Tribal Connections Project, Phase 1
Final Report:
May 1998 - April 2001

Project Background The Tribal Connections Project (Overview) was created in 1998 to assist American Indian/Alaskan Native (AI/AN) communities in the northwest in connecting to the Internet. The hope was that by facilitating Indian Connectivity, this would help minimize isolation and improve access to social and health resources for rural and remote Indian communities. The Tribal Connections Project (Project Background) was funded by the National Library of Medicine (NLM) coordinated through the Regional Medical Library at the University of Washington, Seattle. The project was divided into two phases. Phase 1 (1998 through 1999) was designed to provide assistance to 16 American Indian/Alaska Native communities in Alaska, Idaho, Montana, Oregon, and Washington in connecting to the Internet. Phase 2 in 2000 expanded the methodology of the project to four American Indian communities in the four corners area of the Southwest. The long-term goal of the Tribal Connections Project (TCP) was to demonstrate that increased Internet connectivity provides greater access to health information resources, thereby minimizing geographical isolation and improving access to preventive and diagnostic information, and new knowledge.

Index to TC Phase 1 Final Report Staff Overview Project Background Project Description Lessons Learned Accomplishments

The World Wide Web is the fastest-growing collection of health information and has the fastest-growing use of any information medium. There are estimates that 80% of all information requests on the Web are health-related. However, as our society looks to the Web to provide health information, it becomes obvious that the digital divide--the lack of Web access in minority and poor communities--is a serious barrier to providing equal access to health information. Based on 1990 census data, 53% of Indian homes did not have a telephone, as compared with only 5% of the overall national population. The National Network of Libraries of Medicine, Pacific Northwest Region (NN/LM PNR) had worked with American Indian and Alaska Native communities for some time, especially with the Northwest Portland Area Indian Health Board and the tribal clinics represented in the Northwest Primary Care Association. The RML provided training in effective use of the Internet for finding health information. A continual barrier to accessing NLM online products after training was AI/AN lack of computers and Internet connectivity.

The foremost questions for the RML became: How can we best integrate timely and high quality online health information into the health care decisions of communities that currently lack both technical infrastructure and information-seeking training? Because of the unique position of AI/AN communities in the Northwest and because of our previous experience with AI/AN communities, the RML proposed to the National Library of Medicine that a pilot project be launched that would explore ways to overcome the health information digital divide and perhaps arrive at models that could be adopted by others. The Tribal Connections Project was designed to address these needs.

The Tribal Connections Project was funded by the National Library of Medicine (NLM) coordinated through the Regional Medical Library at the University of Washington. The project was divided into two phases. Phase 1 (1998 through 1999) was designed to provide assistance to 16 American Indian/Alaska Native communities in Alaska, Idaho, Montana, Oregon, and Washington in connecting to the Internet. Phase 2 in 2000 expanded the methodology of the project to four American Indian communities in the four corners area of the Southwest. The long-term goal of the Tribal Connections Project (TCP) was to demonstrate that increased Internet connectivity provides greater access to health information resources, thereby minimizing geographical isolation and improving access to preventive and diagnostic information, and new knowledge.

The three major objectives of the project were to:

1. Establish and improve technology infrastructure for Internet connectivity.
2. Ensure sustained and continued technologic progress.
3. Increase motivation, skill and use of online health information resources to address local health disparities.

Guiding Principles

The Tribal Connections Project was informed by five guiding principles. These include: 1) collaboration, 2) participatory planning, 3) interdisciplinary teamwork, 4) flexibility, and 5) acknowledgement. These principles are interconnected and each is inherently defined by the other. Based on the belief that government and other public agencies working in rural communities can become a catalyst for change, the TC actively sought the collaboration of these agencies in the project's participatory planning process. Local, state, federal, and tribal government agency representatives were invited to participate in and contribute to each site's community planning for Internet based health resource development. Such participation strengthened the interdisciplinary team approach used by the Project Manager and broadened the planning for enhanced computer technology and content development. This level of participation also required that the project demonstrate flexibility in meeting site-specific equipment and training needs. The TC staff believed that flexibility could lead to creative problem solving, resulting in innovative approaches to health network design, implementation and in approaches that fit more seamlessly into the fabric of each community, thus contributing to a better chance of sustainability. The project provided flexible funding—funding that could be allocated as needed for hardware, software, or connectivity—but not for personnel. Personnel contributions from the tribe provided a "matching" component to the project, and, we believe, resulted in tribal ownership of the project's outcome. In addition to flexibility, the project recognized the need to acknowledge team participants and collaborative partners for their contributions of time, experience, and knowledge to the project's planning and implementation process.