HiPHIVE (Hawaii Public Health Information Virtual Emporium)

by Virginia M. Tanji and Sharon L. Berglund

The HiPHIVE project was funded by a National Library of Medicine (NLM^TM) and National Network of Libraries of Medicine (NN/LM®) Partners in Public Health Information Access contract to conduct a needs assessment, develop a website, and then deliver training to underserved public health professionals across the State of Hawaii. A portable Local Area Network (LAN) was utilized to bring hands-on training to remote sites. The goal of the project was to help these professionals fully exploit the wide range of resources available on the Internet. Principal investigators for the project were John Breinich, Executive Director of Hawaii Medical Library, Inc. (HML), and Sharon Berglund (sberglun@csusm.edu), formerly Education and Reference Librarian at Hawaii Medical Library, and currently Science Librarian at California State University at San Marcos. Berglund and Virginia (Ginny) Tanji (tanji@hawaii.edu), of the School of Public Health at the University of Hawaii and now with the School of Medicine at the University, jointly managed the project. The School of Public Health was a collaborator on the contract.

Determining Needs: A needs assessment was developed in the initial phase of the project. It can be accessed on the Partners in Information Access for Public Health Professionals website (http://www.nnlm.nlm.nih.gov/partners/tools.html) under the heading "Needs Assessment" near the end of the page. The needs assessment was conducted among employees of the Hawaii Department of Health (DOH) and members of the Hawaii Public Health Association.

Developing a Website: The results of the needs assessment guided the development of the website which can be viewed at (http://hml.org/hiphive/). The website is divided into 14 major areas based on the input from the needs assessment. Subject areas such as statistical sources, disease and epidemiology, environmental health, health education and prevention, mental health and substance abuse, population groups, and nutrition are included. Pages relating to agencies and associations, public health practice, and rules and regulations are also included. A feature of the site is the inclusion of summary pages of databases and search engines important to public health professionals. A search engine is also included to search the site itself.

Training: The website was used as a basis for the training sessions which were held on the four major islands in the state. In all, a total of 16 sessions were conducted: eight on Oahu, two on Kauai, two on Maui, and four on the island of Hawaii. The smallest, and the first, had only three attendees while the largest, on Kauai, had over 30 eager participants. The total number of trainees who participated in all sessions was 150. Of these, 49 attended two sessions; thus a total of 101 individuals were trained during the contract period.

Four different two-hour training sessions were developed. The sessions were called Public Health Internet Resources for the Neophyte, Hands-on HiPHIVE, Beyond Yahoo, and HiPHIVE Virtual Tour. The first two programs were designed for those with limited computer/Internet skills and incorporated substantial hands-on assistance. The remaining two sessions were largely demonstrations and designed for those already comfortable using the Internet. However, individual sessions were adapted based on the interests of the participants. Using the registration forms as a basis, Berglund and Tanji were especially attentive to showcasing unique Internet resources useful for each participant. It was challenging to meet the needs of participants, who came with a range of experience and expertise with computers and the Internet.

Portable LAN Technology: In order to provide hands-on training opportunities to the individuals who needed it most, Berglund and Tanji utilized a four-station portable LAN. This arrangement allowed them to take their sessions throughout the state, with participants providing nothing more than a room with tables and chairs, electrical power and a single telephone line. Internet access was provided via an HML purchased account with a local Internet service provider. The LAN consisted of four Winbook laptop computers, a 3COM OfficeConnect 10 station LAN modem, network hub and assorted electrical and network cables. The LAN was transported in two compact rolling suitcases small enough to be used as carry on luggage. Because the LAN was capable of connecting to up to 10 computers, Berglund and Tanji were able to connect onsite computers to the LAN, thus increasing the number of participants who could benefit from the hands-on practice. This saved the instructors having to bring more equipment than they could carry.

A local Internet service provider that had local access lines on each island was also critical to the success of the training. One 56K modem connected to a single telephone line could provide adequate response time for as many as eight computers searching simultaneously.

Outcomes: One of the goals of the project was to determine if the HiPHIVE training intervention changed the searching behavior of the trainees (practicing public health professionals). A survey was developed and administered on-site prior to training, with an identical follow-up survey mailed 1-3 months following the training. The survey was administered to all training participants once (since some trainees took two different training sessions). All surveyed were asked to address a blank envelope to themselves when completing the pre-training survey. The post-training surveys were coded so that a statistical analysis (paired T-tests) could be run to determine if there was a significant difference in the reported behavior of each subject post-training.

Questions regarding frequency of searching specific sites and attitudes regarding searching the Internet were asked. Modest but significant changes were detected in the frequency with which participants searched the HiPHIVE web site, MEDLINE®, and MEDLINEplus®. There were also small but significant changes in their attitudes toward searching the Internet for information. Respondents felt they knew where to begin searching and knew where to find high quality public health information on the Internet.

As anticipated, use of the HiPHIVE website increased dramatically as the training sessions progressed and the site was linked from the Hawaii DOH website. Website statistics were collected using the WebTrends software. During the first three quarters of its existence, (January - September, 2000), the website averaged over 200 individual sessions per day with peak use directly following training sessions. Even though the training portion of the contract was completed in June 2000, the website continues to show steady use.

As the contract draws to a close, the project goals have been met. The website provided an excellent basis for training, and the portable LAN allowed for hands-on-training even at rural sites with limited computer resources. More individuals wanted training than could be accommodated, including several from the South Pacific; they were referred to the website. The portable LAN concept has already been replicated by the Pacific Southwest Regional Medical Library at UCLA and is also in use on another consumer health contract at Hawaii Medical Library. "Hits" on the website have increased over the year, and the National Library of Medicine's Health Services Research site (http://www.nlm.nih.gov/nichsr/hsrsites.html) and the Hawaii Department of Health's site now link to the site. Although survey data show only modest changes in searching behavior, ongoing responses from participants suggest evolving sophistication with the Internet.

Berglund and Tanji made a presentation on this contract at the Internet Librarian 2000 Conference in Monterey, California this past November. A paper on the contract has been accepted for the Medical Library Association Annual Meeting in Orlando in May 2001. They continue to maintain the HiPHIVE site although both now have other responsibilities.

Acknowledgements: We must acknowledge the support of John Breinich of HML for the administrative encouragement and support, and John Hoover of HML for his assistance in loading our revised webpages. Also, the staff at the Pacific Southwest Regional Medical Library have been extremely encouraging and supportive, from the writing of the grant to its implementation. Also, various people at the Hawaii Department of Health have been extremely supportive and helpful to us as we have implemented the grant. They are too numerous to mention, but we would be remiss if we did not acknowledge Gerald Ohta, Affirmative Action Officer and Distance Education Coordinator, for his assistance in publicizing and distributing information regarding the needs assessment and training sessions. And last but not least, we are grateful for the feedback we have received from those who have been using the website and from those we trained. We have had a great time working on this contract together and we have grown professionally and personally from the experience. Sharon Berglund and Ginny Tanji

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