H1N1 Information Needs


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Presentation of original research given at the Disaster Information Symposium held at the National Institutes of Health, Bethesda MD on March 29-30th, 2011

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H1N1 Information Needs

  1. 1. H1N1 Information Needs: Serving Health Care Organizations During a Pandemic Robin Featherstone, MLIS McGill University Health Centre Gabriel Boldt, MLIS London Health Sciences Centre Nazi Torabi, MLIS University of Western Ontario Shauna-Lee Konrad, MLIS London Health Sciences Centre
  2. 4. April 29, 2009 <ul><li>0 emails on H1N1 </li></ul>April 30 – March 4, 2009 <ul><li>12 “swine flu” emails on April 30 th alone </li></ul><ul><li>Information received from Gale, Ovid, Thomson Reuters, Ebsco, CABI, PNAS, NAHRS (MLA), university administration, library administration, department of health sciences… </li></ul>Snapshot from a Canadian University
  3. 5. March 5, 2009 <ul><li>Distributed survey to members of: </li></ul><ul><ul><ul><li>SOHLIN: Southwestern Ontario Health Libraries Information Network </li></ul></ul></ul><ul><ul><ul><li>WOHKN: Western Ontario Health Knowledge Network </li></ul></ul></ul><ul><li>Collected details of H1N1 questions: </li></ul><ul><ul><ul><li>When were they received? When was information needed? </li></ul></ul></ul><ul><ul><ul><li>Who was asking? </li></ul></ul></ul><ul><ul><ul><li>What type of information was required? What sources were used to answer the request? </li></ul></ul></ul>
  4. 6. Pilot Survey Findings <ul><li>Senior Administrators as audience </li></ul><ul><li>News media, organizational and governmental websites as information sources </li></ul><ul><li>Pandemic information needs are different! </li></ul>
  5. 7. Agenda/Outline <ul><li>Introduction – Case series research project </li></ul><ul><li>Methodology </li></ul><ul><li>Findings </li></ul><ul><li>Discussion </li></ul><ul><li>Conclusions & Recommendations </li></ul><ul><li>Future directions </li></ul>
  6. 8. Provision of Pandemic Information by Health Sciences Librarians: A Multi-Site Comparative Case Study <ul><li>Objectives: </li></ul><ul><ul><li>Identify information needs of health professionals during a pandemic </li></ul></ul><ul><ul><li>Examine technology’s role in pandemic information provision </li></ul></ul><ul><ul><li>Define health librarians’ roles during a pandemic </li></ul></ul><ul><li>Goals: </li></ul><ul><ul><li>Anticipate pandemic information needs </li></ul></ul><ul><ul><li>Educate and support librarians </li></ul></ul>
  7. 9. Methodology <ul><li>Conducted a literature review </li></ul><ul><li>Received Ethics Approval from the University of Western Ontario </li></ul><ul><li>Recruited & screened cases </li></ul><ul><li>Conducted semi-structured interviews </li></ul><ul><li>Collected supporting evidence (emails, web stats, etc.) </li></ul><ul><li>Coded transcripts using NVivo </li></ul><ul><li>Compared coded sections within 8 themes </li></ul><ul><li>Analyzed content to compare cases </li></ul><ul><li>Summarized findings </li></ul>
  8. 10. Cases Case Subject(s) Requestor/Audience Project 23 Academic health sciences librarian <ul><li>Self-initiated </li></ul><ul><li>For audience of clinicians and nurses </li></ul>Monitored, selected and shared H1N1 information sources via social software 36 Team of hospital librarians -Client-initiated (incident management team for an urban hospital system) Supported administrative decision-making by providing H1N1 statistics and relevant news items via daily email updates 56 Medical librarian -Self-initiated -For audience of health sciences librarians Monitored, selected and shared H1N1 information sources via social software 92 Outreach librarian at an academic center - Client-initiated (government public health department) Supported clinical and administrative decision-making by providing high-quality evidence from the literature
  9. 11. Analysis/Coding Themes <ul><li>Time </li></ul><ul><li>Communication </li></ul><ul><li>Technology </li></ul><ul><li>Evaluation </li></ul><ul><li>Personnel </li></ul><ul><li>Organizational Structure </li></ul><ul><li>Information Request </li></ul><ul><li>Information Gathering </li></ul>
  10. 12. Findings - Time <ul><li>Intense demand for information between late April and June, 2009 </li></ul><ul><li>Declining information need between June and November, 2009 </li></ul><ul><li>Self-initiated project work (cases 23 & 56) took place during “off hours” </li></ul><ul><li>More work hours allocated for client-initiated project work (cases 36 & 92) </li></ul>
  11. 13. Findings – Time (continued) <ul><li>In all cases demand for information was immediate/ high </li></ul><ul><li>Client-initiated projects required additional support from colleagues </li></ul>
  12. 14. Findings – Communication <ul><li>Self-initiated projects “Pushed” information using social software </li></ul><ul><li>Clients defined communication methods: </li></ul><ul><ul><li>Case 36: Emails formatted for Blackberries (plain text with html links) </li></ul></ul><ul><ul><li>Case 92: Emails and face-to-face interviews </li></ul></ul>
  13. 15. Findings - Technology <ul><li>Self-initiated projects used Wikis, blogs, Twitter, RSS, Facebook, etc. </li></ul><ul><li>All projects utilized alerting services (Google Alerts, PubMed email alerts, RSS) to monitor information </li></ul><ul><li>All projects lacked time to adequately test and implement technology solutions </li></ul>
  14. 16. Findings – Evaluating the Service <ul><li>Self-initiated projects collected feedback through informal methods </li></ul><ul><li>Librarians tracked webpage metrics </li></ul><ul><li>One client-initiated project utilized a formal evaluation </li></ul><ul><li>All participants evaluated their services to be “useful,” if not “essential.” </li></ul>
  15. 17. Findings – Evaluating the Evidence Challenges <ul><li>Locating high quality evidence during the initial stages of a pandemic </li></ul><ul><li>Preventing information overload </li></ul>Opportunities <ul><li>Identifying the highest quality information quickly from available sources </li></ul><ul><li>Evaluating information to meet the needs of particular audiences </li></ul>
  16. 18. Findings – Information Request <ul><li>Health administrators sought librarian assistance </li></ul><ul><li>Audience included health providers “in the field” </li></ul><ul><li>One library’s involvement had been formalized in their institution’s pandemic plan </li></ul>
  17. 19. Findings – Information Requested <ul><li>Clinical questions during the peak period </li></ul><ul><li>Critical news alerts during the peak period </li></ul><ul><li>Canadian, American and international mortality and morbidity statistics during the peak and decline </li></ul><ul><li>Research questions during the decline and after the pandemic </li></ul>
  18. 20. Clinical H1N1 Questions <ul><li>Effectiveness of antiviral agents? Protective agents (masks, gloves)? H1N1 vaccine? </li></ul><ul><li>Effects of H1N1 on immunosuppressed or immunocompromised patients? Pregnancy? </li></ul><ul><li>Are there adverse reactions to taking the H1N1 vaccine? Under which conditions? </li></ul><ul><li>Relapse possible after taking antivirals? Other medications? </li></ul>
  19. 21. Research H1N1 Questions <ul><li>H1N1 in Aboriginal populations? </li></ul><ul><li>Socioeconomic factors related to H1N1? </li></ul><ul><li>Epidemiological reviews of H1N1 and influenza? </li></ul><ul><li>Reviews on Tamiflu and H1N1? </li></ul><ul><li>Usefulness or effectiveness of H1N1 public health surveillance? </li></ul><ul><li>Household transmission of H1N1? </li></ul><ul><li>Pandemic modelling studies? </li></ul>
  20. 22. H1N1 Information Sources Gov’t or NGO Websites News Sites Canada <ul><li>-Public Health Agency of Canada </li></ul><ul><li>-Health Canada </li></ul><ul><li>-Regional Centers for Disease Control </li></ul><ul><li>-Ministry of Health and Long Term Care </li></ul><ul><li>Provincial health agencies </li></ul><ul><li>CBC </li></ul><ul><li>CTV </li></ul><ul><li>The Globe and Mail </li></ul><ul><li>Calgary Herald </li></ul><ul><li>Vancouver Sun </li></ul>North America <ul><li>US Centers for Disease Control (Morbidity and Mortality Weekly Report) </li></ul><ul><li>CNN </li></ul>International <ul><li>World Health Organization </li></ul><ul><li>Pan American Health Organization </li></ul><ul><li>European Centers for Disease Control </li></ul><ul><li>BBC </li></ul><ul><li>The Guardian </li></ul>
  21. 23. H1N1 Information Sources Databases -PubMed -Scopus Clinical tools -BMJ Clinical Evidence -UpToDate (Epidemiology, clinical manifestations, and diagnosis of swine H1N1 Influenza A; Treatment and prevention of swine H1N1 influenza) Journals -American Journal of Public Health -Annals of Internal Medicine -BMJ -CMAJ (Canadian Medical Association Journal) -JAMA -NEJM (H1N1 Influenza Center) -Nature Search Engines -GoogleScholar
  22. 24. Discussion – Study Limitations <ul><li>Lack of generalizability – small number of cases </li></ul><ul><li>Bias of self-reporting </li></ul><ul><li>Recall error </li></ul><ul><li>Reduced researcher bias through triangulation </li></ul>
  23. 25. Conclusions & Recommendations <ul><li>Strategic communication methods consider audience capacity and use appropriate technologies </li></ul><ul><li>Alerting services are essential for information providers during a pandemic </li></ul><ul><li>Projects that use social software to “push” pandemic information are difficult to evaluate </li></ul>
  24. 26. Conclusions & Recommendations (continued) <ul><li>Pandemic information projects benefit from prior planning </li></ul><ul><li>Proactive librarians offer services and are integrated into organizational planning teams </li></ul><ul><li>Librarians’ skills to evaluate and disseminate information prove essential during the early stages of a pandemic </li></ul>
  25. 27. Future Directions <ul><li>Recognize uniqueness of pandemic information needs </li></ul><ul><li>Develop best practices for information services based on case evidence </li></ul><ul><li>Formally evaluate future pandemic information provision </li></ul>
  26. 28. Questions <ul><li>Robin Featherstone, MLIS </li></ul><ul><li>McGill University Health Centre </li></ul><ul><li>[email_address] </li></ul><ul><li>Gabriel Boldt, MLIS </li></ul><ul><li>London Health Sciences Centre </li></ul><ul><li>Nazi Torabi, MLIS </li></ul><ul><li>University of Western Ontario </li></ul><ul><li>Shauna-Lee Konrad, MLIS </li></ul><ul><li>London Health Sciences Centre </li></ul><ul><li>[email_address] </li></ul>
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