How Public and NHS Libraries are Helping Health Literacy in Somerset, England
Librarians team up with healthcare providers to increase access to health education in rural areas.
Remember the early days of the COVID-19 pandemic? All of a sudden, we were all faced with conflicting and confusing information about the new virus and how best to cope.
The importance of what’s often described as “health literacy” became all too apparent. There are various definitions, but according to the World Health Organization in 2015, it’s “the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.”
Helping to provide this information is where libraries can really come into their own. As a National Health Service librarian, my role is primarily to collate clinical information for nurses, physicians, and other medical professionals. In many NHS libraries, we rarely, if ever, encounter members of the public directly.
For my colleagues in public libraries, however, the average day is very different. They’re often asked for health information directly by members of the public — and that’s certainly been the Somerset experience. I left the county in the summer of 2022, but one of the most enjoyable and productive projects I worked on involved working with our NHS Outreach Librarian and the local public library service.
In Somerset, the two largest public libraries are in the county town, Taunton, and in the second largest town, Yeovil. As Taunton is the county town, public transport links and car parking are both relatively good; the library also benefits from being in the town centre. Somerset looks like a tiny county on the map — and it is —but it can often take hours to travel across it, partly due to the road layout. Public transport is often expensive and irregular, especially in more rural areas, where internet signals can also be faint and erratic.
Getting to see a doctor, or even a pharmacist, can be tricky in some areas, and in many cases, patients are looking for information in the first instance. Signposting enquirers to this information is where libraries can help, but there is so much misinformation out there that it can be difficult to know what can be trusted.
A one-year joint Health Education England-funded project between NHS and public libraries in Somerset aimed to address levels of health literacy and make information more accessible to members of the public.
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The public libraries provided the “hardware” in the form of physical space, access to iPads (including integral SIM cards and data), and staff members and volunteers. The library service at Somerset NHS Foundation Trust provided the “software” in the form of training and input from myself and Veronica Price, our Outreach Librarian.
After initial joint discussions, we started by collating a list of useful and authoritative healthcare-related resources. Many of these were originally put together by the NHS and charities in the UK and often held the “PIF tick,” a nationally recognized quality standard. We also included well-known and well-researched international sites like Johns Hopkins University, the Mayo Clinic, and the National Library of Medicine.
A previous public libraries project had allowed members of the public to borrow iPads for several months with preloaded resources and data to help them into employment. These were now repurposed as health information iPads. The public libraries helped to design a dedicated subject-based home screen: The intention was not to overwhelm but to reassure.
Taunton Central Library hosted Health Coaches on weekday mornings. These NHS-funded health professionals were on hand to help with health-related queries. And when Fred arrived, he proved very popular. (Fred was the name given to the blood pressure monitor machines that took up residence at Taunton and Yeovil public libraries.) The Health Coaches and the library staff also helped users access portable blood pressure monitors. These could be borrowed for several days and used in the peace and privacy of library users’ own homes.
During this time, the public library staff also took part in various health information sessions, including health technology days; the OMMI projector absolutely stole the show. The well-being areas in several of the libraries were also revamped during this time, and large information screens were installed.
It all started as a very small project, but as is often the case, the project grew…
We knew it before we started, but the importance of building and sustaining congenial relationships with our public library colleagues was vital — we couldn’t have done it without them. We were lucky enough to have strong personal relationships in place with public library colleagues right from the start.
We’d hoped to be able to deliver our sessions in person, but due to the pandemic, we had to make use of Teams, and we learned a lot about what techniques can help to make this more interactive, including quizzes, chat, and show of virtual hands.
One approach was tailored to the public library staff, and the other was more focused on the Health Coaches, although the core content was the same. In total, our part of the healthcare literacy project lasted for about a year.
My own role as Primary Care Librarian to Somerset also meant that supporting the Health Coaches dovetailed perfectly with the rest of my day job. I was also able to keep primary care staff in the county up to date with the public library's offer of healthcare information and, for example, the Home Library service.
The response we had from library staff, volunteers, and the Health Coaches to our training was positive. We learned about the importance of getting the message out to members of the community about what is on offer — in the ordinary way, we’d have relied on members of the public just walking in, but that wasn’t an option during the pandemic.
For me personally, it brought home again just how many NHS colleagues aren’t aware that there is a dedicated library and knowledge service to help and support them and how much work we still need to do.
Information from members of the public who took part in the project is still being collated.
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From a patient perspective, it’s hoped the next stage will allow the team to identify a GP surgery as a pilot to forward blood pressure results from the machines in real time. Hopefully, this will help identify conditions early, leading to a positive clinical outcome, although maintaining patient confidentiality needs to be addressed before this can proceed.
High blood pressure, in particular, is a very common condition in both the UK and the USA and can often be a warning sign for long-term illnesses. If you’d like to check out the statistics, there are plenty at https://www.bloodpressureuk.org/news/media-centre/blood-pressure-facts-and-figures/ or https://www.cdc.gov/bloodpressure/facts.htm
Having input and feedback from the Health Coaches throughout the project was absolutely invaluable. It helped us identify gaps in our information collections for those with visual impairment or hearing issues, SEN, or whose first language wasn’t English — and even though I’m now in a different part of England, these gaps remain the same.
Our findings have been shared with several colleagues across England via online CPD events, mainly in health libraries at this point. They are also due to be presented at a national information literacy conference in the spring of 2023. In addition, content is regularly added to national Community of Practice pages at https://southlks.libguides.com/healthliteracy/home.
Online, Not Digital
And as a final “take-home nugget,” one of the most useful lessons we learned was this: Using the word “digital” acts as a barrier for most members of the public, but the word “online” doesn’t have the same off-putting connotations.
So, from now on, online health information it is!
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