the national library of medicine’s native america outreach portfolio: overview and lessons learned

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The National Library of Medicine’sThe National Library of Medicine’sNative America Outreach Portfolio:Native America Outreach Portfolio:Overview and Lessons LearnedOverview and Lessons Learned

by Fred B. Wood, Gale Dutcher, Angela Ruffin, by Fred B. Wood, Gale Dutcher, Angela Ruffin, Paul Theerman, and Patricia Tuohy, NLMPaul Theerman, and Patricia Tuohy, NLMConference of Native AmericanConference of Native American

Health Information ServicesHealth Information ServicesAlbuquerque, NM – July 20-21, 2006Albuquerque, NM – July 20-21, 2006


OutlineOutline

Overview—Fred WoodOverview—Fred Wood Sacred Root—Gale DutcherSacred Root—Gale Dutcher NN/LM Lessons Learned—Angela NN/LM Lessons Learned—Angela

RuffinRuffin MHA Systems—Paul TheermanMHA Systems—Paul Theerman Native Healing Exhibit—Patricia Native Healing Exhibit—Patricia

TuohyTuohy


Native Outreach Native Outreach PortfolioPortfolioThumbnail SketchThumbnail Sketch

by Fred Wood, OHIPD/NLMby Fred Wood, OHIPD/NLM Tribal Connections NN/LM, OHIPDTribal Connections NN/LM, OHIPD

– I (Pacific Northwest) PN RMLI (Pacific Northwest) PN RML– II (Pacific Southwest) PN RMLII (Pacific Southwest) PN RML– III (3 Northwest sites) PN RMLIII (3 Northwest sites) PN RML– IV (Four Corners NM, AZ, UT, CO)IV (Four Corners NM, AZ, UT, CO)

3 RMLs, 4 RLs3 RMLs, 4 RLs


Native Portfolio, Native Portfolio, Cont’dCont’d Sacred Root Native Internship Sacred Root Native Internship

Project, SISProject, SIS Tribal College Outreach and Tribal College Outreach and

Librarianship Projects, NN/LM & SISLibrarianship Projects, NN/LM & SIS Tribal Community Outreach Tribal Community Outreach

Projects, NN/LMProjects, NN/LM Tribal Powwow Participation, NLM Tribal Powwow Participation, NLM

& NN/LM& NN/LM


Native Portfolio, Native Portfolio, Cont’dCont’d Intertribal Collaboration, e.g., NCAI Intertribal Collaboration, e.g., NCAI

Health Information Task Force, SISHealth Information Task Force, SIS Listening Circle Project, NLM, OHIPDListening Circle Project, NLM, OHIPD Health Information Web SitesHealth Information Web Sites

-- -- Tribal Connections, PN RMLTribal Connections, PN RML

-- -- Native American Health on MedlinePlus, Native American Health on MedlinePlus, LO/PSDLO/PSD

---- Arctic Health, SIS Arctic Health, SIS

-- -- American Indian Health, SISAmerican Indian Health, SIS


Native Portfolio, Native Portfolio, Cont’dCont’d Native Hawaiian Community Project, Native Hawaiian Community Project,

Miloli’i and Waimanelo, OHIPDMiloli’i and Waimanelo, OHIPD Native Hawaiian Healing Materials Native Hawaiian Healing Materials

Project, OHIPDProject, OHIPD Tribal Economic Development Project, Tribal Economic Development Project,

MHA Nation, OHIPD, HMD, SISMHA Nation, OHIPD, HMD, SIS Native Health & Healing Exhibit, HMDNative Health & Healing Exhibit, HMD


Underlying Outreach Underlying Outreach StrategiesStrategies Improving information infrastructure Improving information infrastructure

and technical capabilitiesand technical capabilities Employing communication methods Employing communication methods

that are culturally sensitive and that are culturally sensitive and appropriate—Native consultation is appropriate—Native consultation is keykey

Building effective partnerships with Building effective partnerships with Native community groups and Native community groups and national organizationsnational organizations


Strategies, Cont’dStrategies, Cont’d

Training Native health and Training Native health and information professionals, and information professionals, and community leaders and memberscommunity leaders and members

Increasing the scope of NLM’s Increasing the scope of NLM’s information products and services to information products and services to cover more Native-related materialcover more Native-related material

Emphasizing capacity building in Emphasizing capacity building in Native communities where possibleNative communities where possible


Strategies, Cont’dStrategies, Cont’d

Making site visits to assure direct Making site visits to assure direct interactions, full understanding, and interactions, full understanding, and effective working relationshipseffective working relationships

Fine tuning outreach planning and Fine tuning outreach planning and evaluation for Native community-evaluation for Native community-based projectsbased projects

For more info, see JMLA Vol. 93, No. 4, For more info, see JMLA Vol. 93, No. 4, Supplement on Community-Based Supplement on Community-Based Health Information OutreachHealth Information Outreach


Some Native Some Native InspirationInspiration All my relatives (family, friends, All my relatives (family, friends,

peoples, and intelligences)peoples, and intelligences) Let every day be a good dayLet every day be a good day Live in harmony with the Medicine Live in harmony with the Medicine

Wheel and Sacred TreeWheel and Sacred Tree With the wisdom, foresight, and With the wisdom, foresight, and

strength of the Eaglestrength of the Eagle For the good of the Next Seven For the good of the Next Seven

GenerationsGenerations


Sacred RootSacred RootNative American Native American Information Fellowship Information Fellowship by Gale Dutcher, Head,by Gale Dutcher, Head,

Outreach & SpecialOutreach & Special

Populations, SIS/NLMPopulations, SIS/NLM


Purpose of Fellowship Purpose of Fellowship ProgramProgram Develop capacity of native Develop capacity of native

communitiescommunities Improve access to health Improve access to health

informationinformation Develop relationshipsDevelop relationships


How it WorksHow it Works

Two year programTwo year program Two participants from each groupTwo participants from each group

– Mid-career professionalsMid-career professionals– Health and/or technology backgroundsHealth and/or technology backgrounds

FundingFunding– StipendStipend– TravelTravel– TrainingTraining– Laptop computerLaptop computer– Local projectLocal project


ActivitiesActivities

Initial two weeks at NLMInitial two weeks at NLM– Online training classesOnline training classes– Orientation to NLMOrientation to NLM– Focused meetings with staffFocused meetings with staff

Training/ConferencesTraining/Conferences– Dependent upon specific needs/interestsDependent upon specific needs/interests

Connection with RML and NN/LMConnection with RML and NN/LM Additional activities possibleAdditional activities possible


Project DevelopmentProject Development

Culminating activityCulminating activity Proposal writingProposal writing Funding provided by NLMFunding provided by NLM


Origins of Fellowship Origins of Fellowship ProgramProgram Co-funding by the Co-funding by the

NCMHD – end of NCMHD – end of 20012001

Meeting with Tex Meeting with Tex Hall, Chairman, Hall, Chairman, MHA NationMHA Nation

Creation by NCAI of Creation by NCAI of President’s Task President’s Task Force on Health Force on Health InformationInformation


Current StatusCurrent Status2002 – Interns from MHA 2002 – Interns from MHA

Nation - Richard Mayer Nation - Richard Mayer and Deborah and Deborah ThompsonThompson

– Internship completedInternship completed– Project implementedProject implemented– Training relationship Training relationship

Univ. North Dakota HSLUniv. North Dakota HSL– Project ExpansionProject Expansion– Ongoing NLM-MHA Ongoing NLM-MHA

activitiesactivities


Status, continuedStatus, continued

2003 –Nez Perce 2003 –Nez Perce Tribe – Tina Tribe – Tina Bullock and Jim Bullock and Jim PondPond– Year one Year one

completed 2004completed 2004– Project underwayProject underway


Nez Perce ProjectNez Perce Project

Tablet PCs and Hand-held devices Tablet PCs and Hand-held devices for cliniciansfor clinicians

Access health information with Access health information with patientspatients


20042004

Native Hawaiian Native Hawaiian FellowsFellows

Papa Ola LokahiPapa Ola Lokahi

LorrieAnn Santos LorrieAnn Santos and Momi and Momi FernandezFernandez


Hawaiian ProjectsHawaiian Projects

Support for Cancer projectSupport for Cancer project– Development of gameDevelopment of game– Promotional materialsPromotional materials

Develop GIS capacityDevelop GIS capacity– TrainingTraining– Implementation of Health Equity Implementation of Health Equity

ReviewReview Data users groupData users group


PlansPlans

Continue to work with Continue to work with NCAI Task ForceNCAI Task Force

Next group will start Next group will start in the fallin the fall

Evaluation of programEvaluation of program Continue to build Continue to build

upon these upon these relationshipsrelationships


By Angela Ruffin, Head, NNO/NLMBy Angela Ruffin, Head, NNO/NLM

Outreach to Minority, Underserved Outreach to Minority, Underserved and Native Communitiesand Native Communities– Lessons learned through the yearsLessons learned through the years– Enhanced lessons learnedEnhanced lessons learned

2006 – 2011 Priorities2006 – 2011 Priorities

Reflections on NN/LM Reflections on NN/LM OutreachOutreach


Earlier Lessons Learned Earlier Lessons Learned -Pre Web Access-Pre Web Access

Time to plan and implement Time to plan and implement projectproject

Identify information needs of target Identify information needs of target populationpopulation

Identify onsite contact personIdentify onsite contact person Tailor training to audienceTailor training to audience


Earlier Lessons Learned Earlier Lessons Learned Electronic AccessElectronic AccessOutreachOutreach Getting outGetting out Cultural competenceCultural competence TrainingTraining - Demonstration/Training- Demonstration/Training

– Training contentTraining content CustomizeCustomize Hands-onHands-on Basic computer skillsBasic computer skills

– Train the trainerTrain the trainer– Location of training (onsite/offsite)Location of training (onsite/offsite)– Follow-up trainingFollow-up training


Earlier Lessons LearnedEarlier Lessons LearnedElectronic AccessElectronic AccessProject AdministrationProject Administration

PlanningPlanning DelaysDelays StaffingStaffing FlexibilityFlexibility


Earlier Lessons LearnedEarlier Lessons LearnedElectronic AccessElectronic AccessAssessing Information Assessing Information NeedsNeeds

Not a one-time exerciseNot a one-time exercise Needs vary by group and readinessNeeds vary by group and readiness


Earlier Lessons LearnedEarlier Lessons LearnedElectronic AccessElectronic AccessObjectives and OutcomesObjectives and Outcomes

Objectives follow from assessing needsObjectives follow from assessing needs Identify key players/community leaders at siteIdentify key players/community leaders at site Continued presence & communicationContinued presence & communication Stay poised to alter courseStay poised to alter course OutcomesOutcomes

– Raise awarenessRaise awareness– Increase accessIncrease access– Affect use & effectivenessAffect use & effectiveness– Change in information seekingChange in information seeking


Earlier Lessons LearnedEarlier Lessons LearnedElectronic AccessElectronic AccessCollaborationsCollaborations

Leadership/Key on-site contactsLeadership/Key on-site contacts Diverse expertiseDiverse expertise CommitmentCommitment CommunicationCommunication SustainabilitySustainability


Earlier Lessons LearnedEarlier Lessons LearnedElectronic AccessElectronic AccessPartnershipsPartnerships

Require common needs, mutual Require common needs, mutual goals, mutual respect, shared goals, mutual respect, shared resourcesresources

CommunicationCommunication


Enhanced Lessons LearnedEnhanced Lessons LearnedCommunity Based OutreachCommunity Based Outreach

Understand the communityUnderstand the community - Language- Language - Culture, beliefs, traditions- Culture, beliefs, traditions - What they think & worry about- What they think & worry about - Information needs & uses- Information needs & uses - What/who are their communication channels- What/who are their communication channels - What/where are their cultural and friendship - What/where are their cultural and friendship

centerscenters Meet them on their turf and ‘where they are’Meet them on their turf and ‘where they are’ - Telecommunication infrastructure- Telecommunication infrastructure - Information skills- Information skills


Enhanced Lessons LearnedEnhanced Lessons LearnedCommunity Based OutreachCommunity Based Outreach

Participatory planningParticipatory planning Asset-based versus solely needs-Asset-based versus solely needs-

based approachbased approach Relationship buildingRelationship building CreativityCreativity More community engagementMore community engagement Community partners as Community partners as

empowermentempowerment


2006-2011 RMLs and 2006-2011 RMLs and CentersCenters

National Training Center and Clearinghouse (NTCC) – New York Academy National Training Center and Clearinghouse (NTCC) – New York Academy of Medicineof Medicine

Outreach Evaluation Resource Center (OERC) – University of WashingtonOutreach Evaluation Resource Center (OERC) – University of Washington Web Services, Technology Operations Center (Web-STOC) – University of Web Services, Technology Operations Center (Web-STOC) – University of

WashingtonWashington

University of Massachusetts

University of Maryland, Baltimore

New York University

University of Illinois, Chicago

Houston Academy of Medicine – Texas Medical Center

University of California, Los Angeles

University of Utah

University of Washington


OutreachOutreach– Community partnerships, CBOsCommunity partnerships, CBOs– Regional evaluation expertsRegional evaluation experts– Dissemination of best practicesDissemination of best practices– Encourage/identify cross regional Encourage/identify cross regional

opportunitiesopportunities– Proposal writing assistanceProposal writing assistance– Health information literacyHealth information literacy– Expanded scope of technology conferencesExpanded scope of technology conferences

Priorities for 2006-2011Priorities for 2006-2011


The Outreach Evaluation Resource Center

2001-2006

Instruction, consultation, and planning support based on Measuring the Difference: Guide to Planning and Evaluating Health Information Outreach,

…plus three new booklets to update the Guide!

http://nnlm.gov/evaluation/


NN/LM Funding MechanismsNN/LM Funding Mechanisms

Major outreach/consumer health projectsMajor outreach/consumer health projects ““Express” outreach awardsExpress” outreach awards Outreach Planning awardsOutreach Planning awards Outreach Follow-up awardsOutreach Follow-up awards Partnership planning awardsPartnership planning awards Technology improvement/Internet connections Technology improvement/Internet connections

awardsawards Training awards Training awards Technology awareness conferences Technology awareness conferences Exhibit awardsExhibit awards


MHA Systems and MHA Systems and NLM’s History of Medicine NLM’s History of Medicine DivisionDivision

Collaboration in Library Work:Collaboration in Library Work: A Learning ProcessA Learning Process

by Paul Theermanby Paul TheermanHead, Images and Archives Head, Images and Archives History of Medicine DivisionHistory of Medicine DivisionNational Library of MedicineNational Library of Medicine



MHA Systems—MHA Systems—– A tribal business of the Mandan-Hidatsa-A tribal business of the Mandan-Hidatsa-

Arikira Nation, the “Three Affiliated Arikira Nation, the “Three Affiliated Tribes” of Fort Berthold Reservation, New Tribes” of Fort Berthold Reservation, New Town, North DakotaTown, North Dakota



BackgroundBackground– Listening Circle established through NLM’s Listening Circle established through NLM’s

Office of Health Information Programs Office of Health Information Programs Development (OHIPD), Elliott Siegel, Development (OHIPD), Elliott Siegel, Director, and Fred Wood as principalsDirector, and Fred Wood as principals

– NLM’s Director, Dr. Donald A. B. Lindberg, NLM’s Director, Dr. Donald A. B. Lindberg, met with Mr. Tex Hall, Chairman of MHA met with Mr. Tex Hall, Chairman of MHA Nation, to begin a project to build tribal IT Nation, to begin a project to build tribal IT capacity and to provide NLM with digitized capacity and to provide NLM with digitized datadata



Specific StepsSpecific Steps– MHA Systems to scan and mark-up books and MHA Systems to scan and mark-up books and

manuscript materials from the History of manuscript materials from the History of Medicine DivisionMedicine Division

– NLM to assist MHA in assessing technical NLM to assist MHA in assessing technical needs—skills, technology, work flow, quality needs—skills, technology, work flow, quality control, and with business management control, and with business management trainingtraining

– NLM to secure appropriate training and NLM to secure appropriate training and provide oversightprovide oversight

– Move to production after training periodMove to production after training period



What was scanned?What was scanned?– Wyndham Miles’s Wyndham Miles’s History of the National History of the National

Library of MedicineLibrary of Medicine – Minutes of the Library’s Board of Regents Minutes of the Library’s Board of Regents

meetings meetings – NLM Annual ReportsNLM Annual Reports – NLM Technical BulletinsNLM Technical Bulletins

What was produced?What was produced?– PDF files and XML mark-up for web displayPDF files and XML mark-up for web display



Who were involved from NLM?Who were involved from NLM?– Fred Wood—Office of Health Information Fred Wood—Office of Health Information

Programs Development, NLMPrograms Development, NLM– John Rees, Curator of Manuscripts, Images John Rees, Curator of Manuscripts, Images

and Archives Section, History of Medicine and Archives Section, History of Medicine DivisionDivision

– Paul Theerman, Head, Images and Archives Paul Theerman, Head, Images and Archives Section, History of Medicine DivisionSection, History of Medicine Division

– Susan Schreibman, Assistant Dean and Head Susan Schreibman, Assistant Dean and Head of Digital Collections, University of Maryland of Digital Collections, University of Maryland Libraries—technical training and assistanceLibraries—technical training and assistance



Who were involved from MHA?Who were involved from MHA?– Rosie Johnson, and then Richard Mayer—Rosie Johnson, and then Richard Mayer—

MHA Systems CEOMHA Systems CEO– Chris Rabbithead and then Jonathan Chris Rabbithead and then Jonathan

Berryhill—project directorsBerryhill—project directors– Joan Zavalny—MHA SystemsJoan Zavalny—MHA Systems– Jerry Stai—Minot State University School of Jerry Stai—Minot State University School of

Business, advisorBusiness, advisor– Many scanners and coders from MHA Many scanners and coders from MHA

NationNation



TimelineTimeline– Materials sent fall 2004Materials sent fall 2004– Site visit in December 2004—Theerman, Site visit in December 2004—Theerman,

Rabbithead, Zavalny, Johnson, and Rees Rabbithead, Zavalny, Johnson, and Rees (Wood photographing)(Wood photographing)



TimelineTimeline– Training in April 2005—Rees and Training in April 2005—Rees and

Schreibman, Theerman and Wood as Schreibman, Theerman and Wood as assistants/observersassistants/observers



Successful TraineesSuccessful Trainees



TimelineTimeline– Into production in the second half of 2005Into production in the second half of 2005– Materials added to NLM’s website, “NLM Materials added to NLM’s website, “NLM

Archives,” in 2005-2006Archives,” in 2005-2006http://www.nlm.nih.gov/hmd/manuscripts/nlmarchives/http://www.nlm.nih.gov/hmd/manuscripts/nlmarchives/

index.htmlindex.html

– Total amountsTotal amounts A 525-page bookA 525-page book 40 sets of Regents’ Minutes40 sets of Regents’ Minutes 52 Annual Reports52 Annual Reports 271 issues of Technical Bulletins271 issues of Technical Bulletins



New ProjectsNew Projects– New project in 2006: scanning printed New project in 2006: scanning printed

materials to provide an on-line guide to a materials to provide an on-line guide to a very large NLM collection on the Food and very large NLM collection on the Food and Drug Administration (FDA)Drug Administration (FDA)

– 60 volumes of materials to be scanned 60 volumes of materials to be scanned prior to OCR and data extractionprior to OCR and data extraction

– Project will go into 2007Project will go into 2007



Experience—some hesitationsExperience—some hesitations– Staff turnover was high.Staff turnover was high.

– Tension between a turn-key operation and Tension between a turn-key operation and one with stronger input from MHA.one with stronger input from MHA.

– Difficulties in working half a continent Difficulties in working half a continent away.away.



Experience—some positivesExperience—some positives– Technology not a barrier, and was a help.Technology not a barrier, and was a help.

– Great pleasure in the training and in Great pleasure in the training and in seeing the project take off.seeing the project take off.

– It works!It works!



Thanks to:Thanks to:– Elliot Siegel and Fred Wood, Office of Elliot Siegel and Fred Wood, Office of

Health Information Programs DevelopmentHealth Information Programs Development– John Rees, Curator of ManuscriptsJohn Rees, Curator of Manuscripts– Susan Schreibman, technical consultantSusan Schreibman, technical consultant– Jonathan Berryhill, Rosie Johnson, Richard Jonathan Berryhill, Rosie Johnson, Richard

Mayer, Chris Rabbithead, Joan Zavalny, Mayer, Chris Rabbithead, Joan Zavalny, and numerous scanners and coders, MHA and numerous scanners and coders, MHA SystemsSystems

– Jerry Stai, business consultantJerry Stai, business consultant


Developing an NLM Exhibition Developing an NLM Exhibition about Native American about Native American Concepts Concepts of Health and Diseaseof Health and Disease

A discussion aboutA discussion about

cultural competencycultural competency

by Patricia Tuohy, Headby Patricia Tuohy, Head

NLM Exhibition ProgramNLM Exhibition Program


SourcesSources

Center for Effective Collaboration and Practice Center for Effective Collaboration and Practice cecp.air.orgcecp.air.org

National Center for Cultural Competence Georgetown National Center for Cultural Competence Georgetown University Child Development Center University Child Development Center gucchd.georgetown.edu/nccc/gucchd.georgetown.edu/nccc/

Terry Cross, et al. Terry Cross, et al. Towards a Culturally Competent System Towards a Culturally Competent System of Care.of Care. 1989 1989

Michael Baxandall, “Exhibiting Intention: Some Michael Baxandall, “Exhibiting Intention: Some preconditions of the Visual Display of Culturally Purposeful preconditions of the Visual Display of Culturally Purposeful Objects,” Objects,” Exhibiting Cultures: The Poetics and Politics of Exhibiting Cultures: The Poetics and Politics of Museum Display.Museum Display. I. Karp and S. Lavine, eds. I. Karp and S. Lavine, eds.


What exhibition What exhibition development development has in common with has in common with competent health promotioncompetent health promotion

Culturally competent approaches to Culturally competent approaches to health promotion respects the cultural health promotion respects the cultural values, beliefs, and practices of the values, beliefs, and practices of the intended audienceintended audience

So, too, does good exhibition So, too, does good exhibition development development


Working definitionsWorking definitions

Cultural knowledge:Cultural knowledge: familiarization with selected familiarization with selected cultural characteristics, history, values, belief cultural characteristics, history, values, belief systems, and behaviors of the members of another systems, and behaviors of the members of another ethnic group.ethnic group.

Cultural awareness:Cultural awareness: developing sensitivity and developing sensitivity and understanding of another ethnic group. This usually understanding of another ethnic group. This usually involves internal changes in terms of attitudes and involves internal changes in terms of attitudes and values. Awareness and sensitivity also refer to the values. Awareness and sensitivity also refer to the qualities of openness and flexibility that people qualities of openness and flexibility that people develop in relations to others.develop in relations to others.

Cultural sensitivity:Cultural sensitivity: knowing that cultural knowing that cultural differences as well as similarities exist differences as well as similarities exist without without assigning values to those cultural differences.assigning values to those cultural differences.


What is cultural competencyWhat is cultural competency

Cultural competencyCultural competency is defined as a is defined as a set of congruent behaviors, attitudes, set of congruent behaviors, attitudes, and policies that come together in a and policies that come together in a system, agency, or among professionals system, agency, or among professionals and enables that system, agency, or and enables that system, agency, or those professionals to work effectively in those professionals to work effectively in cross-cultural situations. cross-cultural situations.

Cultural competency emphasizes the Cultural competency emphasizes the idea of idea of effectively effectively operating in different operating in different cultural contexts.cultural contexts.


Health Health promotionpromotion

medical expertsmedical experts

health health communicatorscommunicators

audiencesaudiences

Making Making exhibitionsexhibitions

makers of objectsmakers of objects

exhibitors or exhibitors or exhibition exhibition developersdevelopers

viewers of made viewers of made objects or objects or exhibition visitorsexhibition visitors


Questions for you. . .Questions for you. . .

How do you adapt and respond to How do you adapt and respond to different cultural beliefs and practices different cultural beliefs and practices when providing health information?when providing health information?

How do you and your organization or How do you and your organization or institution practice cultural institution practice cultural competency?competency?


NLM contacts for NLM contacts for further informationfurther information Fred Wood, OHIPD, ph:301-402-9278, Fred Wood, OHIPD, ph:301-402-9278,

[email protected]@mail.nih.gov Gale Dutcher, SIS, ph:301-496-5082, Gale Dutcher, SIS, ph:301-496-5082,

[email protected]@mail.nlm.nih.gov Angela Ruffin, NNO, ph:301-496-4777, Angela Ruffin, NNO, ph:301-496-4777,

[email protected]@mail.nlm.nih.gov Paul Theerman, HMD, ph:301-594-Paul Theerman, HMD, ph:301-594-

0975, 0975, [email protected]@mail.nlm.nih.gov Patricia Tuohy, HMD, ph:301-435-Patricia Tuohy, HMD, ph:301-435-

5240, 5240, [email protected][email protected]

the national library of medicine’s native america outreach portfolio: overview and lessons learned

Documents

native american health

contdtraining native

native community groups

native inspirationall

information professionals

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arctic health

outreach specialpopulations