NLM realized that its toxicological and chemical databases, if brought to the attention of health professionals and scientists working in minority communities, could play a significant role in improving the health in these communities. One potentially effective way to do this was to work with HBCUs.
Because health professionals were the primary target audience for NLM's efforts to increase the use of the toxicological and chemical databases in minority populations, working with those HBCUs with schools or significant programs in medicine and pharmacy was indicated. The HBCUs with major programs in these areas had formed an association in 1976, and members of this Association of Minority Health Professions Schools and the Minority Health Professions Foundation were logical partners for NLM. According to the Association of Minority Health Professions Schools, their 12 member colleges and universities educate and train 50% of African American physicians, 50% of African American dentists, 50% of African American pharmacists, and 75% of African American veterinarians in the United States [19
]. Most of these HBCUs also see their mission as working with their surrounding communities.
In 1991, NLM created the Toxicology Information Outreach Project (TIOP) with the main purpose of increasing the capacity of HBCUs to use NLM's toxicological, chemical, environmental, and occupational resources. Nine institutions identified as having significant programs in medicine, pharmacy, or veterinary medicine were invited to participate in TIOP (). In addition to representatives from these nine universities, TIOP included representation from the National Science Foundation, National Institute of Occupational Safety and Health, Occupational Safety and Health Administration, and several consultants. Unlike most NLM programs, which generally involved working with libraries or librarians, this panel consisted of administrators, deans, and faculty members in departments relevant to toxicology, pharmaceutical science, or environmental health.
Table 1 Toxicology Information Outreach Project/Environmental Health Information Outreach Program (EnHIOP) institutions
Each of the participating schools received customized personal computer workstations with multimedia capabilities from NLM. It is important to recognize that personal computers (PCs) were not in common use at that time and were quite expensive. Indeed, during a later assessment of the program, several schools reported that these computers might have been the first ones in specific departments at the colleges [20
]. Each school was given free access to NLM's online databases and extensive training in their use. The first classes were three days in length and included detailed training in the use of the complex command language that was used at that time for online searching. (Although Grateful Med, an easy-to-use, PC-based search interface, was introduced by NLM in 1986, it initially only helped with searching MEDLINE, not the toxicology or chemical databases.) The students in these online training courses were generally faculty members and staff. NLM also provided extensive manuals and documentation that the faculty members were able to use to prepare training sessions for their own students as this was intended to be a train-the-trainers activity. The schools were also given access to several self-instructional tutorials: CHEMLEARN, TOXLEARN, MEDTUTOR, and ELHILLLEARN. The initial tutorials were mainframe computer tools, while the subsequent tutorials were PC based and multimedia. The historical context is important because, in 1991, there was a fee for searching the NLM databases and the command line searching required extensive training to perform.
Although TIOP was originally planned as a one-year pilot project, the initial success was sufficient to persuade NLM to continue the project. Not long after the commencement of TIOP, the Agency for Toxic Substances and Disease Registry (ATSDR) provided NLM funding to support training faculty and staff from additional HBCUs that were not specifically part of NLM's program. In addition, the Environmental Protection Agency's Office of Environmental Justice specifically supported training faculty and staff from institutions that were members of the United Negro College Fund. As with the courses for the TIOP members, the training used a train-the-trainers model so that the faculty who were trained would be able to implement training on their campuses as well as incorporate the use of these databases into their courses—an important factor because the goal of the TIOP pilot project was to train current and future minority health professionals. In addition, ATSDR provided funding to develop the research capacities of these institutions and enable them to conduct research in environmental health to help fill data gaps in this area.
TIOP's first ten years focused on training HBCUs in the use of NLM's databases. During that timeframe, NLM provided training to more than eighty HBCUs. The TIOP panel itself met annually and provided NLM with feedback about the content of the databases and the ways they were being used. NLM also provided updates to the panel members about new programs and services, both from the library and from other National Institutes of Health institutes and centers, including grants programs and the grants application process. NLM created opportunities for participation in other types of activities such as telemedicine and informatics meetings to help involve the HBCUs in cutting edge areas. The training activities also changed substantially as NLM expanded its database offerings, moved from its original custom-designed retrieval systems to Web-based interfaces, and provided free access to its databases starting in 1997 [21
]. During this period, the participating schools changed () so that, at the time of the tenth year anniversary, the roster of participating schools included two schools with their primary focus on other minorities besides African Americans.