April 23, 2004

Creating a Community Through E-Health Access

By Sara Rose

In San Diego’s Sherman Heights neighborhood, a young mother came to the community center searching for help. New to this country, alone, overwhelmed with feelings of isolation and worried about her family’s health, she stumbled into a room filled with computers.

Maria was quickly greeted by a staff member, a promatora, working in what Maria later learned was the Family Health Center of San Diego’s community computer center. At the time, Maria was not at all interested in computers or the Internet. She was looking for help. She was looking for someone to talk to about her feelings of detachment from her family and the fact that, for months, she had been swinging between feelings of sadness, anxiety and fear. Her children were worried and the tension with her husband was palpable. 

Compounding Maria’s distress was her pregnancy. How could she support another child when on any given day, she felt like any number of people other than herself? Listening to her story, the promatora convinced Maria to sit down with her at the computer and search for information on her symptoms. The promatora, who is trained in distinguishing the good health information from the bad on the Internet, and Maria were bombarded with any number of possible causes for Maria’s problems ranging from schizophrenia to depression. Maria was amazed at the amount of information, amazed that her feelings and fear could be validated. Understanding that something was seriously wrong, the promatora referred Maria to the Family Health Center next door and she soon began treatment with her family. 

In our familiar world teeming with computers, email, and on-line information, it’s strange to think that for many this world is still out of reach. It’s strange to think that many visitors to the computer center had never used a computer let alone searched for health information on the Internet. But, this was exactly the case for the mostly monolingual Latino residents of this San Diego neighborhood. 

The on-line world has become a vital and dynamic source for information and communication and as many of us will attest to, the most vital of the information to be found on-line is related to our health. Whether it’s a visit to WebMD or a search for information on a new medication, the Internet has become a site for second, if not first, medical opinions and diagnoses for our selves and our families. But, for this community, access to this medical information, the information which enables us to have an educated hand in our own medical care, was blocked in three significant yet ultimately easily remedied ways: language, access to Internet technology, and education. 

With funding from the California Telemedicine and eHealth Center, a statewide resource center working to improve access to eHealth through support from The California Endowment, the Family Health Center of San Diego created an Internet-ready computer center within the Sherman Heights Community Center in May 2000. Physically connected to the Sherman Heights Family Health Center, the concept behind the computer center was to provide the neighborhood’s Spanish speaking residents access to e-health information in a comfortable environment under the guidance of two trained Spanish-speaking promatoras, or helpers. As envisioned by the project director Nora Cole, visitors would come to the center with health related questions, the Prom-atoras would assist them in finding relevant and trustworthy e-based information, help decipher the information, and then, if warranted, provide them a referral to the clinic nearby. 

  In reality, the project has far exceeded its original goals for creating a welcoming, educational space for its primarily female visitors. The computer center became so popular that, according to statistics provided by the project’s current director Tony de la Santos, in 2003 women accounted for 80 percent of the computer center’s 630 visits. And, of those women, 96 percent were Latinas. So, in addition to knocking down the barriers of language, access and education in e-health, the Sherman Heights computer center has become a social hub providing a vast new world of communication and education opportunities for a community that is often marginalized when it comes to health and technology.   

The future for the Sherman Heights Community Center computer center looks bright. With funding from the Community Technology Foundation of California, the Family Health Center is continuing to improve the computer center’s technology and community out-reach. The center’s Internet connection was recently upgraded to allow for video-streaming, expanding the learning opportunities for both visitors and staff. In fact, the upgrade has already proven extremely useful for the promatoras who are continuing their own health education through streaming technology. 

In addition to learning on-line, the project coordinator, Clara Cabrera, is continuing to provide the proma-toras with health education and training in the services provided by the Family Health Center. The ongoing goal for all of the staff is to continue to learn and provide informed outreach and assistance within the community, but the ultimate goal, the goal all staff members are striving for, is to bring Latino men and young adults into the computer center. Happily, according to the information provided by the project director, the computer center is working to achieve this ultimate goal, promoting the center as the true community resource envisioned by the Family Health Center and its supporters.

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