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Women’s Health Information: A Literature Review Includes: Final Report By Natalie Wasserlauf Completed for: Women’s Health Centre Supervising Professor: Prof. Joan Ayre and Molly Westland, Trent University Trent Centre for Community-Based Education Department: Nursing Course Code: NURS 302 Course Name: Term: Fall/Winter 2003 Date of Project Submission: March, 2003 Project ID: 563 Call Number: 1 Literature Review Presented to: Joan Ayre, Molly Westland, Judy Marshall and Jennifer Bowe. By: Natalie Wasserlauf March 17, 2003 2 Intro……………………………………………. …………………………………………………. 3 Marketing a Health Care Library………………………………………………………………3 Information seeking behavior of Women ……………………………………………………..5 Assessing the Strengths versus Weaknesses of the Internet ……………………………….6 Evaluating the Effectiveness of Library Services and Marketing Plan ………………….8 Conclusion ………………………………………………………………………………………10 Bibliography ……………………………………………………………………………………. 11 3 Intro The Women’s Health Care Centre was established in 1989 to address the health needs of women in the counties of Peterborough, Northumberland, Haliburton and Victoria. A Community Advisory Board provides a formal link with the community and advises the Director and staff on needs of the community as they know them through their paid or volunteer work or personal community connections. The 12 members act as “ambassadors” of the Women’s Health Care Centre by informing other women in the community about the services and programs available (Women’s Health Care Centre, 1999). This literature review has been conducted to develop a strong knowledge base to carry out my library marketing research project in conjunction with the Women’s Health Care Center and the Trent Centre for Community Based Education. The goals of this literature review include: ascertaining further information about marketing a health library; investigating the information seeking behavior of women; assessing the use, strengths and weaknesses of the internet; and evaluating the effectiveness library services and marketing plan. Marketing a Health Library Marketing has been defined as the identification of service users and their needs. Marketing allows librarians to determine the perceived value of their activities and use that information to make arguments for and adjustments to their plans and purposes (Smigielski and Wulff 2002). A search of the library literature conducted by Smigielski and Wulff (2002) revealed an increase interest in marketing libraries over the past 4 decade. Coote (1995) believes that marketing library services is essential to “stay alive and thrive” in this competitive information age. She argues that marketing influences the way a product is perceived by its customer; the most effective way of changing people’s perceptions is by carefully considered, planned, executed and ongoing marketing. She continues by adding that marketing helps librarians plan how to provide a service which is in tune with what customers want and adds perceived value to your organization. Weaver (2001) outlined the three main benefits to marketing: to counteract library/librarian stereotyping, to provide optimal services, to enhance career planning. Smigielski and Wulff (2002) have written that the health sciences library’s “product” is its service, therefore, librarians must provide quality services to match the users’ needs. They believe that good marketing practices provide a reality check of the perceptions of librarians against those of their users. The marketing process informs the balance between what librarians need to do and what their customers need. Weaver (2001) has developed a six step process which libraries should follow to achieve a successful library marketing plan. These steps include: situation analysis (market research and segmentation), opportunity analysis (service profile), developing a strategy (positioning), marketing mix (service design and promotion), evaluation (feedback), and repetition. Coote (1995) outlined the five main elements of a library marketing strategy. These elements are: assessment of who the customers are, the services they want and the benefits they are looking for; analysis of the library’s strengths; weaknesses and opportunities and the services it provides; assessment of the strengths and weaknesses of the competition; understanding what the real differences are between the library and the 5 competition; a practical action plan which draws on this understanding of the marketplace and sets out measurable actions to achieve current objectives. Information seeking behavior of women A study done in 2000 by the Pew Internet and American Life Project found that compared to men, more frequently search for information about illness or symptoms, and they were more likely to do so online health searches after visiting a doctor. Women were also more likely to seek health information on behalf of their children and were more concerned than men about the accuracy of the information they were receiving. Gallop (2003) conducted a study on the information seeking behaviors of urban women. The possible determinants examined in her study were: perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly. Reese and Bath (2001) conducted a study to explore the information- seeking behaviors of women with breast cancer. The researchers found that the informationseeking behaviors of women with breast cancer, were not significantly associated with their demographic (e.g., age, socioeconomic class) and illness-related characteristics (e.g., months since diagnosis, surgery, therapeutic regimens). The focus group discussions suggested that the information-seeking behaviors of women was highly individualistic. Although some women actively sought information, others avoided information. In addition, women sometimes fluctuated between seeking and avoiding 6 information. Women who sought information to cope with breast cancer were attempting to regain a sense of control, increase their feelings of confidence, and help facilitate the decision-making process. Women who avoided information were attempting to escape from worry, fear, and feelings of negativity and depression. The individuality of women’s information seeking behavior is also noted in a study by Baker (1995). He found that studies on information needs and information-seeking patterns of patients focus on people who seek information and rarely attempt to explain the behavior of people who do not want information. Strategies for coping with stress may yield insight into information-seeking patterns. Baker’s study of information preferences of women with multiple sclerosis was based on a theory of information seeking that states that "monitors" cope by actively seeking information, whereas "blunters" reject information. Results revealed that both monitors and blunters wanted information but differed in what they wanted and when they wanted it. Assessing the Use, Strengths and Weakness of the Internet Gaithersberg (2001) analyzed and critiqued Internet research from a feminist perspective. Her analysis indicates that the use of the Internet in research frequently brings about a selection bias because of a limited pool of potential participants. Moreover, she believes that the Internet does not provide contextual data on research encounters, it does not uncover women’s subjective experiences under marginalized situations and it tends to raise power issues related to the relationship between the searcher and the information. However, Gaithersberg conceded that despite the limitations, the use of internet for research provides better communication channels for 7 participation, more flexibility in time and place of data collection and less expense for data collection (Gaithsberg, 2001). Budtz and Witt (2002) conducted a study to describe where patients in Danish general practice get information about health and disease, particularly how patients prepare for a visit to their GP, with special reference to use of the internet. Only two patients never looked for health information. Of all patients, 20% had used the Internet to get health information. Women used the sources of information more than men did. Personal contact with family, friends or neighbors was the most commonly used source of information. Budtz and Witt (2002) concluded that the Internet is commonly used in direct preparation for a visit to the general practitioner. Periera. et. al (2002) noted increasing number of breast cancer patients are accessing the Internet for medical information. A survey was administered to breast cancer patients and their families attending follow-up outpatient clinics in a comprehensive cancer care center to explore their frequency of Internet use, their motivation for online activity, the type of information they sought, and the perceived impact of the information they found on the Internet on their medical care. The survey was conducted over a 4-month period. A total of 107 surveys were returned. Seventy-nine of these were from patients while 28 were from family members and friends. Thirty-four of the patient responses (43%) indicated that the patient had used the Internet to look for cancer-related information. Patients who had used the Internet to access cancer-related information were significantly younger (P = 0.007), better educated (P = 0.027), and less satisfied with the amount of treatmentrelated information given by caregivers than those patients who had not used the Internet to access cancer-related information (P = 0.032). The majority of patient Internet users desired more information on their cancer and its treatment (91%), looked up information 8 that was presented to them by their clinicians (66%), researched other treatment options (63%), and obtained more information on "alternative treatments" (63%). Patient Internet users generally found the cancer-related information on the Internet to be useful, and the majority discussed Internet-derived information with their health care providers and perceived that clinicians listened to such information. However, 53% were undecided about the trustworthiness of the medical information obtained via the Internet. Internet nonusers commonly lacked Internet access (53%) or were unfamiliar with the Internet (33%), but few (13%) distrusted Internet-derived information. Evaluating the Effectiveness of Library Services and Marketing Plan Smigielski and Wulff (2002) propose that evaluation is analogous to a compass- it indicates whether the planning and marketing efforts are on course or if a change of direction is needed. Ultimately, adjustments are based on evaluations. Evaluation should include both process and outcome measures (Goode, 1995). LoBiondo-Wood and Haber (2002) believe that it is important to know if staff are using the new practices as noted in the written proposal. They believe that evaluation consists of three main features: barriers that staff encounter in carrying out the practice (i.e. lack of information); differences of opinions among service providers; and difficulty in carrying out the steps of the practice as originally designed (LoBiondo-Wood and Haber, 2002). Plosker (2002) writes that measuring value is the key issue in evaluating library services and success. He believes that some of the best measures that have been seen to date include an attempt to determine if library use has helped to: save time/money, generate new ideas/insights, expand perspective/add dimension, lead to discovery, meet individual or organizational 9 goals. Plosker (2002) has written that libraries can evaluate their success or need for improvement by utilizing reference interviews and user surveys. Information from Creative Communications Marketing Company (www.creative communications.com) concurs with Plosker’s evaluation choice of interviews and surveys. The marketing firm believes that analyzing the results of a marketing communications program can provide information that leads to a better program next year ... and even better results. They believe that the time to think about program evaluation is during annual planning. In order to properly evaluate results, the marketing communications objectives in your plan have to be measurable. Typical measurable objectives include increasing customer awareness, changing customer preference and generating inquiries. Creative Communications recommends the following schema for evaluating the success of marketing programs: Survey design and analysis, the library should develop a research questionnaire based on the initial marketing objectives. After response tabulation, the library should compile, analyze and report on the results; Sample Selection, for valid results, the survey sample needs to precisely match the program’s target audience in terms of the industry/demographic; Format, surveys can be done by telephone, fax or mail (and e-mail is on the way). The method used is often determined by the media services that can be negotiated for the library, but telephone surveys are preferred because they are usually more statistically reliable (Creative Communications, 2003). Marketing experts believe that when analyzing the program results, an agency must remember that awareness builds slowly and depends on a consistent marketing communications program. The number and quality of inquiries the program generates will be influenced by the types of publications used and your ad messages. Preference begins to develop only after the target audience gains knowledge 10 about (and, perhaps experience with) the product or service. Conclusion This literature review has revealed that a moderate amount of information about library marketing exists in current literature. Minimal theoretical development between the related concepts of library science, community, and women’s issues highlight the need for further quality investigation. The use of marketing, as a tool in library promotion, is still a relatively new idea. Hopefully this literature review will contribute to the ongoing dialogue about user needs among librarians and their patrons. Specifically, this literature review was meant to shed light on the information seeking behavior of women and the manner in which the Women’s Health Care center can market their library resources. Due to the highly individual nature of women’s information seeking behaviors, library staff should support a multidisciplinary approach to providing information services to their female users. The use of evaluation is an invaluable tool in measuring the success of the library marketing program. The Women’s Health Care Centre should encourage library staff to distribute surveys, conduct interviews and actively seek out the feedback from women in their demographic. 11