Margaret (Peg) Allen, MLS-AHIP Hmong Health Education Network Coordinator

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Margaret (Peg) Allen, MLS
-
AHIP

Hmong Health Education Network Coordinator

Presentation will be available at Hmonghealth.org, linked from News




Community Analysis Principles


Know the Healthcare Consumer


Cultural history; health needs


Know the Healthcare Environment


Access issues; potential partners

Baker, L. M., & Manbeck, V. (2002).
Consumer health information for public
librarians
. Lanham, Maryland and London:
Scarecrow Press.

Project History


2001 Hmong Health Information Promotion NLM
Subcontract awarded to Northern Wisconsin AHEC


2003


2004 Hmong Health Education Network funding
from NLM Office of Special Populations


Wausau Community Health Foundation funding for STD
Prevention video produced by UW Family Health with
distribution support from network


Wausau Area Hmong Mutual Association (WAHMA)
emerged as key partner

Leadership and support from Hmong association critical
to credibility with the Hmong community




Wausau Area Hmong Mutual
Association & Health (WAHMA)


Wausau 2000 Needs Assessment


Bridge Community Health Clinic, 1995


Marathon County Director of Minority Affairs:
Thomas Lee


Office of Minority Health grants
1993


1995

English
-
Hmong Medical Anatomy & Phrase Book/


Aaskiv
-
Hmoob Tib Neeg Lub Cev & Tshuaj Kho



Included anatomy and medical terminology training
for Hmong medical interpreters


Presentations to health & social service
providers


Key informant for 2001 proposal

Project Partners, 2001 to date


Wausau Area Hmong Mutual Association


American Cancer Society


American Red Cross


Marathon County Chapter


AmeriCorps Team
-

Greater Wausau Area


Aspirus Wausau Hospital


Bridge Community Health Clinic



Children’s Service Society of Wisconsin


Marathon County Health Department


Marathon County Public Library


Marshfield Clinic


Ministry Health Care/Saint Clare's Hospital



The Neighbor’s Place


NorthCentral Technical College


Northern Wisconsin Area Health Education Center


UW
-
Center for Tobacco Research and Intervention


UW Eau Claire School of Nursing


UW Wausau Family Practice


UW Marathon County & UW Extension


UW Stevens Point


Wausau Family Planning/Health Promotion/WIC


Wausau School District & DPI Early Identification Program


Wausau churches, including First Presbyterian


Hmong Health Care Professionals
Coalition, St. Paul/Minneapolis


Aurora Health Care


Eastern WI


Gundersen Lutheran Medical Center,
La Crosse


La Crosse County Health Department


WI Department of Workforce
Development


WI Division of Public Health



Wisconsin Literacy


Wisconsin United Coalition of Mutual
Assistance Organizations (WUCMAA)


Hmong National Development


NLM & NN/LM


Refugee Health Information Network

October 2004 to date


NLM continuation award via Refugee Health Information
Network, www.rhin.org


Health Navigator Program 2005 to date, funded by Ministry
Health and Alexander Judd Foundations


WUCMAA Health Education funding 2005


2006


National Network/Libraries of Medicine Consumer Health &
Exhibit Awards, 2006


NN/LM Health Disparities Subcontract, November 1, 2006 to
June 30, 2008: Website enhancement & multimedia


RHIN funding, July 1, 2008 to June 30, 2009:


Hmong Health Education Network: Promoting Hmong Health Literacy


Hmong Family Health Guide, online and in print


Marketing network and resources



Key Project Staff: Fall 2008


Peter Yang, Executive Director, Wausau Area Hmong Mutual
Association (WAHMA)


Shu Blong Her & Karl Thoj, Translators,WAHMA


Bao Lee, Web Assistant, WAHMA (AmeriCorps worker & UW
Marathon County student)


Xa Xiong, DC, MD, volunteer Medical Consultant, Aurora Health
Care


Jeff Allen, Technical Consultant, Fossil Designs LLC


Community Health Workers: Pang Moua, Marathon Co. and Mor
Lor, WAHMA


Babs Zehren, Office Manager and Mai Yia Yang, Receptionist,
and all other WAHMA & WNRB staff

Focus on Collaboration

“We need to understand how Western medicine works. And
the doctors need to understand our culture.” (Blong Moua,
Wausau Daily Herald, July 2, 2003)

Mission


The Hmong Health Education Network will develop health information
resources, services and model programs to improve Hmong patient
-
health professional communication, by focusing on the health literacy of
the Hmong population and providers’ understanding of traditional
Hmong health beliefs and practices. Our target audiences include
providers and interpreters, as well as Hmong leaders and consumers.
We will use technology as a tool that can deliver information in formats
that can be utilized by all Hmong


not just those with Internet access or
reading skills.

Community Analysis:

Who are the Hmong?



Migration from China to Laos


oral
traditions, writing new


Fought for U.S. in Viet Nam War;
34,000 lives lost


Refugee status Thai camps, 1974


2005


Emigration to U.S., Australia & Europe,
1979


(mostly as refugees)


15,000 new refugees, 2004 +


Many still trying to leave


ongoing
political issues abroad and in U.S.


Culture clash


Current focus on integration

Relationships, Language & Health


Extended families


Both parents work, often multiple jobs


In traditional agrarian society, children worked alongside
parents


Hmong speaking grandparents often caregivers for young
children (language at home)


Elders in clans must be consulted for
significant medical decisions


18 Clans Council


Health education needs extend
beyond

patient


Cultural brokering roles

Traditional Healing


Shamanism


Herbs & traditional
healing practices


Pregnancy practices


Funeral: guiding
souls to afterlife

Partner goal:
Balance

between
Western and Traditional practices

Project Planning & Development


Hmong Health Steering Committee


Teams for specific projects


Virtual communication


Email


Hmong Health listserv


Telephone

Unique Challenges


Relatively few Hmong/English bilingual resources


Hmong vocabulary does not include many Western foods
or medical concepts


Some resources not appropriate


Reading level; literal translation


Not culturally relevant


Lack of appropriate resources to translate/adapt


Reading level


Not culturally relevant; images all non
-
Asian


Need to develop our own resources


Very few Hmong providers or health profession students


New generation does not read or write Hmong

Hmong Language (
Moob
/
Hmoob
)

Two main dialects:


White


Green (or Blue)


Reference: The Hmong
Language by Nachee S. Lee,
2000

www.hmongcenter.org/hmonglanguage2.html



15

Key Needs for Health Information


Bilingual

resources


Audiovisual


Prefer English subtitles;
find written Hmong
confusing


Culturally appropriate


Relevant to current
Hmong health Issues


16

http://www.unitedhealthfoundation.com/

United Health
Foundation campaign:
the more you know, the
healthier you'll be

1. Ask questions

2. Educate yourself

3. Network with others

Health Literacy
Important for ALL

Library Resources

needed for

Hmong health education


Portal
for finding online
and in librarie
s


Bilingual
resources


Audiovisual


graphics!


Culturally appropriate


Relevant
to current Hmong
health issues


Support
health education:
clinic, classes, health fairs...

Hmong Health Website


Website developed with
extensive input from Hmong
team members


Original embroidery
concept rejected




photos preferred


Quick tour:
www.hmonghealth.org


Content Management System (CMS)

Resource goal from 2001:

Develop culturally and linguistically
appropriate health information resources



Bilingual model



see poster &
www.hmonghealth.org


Permission to use WAHMA book,
but not anatomy drawings


Challenge to find appropriate
resources to translate


White or Green Hmong?


Are written resources needed?
Appropriate?

Hmong Health Video Resources Team


Assess needs:


Available videos


Prioritize topics


Support video
production

STD Prevention Video


Highest priority topic


Controversial


Translation challenge


Digital production


$10,000 local grant to UW
Wausau Family Practice


In first two years, distributed
114+ videos and 68+ CD
-
ROMs
to more than 80 organizations in
17 states


NLM funding to convert to DVD
& use sections individually



Health Crosses a Culture

Cancer
DVD



8 parts


ACS health educator
worked with Hmong
association and area
providers


Debut: Hmong
Language workshop:
Finding Cancer Early
can Save Your Life,
April 26, 2006

Serving size comparison

Heart Health Multi Media


Goal from first
connection with Dr.
Gillespie


First English modules
put on HRM site with
project funds


Early photo project


Scripts culturally
adapted


English on slides


Hmong Family Health Guide


Phau Ntawv Moob Qha Txug Kev Noj Qaab Haus Huv



Online and print


goal from 2004


2008 decision:
Both

dialects


Dr. Xa Xiong reviewing translation


Online in progress; print 2009 by April 3
-
5
Hmong National Development Conference,
Appleton, WI


Adapted resources, some already translated


Original anatomy drawings


also in Health
illustrations


Glossary/index as basis for online
dictionary

Lessons Learned


Audience

includes Hmong consumers, interpreters and
health & social service providers


Bilingual resources

are critical


Culturally appropriate graphics



Internet
most appropriate for delivery of resources that can
be
downloaded

as well as used online


Finding tools

are needed


must include
resources not
online (
books, pamphlets,
videos)


NLM, RHIN and partner support vital to success


Time

and
funding

needed for continuing success: Don’t
attempt too much at once


Future Plans


Match needs with funding organizations
-

develop
proposals with potential partners


Continue to evaluate all activities


Act local


think global


Collaborative

Hmong Health Education Network



Local Hmong Health Steering Committee on hiatus


Consider relationships with other Hmong organizations:


Hmong National Development


Wisconsin United Coalition of Mutual Assistance Organizations
(WUCMAA)


Virtual network?


Questions?


Contact pegallen@verizon.net or
pegallen67@yahoo.com


Join Hmong health listserv or others

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