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Running head: YOUR HEALTH MATTERS 1

Orlando Public Library:


“Your Health Matters”
Crystal S. Stephenson
University of South Florida
YOUR HEALTH MATTERS 2

Orlando Public Library: “Your Health Matters”


The Orlando Public Library serves as the main branch, headquarters, and resource center

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

fruition and the determinants of success following evaluation.


The Orlando Public Library is located at 101 East Central Boulevard in Orlando, Florida,

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

those reportedly making $20-35,000 and $50-75,000 respectively. Surrounded by an expansive


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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

at 23 percent, while 18 percent of employment is in educational services, and 11 percent in

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

demographics of poverty and prevalence of homelessness in the community is concerning. One

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

government forms, but 0 percent assistance with online health resources.


Kayla Fargo of Demco Software cites a Pew Research report that identifies “80% of

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

information and services, and how well he or she understands them.”


Like most public libraries, the Free Library of Philadelphia “had traditionally offered

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

their adult programming and services.


The Orlando Public Library employs a floating social worker who travels amongst the

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

Library Association’s Consumer Health Information Specialization Program, “a yearly

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

population reach and untapped potential to improve population health.”


Recognizing how instrumental health literacy is to a library’s community, the Public

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
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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

further assist them with medical attention and health concerns.


The first step to developing the “Your Health Matters” program is to thoroughly review

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
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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

find, evaluate and use health-related information” (Fargo, 2018).


Partnerships are integral to funding efforts, so in addition to local outreach and Friends of

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

for those populations’” (Radick, 2015).


The budget determined for the inaugural three months of the “Your Health Matters”

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

and do not affect the funding allocated for this program.


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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
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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

demographics, including high unemployment and percentage of uninsured, reveals a growing

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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Libraries. Retrieved from https://americanlibrariesmagazine.org/2015/10/30/improving-

health-literacy-public-library/

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