Community health centers (CHC) provide community-based healthcare to high-need urban and rural citizens. CHCs often serve as a patient’s medical home by coordinating medical, dental, mental/behavioral, pharmaceutical, substance abuse, and vision care. The Bureau of Primary Health Care (BPHC) oversees the Health Center Program, a national network of CHCs serving over 24 million patients in areas that have economic, geographic, or cultural barriers to accessing primary health care. In practice for over 50 years, these centers (with 519 sites in the MCR states) have become the largest safety net and most successful primary care system in the U.S.1
The National Network of Libraries of Medicine, MidContinental Region (NN/LM MCR) identified CHCs as a group they would like to work with and learn more about their access to health information. The NN/LM MCR partnered with the Community Health Association of Mountain/Plains States (CHAMPS) to promote the online questionnaire to 1,085 association members in Colorado, Montana, North Dakota, South Dakota, Utah and Wyoming. CHAMPS supports community health centers by providing education and training, networking, and workforce development.
The CHC questionnaire was based on a needs assessment conducted by the Southwestern Pennsylvania AHEC (funded by the NN/LM Middle Atlantic Region). The CHC questionnaire consisted of 10 multiple selection questions and was made available online via SurveyGizmo. During the 30-day open period in the fall of 2016, 108 completed responses and 4 partial responses were received.
The following table provides a breakdown on the respondents by self-identified position at the CHC:
|Respondent Self-Identified Position with CHC||Number of Responses|
|Physician Assistant: anyone identifying primarily as a PA, family practice PA, PA-C, pediatric PA, or physician assistant.||24|
|Physician: anyone identifying primarily as a family physician, pediatric physician, or FP.||22|
|Nurse Practitioner: anyone identifying primarily as a nurse practitioner, psychiatric nurse practitioner, CNP, FPN, or NP.||16|
|Administrator: anyone identifying primarily as an associate medical director, chief clinical officer, clinical quality specialist, CMO, manager, medical director, nurse program manager, performance improvement coordinator, QI director, QI manager, or VP behavioral health.||15|
|Dentist: anyone identifying primarily as dental director, dental provider, dentist, or DDS.||14|
|Behavioral Health: anyone identifying primarily as BH, BHC, behavioral health clinician, behavioral health provider, clinic counselor, LCSW, licensed clinical social worker, or mental health.||8|
|Registered Nurse: anyone identifying primarily as RN, APN, or ARNP.||4|
|Registered Dental Hygienist: anyone identifying primarily as RDH, registered dental hygienist.||3|
CHC staff were asked about their practices in seeking clinical information for patient care or patient education, point of care tools were utilized the most on a daily basis, asking colleagues ranked second, and searching the web came in third. On a weekly basis, asking colleagues ranked first, web searching ranked second, and visiting professional association websites ranked third. Librarians come in last. There could be a variety of reasons: CHCs operate on tight budgets making it difficult to fund the employment of library personnel; CHCs are often geographically far from a medical or hospital library that could potentially serve their needs; and though CHCs might be geographically closer to a community library, time constraints may come into play having to interlibrary loan biomedical journal articles not generally owned by a public library.
When asked the frequency of looking for specific types of information to address clinical questions, drug information was the most sought after on a daily basis, followed by patient education and therapy/treatment. On a weekly basis, clinical guidelines ranked number one, followed by patient education and therapy/treatment.
When queried about the patient education topics they wanted to provide, prevention and risk factors came in first, followed by nutrition and weight status, and treatments and therapies.
Needed types and formats for patient education in order of most responses included low literacy, multiple languages, print brochures, online videos, web sites, online tutorials, print tutorials, and audio formats. Languages of interest for patient education included Spanish, Arabic, Russian, Nepali, Burmese, Chinese, Somali, Vietnamese, Mandarin, and Swahili.
When asked to select barriers to accessing health information:
Next steps include following up with respondents who provided contact information, locating appropriate resources to address identified needs, and offering training to address identified gaps (preferred formats for training as identified by respondents and based on rank: web-based independent study, evening lecture or workshop, webinar, visit to office/clinic, training email sent weekly/monthly, and at a conference).
-Dana Abbey, Colorado/Community Engagement Coordinator
1 Health Center Fact Sheet. (2015). Retrieved January 11, 2017, from Bureau of Primary Health Care: Health Resources and Services Administration, https://www.bphc.hrsa.gov/about/healthcenterfactsheet.pdf