Academic journal article Journal of the Medical Library Association

Navigating the US Health Care System: A Video Guide for Immigrant and Diverse Populations*

Academic journal article Journal of the Medical Library Association

Navigating the US Health Care System: A Video Guide for Immigrant and Diverse Populations*

Article excerpt


Commitment to diversity is an important part of the strategic plan of the University of Nebraska Medical Center (UNMC) [1]. As part of this commitment, the university provides support and incentives for diversity initiatives. It is hoped that, in addition to promoting diversity, the funded initiatives will strengthen existing relationships and build new, positive relationships with local community service organizations.

In 2004, the McGoogan Library of Medicine at UNMC was selected as one of the units to receive diversity funds. A team of five librarians, the authors, was chosen to work on this project. While no exact guidance was given, the team was encouraged to address the health information needs of diverse or underserved populations in Nebraska. Twenty-five thousand dollars in one-time funding was provided. As continued funding could not be anticipated, it was important that the project be relatively timeless.

While brainstorming about the type of project to undertake, the team found numerous studies describing difficulties recent immigrants might encounter when dealing with the US health care system [2-7]. Difficulties ranged from making appointments to understanding the need to disclose personal information or express disagreement with a physician. The team realized that many of these issues can result from a lack of knowledge about the basic elements of a doctor's appointment in the United States. These basics likely do not change rapidly over time; thus, a resource explaining these concepts should have long-lasting usefulness.


A literature search revealed reports of some health education programs that had been designed to teach basic health maintenance concepts to children of immigrants. Creators of one program felt that it was successful because the children could share the basic information they had learned with their parents and that parents were open to people who cared about their children [8].

The team felt that aiming the project at children could teach basic information without being condescending, and it was likely that such basic information would be shared with the children's parents. After meeting with several individuals who worked with Nebraska's diverse underserved and immigrant populations, the team decided that much information could be conveyed through a video, narrated in several languages, that would follow a child's family through the process of making a doctor's appointment, visiting the doctor, and visiting the library to obtain additional health information. A subsequent meeting with a local school nurse confirmed the need for basic information about what to expect when visiting the doctor.

Because none of the team members had ever participated in the creation of this type of video, it was unknown if it would be possible to produce a video with the given budget and proposed one-year timeframe. Several local video production companies were contacted, but ultimately the team decided to work with the UNMC Video Services Department. The video services staff had worked on previous projects with the library, and it was felt that a familiar face on campus might ease some of the team's anxiety about venturing into new territory.

Review of the literature about the obstacles faced by immigrants seeking health care produced a list of elements that the team wanted to include in the video (Figure 1). Children's books and a children's video about going to the doctor were also reviewed to see what others considered important or interesting to children. The team decided to aim the video at an early- to mid-elementary school audience. Specifically, the aim was for complete comprehension by eight-year-old children and at least partial comprehension by fiveyear-olds. To accommodate the attention span of younger children and viewers of all literacy levels, the target length for the video was set at ten minutes [9]. …

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