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Letters from the big house providing consumer health reference for texas prisons final


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Poster from 2016 annual meeting of the Medical Library Association

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Letters from the big house providing consumer health reference for texas prisons final

  1. 1. Letters from the Big House: Providing Consumer Health Reference for Texas PrisonsEmily Couvillon, MSIS BACKGROUND Legal: case or docket info Disease: consumer level disease info Drug: medication or side effect info Literature search: research articles or reports on health topics Policy: info on prison standards for food, quality, or treatment Out of scope: requests for legal or medical advice Inappropriate: request for sexual or pornographic material Referral: contact info of other agencies Multi­disciplinary nature of OOS questions suggest prison reference service could be improved by working more closely with legal and governmental organizations OBJECTIVE METHODS Identify top health information needs of inmates using mail health reference service. Develop initial coding scheme of key concepts  Test codes on sample set of 10 letters Refine codes based on input from two coders Apply codes to entire set of 212 letters received between 2010­2016 Identify key themes Codes RESULTS CONCLUSIONS “I have little hope of justice and even less money… you [are] my only hope.” EXCERPTS "I think they are trying to post­pone the treatments because of $; or they are trying to prolong the window closure criteria until I exceed the limit on treatment. In other words, they are intentionally stalling until my Hep C is beyond treatment.” "T.D.C. medical has refused to treat [my Hepatitis C] for 13 years.” “It is necessary to do our own research without access to a computer.” "You have been very helpful. In here it is very hard to receive an honest answer from our medical staff." Consumer Health Information Majority of letters requested basic drug or disease info and fell within scope of service Prisoner consumer­level health info needs are being adequately covered with resources like MedlinePlus Distrust of Prison Health System Advanced and Legal Health Information Out of scope (OOS) requests for test result interpretation, diagnosis, or drug recommendations suggest some advanced info needs are unmet within health system OOS requests for interpretation of sexual assault examination reports imply efforts to use health info as legal defense Some info needs require more legal and medical expertise than librarians can provide Requests for prison environmental health regulations highlight suspicions regarding sanitation and food safety Direct statements of distrust suggest that info sources within prison are considered unreliable Room for Improvement Adela Justice, MSLS, AHIP Inmates in 45 prisons across Texas request consumer health information via the TMC Library U.S. mail program.