Providing Consumer Providing Consumer Health Information at Health Information at Your LibraryYour Library

Andrea KenyonAndrea KenyonDirector of Public Health and Community OutreachDirector of Public Health and Community OutreachDirector of PhillyHealthInfo.orgDirector of PhillyHealthInfo.orgThe College of Physicians of PhiladelphiaThe College of Physicians of Philadelphia

Located: 19 South 22nd Street, Center CityLocated: 19 South 22nd Street, Center CityOnline: Online: www.collegeofphysicians.org www.collegeofphysicians.org

• Founded in 1787Founded in 1787• Non profit cultural and educational organizationNon profit cultural and educational organization• Mission:Mission: Advancing the cause of health while Advancing the cause of health while

upholding the ideals and heritage of medicine.upholding the ideals and heritage of medicine.

Programs:Programs:• Improving the health of the public throughImproving the health of the public through

PhillyHealthInfo.orgPhillyHealthInfo.org• Historical Medical LibraryHistorical Medical Library• Mütter MuseumMütter Museum• Lectures, symposiaLectures, symposia

Since all people make Since all people make health decisions, all health decisions, all people need health people need health

informationinformation

What is health literacy?What is health literacy?

The degree to which individual have the capacity The degree to which individual have the capacity to obtain, process and understand basic health to obtain, process and understand basic health information and services needed to make information and services needed to make appropriate health decisions [Healthy People appropriate health decisions [Healthy People 2010]2010]

What is information What is information literacy?literacy?A set of abilities enabling individuals to recognize A set of abilities enabling individuals to recognize when information is needed and have the ability to when information is needed and have the ability to locate, evaluate and use effectively the needed locate, evaluate and use effectively the needed information [ALA 1998]information [ALA 1998]

Why Public Libraries?Why Public Libraries?

Public Library seen as a trusted institutionPublic Library seen as a trusted institution

Community hub for information Community hub for information

Champions of universal access Champions of universal access

Computer access and trainingComputer access and training

Deliver information to those who Deliver information to those who need it mostneed it most

Librarians Have Valuable SkillsLibrarians Have Valuable Skills Strong service orientationStrong service orientation

Information managementInformation management

Critical evaluation skillsCritical evaluation skills

Skilled at finding answersSkilled at finding answers

Librarians Have Valuable SkillsLibrarians Have Valuable Skills Experts at providing information in multiple formats for a variety Experts at providing information in multiple formats for a variety

of needsof needs

Provide info where and when most neededProvide info where and when most needed

Responsive rather than prescriptiveResponsive rather than prescriptive

Public Library ChallengesPublic Library Challenges Time requirements to answer health questionsTime requirements to answer health questions

Financial, staffing and physical space constraints for Financial, staffing and physical space constraints for specialized services and resourcesspecialized services and resources

Limitations of staff expertise and training in responding to Limitations of staff expertise and training in responding to health information questionshealth information questions

Scope of medical and healthcare topicsScope of medical and healthcare topics

Consumer health information needs and expectationsConsumer health information needs and expectations

Public Library ChallengesPublic Library Challenges Unclear understanding of public library roleUnclear understanding of public library role

Fear of providing the wrong answer Fear of providing the wrong answer

Absence of guidelines for dealing with health information Absence of guidelines for dealing with health information requestsrequests

Fear of providing medical adviceFear of providing medical advice

Unclear on appropriate procedures for referral to health Unclear on appropriate procedures for referral to health professional or agencyprofessional or agency

Keys to SuccessKeys to SuccessKnow your communityKnow your community

Understand your audienceUnderstand your audience

Provide quality health information services and resourcesProvide quality health information services and resources

Define your roleDefine your role

Develop community based outreachDevelop community based outreach

PromotionPromotion

Hone your health information skills Hone your health information skills

Know Your CommunityKnow Your Community Conduct a community needs Conduct a community needs

assessmentassessment

Determine local impact of national Determine local impact of national health issueshealth issues

Find out the most common hospital admissionsFind out the most common hospital admissions

Track health reference, ILL and circulation requests Track health reference, ILL and circulation requests

Identify health related programs in your communityIdentify health related programs in your community

Know Your CommunityKnow Your Community Sources: Sources:

• http://www.leapfroggroup.org (Click on for consumers’ link (Click on for consumers’ link and and type in local zip code, city, hospital name, etc.)type in local zip code, city, hospital name, etc.)

• http://www.healthgrades.com (Click on hospital ratings, then (Click on hospital ratings, then on hospital ratings free section)on hospital ratings free section)

• http://en.wikipedia.org/wiki/Diagnosis-related_group

Know Your CommunityKnow Your Community Analyze the demographic profile of your communityAnalyze the demographic profile of your community

Age of population Age of population

Education level Education level Cultural characteristicsCultural characteristics

What languages are spoken in the community?What languages are spoken in the community?

Economic profile? Economic profile?

Understand Your Audience!Understand Your Audience!

Understand Your AudienceUnderstand Your Audience To effectively provide health information, we must understand:To effectively provide health information, we must understand:

Barriers to informationBarriers to information

Information-seeking behaviorInformation-seeking behavior

Characteristics and expectationsCharacteristics and expectations

Health Information needsHealth Information needs

Barriers to Health InformationBarriers to Health Information Illiteracy or low literacyIlliteracy or low literacy

Lack of culturally relevant informationLack of culturally relevant information

Difficulties in identifying and evaluating quality health Difficulties in identifying and evaluating quality health informationinformation

Inadequate resources that address narrow information Inadequate resources that address narrow information needsneeds

Information overloadInformation overload

Information Seeking BehaviorInformation Seeking Behavior AgeAge

DisabilityDisability

GenderGender

Race and ethnicityRace and ethnicity

Socioeconomic factorsSocioeconomic factors

Language BarriersLanguage Barriers

Consumer Characteristics and Consumer Characteristics and Expectations Expectations

No library or research skillsNo library or research skills

Expect to find simple, straightforward answers to what are Expect to find simple, straightforward answers to what are often complex questionsoften complex questions

Expect to find specific information that addresses their Expect to find specific information that addresses their unique problem(s)unique problem(s)

Come to the library with misinformation or inadequate Come to the library with misinformation or inadequate informationinformation

Consumer Characteristics and Consumer Characteristics and Expectations Expectations

Difficulty knowing how to interpret conflicting informationDifficulty knowing how to interpret conflicting information

No skills in evaluating quality of informationNo skills in evaluating quality of information

Unable to evaluate or interpret the medical information and Unable to evaluate or interpret the medical information and statisticsstatistics

Can exhibit intense emotionsCan exhibit intense emotions

What are people What are people searching for?searching for?

Diseases and conditionsDiseases and conditions

Treatment and expectationsTreatment and expectations

Wellness and preventionWellness and prevention

InsuranceInsurance

E-PatientsE-Patients

Provide Quality Information!Provide Quality Information!

Reference Interview Steps Reference Interview Steps Reduce a patron’s hesitation by appearing Reduce a patron’s hesitation by appearing

sincere and helpfulsincere and helpful

Watch facial expressions and pay attention to the language Watch facial expressions and pay attention to the language used by the patronused by the patron

Try to avoid anything that could be interpreted as Try to avoid anything that could be interpreted as judgmentaljudgmental

Lower your voice to match the level of the patron who wants Lower your voice to match the level of the patron who wants to speak confidentiallyto speak confidentially

Assure the patron that the reference transaction is Assure the patron that the reference transaction is confidentialconfidential

Search Strategies for Effectively Search Strategies for Effectively Answering Health QuestionsAnswering Health Questions

Bookmark quality Internet health sites Bookmark quality Internet health sites

Maintain a current health information collectionMaintain a current health information collection

Familiarize yourself with community-based referral Familiarize yourself with community-based referral resourcesresources

Search Strategies for Search Strategies for Effectively Answering Effectively Answering Health QuestionsHealth Questions

The only way to know if you have fully answered the The only way to know if you have fully answered the patron’s question is to askpatron’s question is to ask

Encourage patrons to consult a health professional with any Encourage patrons to consult a health professional with any questions regarding interpretation of informationquestions regarding interpretation of information

Telephone Health Telephone Health Reference InterviewReference Interview

Restate or clarify the question before starting Restate or clarify the question before starting to look for the answerto look for the answer

Verify spellings of medical termsVerify spellings of medical terms

Cite the source & DATE!!Cite the source & DATE!!

Telephone Health Telephone Health Reference InterviewReference Interview

Always quote verbatim from the sourceAlways quote verbatim from the source

Maintain a patron’s confidentiality if you call Maintain a patron’s confidentiality if you call them back - e.g., don’t leave specific information them back - e.g., don’t leave specific information on an answering machineon an answering machine

Providing Information on a Providing Information on a Serious Disease or ConditionSerious Disease or Condition

Determine what information patron hasDetermine what information patron has

Let the authoritative sources do the informingLet the authoritative sources do the informing

Hand the patron background informationHand the patron background information

Find a private area Find a private area

Ask if you can call someoneAsk if you can call someone

Refer them to a support groupRefer them to a support group

Legal IssuesLegal Issues Practicing medicine without a licensePracticing medicine without a license

Fraud and misrepresentationFraud and misrepresentation

DefamationDefamation

Refusal to provide informationRefusal to provide information

MalpracticeMalpractice

Librarian’s RoleLibrarian’s Role It is essential that the reference librarian make a clear It is essential that the reference librarian make a clear distinction between giving advice and giving informationdistinction between giving advice and giving information Provide information, not advice. Medical advice should only Provide information, not advice. Medical advice should only

be given by a medical professionalbe given by a medical professional

Be careful by applying good practice standards Be careful by applying good practice standards Sound Collection guidelines Sound Collection guidelines

Community-Based OutreachCommunity-Based Outreach Start with needs that are already expressed by the Start with needs that are already expressed by the communitycommunity

Vary approachesVary approaches

Involve healthcare professionalsInvolve healthcare professionals

Test your ideasTest your ideas

Learn from othersLearn from others

PromotionPromotion

Honing Your SkillsHoning Your SkillsNational Library of MedicineNational Library of Medicine

MedlinePlus and other consumer databases: http://www.nlm.nih.gov/medlineplus/MedlinePlus and other consumer databases: http://www.nlm.nih.gov/medlineplus/

Training resources: http://www.nnlm.nlm.nih.gov/pnr/trainTraining resources: http://www.nnlm.nlm.nih.gov/pnr/train

Public Libraries and Community Partners: Working Together to Provide Health Information Public Libraries and Community Partners: Working Together to Provide Health Information http://nnlm.gov/outreach/community/http://nnlm.gov/outreach/community/

Medical Library AssociationMedical Library Association

Consumer Health Information Specialization Program: Consumer Health Information Specialization Program: http://www.mlanet.org/education/chc/index.htmlhttp://www.mlanet.org/education/chc/index.html

CAPHIS - Consumer and Patient Health Information CAPHIS - Consumer and Patient Health Information Section Listserv: http://caphis.mlanet.org/Section Listserv: http://caphis.mlanet.org/

Honing Your SkillsHoning Your Skills BooksBooks

Barclay, Donald A., Halsted, Deborah D. “Consumer Health Reference Service Barclay, Donald A., Halsted, Deborah D. “Consumer Health Reference Service Handbook,” Medical Library Association, 2001.Handbook,” Medical Library Association, 2001.

Casini, Barbara, Kenyon, Andrea. “The Public Librarian’s Guide to Providing Casini, Barbara, Kenyon, Andrea. “The Public Librarian’s Guide to Providing Consumer Health Information.” Chicago, IL: Public Library Association, 2002.Consumer Health Information.” Chicago, IL: Public Library Association, 2002.

McKinney, Julie & Kurtz-Rossi, Sabrina. “Family Health and Literacy, a Guide to McKinney, Julie & Kurtz-Rossi, Sabrina. “Family Health and Literacy, a Guide to Easy-to-Read Health Education Materials and Web Sites for Families.” Boston, Easy-to-Read Health Education Materials and Web Sites for Families.” Boston, MA: World Education, 2006.MA: World Education, 2006.

Spatz, Michele. “Answering Consumer Health Questions.” New York, NY: Neal-Spatz, Michele. “Answering Consumer Health Questions.” New York, NY: Neal-Schuman Publishers Inc, 2008.Schuman Publishers Inc, 2008.

Additional ResourcesAdditional Resources

WebsitesWebsites

Agency for Healthcare Research and QualityAgency for Healthcare Research and Qualityhttp://www.ahrq.gov/

HealthfinderHealthfinderhttp://www.healthfinder.gov/http://www.healthfinder.gov/

Caphis Top 100 Caphis Top 100 http://caphis.mlanet.org/consumer/generalhealth.htmlhttp://caphis.mlanet.org/consumer/generalhealth.html

MLA Resources for ConsumersMLA Resources for Consumershttp://www.mlanet.org/resources/consumr_index.htmlhttp://www.mlanet.org/resources/consumr_index.html

MLA Top 10 Most Useful WebsitesMLA Top 10 Most Useful Websiteshttp://www.mlanet.org/resources/medspeak/topten.htmlhttp://www.mlanet.org/resources/medspeak/topten.html

Additional ResourcesAdditional Resources

For SeniorsFor Seniors

NIH Senior HealthNIH Senior Healthhttp://nihseniorhealth.gov/http://nihseniorhealth.gov/

Nursing HomesNursing Homes

Residential Care and Assisted LivingResidential Care and Assisted Livinghttp://www.ahrq.gov/research/residentcare/http://www.ahrq.gov/research/residentcare/

Nursing Home CompareNursing Home Comparehttp://www.medicare.gov/NHCompare/http://www.medicare.gov/NHCompare/

Additional ResourcesAdditional Resources Health Literacy WebsitesHealth Literacy Websites

What is Clear Health CommunicationWhat is Clear Health Communication

http://www.pfizerhealthliteracy.com/http://www.pfizerhealthliteracy.com/

Questions are the AnswerQuestions are the Answer

http://www.ahrq.gov/questionsaretheanswer/

Ask Me 3Ask Me 3

http://www.npsf.org/askme3/http://www.npsf.org/askme3/

It is in the provision of It is in the provision of consumer health information consumer health information

that we as librarians might that we as librarians might have our greatest opportunity have our greatest opportunity

to experience the impact of to experience the impact of information on every member information on every member

of the community.of the community.

Thank You!Thank You!

Questions?Questions?