Subject: Community networks and health education

From: Catherine Holland <[email-masked]>
Date: Fri, 8 Oct 1993 10:42:56 -0700

Last month the Washington Association of State Sexuality
Educators and Trainers (ASSET) held its annual meeting in
Seattle. ASSET's membership is composed of the state's Planned
Parenthood Affiliates, city, county, and state public health
educators, and various freelance and consulting trainers and
curriculum developers. 

We were invited to give two presentations. Steven did the
first one, along with Steve McCallister of the Snohomish
County Planned Parenthood, on information privacy in the era
of health care datamation/dataveillance. My talk was entitled,
"Envisioning Sexuality Education and Emerging Technologies".
It's emphasis was on the use of community networks to deliver
innovative and effective health and sexuality education, and
the implications and ramifications for the profession of so
doing.

Following is a transcript of the presentation portion of the
symposium. You may pass it along provided you cc: me. It is
avialable for archiving upon request. I welcome your feedback.

Thanks,

Catherine

You may also retrieve it by ftp from ftp.u.washington.edu,
cd /usr/ftp/pub/user-supported/horsehorse. The filename is
C-BINs6.1.txt

    ______________________________________________________
   |                                                      |
   |    HORSE HORSE LION LION, A Consulting Cooperative   | 
   |              "Information into Culture"              | 
   |                                                      | 
   |      Steven Hodas/Catherine Holland, Principals      |
   |                                                      | 
   |    [email-masked]   VOICE/FAX 206.285.5975    |
   |______________________________________________________|

--------------------------------------------------------------------

Envisoning Sexuality Education and Emerging Technologies
   Delivered to the 1993 meeting of Washington ASSET

                          by 

       Catherine Holland, [email-masked] 
         Copyright 1993 Horse Horse Lion Lion. 
                  All rights reserved. 

"Envisioning Sexuality Education and Emerging Technologies"
...hmmm. Kind of a daunting title for a talk to people whose
business is people, who thrive on human interaction and
personal connection. So I'm glad we've got so many brave souls
here, because what I want to talk about is really central to
communicating with people, to serving people, to helping
people make important decisions about their lives. I'm going
to speak for about forty-five minutes to give you some
background. We'll take a quick break, and then come back, I
hope, for some Q&A.

The reason I want to talk about our work in terms of emerging
technologies is that the tools we use and don't use to do our
jobs, define our jobs. They set the limits and the
possibilities of what we can do, of what we can even imagine
doing. 

Think about the telephone, for example, something we all take
for granted, that we've probably taken for granted since we
were old enough to focus that far in front of us. Now imagine
what your job would be like without a phone. Imagine trying to
get hold of the information you use everyday without one, or
setting up meetings, or making appointments. Would we come to
conferences if we couldn't call back to the office during
breaks, or call home in the evenings? When your clinic windows
get smashed, how would you get them replaced without being
able to call the window guy or the insurance company? When you
need advice, or input, or consolation and you need it fast,
how would you get it? All these things we take for granted,
all these large and small relationships are made possible as
we know them by the telephone. The phone for us today is a
very important window onto the world, a very important
facilitator of our social relationships.

What I'm getting at, and something I want you to keep in mind
during this session, is that a technology is not just a
machine, or even a machine at all. A technology is a whole
system of values and practices that support some activity of
ours. So the important thing about the technology of
telephones is not the buttons you press or the thing you hold
against your face or the wires in the phone. The important
thing is the way it lets you do things, to call whomever you
want and say whatever you want, and that other people
understand how to do it too and have pretty much the same set
of expectations about what we can use phones for.

A technology doesn't have to be a machine at all. This
conference is a technology, a technology for getting out
information and strengthening professional relationships. We
have other technologies for that kind of thing too, like
newsletters, or joint projects, or even schools. Safer sex and
abstinence are both technologies of protection, but the fact
that we see them as so different from one another points up
how technologies are defined by the human, social values we
embed in them, our assumptions about the world and our place
in it. Religion is a technology for the accumulation of
understanding and sense-making, for connecting ourselves with
one another as well as with something larger than us. So is
science, in a different way, but maybe not quite as different
as some people would have you believe.

I say all this because I want you to be open to the tremendous
relevance, even urgency, that what we're discussing has to
your roles as educators, trainers, and citizens. A lot of
people in the social services imagine for some reason that
technology is irrelevant to their work or worse, that somehow
the values of technology are actually hostile to their
concerns and their mission. Partly I think that perception
comes from the fact that often in our culture we as citizens
don't have very much say in what machines get developed or how
they're put to use. And so because we're not involved, the
machines end up being used to support things we don't believe
in, or whose use has consequences we find unacceptable. 

Just remember, though, that the issue is not the machines
themselves but how they're used, what values they support and
what values they undermine. Computers for example, as we heard
in the talk on privacy, can pose real threats to our privacy,
but they also offer the opportunity to protect us and all our
information with an ironclad anonymity that gets its strength
not from the laws of government but from the laws of physics.

And also, I want you to keep in mind this quote from Sir
William Preece, who was chief engineer of the British Post
Office in 1876. He said, "The Americans have need of the
telephone, but we do not. We have plenty of messenger boys."

How many of you have heard of the Internet? Good. How many of
you had heard of the Internet two years ago? Right. Since
January of this year there have been over 300 articles
published in newspapers and magazines on the Internet, the
information infrastructure or the "data superhighway." Last
year there were fewer than 20. This is a hot topic, and unlike
virtual reality, artificial intelligence, or robots in the
home it's actually here now as a presence in the lives of
16-20 million people around the world.

The Internet is a network of networks that can be used to
exchange mail, data, and video. It lets you carry on
screen-based conversations with dozens of people around the
world simultaneously, or use university supercomputers, or
download data from NASA, all from your home office, or
classroom. No one "runs" the Internet. There is no
headquarters, no policy-making board, except to set the
technical standards that allow all these machines to hook up
with one another. You get access to it by signing up with a
local provider whose system is connected to the net. You
follow the rules and policies of your provider, which vary
tremendously from place to place. 

Access to the net can be had for free, for the cost of a phone
call, or for anywhere from $5 to $50 per month, depending on
how you get it. Large companies, universities, and government
agencies have provided their people with access to the net for
years because it makes it easy and cheap for them to
collaborate with other people in their field. The net is
distance-insensitive, which means you can get files from a
computer in Australia as quickly and as easily as from a
computer across town. Once you're logged on there are no
long-distance charges, so that Australian file doesn't cost
any more either. Most people who pay for their connections pay
a flat fee every month for unlimited use of e-mail,
conferences, file transfer and everything else. Now that
everyone wants it, the phone companies, the cable TV
companies, and the on-line services like America On-line and
Compuserve are getting into the business of Internet access.
Starting next year in parts of Massachusetts you'll be able to
get on the net through your cable box.

I've pulled some numbers to try to give you a sense of just
how much people are using the net. The Internet is growing at
the rate of 10-15% every month. In 1981 there were around 200
computers connected to it. By 1985 there were 2000, and by
1989 160,000. Today, less than four years later, there are
more than 1.8 million computers connected to the Internet.
Usenet, which is the collection of news and discussion groups
on the net, receives about 425,000 articles every two weeks.
For those of you who never seem to have enough space on your
hard drives, imagine filling about 60 megabytes every day, or
more than 800 megabytes every two weeks. For those of you
without computers, that's the equivalent of about 200
full-length novels, every day. And that number doesn't include
e-mail, or file exchanges, or chatting, or any of the myriad
other activities that the net supports.

But why does this matter to us as citizens, as educators? Why
is trying to drink from this fire hose of information any
different from 500 channels of cable TV with nothing on worth
watching? In terms of stuff we're already familiar with, the
Internet is a lot more like the telephone than the television.
TV follows the broadcast model of one-to-many. Lots of people
listen to what one organization has to say. We can't really
use the technology of TV to talk to our friends or to talk
back to the TV station. The information flows one way. Even
public access cable, which lets anyone get on TV, is still
one-to-many. Since access to TV air-time is controlled by just
a few big companies, is very profitable, and is regulated by
the government, you don't see very much diversity of content
or opinion. Since millions of people are watching the same
stuff they have to shoot for the lowest common denominator.
That's what makes TV, TV.

The telephone follows a different model. Instead of
one-to-many it's many-to-many. Anybody can call anybody else.
We can say whatever we want. We can sing, we can do business,
we can talk to our moms, or we can have phone sex. With modems
and computers we can connect to other machines and exchange
stuff. Each time we pick up the phone we can use it for any of
these things, or all of them. The phone is a tool to help you
do all kinds of different stuff. TV is not. It always forces
you into the same passive relationship. The net is like the
telephone in that it can facilitate many different activities
and relationships, from the very passive to the very active.

But I'm not really here to talk about the Internet. Instead I
want to talk about one particular kind of technology that the
net makes possible, what I call the Community-Based
Information Network or, C-BIN. If the Internet is an
information superhighway, then C-BINS are like the small towns
along the road. Some people refer to them as "electronic
greenbelts" or "virtual villages." Whatever you call them,
they're designed to be places in which you spend time
teaching, learning, and interacting with other members of your
community.

The idea behind C-BINs is to provide resources and means of
communication that support the civic life of a community. They
provide electronic mail, library resources, discussion groups,
and a means to communicate directly with city government and
elected officials. A C-BIN might have a homework helpline, a
community events calendar, a listing of local merchants. They
can be run directly by city or state governments, by
non-profit volunteer groups, or, occasionally, by commercial
services. 

With the exception of those run by commercial services, access
to C-BINs is either free or very low-cost. Their operating
expenses are supported by donations, grants, and government
money, and special efforts are usually made to place terminals
in public places like libraries, schools, and social service
agencies so that people who don't own computers can
participate as well. In many cities the community networks are
connected to the Internet, giving their users access to other
community networks around the world, as well as to all the
other Internet resources. Today there are community networks
operating in twenty or so cities around North America in
places like Dillon, Montana; Youngstown, Ohio; and Victoria,
British Columbia, and C-BINs are in the works for Seattle and
Snohomish County.

Let me show you a couple of examples. I've brought along some
sophisticated visual aids, which my lovely and talented
assistant will now demonstrate. These are snapshots of
opening screens of a few community-based information networks
that were collected by Steve Cisler of the Apple Libraries of
Tomorrow project for a terrific paper he wrote on community 
networking.

The first one, which unfortunately didn't make it into your
packets, is from the Cleveland Free-Net. As you can see, the
metaphor used is that of a small town, with distinct places to
go for schools, libraries, news, social services, and access
to government. The Cleveland Free-Net was the first real
community network, and has served as a kind of a template for
the other Free-Nets that use its software. Although it may not
look very pretty, the advantage of its all-text interface is
that it can be accessed from any type of computer using the
most basic communications software.

Next up is a selection from Wellington, New Zealand. If you've
used a Mac or Windows, you'll recognize the metaphor of
folders and the documents they contain. The front window here
contains City Council information like by-laws, policy
statements, and election results. In the background you can
see the icons for information on Wellington's churches,
hotels, and kids' activities. Because this interface depends
on graphics you need a particular kind of software to get the
full benefit.

Next we've got a screen from the Cupertino CityNet down in
Silicon Valley. Notice the icons at the bottom for mail, news,
conferences, and help. In the middle of the screen you can see
the places to go for general information about the city's
history, demographics, meetings, and events. In the background
are places to go for discussions and public chats with other
users.

Lastly, I 've got a shot from a kind of hybrid
commercial-community network that's accessible from America
On-Line, which is a dial-up bulletin board service like
Compuserve or Genie and charges by the hour. Right now it's
not connected to the Internet, but you can use it to send
electronic mail over the net to millions of people who are not
America On-Line subscribers. This area in America On-Line is
sponsored by the San Jose Mercury Newspapaer and is basically
an expanded electronic version of the paper. In the center you
see the headlines, and off to the left the different areas or
sections like entertainment, sports, and classified ads.
There's a news library you can browse for research, and you
can search the current issue by keyword to find all stories,
say, that contain references to both peanut butter and
Venezuela. Below that is a communities section where you can
go for more detailed information on your particular
neighborhood. You can tell that this one has less of a "civic"
feel than the others, not because it's more slick, but because
its metaphor is the privately perused newspaper rather than
the shared community.

Okay. So now you know a little bit about the Internet, and a
little bit about community networks. What's the point? Why
talk about them here at a conference on family planning? Well,
for several reasons, some having to do with where we are today
and some having to do with where the world is going and the
positions we'd like to occupy in the midst of these changes.
First, information is vital to us because it's a big part of
our business. We gather, generate, and distribute information;
people come to us in great measure because we have the
information they want or we know how and where to get it. To
those who seek us out we are an information technology. If we
want to remain in this business we need to be aware of and
skilled with all the ways information is delivered. We need to
understand their implications for our profession and for the
groups and communities we serve. The role of face-to-face
counselling, lectures and brochures changes when they're not
the only or most accessible game in town.

I want to spend a bit of time talking about our relationships
to information because that's where our practice intersects
with the heart of C-BINs. We, as educators and counselors and
service and information providers, are involved with
information. It begins with gathering resources and culminates
in developing effective ways to serve our clients. On this
path we read newspapers and journals, seek out lectures and
conferences, wrestle with what we've read and heard. I may
have heard in passing that some people are using Glad Wrap
instead of dental dams to protect women and their partners
during oral sex. I may or may not pursue this tidbit, but if I
did, I'd want to know, first of all, is this true or just a
rumor. I'd probably call a few colleagues to find out if
they've heard anything, know of any references, have positions
on it. I'd track down any available research, and try to talk
to people who've made the switch, although I don't know how
successful I'd be on this step. After mulling this all over,
discussing it with friends and co-workers, I'd make a decision
about whether to incorporate this new information into my
teaching, counselling, or patient education. 

Some of these steps involve relatively more initiative and
agency on my part, and some of them will hit dead ends because
the people with the information don't happen to be in my
circle. With a C-BIN I'm likely to get my information more
directly, more completely, and more reliably because I can
post my questions to a newsgroup dedicated to safer sex for
women. Because the network of people coming together here is
so vast, there's little doubt I'd get some responses, and more
likely I'd be inundated with information and references.

This brings me to the other relationship to information that I
believe is fundamental to the work we do. Once we've taken in
the vast wealth of information available, worked it over, and
developed ourselves and our programs with it, we take our
ever-expanding folder of resources and devise programs to
educate other people. We order or design curricula, collect
articles, compose charts, create activities, and then take all
this stuff into classrooms, community centers and homes. The
manner in which we present our information ranges from
straight lecture to highly interactive projects like role
playing games, but it is mostly a program in which we lead and
our students follow. People approach us with questions, and we
answer them outright or get them resources in which the
answers are contained. We try to be responsive and
forthcoming, but we do occupy the position of gatekeeper; we
determine which information we believe will best answer those
questions. In essence what we do is information distribution;
we've gathered the information and now we're going to share it
with those who ask. 

So, why does that matter? In the current scheme of things
information gets passed along in relatively straight lines;
someone with a question poses it to someone with an answer and
hopefully receives the desired information. In this
relationship, one person has the information while the other
tries to get her to share it. This simple dialectic has
far-reaching consequences because the person who controls the
information makes choices, consciously or unconsciously, about
the content, delivery, and tone of her answer. She defines the
terms, crafts the lens, through which that information will be
understood. 

For example, if I begin a program on sexuality with all of the
dangers associated with sex- like sexually transmitted
infections, pregnancy, sexual violence, etc.- rather than
starting with a discussion of sex as healthy, natural, and
complex I've cast the topic in sex-negative terms from the
outset. I may in fact want my students to believe that sex is
dangerous, and so this serves my purpose. But for the
students, their reliance on me as the principal source of
information about sex leaves them with my rather singular view
of things. This is the model we generally see operating in
classrooms and, consequently, the mode most of our clients
carry with them to other walks of life. They're taught to
accept what I've told them, not to question it, and certainly
not to look further. They learn only what they're taught, not
what they discover for themselves. They're not sophisticated
consumers of information. I don't think we've always been
adept at teaching our clients how to get information from
multiple sources, how to look at it critically, or how to use
it in their day-to-day lives. By controlling people's access
to information either at the source or through the skills we
do or don't impart, educators ultimately have a profound
impact on the general levels of cultural and civic
participation. Traditional educational settings encourage
passivity. This, in turn, contributes to the lack of
involvement in community affairs on the part of so many
members of our society.

There are lots of things we can do with C-BINs that help us
get around these obstacles. For instance, we could coordinate
an on-line adolescent development program for parents of
teenagers or puberty-age kids. We could post weekly segments
on the changes young people undergo at these periods, the joys
and difficulties parents encounter with their children through
their teen years, how to be effective educators for their
children, and so on. Parents would be invited to post
questions and observations. We and the other participants
would respond to them, with the discussion circulating among
everyone involved.

Another project, one that shows how a new community can
develop through electronic exchanges, is the facilitation of a
discussion group for boys ages 12 to 18 on issues of male
responsibility in teen pregnancy. The moderator could put out
a notice on the network describing the forum, and invite
participants from all over the country. Provocative questions,
statements, or scenarios would be offered, and teen boys would
respond with their opinions, thoughts, or queries. This type
of format encourages openness because kids can ask and say
things they'd be reluctant to voice in person. As long as the
facilitator supports people exploring these issues, even if
their thoughts aren't always "correct," you'll have a place
where boys can really start to tease out the complexities of
this subject. Because of the age range and geographical
diversity of the participants there would be great differences
of experience and opinion which can serve to broaden and
enrich the values of those involved. Such a group can grow
readily into a new community, one founded on common interest
but strengthened by wide diversity. 

There are always a number of different ways any given set of
goals or information can be put into an instructional program.
We know now that sometimes a lecture makes sense, sometimes a
role-play, sometimes a brochure, sometimes a counselling
session. The same holds true for electronically-mediated
information. On community networks, for example, I could
choose to use a database, a real-time chat group, moderated
discussion groups, unmoderated e-mail, and so on. Each of
these has different characteristics, and brings out different
values and skills in the people who use them. The flexibility
of the system and the variety of available modes are useful
for us as educators because we can get our students to
practice certain qualities, like reflection or spontaneity,
simply by choosing one tool over another. 

For example, if I were running a program designed to teach
teenage boys to be less aggressive and more reflective, I
might run it over e-mail because that medium encourages
deliberation while keeping the discussion fresh. If I were
working with adolescent girls to help them be more assertive
about their limits I might run it in a live chat forum, which
encourages spontaneity and provides a safe space in which to
practice being assertive, practice controlling conversations.
Rather than just preaching these values at my students, trying
to work them in from the outside, I can embed them in the
technologies of communication they use, so that every act of
their self-expression becomes an exercise in practicing those
values, trying them on, getting comfortable with them. 

Let's look at another example, a person who's interested in
finding out the rates of HIV infection among women within her
community and how they compare to the national figures. With a
C-BIN at her disposal she could do this with ease from
terminals at her home, local library, or school. She wouldn't
need to rely on a teacher to give her that information; she
has direct access to it herself through a number of electronic
pathways, like the local health department, the Centers for
Disease Control, the Women's Health Network, etc. 

I want to develop this person a bit so we can look at why
C-BINs would be appealing to all of us now, and where they can
take us in the future. Let's say this person is a young
African-American woman, about 17 years old, and she's noodling
around on-line one day, perhaps sending her friend an e-mail
about an upcoming party, and she stumbles across a pointer to
AIDS resources. She's mildly curious so she looks in further
and finds that list splitting off into an assortment of more
specific areas, like epidemiology, pediatrics, gay-lesbian-bi
youth, and so on. She settles on the Women and AIDS topic and
starts poking around in there. There are statistics, articles,
projects devoted to a wide array of topics, including the
impact of HIV disease on African-American women nationally and
locally. This young woman isn't surprised to learn that HIV is
having different impacts on women of different races. Her
curiosity, joined with the ease of access to data that the
network provides, encourages her to explore the reasons why
these differences exist.

Now, this young woman, let's call her Emma, is not an anomaly.
She's displaying qualities and using skills that are
increasingly common among young people today. She's at ease on
a computer, in an electronic world, and she's learned to use
an important means of communication broadly by adapting it for
both her social and cognitive use. Most young people haven't
yet learned to rigidly compartmentalize their lives, so things
learned in one context often spill over into others. The
beauty of working with them is the incredible array of uses
they create for tools we've designated as singularly
appropriate for work or school or social settings.

Emma is doing another thing young people do all the time...
looking into things she's curious about, things that affect
her world. But this HIV stuff is not a burning passion of
hers, so if more effort was necessary to explore it, she might
have left it at the "I wonder..." level. But exploring on a
CBIN is so easy, just a few keystrokes and a little reading,
and her "I wonder" stretches out to become a chain of "Oh
reallys". The ease of access to information and people
inherent in computer networks should not be
underestimated...Emma's world broadens and deepens because so
many other worlds were right there, open to her.

Emma is a tremendous resource, not only for her own
communities, but also for us. On the simplest level she's
learning more and more, and can educate her peers formally or
informally. On the next level, she's learning how to get
information herself, and what those skills open up for her.
For us as educators, Emma is a person who can guide and shape
our involvement in her community because she has her own sense
of the needs. She can act as an engaged participant in both
her own world and ours. Imagine the increased impact of a
program like CAPE, for instance, if its participants
incorporated information retrieval and assessment skills into
their peer education efforts.

C-BINs offer communities the opportunity to more actively and
directly define their educational needs by providing an
information infrastructure that is accessible on a truly local
level. Such a system, by its very nature makes its users
function as both information recipients and producers. For
example, with direct and ready access to the infant mortality
rate among babies born to teenage Latina girls in King County,
anyone within that community could use their network to raise
awareness of the issue, to communicate with other like
communities, to discover what's being done elsewhere to
confront the problem, and to initiate interventions. All of
this can be done from within a community rather than being
done for them by outsiders, however benevolent they may be.
The ease of access to information, coupled with the
interactive nature of community networks, encourages inclusion
and civic involvement by grounding action within the
community.

Now, how do community networks change our professional roles
and their relationships to each other, and what are the deeper
consequences of these changes? C-BINs get rid of the notion
and practice of a single information source. Information
becomes widely and cheaply available from multiple origins.
They do this by establishing access points for the public at
citywide terminals, in schools, or in homes that allow people
to link into the services that a municipality has provided on
its network. In addition, with broader connections to other
networks nationwide the information available through a C-BIN
multiplies immeasurably. This increase in the number of
information pipelines has the effect of diffusing the
authority of any single source. There's more than one place to
find out what you want to know, and as a result many more
facts and many more interpretations come into circulation. The
accessibility of a wide range of opinions, ideas, and data
provides people with the support to shape their positions much
more critically than is possible if you're relying on a single
person or place for your information. 

C-BINs redefine the idea of community by basing it on shared
interest or affiliation, rather than on common place. Instead
of people's bonds growing, if at all, out of the geographical
settings they more or less reluctantly share, they emerge from
the willing exchange of ideas and opinions that a networked
forum relies on. Take the case of a large, urban high school.
The people involved with this school come from a vast range of
backgrounds and have opinions and values that vary
accordingly. Because the school has an interest in serving as
many of its different constituencies as it can, or at least in
outraging as few of them as possible, it will shape its
programs to meet the least controversial common denominator. A
program on prevention of sexually transmitted infections will
be so vague or single-minded- like saying abstinence is the
only protection we can support- as to be virtually useless.
And still the school will miss. There will be those who are
scandalized that their child learned anything about sexuality
in school, and those who will be disgusted that their child
isn't learning anything useful about sexuality in school. 

C-BINs address these problems by enabling people to come
together around common interests and values, rather than
trying to organize them around common zip codes. Thus,
parents, educators, and administrators who are interested in a
comprehensive program to teach young people about sexual
health can participate in a forum devoted to this issue on
their community network. No one there is a captive audience,
and everyone there is interested in making a contribution.
Network pathways offer educators a viable alternative to the
schools, thereby undoing the stranglehold that the threat of
controversy seems to sustain in many formal educational
settings.

C-BINs foster active seeking and discovery on the part of
young people for information that is otherwise limited within
their communities. They extend the use of a medium with which
kids feel comfortable into many more areas of their lives.
They can link up civic, school, home, and business computing
resources, so that these artificial boundaries dissolve, if we
want them to. They provide youth with a place to search that
is within their control, and whose resources are equally
available to everyone regardless of age. This can be essential
in locations where health care providers are scarce, libraries
are inadequate or non-existent, or community values discourage
making controversial material available. A young man with
questions about his sexual orientation could discover an
on-line support group for gay, lesbian and bisexual youth with
participants spread all over the country. He can forge ties
with a new community, a virtual neighborhood, which can offer
him the support and openness lacking in his physical
community. Such connections provide people a path out of the
isolation they may be experiencing, for whatever reasons, in
their own municipalities.

C-BINs offer people accessible sites for exploration of
sensitive topics where voluntary anonymity is easily
maintained. This is especially useful for young people who are
looking at sexual development, identity, expression, etc. but
who don't always have the tools or the support to do this in a
face-to-face situation. There is research that supports our
observation that many students are more comfortable getting
feedback from a machine than from a teacher, because of how
kids feel adults judge them. Now, such findings obviously
raise some unsettling implications for us as educators and
adults, and I'd certainly be the last to say that we shouldn't
work on this. But in the meantime, it seems sensible to me to
increase the number of venues available to young people where
they feel free to ask sensitive questions, and receive
complete and accurate answers at their own pace, on their own
terms.

In addition to creating new communities of interest, C-BINs
also operate to support and strengthen existing geographical
communities by providing an easy means of involvement for
everyone. This is significant when we consider who, within a
given community, is marginalized because of constraints on
their mobility: mothers with limited access to child care,
individuals confined to their homes because of disability,
older people who are no longer ambulatory, young people with
transportation difficulties, and so on. These people would be
able to participate in community affairs through home, school,
or neighborhood terminals that linked them all up to the
network. By re-integrating community members whose absence we
may have lamented but been unable to overcome, we can use
C-BINs to strengthen existing neighborhoods, towns, and
cities. Such networks enable participation by many more
segments of the population, and deepen our own resources by
incorporating the talents, knowledge, and skills of those who
have long been omitted or prevented from actively shaping
their communities.

Community networks give us exciting ways of working with
existing communities, but also offer possibilities for
building and supporting new communities, ones built on common
interest instead of common addresses. As educators we'll have
an opportunity to weave ourselves into these actual and
virtual neighborhoods and, in so doing, to become truly a part
of the communities we want to serve. This hasn't always been
easy for a number of reasons; our commitment to working within
the schools has subjected us to oversight that often ends up
watering down the messages and information we'd like to give
to students. This, in turn, cuts down the credibility we have
with young people because we're not able to tell them anything
terribly useful. In addition, when we've chosen to try to work
outside of the educational system, it's often been difficult
to find a central entry point into a community. When we do,
our programs are sometimes not encouraged because they haven't
grown out of the needs expressed by the community, but rather
out of our outsider's ideas of what the community needs. We
may not be far off, but there can be difficulty selling a
project if it isn't created collaboratively.

C-BINs can re-define the very notion of community, a concept
that has traditionally been bound, to varying degrees, by
geography or narrow affiliation. These networks enable the
emergence of virtual communities, no longer founded on
location, profession, organization. Instead, people who share
common interests can come together electronically to exchange
information, ideas, projects that effectively create new
communities. Individuals interested in discussing and
exploring efforts to reduce violence in schools can meet in
their own forum. An isolated, rural community with its first
known case of AIDS can build ties to other communities
affected by HIV to learn about the disease, how to support
people who are infected, and how to educate their community.
High school students interested in practicing abstinence could
begin a support and discussion group with other young people
around the country. Each of these points of interest offers
the participants new associations, new neighborhoods, based on
shared concerns but encompassing a diversity of experience and
background that is not usually found in physical communities.

C-BINs also offer us a great deal as professionals. On the
simplest level they provide a medium for us to disseminate our
numerous brochures, pamphlets, and fact sheets far more
cheaply and easily than we can do today. Educators from
different agencies across the nation can readily collaborate
on a project to jointly educate parents and young people about
adolescent sexual development. Counselors from sites in three
distant cities could team up to co-moderate an on-line support
group for teen parents. We can send and receive electronic
mail between offices, from agency to agency, and to and from
private practitioners. We can establish mailing lists for
colleagues interested in any imaginable topic, like support
programs for kids, or public policy on RU486, or health care
job openings. We'll have immediate access to statistics,
research data and findings, and experts in a variety of areas.
Networks offer agency administrators an easy means of
distributing position papers and health alerts, or of
coordinating statewide lobbying efforts.

Finally, C-BINs can play a crucial role for our organizations
as they evolve under health care reform. There's a lot that's
unknown about what will shake out, particularly in service
delivery. But what's clear is that information, and the
ability to create and disseminate it effectively will be more
important than ever before. Preventive medical care, which is
based on information and education, seems likely to be central
to any plan that is adopted, and in fact health education is
specifically identified as a key component of the national
reform plan just announced by the administration. Easy and
inexpensive information delivery is going to be highly valued
within this developing system. C-BINs offer us the chance to
plant ourselves squarely in the middle of this delivery
stream, and to ensure a vital position for us as
organizations. 

As health care reform reshapes the entire world of medical
practice, agencies that currently provide direct patient care
may no longer do so. All of us need to think about what roles
we might or might not be playing in the future. We have our
own mandate for re-invention: if we don't take it we will
likely find ourselves squeezed out of both the service and the
information businesses by powerful cooperatives with a strong
interest in education and preventive care, and who were able
to see the writing on the community-information wall more
clearly than we. We need to make ourselves much more relevant
to the lives of the communities we serve. There are important
questions about organizational survival which C-BINs can
address. Community networks are a powerful tool for expanding
our educational efforts into communities we hadn't previously
been able to reach, as well as into domains that have a newly
emerging need for strong information providers. 

If we try to hang on to our status as gatekeepers of
privileged information, we will lose. There are very few
secrets that are worth anything any longer, in fact there are
very few secrets at all. We need to begin to understand and
shape our own development in the "information age" so that we
can make smart and effective contributions to the changes
taking place as a result of the rapidly expanding access to
information. 

I want to end with a quote from Bruce Sterling, a science and
science-fiction writer who recently spoke before the National
Academy of Science's Convocation on Education and Technology.
He was speaking of the need to get classroom connected to the
net, which some people refer to as cyberspace, but I think his
words apply to us as well. He said, "I know something
important about cyberspace. It doesn't matter who you are
today -- if you don't show up in that mirror in the next
century, you're just not going to matter very much." Our work
is important. We have to show up in that mirror. Even though
we have plenty of messenger boys.

Thanks for having us, and thanks for coming. See you in ten
minutes, after the break.

---

From: [email-masked]
Date: Mon, 11 Oct 1993 11:02:22 -0700

I don't know how many of you read the recent lengthy posting by Catherine
Holland ([email-masked]), but in addition to its main purpose in
discussing how moving communities on-line affects health education, I think
it was a very good statement of the majority view on the promise of the
Internet and community networking.  As such, I wanted to raise a couple of
reservations I have.  Of course, I'm interested in your reactions.

One theme of the article is the replacement of geographical communities by
communities of interest.  I think this is somewhat overplayed.  Face-to-face
contact and shared real-world experiences are too important to human
relationships to be fully supplanted by electronic relationships with
people in the far corners of the world.  But what these systems CAN do is to
help you make new contacts in your geographical community, and to feel more
free to explore these contacts given the relative anonymity of the situation.

Which leads to my next comment: the article made a good case for the importance
of the availability of anonymity in electronic communications.  I agree.  But
I think it's not at all clear how this is going to evolve in the future.  My
guess is that we need to take a strong stand to preserve and extend the
acceptablility of anonymous communications.

Finally, although I think things are moving in this direction, the fluidity
envisioned in moving between one information source and another is not quite 
there yet.  In particular, there is a distinction between one-way and two-way
communications services that probably shouldn't exist -- it should always be
possible to react, publicly or privately, to what you are seeing.

-Carl Farrington

---

From: Catherine Holland <[email-masked]>
Date: Mon, 11 Oct 1993 11:41:05 -0700

> free to explore these contacts given the relative anonymity of the situation.

Carl, 

I agree that virtual communities will never replace physical communities. 
Rather, I think, they'll augment and strengthen them. As I indicated in 
the talk, 
     "In addition to creating new communities of interest, C-BINs
      also operate to support and strengthen existing geographical
      communities by providing an easy means of involvement for
      everyone."

> acceptablility of anonymous communications.

This is a really interesting and important topic. The current technologies
for insuring anonymity over e-mail, listserv, or usenet (short of
sophisticated hacking of your mailer) often put off many recipients of
anonymous communications. Recently, in the communet mailing list, someone
posted a question from an anonymous remailer. The question was germane,
polite, and completely in keeping with the character of the list. Yet
because it had an anonymous id rather than a name in the "from:" line,
people were made uncomfortable by it and would not reply. 

The notion of "community" has a strong public component to it. But 
they're not synonymous. We all pretty much accept the idea of anonymity 
in topics we consider "sensitive" or which we feel place someone  at some 
risk. But we're far less comfortable with the general right to privacy 
that includes the continual choice of whether or not to reveal ones' self 
as we go about our daily business. As a society we constantly confuse 
privacy, confidentiality, and anonymity, and our default supposition is 
that any of those are for people with something to hide or to protect.

It would be useful to bring together some sociologists and some engineers 
to brainstorm the question of how to provided non-identifiable channels 
of communication that were not tagged with hostile or defensive 
characteristics.

> possible to react, publicly or privately, to what you are seeing.

Absolutely.

> -Carl Farrington

What specific features- interface, content, policy-wise, or anything else 
-would people want to see in the community-health/education portion of a 
community network?

Catherine

---

From: [email-masked] (Thomas Andrew Newman)
Date: Mon, 11 Oct 1993 13:50:47 -0700

Catherine,

>-would people want to see in the community-health/education portion of a 

I have a hard-copy copy of a set of decision trees the local university
health center uses. They help you decide whether or not to consult a doctor
about your cold or headache or other borderline ailment. The health center
told me I could publish them on Peak, our community information service. I
am going to discuss with our gopher editor the possibility of putting them
on our gopher, using gopher's menu hierarchy. 

E.g., you choose "headache" from a menu of other symptoms. The headache
menu asks you where the headache is:

1. back of the head
2. behind your eyes
etc.

Each of these options leads to either more multiple choice questions or a
text file telling you what to do (home remedies, non-prescription drugs,
whether or not to see a doctor, etc.). And a way to send a message to the
health center or the health topic editors on the communet.

Decision trees could be used for other kinds of common problems in many
other areas:
- AIDS
- child-rearing
- law
- money
- property tax assessments
- housing
- k12
etc.

The information could be solicited from the appropriate professional group:
nurses, doctors, teachers, city/county officials, etc.

People will sometimes ask for information only if they can remain anonymous.

>Catherine

Tom
------------------------------------------------------------
Tom Newman
Internet: [email-masked]
Compuserve: 73057,475