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SAVVY LIBRARY SERVICES FOR SENIOR HEALTH
Michelle EberleConsumer Health Information CoordinatorNational Network of Libraries of Medicine New England Region
May 2009
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http://nnlm.gov/ner/
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What is the NLM?
National Library of Medicine Part of the National Institutes of Health The world’s largest biomedical library Creator of PubMed.gov, MedlinePlus.gov and
many other useful health information resources!!!
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Agenda
Access and utilization of health information
Health information seeking behavior
Evaluation of health resources
Training and programs
Recommended resources
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According to the CDC:
http://www.cdc.gov/aging/
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Realities of health care today Patients are now asked to make major
decisions about their own disease process
Most patients do not have the tools to make these kinds of decision
You can provide your patrons with quality health information to enhance their coping skills, wellness and chronic disease management.
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Health literacy
The ability to read, understand and act on health information [Pfizer 2002]
The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions [Healthy People 2010]
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Why is health literacy so critical? Essential life skill
It is the bridge between knowledge and behavior.
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Why is an understanding of health literacy important for older adults?
Adults age 63 and older have lower health literacy scores than all other age groups
Only 3% of older adults surveyed had proficient health literacy skills
The 2003 National Assessment of Adult Literacy
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Ask Me 3
Essential questions to make sure your patient understands:
1. What is my main problem?2. What do I need to do?3. Why is it important for me to do this?
Source: Ask Me 3, Partnership for Clear Communication
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Additional Factors
Vision and hearing changes 2 out of 3 adults with vision problem are over 65 Hearing loss – 1 in 3 adults over 60 and ½ over
85 Cognitive changes
Reduced processing speed More easily distracted Difficulty remembering
new information Disability
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Additional Factors
Multiple conditions
Many, many medications
Talking to doctors
Internet comfort levels
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Talking to Doctors: The New World Order Before 1972,doctors told patients what
they wanted patients to know, and what they wanted patients to do.
1972 – AHA Patient Bill of Rights “The patient has the right and is
encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information about his or her diagnosis, treatment, and prognosis.”
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Talking to Doctors: The New World Order Now, doctors are just part of
the health care team – so is the patient!
The patient is now asked to make decisions about their own health care process
Where do patients get the tools to make those decisions?
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Talking to Doctors: The New World Order
Ask Me 3™ http://www.askme3.org
Questions are the Answer http://www.ahrq.gov/questionsaretheanswer/
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Older Adults and the Internet
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Older Adults & the Internet
The Pew Internet & American Life Project http://www.pewinternet.org
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Older Adults & the Internet
The number of older adults using the Internet increases as computer users join the ranks of older adults. “Seniors” are not just one generation.
Seniors who are online are as likely as younger users to go online on a typical day.
66% of seniors that use the Internet have looked for health information online.
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Older Adults & the Internet
Most seniors live lives far removed from the Internet know few people who use email or surf the
Web cannot imagine why they would spend money
and time learning how to use a computer more likely than any other age group to be
living with some kind of disability which could hinder their capacity to get to a computer training center
Fox, Susannah. “Older Americans and the Internet.” Pew Internet & American Life Project. 25 March 2004.
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Older Adults & the Internet
If 73% of adults over 65 are NOT using the Internet, how are they choosing among the 73 discount drug care programs online through the Medicare Web site?
To get email updates from CMS National Medicare Training Program: http://www.cms.hhs.gov/nationalmedicaretrainingprogram/EmailUpdates/List.asp
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Health Seeking Behaviors
If not the Internet, where do older adults obtain health information? Health care providers Family Friends Workshops/Presentations Print resourcesPew Internet & American Life Project and
Health Information Seeking Behaviors of Older Adults: Results from an Interdisciplinary IMLS-funded Research Project, presentation at 2008 Medical Library Association by Mary Stansbury, Library and Information Science, University of Denver and Ruth Ludwick, College of Nursing, Kent State University.
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Online Health Seeking Behaviors
Many older adults who use the Internet don’t know how to evaluate the information they find
Some either trust information found on the Internet too much or not at all
Wired seniors outpace younger Internet users on only one health topic: Medicare and MedicaidFox, Susannah. “Older Americans and the Internet.” Pew Internet & American Life Project. 25 March
2004.
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What about Boomers?
In 10 years, boomers will age into the 65+ demographic
Younger baby boomers are most likely to have searched online for prescription drug information
Health seeking online is one of the only areas that boomers dominate over other generations
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Evaluation of Health Resources
Not a real drug. Not a real disorder. A spoof.
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Evaluation of Health Resources We’re going to skip the usual discussion
about health information evaluation: Accuracy Authority Bias Currency Coverage
And focus on special usability needs for older adults
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Usability
Font size Glare-free background color/paper Clear organization “White” space Short sentences Jargon-free, definitions of medical terms
included Information in short segments Meaningful images
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Usability
Additional Features for the Web Mouse-free controls Clear explanations No flashing images or distractions High contrast Step-by-step navigation “Read out loud” features highlighted text (hyperlinks) in color other
than blue
Click HERE to Win!!!!!
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Library Programs
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Program Planning
2008 IMLS-funded study in Ohio found that: There are two variables that have a
relationship to how likely it is that someone will read, watch, or use a particular resource:1. the health issue2. The particular resource
These are more important than who dispenses the information
Health Information Seeking Behaviors of Older Adults: Results from an Interdisciplinary IMLS-funded Research Project, presentation at
2008 Medical Library Association by Mary Stansbury, Library and Information Science, University of Denver and Ruth Ludwick, College of Nursing, Kent State
University.
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Program Planning
Most preferred pamphlets/booklets People who were interviewed at senior
centers liked presentations or meetings People who were interviewed at libraries
generally preferred paper brochures and books to presentations or meetings
High blood pressure was the health topic of most importance to those interviewed
Health Information Seeking Behaviors of Older Adults: Results from an Interdisciplinary IMLS-funded Research Project, presentation at
2008 Medical Library Association by Mary Stansbury, Library and Information Science, University of Denver and Ruth Ludwick, College of Nursing, Kent State
University.
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What programs for senior health information are offered by your library?What programs are you thinking about offering?
Sharing
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Program Ideas
Wii! Exercise Relationships/dating Drug information Medicare Choosing nursing homes/assisted living Memory issues/keeping mind active Local resources Legal issues
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Program Ideas
Caregiving End of Life planning Managing medications Evaluating health information
Health Fraud Advanced directives
Hospice Alternative medicines
Sexual Health
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Teaching Health Information on the Internet
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Why We Teach Health on the Internet to Older Adults
Bridge Digital Divide
Increase confidence
Increase knowledge of health conditions and healthy lifestyles
Help people know how to talk to doctors
Increase skills in evaluating health information resources
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What are your tips for training seniors with online health information or online information in general?
Sharing
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Teaching Tips
Observations from instructors: Seniors are very hungry for health information Seniors are eager to learn Learning a new technology may be anxiety
producing Lots of practice and repetition Transportation could be a problem Use health topics they are interested in (HBP) Provide regular access to computers Teach small groups, low teacher/student ratio
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Teaching Resources
Beanworks: Computers, Older Adults, and Libraries http://beanworks.wordpress.com/
computers-older-adults-and-libraries/ Carol Bean, Palm Beach County Library Includes mousing tutorials Helpful articles Other training materials
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Teaching Resources
NIHSeniorHealth: Helping Older Adults Search for Health Information Online:A Toolkit for Trainers http://nihseniorhealth.gov/toolkit/
toolkit.html
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NIHSeniorHealth.gov toolkit for trainers
Lesson plans including:
Instructions for trainers
Handouts Practice Exercises
What’s new?
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Highlights of NIH Senior Health Senior friendly format Short pages Ability to easily change text size, visual
contrast and add audio to the page Videos Share your exercise stories
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Examples of information you can find on NIH Senior Health 30 senior specific health topics Balance problems Falls and older adults Sleep and aging Osteoporosis Exercise and older adults Stroke Taking medicines Hearing Glaucoma
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NIHSeniorHealth.gov
Senior friendly online health information
Features:• Capability to increase
text size, turn on visual contrast, listen to page.
• Over 100 health videos
• Share your exercise stories
• Toolkit for trainers
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User friendly features!
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Senior Health Videos
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Why NIH SeniorHealth.gov?
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What if I need more in depth information?
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MedlinePlus.gov
Created by the National Library of Medicine (NLM) which is part of the National Institutes of Health (NIH)
Funded with your tax dollars Provides health information for the
public
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What will I find on MedlinePlus.gov?• Over 700 health topics• Drug information / herbal information• Medical encyclopedia• Medical dictionary• Directories• Local resources through “Go Local”• Health information in other languages• Surgery videos
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What else will I find on MedlinePlus.gov? Health check tools Low Vision page Easy to read page The latest health news Email announcements and RSS feeds for
the latest health news The MedlinePlus Magazine
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Home page here:
http://www.medlineplus.gov
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MedlinePlus.gov also in Spanish!
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In Spanish too! ¡En Español Tambíen! Just click on the yellow button to switch between English and Spanish!
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Search alphabetically
Search with the Search
Box
Browse by body navigation maps
Navigating the health topics page…
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100+ health topics for seniorsMedlinePlus.gov
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Easy to read health information
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Useful for creating handouts, flyers for seniors
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Health Check Tools
For Seniors:• Joint Health Quiz (Arthritis Foundation)• Check your Arthritis Knowledge (American College of Orthopaedic Surgeons)• Test Your Back Health IQ (Amer. Acad. Of Physical Rehabilitation and Medicine)• Bladder Cancer Risk Questionairre (Siteman Cancer Center)• My Family Health Portrait (NIH)• Interactive Menu Planner (National Heart, Lung and Blood Institute)• Skin Cancer Risk: Understanding the Puzzle (National Cancer Institute)• My Pyramid.gov: Steps to a Healthier You (Department of Agriculture)• Glaucoma: How Much Do You Know (National Eye Institute)
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What’s new?Visual Dx Health Pictures and Photographs
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Search with body navigation maps
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Body navigation maps
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Different parts of the image are clickable, and show green highlighting when the user moves their mouse over the area
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Menu on the right changes to related topics – in this case, The Bones
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Drug, Supplement and Herbal Information
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Drug information from AHFSAmerican Society of Health-System Pharmacists
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Uses Based on Evidence
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What is the most commonly used supplement according to the latest report by the National Center of Complementary and Alternative Medicine?
Question
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Medical Encyclopedia & Dictionary
Encyclopedia includes over 4,000 entries on health topics, and an extensive library of illustrations.
Medical Dictionary
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Directories Page
Doctors and Dentists
Hospitals and Clinics
Specialists
Other Healthcare Facilities & Services
Libraries
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Directories for seniors: Doctor finders, Nursing Home Compare, Home Health Compare, and more!
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The latest news from Reuter Health
What’s new? News now archived 90 days in English and Spanish.
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Current Health News
News from Reuters and HealthDay
Searchable by date or topic
Email Announcements – very useful!
RSS feeds
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Sign up for news from the link -Daily, weekly and specialty topics available
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Can’t find your information on MedlinePlus?Here are alternative sources to consider…
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Does your library provide health information for the public?
Have your library featured on the MedlinePlus.gov Library Directory!!!
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Search Box Powered by Vivisimo
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What are collections?
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What are clusters?
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Expert Search Tips for MedlinePlus.gov
Can I search for a Phrase?Yes, use quotation marks.
Example: “health services research”
Can I Restrict My Search to a Specific Website?Yes, you can restrict your search to a specific site by adding “site:” and the domain or URL to your search words.
Example: If you want to find breast cancer information in MedlinePlus onlyfrom the National Cancer Institute, search on:
“breast cancer site:cancer.gov.”
• http://www.nlm.nih.gov/medlineplus/searchtips.html
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Expert Search Tips
Is the site case sensitive?
NO
Example: A search on “alzheimer’s disease” also retrieves pages containing the words, “Alzheimer’s Disease”
Will the site check my spelling?
YES
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Is Boolean Searching Allowed?
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Boolean searching
OR Use when you want either term, but not necessarily
both, to appear in the results
Example: Tylenol OR Acetaminophen
NOT or - Use when you do not want a particular term to appear in
the results /
Example: flu NOT bird or flu-bird
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What about Wildcards?
+ Use when you want the word to appear in
your search results exactly as you typed it Example: +mammogram finds resources containing that exact
word; it does not find resources that contain the words mammography or mammoplasty
* Use as a wildcard when you want the search
engine to fill in the blank for you; you must enter at least three letters
Example: mammo* finds mammogram, mammography, etc
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MedlinePlus Magazine
A quarterly publication of the Friends of the National Library of Medicine.
NNLM members get a free subscription for your library!
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What’s new? …in Spanish too!
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NIH MedlinePlus Salud MagazineBilingual format!
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Multilingual health Information:In over 70 languages!
What’s new?A link to the Refugee Health Information Network added to the Multiple Languages Page!
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Interactive tutorials get a new look!!!
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Text Summary of Interactive Tutorials
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MedlinePlus Go Local
http://medlineplus.gov/golocal
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Search by: Location, Provider or Disease
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Search Go Local on MedlinePlus:
Home page Health topics Or directly on the
state’s Go Local site
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Example of search in Go Local Massachusetts for Complementary and Alternative Care Providers for Cancer in Suffolk County
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Get HTML code to link directly to a MedlinePlus icon for the homepage or add a MedlinePlus Search Box to your site.
Do not link to any of the licenses materials on MedlinePlus: surgery videos, Patient Education tutorial, news stories, or encyclopedia
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Includes some tutorials you may download and use when there is no access to the Internet.
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Surgery Videos
Source: OR-Live.com
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The most popular surgery video?
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Surgery videos
For older adults: Hip replacement Hiatal Hernia Cancer Surgeries Osteoporosis And about 100
others!
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In Review: Why MedlinePlus?
MedlinePlus http://medlineplus.gov Links to reliable, understandable
health websites Health Topics for Seniors Easy-to-read articles Slideshows that have sound and contrast Medical dictionary Medical encyclopedia with large illustrations Links to local services English, Spanish and other languages No Advertisements!
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What other resources are useful for senior health information?
Sharing
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Recommended Resources
National Institute on Aging http://www.nia.nih.gov Free publications (English and Spanish) Azheimer’s Disease Education and Referral
Center (ADEAR) Database of more than 300
national organizations that provide help to older adults.
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Recommended Resources
http://positiveaging.org/
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Books
The Merck Manual of Medical Information: Home Edition http://www.merck.com/mmhe/index.html
The Merck Manual of Health & Aging http://www.merck.com/pubs/mmanual_ha/
contents.html
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Collection development guidehttp://library.uchc.edu/departm/hnet/agingresource.htmlUCONN Healthnet: Growing Older: A Health Related Resource Guide
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Other core lists
CAPHIS Collection Development Lists http://caphis.mlanet.org http://caphis.mlanet.org/resources/
index.html#coldev
UCONN Healthnet Resource guides for consumers and librarians http://library.uchc.edu/departm/hnet/
Toronto Public Library http://www.torontopubliclibrary.ca/uni_chi_core.jsp
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Take home points
Older adults are hungry for health information.
Librarians are uniquely qualified to bridge the digital divide for older adults.
We are knowledgeable about technology and information resources.
Think about the resources learned today. Who can you help by sharing this
information?
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Questions?
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Thank You!
Michelle Eberle, MSLISConsumer Health Information CoordinatorNational Network of Libraries of Medicine
New England Region800-338-7657
Presentation co-authored by Karen Vargas