I'm going to go ahead and get us started here with our introductions. We're thrilled to have today for our webinar Megan Weis, the director of community engagement at the South Carolina Center for Rural and Primary Healthcare, also serves as a professor at the University of South Carolina School of Medicine. She'll give a little bit more of onintroduction to her great work shortly. QuinTasha Knox also goes by Quin is theee for the foundation for community impact and health equity and also manages the Lee County Library Community Health Hub. We're very excited to have you here, too, Quin. Dianne Connery is the director of the Pottsboro Library in Texas and will tell us about the new Telehealth Community of Practice for libraries. And Carol Perryman is the associate professor at the School of Library and Information Studies at the Texas Woman's University. We're thrilled to have Carol here as well. I'm going to go ahead and get us started. And have Megan kick us off. Welcome, Megan. >> MEGAN WEIS: Hello. Thank you. I'm so excited to be here with all of you and this webinar. I realize my background is public health. I am not a librarian so I just wanted to take a moment to -- before I jump in, to start with just a little bit about who I am and why I am so passionate about public health and libraries and the potential partnerships. So just a little bit of my origin story if you will. I was involved in a project back in 2013-2014 with my home library in Columbia, South Carolina. I was the health policy person as a part of a project that was working to share accurate information about the Affordable Care Act with members of our community. So that photo on the left that you see is actually a photo that was taken by Lee Patterson, social worker who was hired by the library as part of this project, is still there, of the crowds for the last day of the enrollment deadline. She had the today show on in the morning, she tweeted it out, power of social media, and she saw the photo she took of our library opening up the today show. That experience opened my eyes to how critical and important libraries are as community hubs. Y'all knew this, it brought it home to me. And I wanted to share a more candid photo with my colleagues, Alanti McGill who works with the center for primary healthcare and our graduate assistant, Leah. So our goals for today, we're going to talk about public health and how you may already be supporting it at your library. Sometimes you're doing public health work and don't realize it. Also about how you are able to strategically work with partners about public health. This isn't the end all be all, let's use this to get it going, talking amongst ourselves, with librarians and public health. So start off why public health? This is nothing new for public libraries. This is a reference on the slide for Rubenstein in 2012 talking about how libraries and health information, public health, there's history written about this. There's a hidden history, many of us having been aware of it, I wasn't aware of this. Also this great article published in 1947 for Appalachian Georgia, the nurses went with the book mobile to help someone connect people to information and healthcare. So I would also like to get your ideas if we could go to the poll. Let's see. Yes. Of what do you think of -- here it comes. If you could go to the link for the poll in the chat for what do you think of when you hear the term "public health." We'll take just a moment. So follow the link, please respond to the poll, and we can chat. Then we also will come back to Webex. It takes you to a link outside of the immediate environment to answer. Oh, awesome, everything is coming in. Thank you so much. So we can see your responses when you come back. Really coming in, you guys are participating to much. Thank you. See, of course health in public health, community, prevention, yes, vaccination, of course. Community based, I love seeing that. Information, disease, yes. Accessible, people. I'm trying to read this as it all comes together, I see all the information you guys are putting in, fantastic. Nurses, well-being, education, healthy communities, transit, very excited to see that. Family, safe ways. I see clean, I'm sure that's part of clean air, clean water. The pandemic, yes. The public in public health, I see that, too. Honor. Everyone. I see some responses in the chat as well, safety. Insurance, yes. Moding, assessments, yes. We have so many fantastic things coming in, thank you. So professionals, I see meeting. Support. Providing support. Working. The health departments. I see caring coming into the chat as well. Thank you all so much for sharing everything. I think you see a lot of what you guys already know and see is true. I'd like to talk a little bit specifically about public health first from, you know, the technical aspects. We get all professional and academic. You know, the definition from the CDC, the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities and individuals. So that's a great definition. I really like the American Public Health Association, how they talk about it when we talk about how public health promotes and protects the health of people and the communities where they live, learn, work and play. Also, many communities will also be where we pray together as well. I think there's this image from the Oregon -- from Oregon from the Coos County public health. It touches every day and everything that we do. You wake up, have clean water, kids, tobacco prevention, safe food. You're really ready to do anything. Thank you to Coos County public health, hello to Oregon. Then it gets into the details of what's going on, alarm clock buzzes, you had a safe place to sleep, clean water, kids are vaccinated, they have food, maybe receive food in the school, breakfast for -- breakfast and lunch, tobacco prevention, tobacco-free schools, ready for anything, preparedness, radio is maybe letting you know about a heat advise I. Those of us over here on the Atlantic side talking about hurricanes, we get those warnings, other emergency preparedness, of course the pandemic, healthy moms and babies, exercise, nutrition, how you spend your life. So really every part of the day there's a piece of public health that is connecting with you. So public health really is you. It's your family. It's your community. Pretty much everything we do, it's that we have communities where we live, work, pray and play where we can be safe, have strong qualities of life, healthy outcomes. There was the healthiest nation in one generation we will be sharing the link to, and there's an article I think you were going to speak about. >> Jennifer: Noah was eager to share this idea that we in a recent article take about care of self. We hear a lot of talk about self-care. This also talks about how that should also include care of staff. And then how does that continuum move into community care. Again as Megan is saying here, public health is really health for all of those different combinations and all along that continuum. So just, again, a reminder that public health is really your health, your family's health and your community's health, library staff health as well. >> MEGAN WEIS: Absolutely. It's both the hospitals, our behaviors, our physical environment. I'd like to share this image. Earlier in my career, I won't say how far along I am, this was around a lot, it's a famous image of the public health network, referred to as the egg map, and it's who is a part of public health. Education, philanthropy, behavioral health, advocacy, the media with communication, economic development. Because you have employment opportunities, education that's connected to better quality of life, longer life, and I'm ashamed to say, about 20 years in public health it's only been in the last few, with the experience of Richland Library, this map I've been looking at didn't have public libraries included. That is a glaring omission, and I think one that we're beginning to have more conversations to be able to correct like this one today. And Noah Lenstra shared with me in emails about this graphic with what public librarians have been trying to do. This is another map from the library side of I guess the two silos coming together, everyone working with the library and public health was included. So you guys were ahead of us on the curve. >> Jennifer: No, this was added for this presentation. >> MEGAN WEIS: I'm sorry. I misunderstand that. Thank you for the correction, Jennifer. Seeing how public health comes together. I should have made the edit to the egg map as well. When I talk about why libraries with my public health collaborators and hopefully connecting with you guys, some of this is information you already know. The reach of libraries, you're an integral community resource, and already there's that documented relationship with being able to include population health through social policy. And you have those connections. There are 17,000 public libraries nationwide with an estimated 4 million visits every day. You know, there are counties with no hospitals. No healthcare providers. But there are libraries or some part of library connection. Over 95% of Americans do live in that public library service area. Disparities when we talk about health equity, everyone having a fair and just opportunity to have access to everything you need to live a healthy life, United States we have one of the largest health disparities in the world with our life expectancy varies 20 years within zip codes of the same state. People experiencing homelessness or other life crises tend to seek respite information in libraries. It's incredibly important. We'll talk more about this as well. Then access. The map that was coming up with the word cloud, "insurance" was coming up. Sometimes there are barriers, real or perceived with accessing healthcare but libraries and staff, you guys are free to the public, located in local neighborhoods, deeply, deeply trusted. I know we talk about that a little more too. Frankly users are already coming to the libraries to look for health information. I want to share about what we're doing in South Carolina through the center for world and primary healthcare and rural libraries and health program. We're currently funding five systems across the state in rural areas. That is the focus of this program. In union county, Lee County, Kershaw, Orangeburg and Charleston. Charleston is a fabulous city, wonderful and more urban but it's a large county. When you look at the beaches and the marshes you get away from the resources relatively quickly so we do have rural areas. The program, there is a health liaison with the library or social worker or community health worker connecting people to care. Each community focuses on different areas. I can share later a link in the chat to share about specific examples. But there are a range in models and partners that we're working with, love to talk with any of you, I'll share my contact information later for more, but again, social worker embedded in the library, a community health worker, accessing telehealth, Charleston is working with a local university to provide telehealth, union county as well and Kershaw a focus on women's health meeting the needs of the community, also exploring different models, health liaison embedded in the library, not just once in a while for a health fair but more, Quin will speak to this. Three clinics, federally qualified healthcare centers, FQHC, access health networks in South Carolina, healthcare providers working to reach those under or uninsured, transit authority is a partner in this and academic medical centers so there's a range of partners you can work with, in our examples and others we'll share. These are the references if you download the slides to have them, I wanted those to be available to you. I'd like to transition over to Dianne, please. >> DIANNE CONNERY: I'm Dianne coming to you from Pottsboro Texas, a small rural library. So I hope you're getting the picture that public health programming is scalable to any library. And I want you to think of your community's needs and interest. It covers such a gamut. Digital and health literacy training can be anything from promoting online tutorials like the digitallearn.org, to many patrons don't have email. How do they access their health portals to see lab results or schedule a appointment or check on payments? Digital navigator programs are popping up in libraries all over the U.S. In rural areas the library often has the fastest Internet connection in town, and we have the staff with the digital literacy skills to assist patrons. So some other examples of work libraries are doing around public health, community gardens, graphic medicine discussion groups, sort of a book club around graphic medicine. Storywalks, libraries connecting you to coverage of the Affordable Care Act Megan mentioned, PLA has, you know, the insurance education and outreach initiatives. So there are a lot of possibilities, and I am sure many that we have not even thought of yet. So I hope you will put into the chat some of the things that you're working on. You'll see by this recent article in America public health association's publication that there is a lot of interest in partnering with libraries. And I'm excited about that. Because that was not always the case, that people were anxious to partner with us. This was the fourth-most read public health news story of 2018. And then on the right I just wanted to point out that there are turn key resources that are ready for you to use. The National Network of Libraries and Medicine, NNLM, and the American library association have partnered through the library transform public awareness campaign to create a free health literacy toolkit helping library staff to raise awareness of how they provide trusted health information to their communities. Lots of times we don't have dedicated marketing teams so it's so nice to have these professional graphics available to us. The toolkit provides key messages, program ideas, downloadable marketing materials with things like bookmarks and social media graphics. And libraries can use those to promote health literacy during health literacy month, which is October. And throughout the year. So the resources that are available there cover a variety of health literacy topics, things like genetics and family history and citizen science projects, customizing care and student well-being. So there is a -- I guess a bottomless well of opportunities for libraries in the public health arena. >> Jennifer: Fantastic. Thank you so much, Dianne and Megan as well. As Dianne is explaining, both within the health -- public health sector and in the library world there is many more conversation around health coming up, and I just wanted to quickly highlight those WebJunction projects and resources that illustrate this intersection with health-related needs in our communities. I've been links in here into chat to all three of these different projects that we have been working on over the years, the libraries and the opioid crisis, how libraries are responding to the opioid crisis. Initially began as research supported by IMLS and in collaboration with ALA and PLA, looked at the ways in which libraries are responding and came up with a recommended set of -- a set of recommendations to pursue further. And we actually just received an additional grant to focus on building those resources that will include pragmatic strategies, tools and other help to guide libraries particularly in rural libraries as they determine responses and support for their communities in relation to the opioid crisis. Health happens in libraries as Megan alluded to, the ACA was the launch for a lot of work in libraries related to ACA. As you know, your communities were coming to the libraries for assistance in applying for coverage. Out of that project, a number of key resources were developed that expand beyond ACA needs focused on health literacy, being critical for your patron engagement and how partnerships can help in these changing community needs. There are a wealth of resources to health happens in libraries. There's a guide around communication to think about how do you communicate this need both internally to your stakeholders in the library, externally to your community members as well as those stakeholders in other sectors, intersecting with their health needs. So be sure and explore those resources. There's also a number of library profiles with multiple examples of health-related work undertaken by both state and public libraries nationwide. And then more recently you may have been hearing with the REALM Project, this project reopening archives, libraries and museums has been bringing about research and resources, things like decision making checklists, visual aids of lab results, literature review synthesis looking at how libraries reopened, reclosed, reopened again. Again, this definitely touches on the health-related aspects of our communities. And I just want to give a quick plug, I know that if Noah was here he would love to highlight the library heroes make health happen infographic. This is a resource that is available, folks can download parts of this infographic. It's a wonderful tool for you with stakeholders, perhaps funders. Being able to increase your capacity to respond to these needs is important. This is an excellent resource for you to use. So one more reminder. Recap, again of why libraries, this is a set of points, again, that are great talking points that is in the communications guide from the health happens in libraries project, and I just wanted to put that link specifically in there as well. All right. I think Megan's going to shift us back, and we want to give a little shout-out to Noah for all of his great work. >> MEGAN WEIS: Absolutely. Definitely a shout-out to Dr. Noah Lenstra at the UNC Greensboro who had planned to join us today. I am the substitute Noah, I will do my best to channel him. A lot of what he shares in the conversations I've had with him, just as public health leaders are challenged to become strategists, they are being community access and equity strategists. Public health, talking about the access in the chat, you know, it was shared about a program, and library didn't start it but the health program, no one was showing up until it came to the library. So much of what we do in public health is ensuring equal -- equitable access and coming together. So I do want to say that a lot of the resources and content today have come from Noah as well. Also want to share this quote from a nutrition educator for SNAP-Ed, the class at the library was the most diverse class ever taught, being able to show that equity and work with everybody is important, and the libraries provide that. Another way we can promote diversity equity and inclusion while promoting healthy living is embracing the shared use of the library. This is from the Robert Wood Johnson foundation website, I think we're sharing that link as well, and you have it up there. Just a way that the shared space can be used. Again already seeing that reflected in the chat. So thank you. Also want to be sure to recognize Noah's work in his book healthy living at the library. I have my own personal copy. I do highlight recommend it. Also his website LetsMoveInLibraries.org with information on what's possible, how to get started and move forward with that. So thank you, Noah. I also want to mention that public health is a good partner for assessing community health needs and resources, it's something that public health and libraries do as well. The county health rankings and road maps tool is helpful, it's a WebJunction webinar for launching community conversations with local health data. Your local hospital and health centers have to do community health needs assessment. They are legislated by law to do a community health needs assessment every three years to keep their tax exempt status. So look at where collaborations are already happening, schools, clinics at schools and preventive screenings that haven't happened in COVID. That's coming up too. Libraries being location potentially for mammograms, well visits and other areas as well, they're happening together. >> Jennifer: All right. Let's shift over and talk a little bit about how to start the conversation. Because we know that that's many times the case. And just a quick update that Quin unfortunately had to leave but luckily Dianne is well-prepared to speak to this content as well. Thank you so much, Dianne. >> DIANNE CONNERY: Certainly, yes. So starting the conversation. I -- there are different stakeholders we look at when we're considering this, and so one of them, the internal, our boards may be saying why is this the library's responsibility? And then other people in the community as well. And library staff. And we don't want to be in a position that libraries often get into of adding another responsibility, another service, without having the capacity to deal with it. But I will say I've been doing a lot of thinking about rural libraries and capacity. And I don't think that we are capable of presenting all the programs and offering all the services that we want to without partnerships. And so this comes at a great time when people want to partner with us. So to discuss this issue with stakeholders who might be unfamiliar with the concept of public libraries and public health, a lot of this information speaks to that. And I would like to say that I think a few persuasive points might be within the library. You've all heard it, there's a lot of discussion about a new normal or next normal or new agenda. And just what have we learned from COVID? In our community, what -- we learned how serious the digital divide is, the barriers to digital inclusion just locked many people out of what they needed to do in their everyday lives to operate in today's society. More of life has moved online. And even, after Internet access and device adoption is achieved libraries specialize in literacy skills, and the digital literacy skills required to use those is a massive undertaking. So I think libraries are perfectly positioned to address those issues. And so Charlie cart there, you see on the left, I think the health programming around nutrition is maybe an easy entry to get into gauging community interest in some of these programs. There is not likely to be the kind of funding available that's flowing right now in our lifetime. So I really want us to take advantage of what we learned from COVID and not just to go back to how things were. Someone likened it to those cash machines that you get in and the money's flying around. The opportunities are out there for us. I know several state libraries have allocated money specifically for telehealth and digital navigators, but by working with partners, we can tap into grant proposals with a more robust collaboration, maybe a USDA grant for some of these things. So small, local health foundations as well. And when we're extending public services, essential services, I think it positions libraries to request local taxpayer dollars at budget time. I know our small town doesn't have the money to allocate to what they call quality of life issues, or they consider fluff. But for essential services, that's a different story. So nutrition and food is a different story. And when we're having these conversations, when I started talking about health programming, the pushback I got from other libraries was concerned about inviting people with contagious diseases to come to the library. Or what if they come and they have a heart attack? And to that I would say, you know, people -- that could happen at any time. And we never really know the health condition of people who are coming into the library. But with the telehealth specifically, we've worked with disinfection team to come up with protocol and if there was a medical emergency we would call 911 just like we would always do. So when we do talk about telehealth we'll get into that a little more, it really is ideal for chronic conditions. And so you're not always -- your audience for that will not always be people who are coming just for a contagious disease. But again, these partnerships with food banks and nutritionists and speakers from some of the health science centers are willing and able and they already have the mission to come to our libraries and do outreach. So we've got some ready made programming there for us. >> Jennifer: Excellent. Thank you so much, Dianne. And a reminder to folks that we encourage you to post questions as they come to mind. So feel free as we move through to post questions, and we'll be sure and pause and respond. I know we've got a lot of content still to cover so maybe your question might be addressed in some of what's to come. For know we have another poll. I'm going to have Kendra open up our new poll here. We would like you to characterize your library's current working relationship with public health departments or professionals. So think about where your current engagement falls. And I've posted the link back into chat for you to complete. Again, we have a few more polls so you can keep that window open as we move through. Megan? >> MEGAN WEIS: Wonderful. Enjoying seeing the responses come in. No relationship, not very close, so far not very close is the lead. This is like watching a race in the 100 meters where we're going to come into. I'm not surprised it's coming in around 30, 35%, you know, a little bit over a third. No relationship. A little under a third. Somewhat close and then very close. I am very glad to see in some cases it's very close and that is there but like I said, this is a part of the beginning of the conversation, and part of the transparent, why we're here, we were part of a webinar with the American Public Health Association promoting libraries as partners too so we're working with the public health professionals allowing people for know what wonderful partners you are. As we share this information, there's -- library's a wonderful place and accessible, and you have so many roles to fill but you don't have to do it on your own. There are people looking for people to work with. It's truly to be a partnership, not for something for you to take on without any support. So thank you for sharing that. Also, please post some examples in the chat. Do not -- we don't have a link here -- about different ways that you have worked in sustaining partnerships and collaborations for health. And we'll keep an eye on the chat for this one. We had some shared before with the health and wellness virtual program working with the Area Agency on Aging, another excellent partnerships. Pretty much there should be area agencies pretty much nationwide in different ways. We can try to come back to ideas for finding speakers for things, too, as we go along. Library in Canada working with the local health unit and the university and the mental health association. Working with the Alzheimer's Association in different ways. Senior services and the local hospital about breast health. Blood drives and exercise programs. I believe earlier in the chat there was -- someone mentioned sharing Zoom lessons with yoga and I think some other exercise classes too particularly during the pandemic. >> Jennifer: Just a quick reminder, we ask that you post to everyone so that the presenters can see it. I see a few coming through to attendees. Just a reminder that's the best way to share with everyone. >> MEGAN WEIS: Yes. Partner with project hope to get facemasks, with a local hospital group for wellness checks. Some of the screenings can be done and making that connection for further care when it's needed. With the Utah health literacy coalition, yoga and mindfulness, Florida's agency for healthcare administration for Medicaid enrollment on social media, absolutely. Coming in, these are all fantastic examples, really add to some of the ones we're going to be continuing to share today. Really appreciate your participation. Thank you. >> Jennifer: Fantastic. Now we're going to shift gears and bring Carol to present. Carol's going to talk a little bit about how to build staff comfort, your comfort and confidence around providing health services and programming. So thank you so much, Carol, for being here. >> CAROL PERRYMAN: I better unmute myself. To reiterate what Megan Weis discussed earlier on, librarians and libraries are in a space, they offer safe spaces to trusted information and support decision making. I am here to say while there's always more going on, more to learn it's the nature of our profession we know the most important part of what we need to know. I'm a former librarian who worked in community college university, public and hospital libraries for about 30 years before I began to teach others in a library school. ." Talking to you now from my home in Denton, Texas, where allergens are high. 30 years. I tend not to do math well. It's kind of like looking in the mirror when inside you feel 35 max. I began my career typing card sets on an electric typewriter which was pretty cool. So much has changed but the core has not. It remains constant. Consumer health admittedly occupies about half of my heart. Though I'm not teaching aiming to be libraries I've kept inside me tales of encounters over the years. I'll be sharing some with you. They taught me what matters. I'm taking it from the larger view to the more personal. Considering your own experience with healthcare, please just type one word into the chat. And remember to post that to everyone. I'm here to tell you we're connected to our communities already. And in helping others with their health questions the important part is that connection. I'm approaching this webinar from the assumption that you or someone near you has had experiences with medical settings. >> Jennifer: Yeah, sounds like -- go ahead and post your one word into chat, not into the poll. >> CAROL PERRYMAN: If you've ever been a patient in a hospital for any reason, ever had a chronic illness or emergency, if someone close to you has been either of these things. Even though I've been a medical librarian and teach it I have felt like a stranger in a strange land, nervous, frightened, confused, sometimes angry, somebody I saw said frustrating. I don't always know what to ask. Do I have time to ask it? So it's interesting to see your feedback. Some feel comforted, some alone or rushed. Yep. I definitely can identify with that. Maybe you felt all of these things. There's too much to take in. And in fact we're expected to be part of the decision making without always having the knowledge that we need to support us. It's worth thinking about. Here's my first tale. In a public library when I was working as an information specialist, that's a reference librarian without an MLS an older woman approached to ask if we had any books on alcoholism. While we walked to the shelf she cried and told me it was about her adult daughter. She wanted to know how to know if it was true. Internally as an aside I thought, my first husband was an alcoholic so I was triggered, I wanted so much to give her a hug, tell her that I understood, that I'd been there too. Immediately I had connected. But in the moment I realized that I could not both share my own experience and feelings, which would make it about me, and listen and help with the questions she had. That was about her own need. This understanding has been really important to my identity and values as a librarian and as a consumer health librarian. I cannot overconnect and be who I am professionally. It cannot be about me. But I can see her, meet her eyes, listen, take her questions seriously. So here's a question for you, too. In helping patrons with any kind of question, what level of understanding do you find they have? As with any other area of information our patrons come to us with knowledge not only from education and experience but with their unique literacy levels. It's our job to figure that out in the moment, kind of a challenge. It can be uncomfort for many librarians depending on the question. In my experience it works quite well to ask how comfortable are you with medical words? Or what have you already read about this? Connect to understand. Even people, by the way, who have a very high level of literacy may have a low level of health information literacy. When they're in crisis, when we're ill our understanding can be adversely affected, in fact, health information may either be a way to help you feel in control of onuncontrollable situation, or you may feel as my older sister does like you want to avoid information because it's frightening and we're not ready to face it. According to the health services and resource administration health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions. Also according to them low health literacy can occur when healthcare providers use words patients don't understand. Oh boy have I seen that. When the patron has limited education, when there are cultural barriers to healthcare, and if the patron might have limited English proficiency. Do you have time? Yes. Please come in. So he sat and told me about his wife. She'd had breast cancer, had been treated with chemo and radiation therapy which burned her organs. She had been told not to permit retherapy in the same spot where radiation therapy had been done due to the damage caused. Now five years later the cancer was back, and they were advised to get radiation therapy in the same place. What's the truth, he asked? I'm afraid it'll cause harm. I said let me look. Give me a minute. While I listened to his story I sat quietly facing him using eye contact and body language to say I am listening, I am caring. Internally I focused on building a connection. I actually think of it sort of as a bubble of trust. In a minute he asked if it would be okay to go get his wife from the car where she was waiting, so traumatized by her previous experience that she was afraid to enter the building. Okay. She sat with us nearly knee to knee in this small room. I shared what I'd found, asked if she had other questions. She did, and I did what I could right then, then I got my email and shared my own to follow up with resources. I don't remember what I shared. What stays with me is her fear and the gift they gave me of their tentative trust. Make no mistake it was a gift beyond measure and clear evidence of the value and the responsibility of consumer health support in any kind of setting. Internally, I thought having learned a few things, most of which had little to do with resources, I understood how to be. I had successfully conveyed my caring and earned their trust by body language, listening and eye contact. So much of what we do is about listening. What comes to mind for you when I mention active listening? Go ahead and put one word in chat and think about it but don't think too much. Just put one word characterizing what you think of as active listening. And as a reminder, make sure that you post that to everyone in the chat. This is not a poll. Yeah. There's a certain amount of energy that it takes to really intensely focus on somebody else. And sometimes it can be frustrating, I understand that so well. Anybody else? I'm going to quote from something I did not know, by the way, did you? There is the international listening association. In 1995 they defined listening as the process of receiving, constructing messages from, and responding to spoken, and this is the important part, and/or nonverbal messages. >> Jennifer: Yeah. There are lots of great responses in there for sure. >> CAROL PERRYMAN: Let me scroll down and see. Yeah, yeah, sometimes you need to ask for clarity, right? I love your responses. Thank you all. Yeah. Several people said frustrating, scary, yeah. Oh, more frustration, rushed, yeah. So active listening begins with your own self-awareness. There's a term called "person-centered" listening beginning with mindfulness to guard against overengagement with your own emotions. Remember the older woman with the alcoholic daughter. The focus needs to be on empathy. I see you. I hear you. I recognize that you're trying to deal with an important issue. I want to understand and to help. Use your skills to paraphrase or summarize what you hear. You know, it sounds like you are wanting information on . . . you know this, right? Don't disengage from your recognition of their emotional state. Research has shown that in person centered listening helps someone better. There's a thing called the five-facet mindfulness questionnaire from 2006. In it they include the acts of observing, acting aware rather than focusing on how you might respond. I think I've been guilty of that, too, and describing, mirroring back. Express acceptance by being nonjudgmental, non-reacting, let go of your own emotions once you realize them, even your sense of shock. Focus on your connection and your will to understand. My third tale. In the hospital library a really young couple asked me for information on trisomy 13 they had a 3-day-old baby girl newly diagnosed. It's a rare genetic disorder, this is what was said from the NIH home reference site. Medical residents, students and library staff worked all around us in our busy library. I provided them with a medical dictionary, stood near but distanced myself slightly thousand them privacy. Internally thought, as the mother of a young child myself at the time every part of me ached for them. I was attuned to their fear and pain but this was their journey, not my own. Being there was what I could do. With my eyes, I said, you are what matters. I used body language drawing closer to hear them but then further away to allow their own closeness to one another. My eyes moved away as they read and absorbed but I was highly attuned to their every move. As humans we can connect. As professionals we can bridge the gap. And by doing so we truly can help. There's more to learn, of course, and more to keep in mind but it's so different. Is it different from other reference questions? Yeah. And no. Know the patron's literacy level, understand what they know already, and be attuned to their apparently emotional status. And knowing where to start can help. There's many ways to learn, and there's so many resources to know about. But keep in mind do not overwhelm your patron with information. Begin with the basics, the name of the disease, for example. Make sure it's spelled right. That's important. Remember that part about how it felt about being a stranger in a strange land. Invite them with your misdemeanor and words to engage in an ongoing relationship where you can be there for their further questions. You might feel anxious or frustrated especially at first but remember what's important. First we connect. In the next few slides I'll share resources just a few that are great starts for references and can create displays in your library. It can bring to your patrons' attention that they can help. Often in libraries you aren't asked because people don't think about it. You might hear me saying this but think I'm not confident about health information. How can I help others? Here's a thing to remember, though. We may understand this well with other information. Once we look at what's available we're already steps ahead of our patrons. If you only go to one site, book mark medlineplus.gov and take time to explore. It includes a medical encyclopedia, a list of medications with side effects and medications and therapies and so much more that all I can do is point you to the door. Start with what is a cataract, what is heart disease, explore the many resources. Among so much else there's information in multiple languages for multiple literacy levels and videos of medical procedures. While reviewing the site I noticed something new to me, a tutorial on understanding medical words. What medlineplus.gov is also, it's a portal site for further information from other authoritative sites such as the American Heart Association. Start here and follow to find more. You can use this site to build programs, one, for example, with a focus on heart health. Introduce the topic using the clear, informative images and text and demonstrate things. Or focus on children's health, take a look at nutrition. You get the point. It's tailor-made to help make you comfortable in providing consumer health information and to the general public in many languages. I'd like to encourage you to go even further. You may have heard of the CHIS, acronym for the consumer health information specialization certificate. Go to the professional development link and look for the CHIS information. It's right there and also free. This excellent series helps you to learn at your own pace. You might even consider becoming a library specialist in the area of consumer health. There's two different levels. Mentoring your colleagues and advancing your own career in the process. Check out the NNLM.gov page as well. It's been mentioned here also by Dianne Connery. Here you can find training videos intended for librarians. They're available as recordings even after they're shared live free of charge. Support your own continuing education by pursuing the CHIS specialization, share what you learn with other staff, gain confidence by exploring resources. We're needed in our communities, especially now. It's important to get the word out, though. This website has free promotional materials you can use for that purpose. Like everything else in library practice we too are connected. Share your experiences, knowledge with other staff. Ask for help when you need it. From your colleagues, from those at another library or from local and regional health organizations. Find your level of comfort with patrons, understand how important our support can be, then expand, reach out to public health organizations. We are not alone any more than our patrons are though they may feel that way first. First, we connect. >> Jennifer: Fantastic. Thank you so much, Carol. Such excellent resources, and your stories are really, really powerful in illustrating just how much of a role we can play in the lives of these folks related to their health needs. Thank you so much. Let's shift gears here and you know from WebJunction webinar experience that we love to share examples. So we've got some more examples that we're going to talk through here, and I'm actually going to have -- first I wanted to mention this resource that is something that we learned about as we prepared for this session. It was a project in conjunction with PLA, NNLM, and the American public health training center. So it's a resource that actually focuses on exploring how to sustain -- build and sustain strong partnerships between public libraries and public health departments. So definitely check out that with lots of examples. Again, we love to share examples. But then I'm going to actually have Megan, since Quin had to step out, talk a little bit about the Lee County Public Library Community Health Hub efforts as she is well aware of how those unfolded. Thank you again, Megan. >> MEGAN WEIS: Thank you, Jennifer. I would also like to give a shout-out to the toolkit that you shared in the previous slide as well. I've been working through it too, my own education with links to podcasts and different educational materials and whatnot as well. So I really encourage everyone to check it out if you find what we're saying here compelling and you'd like to learn more and more about how to connect. The Lee County Public Library Community Health Hub is one of the five programs that is being currently funded by the South Carolina Center for Rural and Primary Healthcare. It's a program that we started where we provide funding for up to three years as we receive our funds from our state legislature to be able to support a health liaison within the library system. Lee County has really focused on increasing clinical and community linkages between high-risk underserved residents in Lee County South Carolina and also with health and social service providers to improve health outcomes and they use the Lee County public library as the hub. As you can see, Quin, wonderful story tell they are she is, I hope I am able to share their story adequately, these photos show what happens. They partner with a federally qualified healthcare clinic in the area called care south who employees healthcare workers. Every Wednesday from 12:00 to 1:00, I think they're going to be expanding hours soon, the community health workers at the library. The consistent presence, the community healthcare worker is there all the time. They have a corner set up for when patrons come by and the health worker isn't there with resources they're able to share and other information. They have the books for kids so it's welcoming in many ways. The hours that the Community Health Hub is open the health worker is there, she's a wonderful person, it's always the same person, to have the relationships, mostly the same health worker, she meets with patrons who come, goes through an assessment and whether they get a screening for diabetes or cardiovascular disease or other areas, I was there during a community health celebration thanking the community members and the library. They were doing a success story. One gentleman that I met when I was there, this was all the work of everyone at the library, he was coming by because he had come by to see the community health worker, he was applying for a job, he got the job, and he's a single father caring for a daughter with special needs so he is continuing to get services but there was the immediate impact within the first year of the program. These images highlight a partnership that they have with the local farmers, money going back out into the community, local development utilizing local resources. Vouchers are given to members of the Community Health Hub, they have a voucher they're able to use at the farmers market happening at the library from a local farmer for fresh fruits and vegetables. They do cooking demonstrations and share useful information around that as well. The voucher program is popular for that as well. They are working on quite a few things, they just finished their first year, looking to expand their services to other areas of the county. Looking at securing a van for library and health hub services and continue to partner with local agencies to expand their services to members. One exciting partnership, they have the health hub on Wednesday afternoons. The original plan was to go out to different areas of the community. Then with COVID and other barriers it was difficult but they thought of new ways and partnerships. They partnership with the transit authority so the Lee County transit authority on Wednesdays one of the bus routes changes to go to areas of town and population centers within their rural area, places and apartments, and the bus route includes the health hub specifically to get people to the health hub and back home. With the transit authority partnership. They're looking to expand for hypertensive and diabetic members to provide more services. They have noticed through the screenings and working with the community that that is a high need for their community. >> Jennifer: Fantastic. Thank you, Megan. So exciting to hear about the great work in South Carolina. Let's also shift and hear a little bit about the wonderful work happening in Texas. Dianne Connery, let's hear a little more about your telehealth program. >> DIANNE CONNERY: Yes. And I am so interested to hear that transportation keeps coming up. Because that's not an immediately obvious factor but we've seen that as a factor in health here in our area. When the pandemic started our library stayed open on a reduced basis because broadband access and digital literacy needs are so high in our area. So many people don't have Internet at home. And we started getting phone calls that people said their doctors wanted to see them but they didn't want to risk them coming into the office. I would set them up in my office which at the time was the only private space in the building. And, you know, get them connected and with the healthcare provider. And then a few months later National Library of Medicine grant became available, and I would highly recommend looking at their resources. We received $20,000 to launch a telehealth program. And I could wrap my head around the library end of things what it would look like here but I couldn't figure out appointment scheduling so that, you know, two people weren't showing up at the same time to use the room. Through the National Library of Medicine I was connected to the University of North Texas health science center, and then that just became a great collaboration, which I can say is continuing to evolve. I always start out going in one direction, and then it's so interesting to watch how things develop. With the health science center we met over a period of months in a number of Zoom meetings. And meeting with various departments. I didn't even know but there was a disinfection, marketing, clinical team. And as a rural library, I often -- one of our advantages is we can kind of fly by the seat of our pants if we get a neat idea, we can do it that afternoon, it's very flexible. But with health issues, and dealing with the hospital, it was very well-structured and organized. So I really came to appreciate that. We came up with a plan to convert an old storage room. Ours happened to have an outside entrance. Into a telemedicine room. That's where I am now speaking to you. You can see the desk which can raise and lower for accessibility. It has a large-print keyboard. Then we have this panel lighting which I discovered is important for telemedicine. The provider really needs to be able to see the coloring, skin coloring to make a good diagnosis. And we have a HEPA filter that runs in here. We have a scale, pulse oximeter, blood pressure cuff, thermometer. And we also had, prior to this, we already had a library of things to check out nontraditional items like bicycles and outdoor games, that sort of thing. But we added durable medical equipment for it, wheelchairs and walkers, that sort of thing. So how this works is two days a week, Tuesdays and Fridays, participants can make an appointment to use our room to connect with healthcare providers at UNT health science center. That's about an hour and a half drive from here. And as I mentioned, transportation is really a barrier to healthcare in this area. We don't have public transportation or ride share, those sorts of things. And there are a lot of resources that talk about, in rural areas, healthcare outcomes are poor and distances to care is one of those reasons. Now, here's the beautiful thing about our setup. The library is not responsible for scheduling appointments or any of the medical information or payments. Participants call the health science center to make the appointments, and they take care of everything. If the participant needs help filling out the previsit paperwork they can come to the library and use our regular computers during operating hours or arrive early for their appointment, and there's an iPad kiosk outdoor where they could check in and do their previsit paperwork. The day before the appointment the library receives an email without any name. So I get an email from the health science center. It says there will be an appointment tomorrow at 10 o'clock. 11:00. They're scheduled with a 15-minute break in between to allow disinfection. As library staff we provide as much technology assistance as they need. And then as information professionals, and I did get my CHIS certification, we can help guide them to authoritative resources for information if they want. I don't perform surgery here but I can help them get information. So getting the word out to people is interesting in a rural community because mostly we're trying to reach people who need digital access. They may not have email. Our town doesn't have a newspaper. So some of it has literally been going door to door and taping these on the left, the promotional materials out. We sent them home with school kids in their backpack. A nearby town has a TV station, they've done several stories on it. But we've shared with churches, community based organizations like Rotary, Facebook, social media through our email news letters. We hosted ribbon cuttings. When we have events at the library we try to make a note of showing it to people. But I still think it is a slow ramp-up. If you think about it, a lot of people don't want to see a doctor to begin with. And if they're not tech savvy then there's another layer of, you know, barrier to getting this. And so as librarians, putting this human-friendly face on our assistance as a trusted organization I think is really key to getting people to use these services. You'll see there we -- our town as a digital sign and so we just put it up on the city sign that's on Main Street. Most people drive through. So I mention that this is evolving. I started thinking, you know, medical conditions. But when talking to school counselors they told me that a lot of the needs they see with their students are behavioral health and mental health. And we connected with a nonprofit child and family guidance in a nearby town that said, you know, they had months-long waiting lists for their appointments. So they were very appreciative of us being able to offer the service. And one thing that has come out of that is that even if people have fast enough connection at home to stream video appointments and they have a computer, they may not have a private space. Especially in a small town, being able to come to a library, park your car at the library, it's a very neutral space, nobody knows what's going on or that you're even coming in for a doctor's appointment. So that's another factor that we've learned along the way. It keeps evolving. Now Megan talked about the community health workers, and working with them. And then the community of practice that we have a link to for libraries who are interested in learning more, this is a place we can share information. Because library staff is so great about that, at sharing information. And so that we don't all have to reinvent the wheel. This is a way we can share information. I'd heard from Idaho, the state library had been approached by a health insurance foundation. So there are so many different stakeholders that are interested in partnering with us. We've got the fast Internet connection, we've got the digital literacy, we can learn the health literacy, so this just makes so much sense to me in a library setting. >> Jennifer: Thank you so much, Dianne, and I can't overstate how helpful your community of practice is, and I look forward to seeing more examples and folks chiming in with their great learning as we expand more telehealth. And Megan's going to talk about a couple more statewide initiatives that we've learned about, and then we are going to continue moving into other kinds of examples. >> MEGAN WEIS: Mm-hmm. Thank you so much again. Also, as Dianne was talking about getting the word out, I thought of some other examples I've seen both in our work and with partners. We have one of the library systems in Kershaw county is exploring using billboards and some direct mailings. We're going to see how that goes and the community health workers and social workers getting out there, of course using social media to promote. Lee County, Quin shared with me they're finding that the children's story time, with people coming in and the mothers and parents and guardians and grandparents that the librarian talks to the guardians and parents who are there with the kids and oftentimes maybe have snacks through the local school board, from the school district, then coming back for the community health worker as well, sharing that as a partnership, not just the health liaison but everyone in the library staff for that. In Delaware they have the first state network for libraries in telehealth. You can see the kiosks for telehealth available for some of the states. They were able to do an entire journal full of journal articles excuse me for information about that to be able to share that. So it really came about in Delaware around the strong track record of access to Social Services and the libraries when the Delaware libraries spear healthed a job center. -- spearheaded a job center. Around 2012 it expanded with the Delaware health and Social Services to put social workers into the libraries. PreCOVID they had 22 libraries with social workers. It's really just an extension of some of the work, taking advantage of it. COVID-19, you know, we've talked about it a bit. In the chat a lot of what you've been sharing has been around some of the pivoting around COVID-19 and services via Zoom. There are other ways that libraries around the nation have been involved in prevention, sharing information, accurate information, about COVID-19. The Columbus Metropolitan Library provided free COVID-19 vaccinations and both there and satellite settings. Public health departments through the federal CARES money, there is money to do this, outreach around COVID. South Carolina we're talking about expansion with libraries and moving to more areas with a partnership with our state health department and addressing disparities within the state based on the knowledge that libraries are already out there. In Ohio with COVID vaccination. Again, a safe, trusted place and a place where people are. Behavioral health is something of a topic, and we're also seeing, along with the COVID, COVID-19 crisis we're seeing an increase in behavioral health crisis and substance use disorders that's going hand in hand. Libraries is a key partner in Bringing Our Best Care consortium in South Carolina. This is an example of one of the advertisements they have for a pop-up mental health clinic at the library. I wanted to highlight the partners, the South Carolina office of rural health, department of mental health, regional medical center, Tri-County commission on alcohol and drug abuse, examples of the partners doing the work, there to be partners, not that you need to do it yourself but partnering with others to take advantage of some of the funds and expertise that is out there. Also we've talked about food justice and food equity. This is an area where libraries have been at the forefront in addressing food insecurity and justice. Even before the COVID. They were places for food distribution with a food share or with local food banks. It's just an example of those existing partnerships that were already in place that perhaps became -- have become stronger in the course of the pandemic as the efforts really increased because fewer kids getting their food. We were trying to put that out through the schools. Then all of a sudden kids weren't in schools because they weren't open to finding another place to do that. There was a Wall Street article -- or WebJunction article with multiple resources that we'll be sharing the links in the chat. Please take a look. It includes more about the collaborative summer library program, something that was already in place, already a partnership with public health that is existing. Looking at the pandemic and beyond, you know, going outside, outside of the walls within the library. So libraries really were able to step up, with community gardens and other areas and ways to connect with folks in the community. The example with the community garden outside, being physically active, growing food, connecting, also bikes to books.com is an excellent resource, you can think outside. Vermont there's a snowshoe checkout program. The quote I have is through funding from the Vermont departments of health, 3, 4, 50 initiative, libraries are letting community members check out free snow shoes with sizes available for adults and children. Getting people in the library, connecting to lots of things, getting outside, physically active and coming back. And the books to book is with the Portland Department of Transportation. Again connecting with transportation. I want to give a shout-out to Storywalk. There's something I see more and more of. I just want to give a shout-out to Ann Ferguson, a specialist at the Vermont department of health in 2007 who started Storywalk, a public health effort, particularly when talking about increasing physical activity for health and just that natural connection between being outside and moving and following a story. You may be doing Storywalk, come to this webinar, I don't know if I'm doing public health, well, you're already doing it. And can borrowing a bike to be able to ride. Finally an example from Louisiana, the lake providence walk audit. That means going together out for a walk, taking a look at what's going on. Are there sidewalks? Space between a sidewalk and a street? Curbs? The ramps or easy curbs to go under so it's accessible to everyone? What might be good, or more barriers to getting outside, working collectively to removing barriers. There is a link to a WebJunction webinar as well. >> Jennifer: As I mentioned earlier, WebJunction's commitment as a part of OCLC to work on libraries responses to the opioid crisis, this is obviously a huge public health need ever-increasing, some of the new data that has come out from the American Medical Association, more than 40 states have indicated recent increases in opioid-related deaths. Rural areas continue to be impacted more heavily. The 2020 overdose deaths were nearly 30% higher than in 2019. I know we've been very focused on COVID but as Megan said, we know that the impacts of COVID are reaching into every aspect of our health lives. So a reminder that we are sustaining our commitment to providing resources for libraries to support this huge community need. And we will keep you up to date on new tools that can help you evaluate your local health data, seek partners, no surprise there, to educate staff and community members on an issue and to consider staff care needs along that self-care to staff care to community continuum. Again, looking at programs and services that will support these needs. So again, so many different things going on, and I know we have a little bit of time for a few questions. So feel free to post your questions. A very special thank you to all of our presenters. And we are so sorry, Quin, you weren't here. Hopefully she'll be able to listen back. But we appreciate all the great work that has been shared in this session. I did see a few questions come through earlier. So one thing that maybe -- maybe Dianne and, you know, Megan if you have experience from the libraries you have been collaborating with, there was a sort of a logistics question about how you address -- for exercise programs, do you provide a waiver for people to sign if they are participating in exercise programs or, Dianne, I don't know if there's any sort of process for people to fill out waivers if they are using your telereference services, telehealth services. Can you speak to that, Dianne? >> DIANNE CONNERY: We have a waiver when people check out bicycles or outdoor equipment. And I think as is often the case I think we borrowed it from another library, I think it was Sacramento. For the equipment we have a waiver. >> Jennifer: Megan, any sense of your experience seeing if there's a legal waiver process for action-oriented programming at the libraries? >> MEGAN WEIS: I believe so but I do not have a specific example. But I'd be happy to follow up with you if there's anything to share to be able to include in the materials. >> Jennifer: Excellent, that's great. Thanks to Carol for posting another example of the library of things waiver, that would be great to see equipment, wheelchairs, crutches being loaned out, that's an excellent thing to add to your library of things list. Another question perhaps to the full group, too, and it was great to hear that this person started a health and wellness virtual program at the library, and they do have a great partnership with the Area Agency on Aging which we have heard in many, many cases is an excellent partnership, offering workshops on topics such as balance, managing chronic pain, exercise and nutrition. And this library's hoping to planned programming to include wellness classes so things like mindfulness, alternative therapies, nutrition, stretching, and is looking for other ways to maybe provide brain health programming to the series. So if you -- I'd love to hear, any of you here on the panel, have you suggestions for how to find partnerships or folks that are willing to present in these areas? And feel free for other folks that have ideas, post to chat. Let's get a little virtual brainstorming going on how to expand the kinds of presenters or partners for this programming. Let's start with Megan. >> MEGAN WEIS: Yeah, sure. So in brainstorming, one, most states have a public health association, affiliates, the American public health have a affiliates. Most have a website and being able to find a contact to say, hey, do you have any suggestions there? Now, a calve @if you leave this webinar the American Public Health Association annual meeting starts on Saturday so there might be a delay. Technical colleges with nursing, programs. Most state agencies are looking for ways to get out. Health department, department of mental health, your area agencies on aging, that was a fantastic idea. Some states also have a hospital association with speakers bureau, South Carolina does, I'm not sure if all the states have that as well. Some of the ideas of where to start, to start getting some ideas for that. Oh, also many communities have maybe a community health coalition or a community development coalition that there may be some connections there as well. >> Jennifer: Just a little plug, I know that Betha and Brenda on the home page of WebJunction talked about tapping your library staff. Some of your staff may have passion around mindfulness or yoga topics. Tap your internal folks. It may give them an opportunity to do some of their own self-care and part of their work. Remember that. We are at the bottom of the hour. Dianne, any final comments related to -- and, oh, the other thing I wanted to encourage folks, I know in many cases when we talk about creating new partnerships, making those connections, that people do hear no answer the first time, no answer the second time. And we encourage you to think about -- do some more creative thinking about who, aside from some of the usually suspects in terms of partnerships, maybe brainstorming with your public health colleague to think outside of your existing spheres who you might be able to ask and ask again. Dianne. >> DIANNE CONNERY: I'll just add to that the -- my partners from the health science center, I got them to come to my library and just seeing the library has turned them on so much to what the possibilities are. We always struggle against nostalgia and the stereotypes of what libraries offer. Maybe to be able to get people into our buildings and talk, really, about what we do would help excite those partners. >> Jennifer: Yep. I think as Carol said, the connections to their stories are another place to start. So thank you all so much for being here. I know this was a lot of information. As I said, the recording will be made available later today. I'll send you a link in email once it's available. I'm also going to send you a certificate automatically within the week -- or within a week. And please, if you have time now, if not, the email will also have a link to the survey I'm going to send you to. We love to collect your feedback to present to our presenters and helping with our decisions on ongoing programming. Thank you to all of you, to our captioner and WebJunction support and to all of you who attended for all your great responses and contributions to this conversation. Have a great rest of your week, and everyone have a great day.