narrowed to caregiving for elders. It was critical to put boundaries on the project, and with caregiving still a large subject area the focus was further defined as information useful to potential and new caregivers for elders. We assumed that the primary users of the site would be spouses or adult children of elders needing care.

Further content definition came from our decision to have the site concentrate on information for action rather than general knowledge. We included information about where to get help and specific guidelines. We also decided to incorporate psycho-social as well as bio-physical information.

We knew that the language used on the site had to be suitable for the audience and must avoid health care jargon. The reading level had to be no higher than eighth grade. At the same time, we wanted to avoid any sense of talking down to people.

Basic technical assumptions defined for the site included:

pages that would load quickly even with a slow connection
access for both PCs and Macs
age appropriate fonts and font sizes
age appropriate use of color and color contrast
meeting Federal accessibility guidelines (Section 508)

Site development depended in part on usability information elicited from elders during focus group sessions. Information from the focus groups was also used to meet the secondary goal of the project which was to research the overlap between generally accepted best practice for elders' usability and usability requirements evoked from elders themselves.

Useful lessons at the end of the project

Focus groups

Focus groups take longer to set up than expected. It is harder to recruit people than you might expect. Double the time and effort you think it will take to organize focus groups.
It is helpful to hold focus groups with older people in their own environment so they do not have to travel.
Be flexible with groups of older people. You may need to adjust focus group questions to help clarify what you're after and to adjust to their experience.
Be realistic about focus group criteria. Use only those that are essential. Each requirement for participation adds recruitment difficulty.

IRB process

Allow triple the time you think necessary for research requests to clear an Internal Review Board (IRB).
Assume that things may get lost during an IRB process and do whatever you can to prevent this, including personally taking papers for signatures rather than mailing them. Make opportunities to visit the IRB staff so they see the person behind the paperwork. Pay close attention throughout the process.

Content:

It is hard for professional people and academics to recognize when their language choice is free of jargon and easily intelligible to a lay person.
When relying on others for content, triple the amount of time you expect it to take to receive material. Be prepared to do significant rewriting and editing, and to do research for additional information.

Usability testing

Get an expert to perform a heuristic evaluation of the site. It is a useful external check on usability. The evaluation is most helpful when the site is close to done yet enough time remains to make changes.
Do some usability tests on peoples' personal computers. Screen size, type of equipment, and kind of connection all make a difference.

Project management:

Recognize that people may not follow through with what they promise. Start reminding people as soon as they miss one deadline. Be persistent.
If a team member is clearly not doing her part, find another person who can step in sooner rather than later.
Build in a lot of time for unexpected delays.
Make sure all the project participants have a shared set of expectations about the project and their role in it.
Get these shared expectations written as agreements. Do not assume that having roles and responsibilities written in the project proposal will be sufficient.

Project # GLIBY0005A, National Network of Libraries of Medicine, Pacific Northwest Region, with support from Training Program in Medical Informatics, National Library of Medicine grant number LM07088-12

To read a detailed description of Mary Devlin's project, including the methodology, go to http://nnlm.gov/pnr/news/200310/devlin_long.pdf ( PDF size: 40 kb, revised: December 19, 2003 )

Other articles in the "Network Members Conclude Outreach Projects" series:

Part I. Cyber Health Camp
Part II. Cross Cultural Health

Dragonfly, Fall 2003 -- Volume 34 Issue 4

This publication is funded in whole with Federal funds from the National Library of Medicine, National Institutes of Health, under Contract No. N01-LM-1-3516.

NN/LM | UW HSL | NN/LM PNR | Contact us: nnlm@u.washington.edu | Revised: December 19, 2003