184809 Onsite and online hepatitis communication training in clinics that serve migrants

Tuesday, October 28, 2008

Kathryn M. Anderson, MA , Community Health Education Concepts, Austin, TX
Claire Loe, MPH , Community Health Education Concepts, Austin, TX
Jillian Hopewell, MPA, MA , Migrant Clinicians Network, Austin, TX
Edward Zuroweste, MD , Migrant Clinicians Network, State College, PA
Carmen L. Retzlaff, MPH, CHES , Community Health Education Concepts, Austin, TX
Deliana Garcia, MA , Migrant Clinicians Network, Austin, TX

Providing a comprehensive healthcare visit to mobile clients is challenging. Clinicians must address multiple issues in a short period of time with a client they may not see again. Hepatitis risk assessment requires staff be culturally competent and have the communication skills for discussing difficult topics often using an interpreter. However, staff of rural clinics may have limited access to training for developing these skills.


This study examined the feasibility of in-person training versus elearning for public health and primary care clinics serving mobile populations.


Twenty-seven clinics were recruited to participate in the HepTalk Project. Ten clinics were randomly selected to receive onsite training and the remaining 17 were invited to online training. Two administrators required their staffs do the online training.

Onsite training included standardized patient instructors (SPs) followed by a workshop on Migration Health, Hepatitis, and Risk Assessment.

The online training modeled the onsite with the SPs in video role plays. Online participants could take the course at their own pace within a two-month timeframe.


An average of 19 people per clinic (185 total) participated in onsite training which received positive feedback and enthusiastic participation.

Eight clinics had at least one staff member participate in at least one online module. Seventeen participants completed Migration Health, 15 Hepatitis, and 12 Risk Assessment.


Conducting training onsite guaranteed high levels of staff participation but was expensive and required clinics close a half day. Online training was poorly “attended.” Some barriers included technical difficulties, staff with minimal computer experience, little administrative enforcement, removal of a social context through asynchronous learning. It can be difficult to provide rural clinics with on-site training, but their staffs may not be inclined to access distance learning or have the technology to do so. New solutions are being tested.

Learning Objectives:
1. Recognize the role of clinic administrators in successful online and onsite training modalities. 2. Identify barriers to elearning for rural clinic staff and consider solutions. 3. Consider the benefits of onsite training compared to the costs.

Keywords: Health Workers Training, Infectious Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the lead developer of the training and elearning modules.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.