Asynchronous online tutorials that award continuing education units without cost and provide knowledge about computers and nursing informatics were made available to registered nurses in Southern California. Four hundred seventy-three nurses enrolled; 52% (246) completed tutorials. Nonsignificant differences in the number of tutorials completed were found across characteristics of participants, meaning that nurses were similarly disposed to participate regardless of age, educational preparation, experience, practice setting, or ethnicity. They tended to overestimate their computer capabilities at the time of enrollment and abandoned the tutorials when they encountered technical problems. Nurses need live workshops teaching computer basics, Internet skills, and how to enroll in and run asynchronous programs. Marketing of online programs should be multifaceted, including live and electronic strategies.

A number of conclusions can be drawn from the themes derived from the interview data. First, even though the most basic physical needs, such as food, clothing, and shelter were being met, a recurring theme from the responses of the homeless was the need for interaction with a caring person. The feeling that no one cares, a lack of self-worth, and a sense of limited control over their lives may lead to depression, hopelessness, and finally illness. The extent and effectiveness of health-seeking behaviors among this group are limited because of decreased trust, decreased motivation for self-care, and isolation from social and health care systems. Second, if health needs are to be met, services must be provided in sites where they can be accessed by the homeless. For transients, health care services may be provided most effectively through the shelters. For the SRO residents, these services could be provided through a combination of clinics in hotel lobbies and visits to rooms. Third, developing trust with the homeless includes meeting their self-perceived basic needs. What may seem like nonnursing activities, such as fixing a meal, may be important in establishing rapport with SRO residents. If a nurse assists a homeless person to meet survival needs, that person may be more willing to deal with health issues. Fourth, the population is highly heterogeneous. Each subgroup has its own identity. Most SRO residents do not want to be identified with street people, even through a portion of them move between street life and SRO life. Health care professionals need to recognize these differences, accept the life-style of each subgroup, and respect each homeless person as a unique individual. Finally, caring is the primary element necessary in providing nursing services to the homeless. Awareness and understanding of the homeless way of life will increase nurses' effectiveness in working with this ever growing population.

Asynchronous online tutorials using PowerPoint slides with accompanying audio to teach practicing nurses about computers and nursing informatics were designed for this project, which awarded free continuing education units to completers. Participants had control over the advancement of slides, with the ability to repeat when desired. Graphics were kept to a minimum; thus, the program ran smoothly on computers using dial-up modems. The tutorials were marketed in live meetings and through e-mail messages on nursing listservs. Findings include that the enrollment process must be automated and instantaneous, the program must work from every type of computer and Internet connection, marketing should be live and electronic, and workshops should be offered to familiarize nurses with the online learning system.

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