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On a world basis, 15% of the population has a disability. Having a disability can result in a higher frequency of health-related information needs than other users might experience. The Web represents a widely used source for health information. People with disabilities, however, often encounter barriers during online searching, such as inaccessible information, poorly designed search user interfaces and lack of compatibility with assistive technology. Consequently, many users are potentially excluded from a range of information sources. Measures are therefore needed to remove these barriers to avoid health disparities that can result from unequal access to information. Public libraries have a social responsibility to include all user groups, and should aspire to make fully accessible services. A good tool in this context is the implementation of the universal design mind-set, where the purpose is to develop services that are available to all people. This chapter discusses how universal design can be a premise for equal access to health information and potentially reduce health disparities in the context of users with disabilities. Both library services and education of librarians will be addressed.

This chapter introduces the focus of this volume – the many ways in which libraries and librarians are helping to increase people’s health literacy and reduce health disparities in their communities. The rampant and rapidly increasing health injustices that occur every day throughout the world are, in large part, caused and exacerbated by health information injustice – something which libraries and librarians are playing an instrumental role in addressing by ensuring the physical and intellectual accessibility of information for all. This chapter opens with an introduction to the central concepts of health justice and health information injustice, focusing on the many information-related factors that shape the degree to which individuals have the information they need to be able to have a sufficient and truly equitable chance to live a long and healthy life. Next, the authors present a timely case study to emphasize the importance of health information justice, looking at the dire importance of health literacy as we navigate the COVID-19 pandemic. The authors then provide a brief glimpse into their 13 contributed chapters, grouped into five categories: (1) Public Libraries/Healthy Communities; (2) Health Information Assessment; (3) Overcoming Barriers to Health Information Access; (4) Serving Disadvantaged Populations; and (5) Health Information as a Communal Asset. In conclusion, the authors discuss their aims for this volume, particularly that readers will become more aware of librarians’ efforts to address health disparities in their communities and excited about participating in and expanding these efforts, moving us closer to health justice.

Results of a previous study showed that use of health information technology (HIT) significantly reduced potential medication prescribing errors. However, the results also revealed a less than 100% rate of HIT adoption by primary care physicians. The current study reports on personal interviews with participating physicians that explored the barriers they faced when attempting to fully adopt a particular HIT. Content analysis of qualitative interviews revealed three barrier themes: time, technology, and environment. Interviews also revealed two other areas of concern; specifically, the compatibility of the HIT with the physician's patient mix and the physician's own attitude toward the use of HIT. A theoretical model of technology acceptance and use is used to discuss and further explain the data derived from the physician interviews. With a better understanding of these issues, health care administrators can develop successful strategies for adoption of HIT across their health care organizations.

This mixed methods multiple case study examines the knowledge, understanding, and awareness of 25 health board/facility oversight managers and 20 health professional association directors about privacy and security issues important to achieving health information exchange (HIE) in the state of Nebraska. Within case analyses revealed that health board/facility oversight managers were unaware of key elements of the federal agenda; their concerns about privacy encompassed broad definitions both of what constituted a “health record” and “regulations centeredness.” Alternatively, health professional association leaders were keenly aware of national initiatives. Despite concerns about HIE, they supported information exchange believing that patient care quality and safety would improve. Cross-case analyses revealed a perceptual disconnect between board/facility oversight managers and professional association leaders; however, both favored HIE. Understanding state-level stakeholder perceptions helps us further understand our progress toward achieving the national health information interoperability goal. There is an ongoing need to assure adequate patient privacy protection. Licensure and facility boards at the state level are likely to have a major role in the assurance of patient protections through facility oversight and provider behavior. The need for these boards to take an active role in oversight of patient rights and protections is imminent. Similarly, professional associations are the major vehicles for post-graduate education of practicing health professionals. Their engagement is essential to maintaining health professions knowledge. States will need to understand and engage both of these key stakeholders to make substantial progress in moving the HIE agenda forward.

In this closing chapter, the authors first draw on the contributed chapters in this volume to highlight some of the many ways in which libraries and librarians are moving us closer to health justice by working with their communities to increase consumer health literacy and to decrease health disparities. The authors then focus our attention on the COVID-19 pandemic, discussing the fact that disadvantaged populations are bearing the brunt of the negative impacts of this situation and the many existing and novel roles that libraries and librarians are playing to help to fight consumer health information injustice and to contribute toward better health outcomes for all. Next, Dr Beth Barnett brings her viewpoint as a Board Certified Patient Advocate to the volume, pointing out parallels between the roles of librarians and those of patient advocates, as well as important lessons for patient advocates gleaned from the volume. To conclude the chapter, the authors reiterate our aims for the volume and issue a call to the reader to join libraries and librarians in their important role as agents of health information justice.

This study aims to provide a better understanding of Native American women veterans’ experiences with Veteran Administration and Indian Health Services. Eighteen interviews were conducted with special attention to the quality and quantity of health and mental health care services veterans accessed, the barriers and local contextual factors in accessing and utilizing services, and potential solutions to service gaps for women veterans from two Montana reservations, the Northern Cheyenne Reservation and the Confederated Salish and Kootenai Tribes of the Flathead Reservation.

We examine the barriers and needs of Native American veterans in both reservations using qualitative methods. The research analyzed 18 interviews with women veterans from the Northern Cheyenne and Flathead reservations.

Native American women veterans identified a number of barriers to accessing care, some of which include lack of information regarding eligibility and the types of services available. Women often found the application process to be confusing and difficult. Other barriers included distance, cost of travel, and conflicts with their work schedule.

This exploratory case study served to clarify the challenges and obstacles Native American women veterans experience with accessing health and mental health services. This research revealed several patterns and themes in the experience of Native American women veterans in both reservation communities when attempting to access and seek care at Veterans Administration (VA) facilities and Indian Health Services (IHS). This research calls for policy changes and research to clarify how resources can be more efficiently and effectively distributed to rural veterans.

Little research has addressed the needs of Native American veterans. American Indians and Alaska Natives serve at a higher rate in the U.S. military than any other population. This research provides important information about Native American veterans who are often underrepresented in survey research, yet a rapidly growing segment of the United States military and veteran population.

This chapter addresses the shortcomings of current self-efficacy models describing the health information practices of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) communities. Informed by semi-structured interviews with 30 LGBTQIA+ community leaders from South Carolina, findings demonstrate how their self-efficacy operates beyond HIV/AIDS research while complicating traditional models that isolate an individual’s health information practices from their abundant communal experiences. Findings also suggest that participants engage with health information and resources in ways deemed unhealthy or harmful by healthcare providers. However, such practices are nuanced, and participants carefully navigate them, balancing concerns for community safety and well-being over traditional engagements with healthcare infrastructures. These findings have implications for public and health librarianship when providing LGBTQIA+ communities with health information. Practitioners must comprehend how the collective meanings, values, and lived experiences of LGBTQIA+ communities inform how they create, seek, share, and use health information to engage in successful informational interventions for community health promotion. Otherwise, practitioners risk embracing approaches that apply decontextualized, deficit-based understandings of these health information practices, and lack community relevance.

Adults in the United States have low health literacy skills which puts them at high risk for serious health consequences. Libraries have traditionally provided programming on a variety of topics for patrons but barriers such as technology and transportation access may prevent potential patrons from attending. Librarians can help increase the health literacy skills of community members by providing health outreach programming to the communities they serve. This chapter examines strategies and specific examples that library managers can implement to facilitate technology and health literacy skills through programming in communities.