October 2009

Grant Results

SUMMARY

One Economy Corporation designed, launched and marketed a Web site, DC Healthcare for You, designed to help low-income residents navigate the Washington health care system and gain access to information on health. One Economy also evaluated the potential of the site to improve health and health care among its users.

Key Results
Project staff reported the following results to the Robert Wood Johnson Foundation in 2009:

  • One Economy Corporation launched DC Healthcare for You in February 2007. The multimedia Web site, available in English and Spanish, includes audio interviews with local doctors, and videos on local health care resources and how to apply for health insurance.
  • One Economy conducted a print and online campaign to promote DC Healthcare for You, targeting low-income Washington neighborhoods.
  • One Economy expanded public Internet access in low-income sections of Washington and introduced low-income residents to the Web site.

Key Findings
In a report on their evaluation of the Web site, released in January 2009, researchers cited the following findings:

  • Most registered users of the Web site were aged 18–49, and some 65 percent of registered users who identified their gender were women.
  • The ZIP code with the most registered users corresponded with Ward 8, a low-income neighborhood targeted by One Economy.
  • Some 67 percent of registered users said they planned to use the health services they learned about on the site.

Funding
The Robert Wood Johnson Foundation (RWJF) provided $981,500 to One Economy Corporation for this project.

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THE PROBLEM

The Agency for Healthcare Research and Quality's 2004 National Healthcare Disparities Report noted that, despite some advances, "disparities related to racial, ethnic and socioeconomic status still pervade the American health care system."

According to One Economy Corporation, low-income residents of Washington had the nation's highest rates of cancer deaths, infant mortality and AIDS, as well as unusually high rates of chronic diseases such as asthma, diabetes and heart disease. Thousands of low-income residents also remained uninsured despite the fact that they are eligible for public health insurance.

What's more, most of the underserved population lived in wards with little public Internet access, according to One Economy.

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THE PROJECT

One Economy Corporation designed, launched and marketed a Web site, DC Healthcare for You, designed to help low-income residents navigate the Washington health care system and gain access to information on health. One Economy also evaluated the potential of the site to improve health and health care among its users.

One Economy Corporation is a nonprofit organization focused on enabling low-income people to use information technology to make informed decisions on health, education, employment and finances.

To solicit information on the content, design and marketing of the proposed Web site, One Economy convened town hall forums with low-income residents of Washington, and an advisory committee composed of key leaders from area hospitals, clinics, community organizations and government.

One Economy used the resulting information to design the Web site, and to create a marketing and outreach campaign that included:

  • Online and print advertising
  • Partnerships with community health organizations to encourage use of the site
  • Efforts to expand Internet access in low-income sections of the city, and to introduce residents to the Web site

One Economy set the following benchmarks for the project's success:

  • One-fourth of Washington's 56 (14 total) community health centers would agree to promote the Web site among their clients
  • Some 25,000 residents would use the Web site

The Evaluation

One Economy subcontracted with researchers at The George Washington University School of Public Health and Health Services to conduct a preliminary evaluation of the project from February to December 2008. Key features of the evaluation included:

  • The types of individuals who used the Web site
  • The information they viewed most frequently
  • Their opinions of the site
  • The potential impact of the site on their health and access to health care

The evaluation included:

  • Review of the Web site's registration form, completed by 1,648 users. (People could use the site without registering, so many did not. Those who did were eligible to win a laptop. Users who wanted to register but did not have an email address could sign up for One Economy's email service.)
  • Data from One Economy's Web tracking system.
  • Responses to an electronic survey sent by email to all 1,648 registered users, completed by seven people. (Respondents received a $5 gift card.) One Economy surmised that the low survey response rate reflected the fact that many users signed up for email for the first time when they registered on the Web site, and may not have checked their email again.

Key Results
In a 2009 report to RWJF, One Economy Corporation reported the following results:

The Web Site

  • One Economy launched the Web site, DC Healthcare for You, in February 2007. Available in English and Spanish, the site features the following topics:
    • Get Insurance: Users take a simple quiz that points them to services and insurance programs for which they qualify, and explains how to apply for and renew insurance coverage.
    • Find a Clinic: Washington residents can type in their ZIP code or a health issue to search for nearby health clinics.
    • Free Services: The site explains how Washington residents can gain access to free and low-cost health services, as well as information on health and health care.
    • Ask the Expert: Users may submit health-related questions, and One Economy staff post answers from health care providers.

The multimedia site includes audio interviews with local doctors, and videos on local health care resources and how to apply for health insurance.

  • Some 18 of the 56 community health centers in Washington (32 percent) committed to promoting DC Healthcare for You, exceeding the goal of 14, or 25 percent.
  • More than 15,000 residents visited the Web site from February to November 2008. Although the project did not reach the goal of 25,000 users, One Economy staff reported a steady increase in the number of people using the site over time.

Expanded Public Access to the Web

  • One Economy expanded public Internet access in low-income sections of the city and introduced low-income residents to the site. Project staff:
    • Established a computer center with 7 to 10 terminals and broadband connections for public use at the Gatepost Community Center in Anacostia, a low-income neighborhood.
    • Created a "mobile computer lab" consisting of 10 laptops for use by community organizations that encourage clients to explore the Web site.
    • Started a Community Fellows Program, which trained 10 low-income Washington residents to use the Web site and introduce it to others. The program, developed with Faithworks, a faith-based nonprofit, and the Gatepost Community Center, provided fellows with laptops and wireless cards that guaranteed Internet access anywhere in the city.

      The fellows introduced more than 1,500 low-income residents to the site at community hubs throughout the city. Fellows who reached interim targets for enrolling users received stipends, and those who reached the final target could keep their laptop.

Marketing Campaign

  • One Economy conducted a print and online campaign to promote DC Healthcare for You, targeting low-income Washington neighborhoods. Specifically, the corporation:
    • Ran banner ads on the news, weather and sports sections of WJLA, the local affiliate of ABC Online, and News Channel 8, a local cable channel, from August to October 2008. Ads also ran in the online edition of the Washington Post for four weeks.
    • Distributed more than 20,000 pieces of marketing materials about the Web site - including bilingual brochures and posters - to health clinics, community partners, libraries, computer centers, local businesses and health fairs.
    • Placed ads in train stations of the Washington Metropolitan Transit Authority in low-income communities, and ran banner ads on the sides of local buses for six months.
    • Leveraged an existing relationship with Google to place the new Web site at or near the top of search results for health-related terms entered by Washington residents.
    • Used social networking sites such as Facebook to connect with health organizations and Washington residents who wanted to learn more about DC Healthcare for You.
    • Co-sponsored a heart-screening event at the Gatepost Community Center with the Cheney Cardiovascular Institute and Larry King Cardiac Foundation, and distributed a press release on the event. One Economy provided computers and Internet access to enable volunteers to help attendees use the Web site's tools and resources.
    • Included information on DC Healthcare for You in a monthly "Email blast" to more than 10,000 people.

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KEY FINDINGS

In a report on their evaluation of the Web site, released in January 2009, researchers at The George Washington University School of Public Health and Health Services cited the following key findings:

  • Of 1,620 registered users who identified their gender, some 65 percent were women. The availability of public insurance for women with children, and the lack of such options for men without children, may have been one factor in that disparity, according to One Economy.
  • Most registered users of the Web site were aged 18–49. People over age 50 accounted for just 10 percent of users, confirming evidence that older residents are less likely to use the technology, according to the corporation.
  • Most users (61 percent) learned about the Web site from a family member or a friend.
  • The ZIP code with the most registered users corresponded with Ward 8, a low-income neighborhood targeted by One Economy.
  • Free Services was the most popular section of the Web site.
  • Some 67 percent of registered users said they planned to use the health services they learned about on the site.
  • Some 12 percent said they planned to apply for health insurance after using the site.
  • Six of the seven users who responded to the online survey planned to take a health-related action after using the Web site, such as seeing a health provider.

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AFTER THE GRANT

One Economy Corporation continued to update and enhance the Web site, adding features such as enabling users to sign up to receive health tips by email.

One Economy also launched several related projects:

  • With $200,000 in funding from Qualcomm, the corporation began to design DC Healthcare for You Mobile, which will allow cell phone users to gain access to the Web site.
  • With funding from the Consumer Health Foundation, the corporation planned to expand the project to counties surrounding Washington.
  • With funding from the Merck Foundation, the corporation established a similar Web site for Chicago and Atlanta.

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GRANT DETAILS & CONTACT INFORMATION

Project

Investing in wide-scale patient self-management tools to enable people to manage their own health in Washington, DC

Grantee

One Economy Corporation (Washington,  DC)

  • Amount: $ 981,500
    Dates: December 2006 to November 2008
    ID#:  058524

Contact

Sonja Murray
(336) 765-9118
smurray@one-economy.com

Web Site

http://dc.healthcareforyou.org

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Payne PW. DC Healthcare for You Preliminary Evaluation Report. Washington: The George Washington University, 2009.

Survey Instruments

"DC Healthcare for You Web Site Feedback Survey." Fielded February to December 2008 to registered users of DC Healthcare for You. Washington: One Economy Corp., available online.

World Wide Web Sites

http://dc.healthcareforyou.org. Web site created to connect low-income individuals with information on managing their own healthcare. Washington: One Economy Corp., February 2008.

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Report prepared by: Nina Berlin
Reviewed by: Sandra Hackman
Reviewed by: Marian Bass
Program Officer: Albert O. Shar

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