Libraries Meeting Community Health Needs: Trends and Issues 

Barbara Nail-Chiwetalu 

Revised January 18, 2006 

The initiative, Healthy People 2010, launched by the Department of Health and Human 

Services in 2000, outlines a prioritized set of health objectives representing the most 

critical public health issues currently facing the United States. Its two main goals are to 

increase quality and years of health life and to eliminate health disparities. Libraries serve 

an important role in the dissemination of health information and the promotion of healthy 

lifestyles which assists in reaching these goals. Following is a summary of the trends and 

issues reported in the literature in two special issues of Library Trends (2004 and 2005) 

and a supplement in the Journal of the Medical Library Association (2005), addressing 

ways in which libraries are serving or may strive to serve the health needs of the 

community better. 

Reaching Vulnerable or At-Risk Populations 

Reducing health disparities suggests that emphasis be placed on vulnerable, at-risk, or 

underserved populations such as the elderly (Detlefsen, 2004), African-Americans 

(Detlefsen, 2004), immigrants and refugees (Allen, Matthew, & Boland, 2004), Native 

Americans (Siegel, et al., 2005; Wood, et al., 2005), and racial and ethnic minorities 

(Dervin, 2005). Some important concepts for successful outreach with these populations 

include: 

• Developing partnerships beyond traditional constituents as key to outreach 

success (Allen, Matthews, & Boland, 2004; Siegel, et al., 2005) 

• Sharing perspectives to ensure that all perspectives are considered and respected 

(Siegel, et al., 2005) 

• Understanding the information behavior and use of the population (Detlefsen, 

2004) 

• Investigating what is known about the specific population’s use of the Internet 

(Detlefsen, 2004) and computer availability (Allen, Matthew, & Boland, 2004) 

• Assessing the cultural and health issues of the population (Allen, Matthew, & 

Boland, 2004; Detlefsen, 2004;) 

• Considering the use of information prepared for one population which may be 

useful for another (Detlefsen, 2004) 

Community Outreach and Sustainability 

A tremendous effort in reducing health disparities involves a clear consensus of the 

importance of librarians reaching out into the community by making health information 

accessible at the point of need. The process for developing community outreach projects 

may include: 

• Identifying and defining the community, including health needs, before visiting 

or starting any projects (Alpi & Bibel, 2004; Dutscher & Hamasu, 2005; Press 

& Diggs-Hobson, 2005) 

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• Visiting the community in person and approaching key community leaders or 

organizations to develop trust and mutual understanding (Alpi & Bibel, 2004; 

Dutscher & Hamasu, 2005; Press & Diggs-Hobson, 2005) 

• Engaging the implementers and end users of the project at the beginning stages 

of assessment (Ottoson & Green, 2005; Press & Diggs-Hobson, 2005) 

• Locating and assisting in the development of relevant information or materials 

(Alpi & Bibel, 2004; Press & Diggs-Hobson, 2005) 

• Pairing information outreach with other activities in which the population is 

already engaged, such as health fairs, conferences, community events, health 

agencies, educational organizations (Dutscher & Hamasu, 2005; Press & DiggsHobson, 2005) 

• Sustaining the project by integrating health information into ongoing programs 

or efforts reaching the target population in the community, empowering 

members in the community to serve as experts, securing funding, and working 

with people who share a common vision and value the project (Dutscher & 

Hamasu, 2005). 

Establishing Partnerships 

Due to the interdisciplinary nature of what constitutes health, no one entity or 

organization can make effective change alone. Librarians, as one partner in the health 

arena, are encouraged to “think outside the library” (Spatz, 2005, p. 454). Successful 

health information programs establish partnerships with any of a wide range of 

interdisciplinary community partners. Partners might include area health education 

centers, state and local health departments, hospitals, clinics, managed care programs, 

local branches of national health organizations (e.g. National Cancer Society), free 

clinics, community health centers serving uninsured or underinsured, managed care 

programs, nonprofit organizations (e.g., American Heart Association), public libraries, 

hospital libraries, academic institutions, and English for Speakers of Other Languages 

(ESOL) programs (Allen, Matthews, & Boland, 2004; Alpi & Bibel, 2004; Kenyon, 

2005). The process for establishing successful partnerships may include (Spatz, 2005): 

• Understanding the unique role of each agency or partner in order to better 

establish common ground 

• Defining the scope and mission of the partnership to ensure clear understanding of 

mutual goals and one’s relationship to others 

• Establishing accountability to ensure that each partner has a stake in achieving 

success 

• Establishing rules of conduct and communication 

• Providing a form of measurement for evaluation and reflection 

Evaluation of Community Outreach Programs 

Evaluation is an essential component of any community outreach program. It is not only 

a requirement in reports to external funding providers, but is necessary for measuring the 

effectiveness of a program or project and lessons learned. Some considerations for 

evaluation include: 

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• Bringing all stakeholders into the discussion (Olney, 2005; Ottoson & Green, 

2005) 

• Conducting a needs assessment at the onset of a project (Olney, 2005) 

• Monitoring changing needs during the course of the project so that the plan may 

be adapted as needed through site visits and interviews (Olney, 2005) 

• Conducting outcomes assessment through a combination of quantitative and semistructured qualitative assessment (Olney, 2005) 

• Considering use of a participatory approach which assesses use, program, valuing, 

and knowledge construction (Ottoson & Green, 2005) 

• Examining each step in the process to make the design and implementation of a 

project self –correcting (Friedman, 2005) 

Health Literacy 

Health literacy may be defined as the ability to obtain, read, comprehend, and use health 

information to make appropriate health decisions. The development of appropriate and 

effective health communication is an initiative recognized in Health People 2010. To this 

end, improving health communication may call for use of a variety of approaches, which 

may include: 

• Improving the accessibility of appropriate health materials in communities 

(Burnham & Peterson, 2005) 

• Emphasizing readability and comprehension of health communication materials 

(e.g., pamphlets, instruction guides, package inserts, books, Web sites) by 

o acquiring materials that are written in conversational style (active voice) 

(Baker & Gollop, 2004) 

o using short sentences of ten to fifteen words (Baker & Gollop, 2004) 

o translating complex medical terms (Parker & Kreps, 2005) 

o using plain language at the fifth grade level or lower to accommodate 

differing literacy levels (Parker & Kreps, 2005) 

o using caution with medical textbooks written for physicians or other health 

professions with consumer due to the high readability level and 

comprehension of terms (Baker & Gollop, 2005) 

o considering use of nonwritten materials (e.g., charts, diagrams, 

photographs , picture books, videotapes, audiotapes, multimedia 

presentations) with persons having limited literacy (Allen, Matthew, & 

Boland, 2004; Parker & Kreps, 2005) 

• Showing sensitivity to language and cultural needs by 

o providing materials that are culturally relevant (Parker & Kreps, 2005) 

o translating materials into different languages (Parker & Kreps, 2005) 

o using interpreter services to provide direct translations of what is said 

(Allen, Matthew, & Boland, 2004) 

• Adjusting oral communication of health information by 

o slowing down the rate of speech when delivering health information 

(Parker & Kreps, 2005) 

o using a “teach back” or “show me” approach to ensure understanding 

(Parker & Kreps, 2005) 

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o including important family members or close friends in discussions 

including “surrogate” readers (Parker & Kreps, 2005) 

Effective Use of the Internet 

With the rapid advances in technology and as computers become more affordable and 

accessible, use of the Web as a means to provide access to health information becomes 

increasingly valuable. To use the Internet effectively, consideration must be given to the 

design of Web sites, the development or selection of information to be posted or linked 

on the Web pages, and educating health information seekers in not only finding health 

information but being able to critically evaluate what they find for its authoritativeness, 

accuracy, and relevance to meeting their health need. Some considerations in use of the 

Web include: 

• Selecting high-quality information on the Web by librarians including the criteria 

of quality, authority, and accuracy of information; purpose of site; maintenance; 

and minimal redundancy (Miller, Tyler, & Backus, 2004) and validity; 

accessibility, presentation, and design; and Web site transparency, credibility, and 

currency (Crespo, 2004) 

• Educating the health information seeker to classifications of information 

providers such as health information directories and producers of databases that 

license the resources on the Internet (Crespo, 2004) 

• Making health information seekers aware of “pseudo-health” Web sites and other 

quackery (Crespo, 2004) 

• Creating easy to use Web sites by avoiding health care jargon, making the reading 

level no higher than eighth grade, creating pages that load easily, making pages 

accessible to both PC and Mac users, providing a glossary, creating the feeling of 

a “trusted, knowledgeable friend” (Detlefsen, 2004) 

Marketing 

With the rapid closing of hospital libraries nationwide due to reduced hospital funding, 

marketing is necessary to educate and increase the awareness of hospital administrators, 

health professionals, and the public about the value of the librarian’s critical role in 

providing relevant health information (Weldon, 2005). Marketing plans should be 

developed to promote what libraries do for the community (Kouame, Harris, & Murray, 

2005). Low-cost forms of marketing that may be implemented by librarians include: 

• Establishing partnerships between medical libraries and public libraries which can 

be marketed on a health information page on the public library’s Web site 

(Weldon, 2005) 

• Writing an article for the local newspaper highlighting health information services 

provided by the library (Weldon, 2005) 

• Writing articles for journals read by health professionals (Weldon, 2005) 

• Advertising library programs and services on local access television channels 

(Smith, Logsden, & Clark, 2005) 

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• Creating “giveaways” such as pencils, bookmarks, refrigerator magnets, bandage 

holders, or cardboard fans to distribute to the community (Smith, Logsden, & 

Clark, 2005) 

• Displaying exhibits within the library for the duration of a project (Smith, 

Logsden, & Clark, 2005) 

• Using volunteers to promote library services to local media, business and 

religious organizations, and local schools (Alpi & Bibel, 2004) 

• Displaying library brochures at human service providers such as hospitals, clinics, 

and day care centers (Alpi & Bibel, 2004) 

• Reaching out to service organizations with bilingual staff assisting the target 

population or ESOL classes (Alpi & Bibel, 2004) 

Summary 

This document outlines some of the major trends and issues in the implementation of 

community outreach programs by libraries. In order to reduce health disparities, it is 

critical that vulnerable or at-risk populations be reached. Libraries can play a significant 

role in alleviating health disparities by making their expertise in health information a vital 

part of the community. This can be achieved by defining the population and their 

particular health needs and then going into the community, partnering with established 

organizations or groups to integrate health information where it is most useful and best 

received. This entails learning a lot about the community surrounding the library and 

becoming an integral part of it rather than waiting for customers in need to come to the 

library. 

References 

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Alpi, K.M., & Bibel, B.M. (2004). Meeting the health information needs of diverse populations. Library 

Trends, 53(2), 268-282. 

Baker, L.M., & Gollop, C.J. (2004). Medical textbooks: Can lay people read and understand them? Library 

Trends, 53(2), 336-347. 

Burnham, E., & Peterson, E.B. (2005). Health information literacy: A library case study. Library Trends, 

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Crespo, J. (2004). Training the health information seeker: Quality issues in health information Web sites. 

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