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for the Orange County Library System (OCLS) in Central Florida. Its beginnings date back to
1923 and has since grown to four spacious floors of collections, special programs, three
computer labs, four meeting rooms, and the award-winning Dorothy Lumley Melrose Center for
Technology, Innovation and Creativity. Situated in the heart of Downtown Orlando, the library’s
community and patron base is arguably the most diverse among its fifteen neighborhood
branches scattered throughout Orange County. Despite the extensive resources, services, and
programs offered at the Orlando Public Library, a closer assessment of the library’s service
population, demographics, and current amenities reveals a need for more focus on health literacy
and support both on-site and online. This paper will begin with a brief review of the library’s
service population demographics, including economic and health statistics, followed by the
unique challenges that contributed to the development of Orlando Public Library’s “Your Health
Matters” program for adults, including the steps necessary to bring this important program to
and serves a population of over 68,000 members within a three-mile radius. College graduates
make up 49 percent of the population, followed by 41 percent with a high school diploma and 10
percent having never graduated. Among the 68,350 members of the population, 35,191 have a
job, resulting in an unemployment rate of 12.6 percent. While 46 percent of the population are
identified as homeowners, a staggering 18.5 percent subsist below the poverty rate. Reported
household incomes mirror these numbers, with 22 percent making less than $20,000 per year,
followed by 18 percent who make $30-35,000 annually, and subsequently tied at 16 percent are
medical community, including Orlando Regional Medical Center (ORMC) and Winnie Palmer
Hospital, it comes as no surprise that the largest employer for the area is in the field of healthcare
public administration.
Reviewing the population’s health statistics reveals the obesity rate estimated at 34
percent and disability rate at 10 percent, while 20 percent are uninsured. The library provides
many amenities and alternative sources and materials for the hearing and vision impaired, as well
as ramps and elevators for wheel chair access, and a variety of other helpful resources for
members with disabilities. But the percentage of uninsured members coupled with the
respondent surveyed for the Digital Inclusion Survey’s Interactive Map (2013-2014) indicated
100 percent satisfaction in areas of basic literacy, GED education, job applications, and
Internet users – that’s about 93 million Americans – have searched for health-related information
online” (2018). However, despite “health being a topic that affects literally every community
member, most materials on this topic are inaccessible because they’re written at a reading level
that’s above the national average.” This sentiment is echoed in another article by Autumn
McClintock, who cites the Pew Philadelphia Research Initiative for the Free Library of
Philadelphia, which revealed “that one-third of the customers visiting [their] 54 locations were
seeking health information” (2017). In an article for American Libraries Magazine, Lea Radick
interviewed the director of Hall Memorial Library in New Hampshire. As a former medical
librarian, she is fit to assist patrons with healthcare questions “by helping them find information
on Medline-Plus, an authoritative, free website where the public can find health information”
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(2015). The director advises her patrons to never Google their symptoms, but the ease of
navigation is naturally what attracts us all to do so. According to Radick, “More than 90 million
adults in the United States have low health literacy – how well a person can get needed health
scattershot health programs,” but actively responded to survey feedback by building a strategy to
meet the need. According to McClintock, this “reflects the ever-expanding mission of libraries
and librarians and the shift from behind-the-desk reference to into-the-community outreach”
(2017). While librarians became a critical point of contact when the Affordable Care Act
launched in 2013, many libraries generally lack in their health-related resources (McClintock,
2017). When considering Orlando Public Library’s demographic challenges of 12.6 percent
unemployment, 20 percent uninsured, and 18.5 percent surviving below the poverty rate within
their service community, in addition to the lack of online health assistance, it is imperative that
the library develop a strategic plan to address this disparity and improve health literacy through
OCLS branches with meetings held every Tuesday at the main branch. The social worker
provides personal assistance and referrals for affordable housing, counseling, food stamps, and
government services. While a designated social worker is laudable, they do not address medical
needs, online health assistance, or general health awareness and activities, like CPR training,
blood pressure screenings, STD testing, and other health-related workshops. In an effort “to
improve the health of Philadelphia area residents” (McClintock, 2017), the Free Library of
Philadelphia exemplifies the ideal health program that other libraries should aspire to emulate.
An on-site nurse is readily available to patrons, checking blood pressure, advising them of risks
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and suggestions, “talks with library users about their health and acts as a point person for the best
resources.” As a result, it is estimated “that several thousand consumers have taken advantage of
this library service” since it launched. Another impressive example is the South Philadelphia
neighborhood library who employs a consumer health librarian certified through the Medical
accreditation that keeps… staff in the know by providing access to the most up-to-date resources
and programs” (McClintock, 2017). It is important that public libraries explore the growing
demand for health programs, because “public libraries are trusted institutions that have broad
Library Association (PLA) adopted a health information initiative with the National Network of
Libraries of Medicine (NNLM), stating that, “Access to current and reliable health information is
imperative for the well-being of all Americans, and public libraries are frequently a ‘go-to’
resource as people navigate complex issues of health care, insurance, aging and more” (2017). In
their effort to promote healthy communities, the initiative aims to “increase public library
workers’ knowledge and skills related to consumer health services.” Guided by the PLA Health
Initiative Advisory Group, this endeavor is accomplished through a variety of tools and
resources, including the creation of a “Healthy Community Tools for Public Libraries” website
with “training resources, program ideas, and trustworthy health web sites and databases.”
Additionally, membership to NNLM’s Regional Medical Library is free to join and provides
“access to training, funding, and materials” to keep library programming strong and their
communities healthy. PLA also offers a free on-demand webinar to those interested in educating
themselves “about consumer health services and programming [to] help public librarians stay
current and develop new programs and services for their communities.” The webinar provides a
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substantive overview of the requirements and benefits of the Consumer Health Information
Specialization (CHIS) credential for librarians, “which brings an additional, recognized level of
expertise to their libraries and helps them connect with community partners” (Public Library
Association, 2017).
After careful examination of the unique challenges Orlando Public Library faces within
their service community and armed with precedent established by the academic literature and
aforementioned public libraries as a model, the Orlando Public Library has announced the details
of their upcoming “Your Health Matters” program scheduled to launch in the fall of 2019. This
program will feature a varietal series of classes designed to address the health needs of the
community. Activities will include blood pressure screenings, STD prevention and awareness
workshops, personalized assistance navigating online health resources, and provide a safe,
welcoming, and inclusive environment for all patrons to come and address their health concerns.
By establishing essential partnerships with the surrounding hospitals, namely ORMC and Winnie
Palmer Hospital, as well as medical professionals, offices and clinics concentrated in the
downtown area, a rotating pair of registered nurses will provide patrons with critical health
information and assistance twice a week during regular library operating hours, Wednesday and
Saturday evenings, with no attendee limit established at this time. And while budgetary
constraints prohibit the ability to employ an on-site nurse full time, the library will select three
librarians for career development opportunities by providing the necessary means for their
accreditation through the Consumer Health Information Specialization Program for ongoing
assistance to patrons outside of the class schedule. The training provided by NNML is invaluable
as librarians are taught how to navigate medical websites like Medline-Plus and pass those skills
along to their patrons. The “Your Health Matters” program will extend to existing programs and
events as well. For instance, the obesity rate in the community is 34 percent, so current cooking
YOUR HEALTH MATTERS 7
workshops will begin incorporating more nutritional options and education about hypertension,
diabetes, and heart disease. Training and partnerships are key components to this program.
Volunteers from the local medical community will be presented with health statistics,
demographics, and identified informational needs of the library’s service population so they may
determine what topics and activities are best suited for each class. Other services offered through
the program will include nursing assessments, mental health screenings, referrals, and education
about a variety of diseases, like kidney and heart disease, breast and prostate cancer, sexually
transmitted diseases, and so on. Both medical professionals and accredited consumer health
librarians will not only be able to provide vital assistance, but by partnering with the surrounding
medical community they will be able to guide uninsured patrons to offices and clinics who can
the PLA and NNML Health Initiative guide and attend their free webinar for advice moving
forward. NNML’s stated mission is “to improve the public’s access to information to enable them
to make informed decisions about their health” (Fargo, 2018), as well as “equip library staff with
effective skills and high-quality resources.” By joining the NNML at no cost, the Orlando Public
Library will have access to resources, educational materials, training, and funding opportunities.
Another essential resource is the Reference and User Services Association (RUSA), who can be
a valuable contact as they guide “libraries of all sizes serving communities in answering health
and medical reference questions” (Fargo, 2018). Additional resources identified for this program
include WebJunction and Zero Divide’s “Health Happens in Libraries” initiative, the National
Center for Complimentary and Integrative Health (NCCIH), the National Institute on Aging
(NIA), the National Institute of Mental Health (NIMH), the National Library of Medicine
(NLM), and the American Heart Association (AHA). On the local level, it is essential that the
YOUR HEALTH MATTERS 8
Orlando Public Library forge lasting relationships and valuable partnerships with the surrounding
medical community. Since healthcare is the leading sector of employment within the service
population, this endeavor should be fairly easy. Other partnerships to consider include parks and
recreation groups, senior centers, homeless shelters, and churches. In fact, many homeless
members sleep on the stoops of local churches, so many of those considered for outreach
opportunities will likely be open to assisting with or contributing to this program. The public
library is a critical source for the homeless to seek shelter during operating hours and pass the
time, but the availability of computers and reference materials offers the most important need for
information about health and other necessities. In lieu of employment or health insurance, online
health resources are fundamental to their well-being and the overall health literacy of the
community. The goal of this program is to “help community members gain the skills they need to
the Library support, the Orlando Public Library will partner with the Southeastern/Atlantic
Region of the National Network of Libraries of Medicine (NN/LM SEA) for funding and grant
opportunities. Following the example set by the New England Region (NN/LM NER) and the
Middle Atlantic Region (NN/LM MAR), many public libraries have received the necessary
“funding to train staff on how to reach out to patrons who have health care information needs”
(Radick, 2015) and monetary awards that further support the library’s efforts. For instance, the
NN/LM MAR funded a mental health workshop called “Out of the Shadows” in Pennsylvania.
And the East Brunswick (N.J.) Public Library (EBPL) runs a successful “Just for the Health of
It” initiative with support and awarded funding from NN/LM MAR to maintain their proprietary
health portal. EBPL’s manager “credits NN/LM MAR, of which her library has been a member
since 2010, with offering her staff health literacy training opportunities” (Radick, 2015) and
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funding support. In fact, “Five of the professional librarians at EBPL have become certified
consumer health librarians through training provided by the Medical Library Association’s
Consumer Health Information Specialization Program.” On a national scale, the NLM “offers up
to $100,000 for Information Resources Grants to Reduce Health-Disparities – projects that bring
‘useful health information to health disparity populations and the health care providers who care
program is estimated at $57,000. The line items for this budget primarily include salary
compensation, marketing time and supplies, and legal fees. In regard to salary compensation,
three librarians will be afforded the necessary training hours on the clock for their CHIS
accreditation ($5,000), and marketing efforts will reallocate staff hours to community outreach at
their regular hourly rate ($2,000), which accounts for two staff members spending no more than
five hours in the community per week. Marketing supplies considered in the budget include
posters, brochures, tents, tables and rental fees for the setup locations ($20,000). Legal
correspondence and associated fees are a mandatory precaution to insure the protection of the
library from any potential lawsuits stemming from medical advice ($30,000). Many resources for
the program are free or voluntary and do not figure into the budget. For instance, NNLM
membership is free, library operating hours remain constant, and volunteers from the local
medical community will lend their time and expertise for classes. Furthermore, medical
equipment, such as blood pressure cuffs, flu shots, stethoscopes, and CPR dummies, are not
itemized in the budget for the program at this time, as these supplies should be provided by the
medical professional volunteers during class hours. Finally, as much of the education will
involve online resources, the computer labs are covered elsewhere in the annual capital budget
While the most obvious determinant of success for any library program is the number of
attendees, the Orlando Public Library’s reference and consumer health librarians will also
maintain a log of medical reference inquiries to keep track of how effective their expertise and
services are for community members. As attendance is the easiest method by which to determine
success, word of mouth is essential. In order to spread the word about the program, library staff
will be designated community outreach responsibilities, which includes setting up booths and
passing out brochures at various community events and centers, like Farmer’s Markets, Lake
Eola events, senior centers, and homeless shelters. Literature will also be posted on community
boards throughout the metro area. At the close of the three-month trial run, the library will
administer survey questionnaires to patrons and class attendees on-site and online in order to
properly gauge satisfaction, user experience, and perceived improvement in health literacy. Upon
review of attendance, health reference services log, and patron feedback, decisions will be made
as to future direction and any alterations deemed necessary may be incorporated to ensure long-
term success. That said, if the New Hampshire State Library in Concord is any indication, by
empowering Orlando Public Library’s librarians “with reliable, up-to-date health information for
reference interviews and for their library websites,” it is inevitable to see an increase in “access
to health information” for Orlando residents. As a result of their efforts, New Hampshire State
Library revealed post-project evaluations indicating “that 98% of attendees thought the training
improved their ability to find information that they could trust on the internet, up from 75%
before training” (Radick, 2015). In terms of the impact such training has on the community
health and health literacy, the hope is to provide “people with knowing where to find good health
information that they can understand, acquiring skills to find good health information, being able
YOUR HEALTH MATTERS 11
to communicate with their health care providers, and being knowledgeable about medical words
and terminology and how the health care system works” (Radick, 2015).
Public libraries serve as their community’s main source for reliable information. While
librarians are not medical professionals and registered nurses aren’t stationed on site at most
libraries, it is imperative that librarians be able to answer health-related questions and assist
patrons navigating inquiries online. A close assessment of the Orlando Public Library’s
need for online and on-site health assistance. The “Your Health Matters” program is designed to
meet this demand by offering classes led by medical volunteers and providing librarians with the
essential training and accreditation necessary to improve health awareness and the health literacy
in this diverse community. “Libraries have come a long way since the days when their sole
function was to provide the public with books and research materials” (McClintock, 2017), and
increasing focus on “a health literacy initiative is part of this evolution.” By understanding the
unique challenges and health needs of its service population, Orlando Public Library’s goal is to
improve the health and well-being of all who reside in the City Beautiful.
References
Fargo, K. (2018, Apr 19). 13 Resources for Libraries That Are Serious About Promoting Health
Literacy. Demco Software. Retrieved from https://www.demcosoftware.com/articles/13-
resources-for-libraries-that-are-serious-about-promoting-health-literacy/
Institute of Museum and Library Services. (2013-2014) Digital Inclusion Survey Interactive
Map. Retrieved from http://digitalinclusion.umd.edu/content/interactive-map
McClintock, A. (2017, Jan 6). Beyond Books: How Libraries Can Help Meet Health Needs.
STAT. Retrieved from https://www.statnews.com/2017/01/06/libraries-health-resources/
National Network of Libraries of Medicine. (2019). Regional Medical Libraries. U.S.
Department of Health and Human Services. Retrieved from https://nnlm.gov/regions
Orange County Library System. (2019). About Orlando Public Library. Retrieved from
https://www.ocls.info/locations-hours/orlando-public-library/about-orlando-public-library
Public Library Association. (2017, Oct 6). Health Literacy, Programming, and Consumer Health
Information. American Library Association. Retrieved from
http://www.ala.org/pla/initiatives/healthliteracy
Radick, L. (2015, Oct 30). Improving Health Literacy, One Public Library at a Time. American
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health-literacy-public-library/