BOUNDARIES AND INFOMEDIARIES: A QUALITATIVE STUDY OF THE INFORMATION PRACTICES OF COMMUNITY HEALTH WORKERS

Despite successful efforts to treat and manage diseases, public health officials have recently begun a campaign to refocus efforts toward initiatives to alleviate the pressures that are often referred to as social determinants of health. In eastern Kentucky, and in other geographical regions labeled as health professional shortage areas or medically underserved areas, issues stemming from social determinants are compounded with health care systems that are often lacking the human resources to meet basic medical needs. One strategy has been to utilize volunteers and paraprofessionals such as community health workers to lessen the burden on the primary care and hospital systems. Community health workers are frontline public health workers who are trusted members of their communities and who serve to connect their clients to health and social services (American Public Health Association, 2009). Now more than ever, community health workers are seen as an integral piece to providing comprehensive and patient-centered care. The purpose of this study is to, ultimately, better understand the information practices of community health workers in Eastern Kentucky in order for the health science and public library communities to position themselves to better serve this population of health professionals. Two research questions will serve to inform this overall goal: (1) what are the information practices of the Kentucky Homeplace community health workers? And, (2) what is the role of information communication technologies - such as mobile phones, computers, and the internet - in the access and management of information by Kentucky Homeplace community health workers? This study is a qualitative investigation, utilizing multiple methods, seeking to understand the information practices of Kentucky Homeplace community health workers. Semi-structured, in-depth interviews and participant observation with community health workers have been conducted. Conceiving information needs, seeking, barriers, and uses as practices requires the recognition that social practices are located within microcosms which, in turn, situated within meso- and macrocosmic communities, and as such, practices are socio-cultural and political. To understand the socio-cultural context and political ecology in which community health workers operate, semi-structured, in-depth interviews have been conducted with community health worker administrators, state public health officials, and leaders from the statewide community health worker association. To further understand the socio-cultural and political context, this study has conducted thematic content analysis with documents critical to the construction of community health workers’ roles, responsibilities, and authority. Finally, to fully understand the information environment in which community health workers operate, semi-structured interviews have been conducted with directors of public libraries in the 30-county area Kentucky Homeplace covers as well as librarians from regional academic and health science libraries. In total, 6 interviews were conducted with community health workers, 3 interviews were conducted with library directors and/or librarians, and 4 interviews, combined, were conducted with community health worker administrators and individuals from the Kentucky Department for Public Health. A total of 8 hours, 39 minutes, and 47 seconds of interview time was recorded. 16 hours of participant observation was conducted with two community health workers, across two days. The community health workers in this study articulated information needs that related to client information, information about services and resources in their communities, information about services and resources available independent of location, and health information for themselves and for their clients or clients’ caregivers. While some of this information was sought after through information communication technologies, community health workers also indicated that they often seek information through interaction with other community health workers, and with representatives from community organizations. Community health workers function as interstitial agents, crossing boundaries between organizations, or between societal levels. The information that they create, seek, process, and disseminate functions as a boundary object. To do this, community health workers utilize a wide range of information communication technologies including modern modalities such as computers, the world wide web, email listservs, and shared servers, in addition to conventional modes of communication such as the phone, business cards, and printed pamphlets. Ultimately, the role of the community health worker is as an infomediary, positioned to facilitate the flow or exchange of information from one body to another

HEALTH LITERACY: A BIBLIOMETRIC AND CITATION ANALYSIS

The concept of health literacy finds its origins in the field of education. In its brief history the definition, structure, and direction of the field has changed dramatically and has emerged as a multidisciplinary endeavor full of discipline specific manifestations, most recently, public health literacy. Using bibliometric and citation analyses, this study investigated the field of health literacy from the first use of the term in 1974 to the present year, 2010. A range of databases from the various fields that have contributed to the field were searched using the keyword string, “health literacy.” Data was organized, cleaned and parsed using EndNote X3. A free, Java-based application, CiteSpace, was utilized for visualization of author co-citations, document co-citations, keyword co-occurrences, and document co-citation clusters. This research presents researchers, librarians and those interested in the field with information to efficiently conduct literature searches and understand the structure of the field. In addition, this research provides insight into how and where the field may be progressing in terms of multi- and interdisciplinary research

Reviewer Acknowledgments

We offer these reviewers our heartfelt thanks for a task that usually goes unrewarded in the academic environment. This year, we are especially grateful for those people listed below. They have assisted us in reaching the start of our 4th year, by guiding our decisions with your knowledge and capabilities

Search Results Outliers Among MEDLINE Platforms

Objective: Hypothetically, content in MEDLINE records is consistent across multiple platforms. Though platforms have different interfaces and requirements for query syntax, results should be similar when the syntax is controlled for across the platforms. The authors investigated how search result counts varied when searching records among five MEDLINE platforms. Methods: We created 29 sets of search queries targeting various metadata fields and operators. Within search sets, we adapted 5 distinct, compatible queries to search 5 MEDLINE platforms (PubMed, ProQuest, EBSCOhost, Web of Science, and Ovid), totaling 145 final queries. The 5 queries were designed to be logically and semantically equivalent and were modified only to match platform syntax requirements. We analyzed the result counts and compared PubMed’s MEDLINE result counts to result counts from the other platforms. We identified outliers by measuring the result count deviations using modified z-scores centered around PubMed’s MEDLINE results. Results: Web of Science and ProQuest searches were the most likely to deviate from the equivalent PubMed searches. EBSCOhost and Ovid were less likely to deviate from PubMed searches. Ovid’s results were the most consistent with PubMed’s but appeared to apply an indexing algorithm that resulted in lower retrieval sets among equivalent searches in PubMed. Web of Science exhibited problems with exploding or not exploding Medical Subject Headings (MeSH) terms. Conclusion: Platform enhancements among interfaces affect record retrieval and challenge the expectation that MEDLINE platforms should, by default, be treated as MEDLINE. Substantial inconsistencies in search result counts, as demonstrated here, should raise concerns about the impact of platform-specific influences on search results

Examining Care Navigation: Librarian Participation in a Teambased Approach?

Objective: This study investigated responsibilities, skill sets, degrees, and certifications required of health care navigators in order to identify areas of potential overlap with health sciences librarianship. Method: The authors conducted a content analysis of health care navigator position announcements and developed and assigned forty-eight category terms to represent the sample’s responsibilities and skill sets. Results: Coordination of patient care and a bachelor’s degree were the most common responsibility and degree requirements, respectively. Results also suggest that managing and providing health information resources is an area of overlap between health care navigators and health sciences librarians, and that librarians are well suited to serve on navigation teams. Conclusion: Such overlap may provide an avenue for collaboration between navigators and health sciences librarians

Examining MEDLINE Search Query Reproducibility and Resulting Variation in Search Results

The MEDLINE database is publicly available through the National Library of Medicine’s PubMed but the data file itself is also licensed to a number of vendors, who may offer their versions to institutional and other parties as part of a database platform. These vendors provide their own interface to the MEDLINE file and offer other technologies that attempt to make their version useful to subscribers. However, little is known about how vendor platforms ingest and interact with MEDLINE data files, nor how these changes influence the construction of search queries and the results they produce. This poster presents a longitudinal study of five MEDLINE databases involving 29 sets of logically and semantically consistent search queries (five search queries for each set). The goal is to understand whether it is possible to reproduce search queries by: a) analyzing search query syntax per database, and b) controlling for total search results. We also highlight the barriers to creating reproducible queries across MEDLINE databases

MEDLINE Search Retrieval Issues: A Longitudinal Query Analysis of Five Vendor Platforms

This study compared the results of data collected from a longitudinal query analysis of the MEDLINE database hosted on multiple platforms that include PubMed, EBSCOHost, Ovid, ProQuest, and Web of Science. The goal was to identify variations among the search results on the platforms after controlling for search query syntax. We devised twenty-nine cases of search queries comprised of five semantically equivalent queries per case to search against the five MEDLINE database platforms. We ran our queries monthly for a year and collected search result count data to observe changes. We found that search results varied considerably depending on MEDLINE platform. Reasons for variations were due to trends in scholarly publication such as publishing individual papers online first versus complete issues. Some other reasons were metadata differences in bibliographic records; differences in the levels of specificity of search fields provided by the platforms and large fluctuations in monthly search results based on the same query. Database integrity and currency issues were observed as each platform updated its MEDLINE data throughout the year. Specific biomedical bibliographic databases are used to inform clinical decision-making, create systematic reviews, and construct knowledge bases for clinical decision support systems. They serve as essential information retrieval and discovery tools to help identify and collect research data and are used in a broad range of fields and as the basis of multiple research designs. This study should help clinicians, researchers, librarians, informationists, and others understand how these platforms differ and inform future work in their standardization

Enhancing the Care Navigation Model: Potential Roles for Health Sciences Librarians

This study analyzed the overlap between roles and activities that health care navigators perform and competencies identified by the Medical Library Association\u27s (MLA\u27s) educational policy statement. Roles and activities that health care navigators perform were gleaned from published literature. Once common roles and activities that health care navigators perform were identified, MLA competencies were mapped against those roles and activities to identify areas of overlap. The greatest extent of correspondence occurred in patient empowerment and support. Further research is warranted to determine the extent to which health sciences librarians might assume responsibility for roles and activities that health care navigators perform

Delivering health knowledge and wisdom from the hills and hollows of Appalachia

There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health

Reviewer Acknowledgments for 2019

The Editorial Team extends a heart-felt “thank you” to those who have given their time and expertise in the past year to participate in this process with the Journal of Appalachian Health. We know that you have many competing pressures on your time, and that you are not financially compensated for the time you spend reviewing manuscripts. We hope that there are other forms of compensation that make the sacrifice worth the effort