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Staff from the Office of Disease Prevention and Health Promotion (ODPHP) met with 85 American Indian and Alaska Native (AIAN) individuals from 9 target populations (organized according to the context in which they might use the Internet to find health information):
The purpose of a persona is to create sample audiences that can be compared when crafting electronic documents to suit many audience needs. User-experience research refers to persona development as a “necessary foundation of good interaction design.”1 The purpose of the persona is not to provide information on a specific person; instead, personas serve as hypothetical archetypes of actual users. The personas developed in this study are based on the experiences of the interviewers. Alaska Native Patients The typical Alaskan Native patient is 40 years old (we interviewed people ranging in age from 13 to 70) and is employed in a low- or middle-income job or works in a creative capacity (such as craft-making). The typical Alaska Native patient has finished high school but does not have an advanced degree. English is the main language spoken in his or her home. The typical Alaska Native patient has used a computer, often both at work and at home and at the Alaska Native Medical Center (although the typical user defines his or her computer skills as limited). The typical Alaska Native patient is familiar with the Internet. This audience member has not used healthfinder®. When online, he or she visits a variety of sites, using MSN and Hotmail for e-mail. The Alaska Native patient identifies being healthy as being “emotionally, physically, and spiritually well.” Eating right and exercise are important to this user. Navajo Students The typical Navajo student is 23 years old (we interviewed people who ranged in age from 16 to 53) and typically identifies himself or herself as a full-time student rather than as part of the labor pool. The typical Navajo student has finished high school and speaks English outside the home. (A total of 38 percent of students interviewed speak Navajo at home.) The typical Navajo student uses a computer and the Internet regularly, at school, at the library, and at home. The typical student’s skill level could be considered advanced. About 62 percent use the Internet to find health information, but none have used healthfinder®. When members of the Navajo student audience group go online, it is likely that they will use Yahoo, CNN, MSN, and Ebay. The typical Navajo student identifies being healthy as exercising; eating right; taking care of oneself; being free of trouble; and integrating mind, body, and spirit. Decisionmakers/Influentials To meet a member of the decisionmakers/influentials audience is to meet someone who manages health services and takes an active advising role beyond his or her immediate work environment. As a physician or someone with a traditional healing background, this audience member interacts with others at a national level and engenders a great deal of respect from community members. The typical influential uses computers and the Internet frequently (approximately 20 hours a week). These individuals are very Internet savvy and use cable modems at home. Often on the road, they travel with wireless laptops, so that they are always connected to the Internet. They frequently use the Internet to find health information for themselves and for others. Members of this group use healthfinder®, MedLinePlus, CDC, and PubMed. The typical decisionmaker/influential identifies being healthy as being mentally, emotionally, physically, and spiritually well; getting immunized (and undergoing screenings); exercising right; and attending to “mind, body, spirit, and heart.” Health Educators The typical health educator provides a broad spectrum of community health education and prevention programs. He or she spends time training other health educators, adapting prevention messages to cultural and traditional ways, teaching strategies for injury prevention, offering programs to the elderly, and supporting healthy eating and exercise regimens. This person often manages a team of other health educators. The typical health educator has computer skills but is likely to delegate computer tasks rather than to work on the computer himself. This individual relies on the computer at the office but is sometimes connected at home. Online chat provides one route for gathering and sharing information. This person has some familiarity with healthfinder® and uses it as one choice for finding health information. This audience member likes the choices available in the prototype version of healthfinder®’s AIAN section and plans to share this information with staff members and patients. The health educator wants to be able to respond to his or her clients and searches to find additional information. One health educator commented: “The main thing is, I want to gain knowledge of the choices that are up there. We need to know the good and the bad because there is so much quackery in health information. I like to know all and see all.” As an educator, this audience member is looking at information to pass on to others and sometimes incorporates information into teaching materials. This audience prefers finding its way online without struggling with “a lot of words.” Traditional healing is important to the health educator. This person identifies being healthy as being well as a whole person, mentally, emotionally, and spiritually. To this audience member, being fit extends to “being open to helping others.” Nonprofit Executives The typical nonprofit executive works for a research or advocacy organization and has an advanced degree. The typical nonprofit executive uses a computer both at the office and at home, typically around 10 hours a week. This audience member travels to conferences to speak on issues such as the environment and serves as a “clearinghouse” for tribes to help them get funding. Nonprofit executives use the Internet frequently and are very savvy at finding information online. This audience member has not used healthfinder® and is more likely to go to EPA, CDC, and AOL. The nonprofit executive identifies being healthy as being physically, emotionally, and spiritually well. This audience is likely to believe that “all things are connected.” Healthy living depends on a healthy environment for this audience member. Field Nurses/Community Health Aides (Representatives) The typical field nurse travels to rural areas and provides care for her constituents, whereas a community health aide (called a community health representative in the lower 48 States) is recruited by a village. The field nurse will have received formal nursing training, whereas the community health aide is trained in basic first aid, patient education, health promotion, disease prevention activities, making home visits, taking vital signs, and assisting in case management. The community health aide provides primary care and emergency care via telephone supervision or telemedicine with physicians or nurses. Because field nurses and community health aides work together to provide care to individuals who live in remote areas, one can think of them as serving one role. The typical field nurse/community health aide has intermediate computer skills but works on a computer for only 3 or so hours a week. A field nurse/community health aide is likely to delegate finding specific information to an administrative assistant who will print out the information for the field nurse to take into the community. These audience members are not familiar with healthfinder®, but they can see how it will benefit them on the job. In fact, they plan to use healthfinder® as a key resource. They like that they can take Internet information via printouts to their populations. These audience members are likely to get information from PubMed, Yahoo, and the Indian Health Service. The field nurse/community health aide identifies being healthy as being able to participate in activities that one enjoys. This requires an understanding of diet, nutrition, and exercise. Researchers The typical researcher has an advanced degree and works as a librarian or legislative analyst or has a background in public health. Computer savvy, the researcher understands both hardware and software and trains others on using computer systems. It is likely that the researcher will be working on technology initiatives to support tribes. For example, a researcher might explore wireless technology because of the high costs involved in using expensive telephone-based phone systems. The typical researcher will use the Internet from 25 to 40 hours a week. This person logs on to the Internet at work, at home, and when traveling. His or her computer skills can be considered advanced. This audience member is likely to depend on search engines and will visit health sites such as healthfinder®, MedlinePlus, PubMed, and MDConsult and legal sites such as Thomas. This person identifies being healthy with receiving a healthy amount of funding to support good health in clinics and schools. To imagine a healthy person, the researcher might be inclined to visualize a runner. Traditional Healers The typical traditional healer works in the community and provides emotional, spiritual, holistic support and medical care. This audience member conducts ceremonies and provides counseling to people in the tribes. It is likely that this person works collaboratively with Western doctors to combine traditional medicine with Western biomedicine and often speaks at conferences or workshops. The traditional healer rarely uses the Internet. For those who do use the Internet, they would spend approximately 1 hour a week, typically in the office but sometimes at home. Healers find they do not have the time themselves but request staff members to gather information online and synthesize the information before a workshop or talk. They are often interested in learning more about Western perspectives and ensuring that their proposed solutions do not conflict with other approaches. The traditional healer is not likely to get information from the Internet, but when seeking information, is likely to gather data from the Indian Health Service. The traditional healer is not familiar with healthfinder®. Traditional healers are concerned about the way traditional care information can be misused by fraudulent practitioners. They do see value in providing instruction on how to approach a traditional healer and what to expect from the interaction. According to the traditional healer, a healthy person is emotionally balanced, physically fit, and mentally prepared for each day. Recognizing spirituality is important to the healthy person, according to this audience member. Urban Leader The urban leader faces unique challenges providing healthcare information to his or her constituents because urban American Indians are not covered by health insurance and are reluctant to use non-Indian, Government-sponsored resources. The typical urban leader advocates for his or her constituents and speaks about issues facing urban Indians. This audience member uses the Internet 15 hours a week and connects at work, at home, and on the road. He or she is likely to gather information about health issues and political challenges and then disseminate it to the constituents. The urban leader is likely to go to the site Indianz.com, CDC, and local university resources. This audience is familiar with healthfinder®. The urban leader identifies being healthy as living a low-stress life and making healthy lifestyle choices, for example, eating healthy foods. 1A good introduction to personas in user-experience research can be found in Alan Cooper, The Inmates Are Running the Asylum: Why High-Tech Products Drive Us Crazy and How to Restore the Sanity. Indianapolis: SAMS Press, 1999.
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