Savvy Library Services for Senior Health

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Savvy Library Services for Senior Health

• ALA Annual Conference 2008
• Karen Vargas
• Consumer Health Outreach Coordinator
• National Network of Libraries of Medicine, South
  Central Region

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Agenda

• Overview of issues concerning access and
  utilization of health information
• Health information seeking behavior
• Evaluation of health resources
• Training and programs
• Recommended resources

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Access and Utilization Health Literacy

• Health Literacy
• The degree to which individuals have the
  capacity to obtain, process and understand basic
  health information and services need to make
  appropriate health decisions. (Healthy People
  2010)
• ACP Foundation Video http//foundation.acponline.
  org/hl/hlvideo.htm

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Health Literacy

• How is it different from Literacy?
• People of all literacy levels can have low health
  literacy
• However, limited literacy skills are a stronger
  predictor of an individual's health status than
  age, income, employment status, education level,
  and racial or ethnic group. Ask Me 3

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Health Literacy

• 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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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
• U.S. Department of Health and Human Services,
  Quick Guideto Health Literacy of Older Adults

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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/ques
  tionsaretheanswer/

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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/nationalm
  edicaretrainingprogram/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 resources
• Pew 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 dont 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 Medicaid
• Fox, 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
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Evaluation of Health Resources

• Were 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
Click HERE to Win!!!!!

• 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
• No blue highlighted text (hyperlinks)

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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
• the health issue
• 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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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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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

• NIHSeniorHealth Helping Older Adults Search for
  Health Information OnlineA Toolkit for Trainers
• http//nihseniorhealth.gov/toolkit/toolkit.html

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Teaching Resources

• Beanworks Computers, Older Adults, and Libraries
• http//beanworks.wordpress.com/computers-older-adu
  lts-and-libraries/
• Carol Bean, Palm Beach County Library
• Includes mousing tutorials
• Helpful articles
• Other training materials

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Recommended Resources

• NIHSeniorHealth
• http//nihseniorhealth.gov
• Health information for older adults
• Partnership of National Institute on Aging and
  National Library of Medicine
• Information comes from National Institutes of
  Health
• Senior-friendly features (large text, sound,
  contrast)
• Information in bite-sized pieces

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Recommended Resources

• 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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Recommended Resources

• National Institute on Aging
• http//www.nia.nih.gov
• Free publications (English and Spanish)
• Alzheimers Disease Education and Referral Center
  (ADEAR)
• Database of more than 300 national organizations
  that provide help to older adults.

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National Network of Libraries of Medicine
(NN/LM)

• Who are we?

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National Network of Libraries of Medicine (NN/LM)

• We are a network of over 5,000 medical libraries,
  public libraries, academic libraries, clinics,
  public health departments, and community and
  faith based organizations.
• The NN/LM is dedicated to serving the health
  information needs of librarians, healthcare
  practitioners, educators and consumers across the
  United States

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National Network ofLibraries of Medicine (NN/LM)

• We provide free
• Classes and Programs
• NLM Promotional Materials
• Funding
• Networking opportunities
• To Join
• http//nnlm.gov (Click on your state)
• Or visit the National Library of Medicine booth
  here at ALA

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Thank You!

• Questions?
• Karen Vargas, MSLS
• Consumer Health Outreach Coordinator
• National Network of Libraries of Medicine,
• South Central Region
• 800-338-7657
• karen.vargas_at_exch.library.tmc.edu
• Developed by NN/LM SCR staff.  This project has
  been funded in whole or in part with Federal
  funds from the National Library of Medicine,
  National Institutes of Health, Department of
  Health and Human Services, under Contract No.
  N01-LM-6-3505 with the Houston Academy of
  Medicine-Texas Medical Center Library.