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«How the American Public Benefits Opportunity for All from Internet Access at U.S. Libraries The U.S. IMPACT Study A research initiative examining the ...»

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• Users who speak a language other than English at home have odds of seeking information about medical conditions higher than users from English-only households by a factor of 1.42.

Holding other characteristics of users constant, there are no statistically significant differences in the odds of using library computers and Internet connections for getting information about medical conditions between Hispanics and non-Hispanics, men and women, or people with different educational attainment. However, users between the ages of 55 and 64 years have greater odds of using library computers to seek this type of information than both older and younger public access technology users.

The information public access technology users gather about medical conditions is often put to immediate use. For example, 22-year-old, unemployed Margarita, who was interviewed at the Oakland Public Library with her boyfriend, used the computers to help diagnose a skin condition: “[Our son] had ringworm and we didn’t even know what that was. We looked online and put in his symptoms and everything and then it told us what he had, told us what kind of medicine to give him. Because we didn’t know what he had at all. We thought it was just a regular rash.” Her fiancé agreed, “When the kids get sick, [we] can just go online and… it helps a lot with that.” With household income for their family of five well below the poverty guidelines, Internet access at the library is critical for Margarita and her family to have access to medical information.

Similarly, a 25-year-old survey respondent from Tulsa, Oklahoma, who uses public access technology as his sole means for accessing the Internet, wrote that 106 | Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries he had used a library computer to get pictures of tick bites to help him determine if one he received could have exposed him to Lyme disease.

In many cases, users of the library computer resources distribute information about illnesses or diseases to others. For example, Mark, a 15-year-old high school student with a large, extended family, explained, “Just yesterday I went to use the computer for my aunty. She's the government of the whole family so she asked me to look up Swine Flu, the new flu that's coming out. She asked me to see what to tell [the rest of the family] to help not get that flu.” By passing along the information he had gathered about the H1N1 flu virus in order to help his family avoid contracting it, Nick demonstrates one of the ways that the value of the information retrieved through library computers and Internet Learning about Medical Procedures connections extends beyond the individual users to encompass families.

Searching for information on medical procedures and tests is also an important activity for many health and wellness users, 54 percent of whom use library computers and Internet connections for this purpose (Appendix Table 45).

Procedures: 54 percent of those using library computers for health and wellness purposes learn about medical procedures.

Among all users of library online resources, those most likely to look for information on

medical procedures are:

• People with household incomes below the poverty guidelines;

• Latinos or Hispanics;

• 55–74 year olds;

• Women; and

• People who speak languages other than English at home.

As with searching for information about medical conditions, certain types of users are more likely to use library technology to find information about

procedures:

• For people with household income below the federal poverty guidelines, the odds of using library computers to seek information about medical procedures is higher by a factor of 1.41 than for those with income more than 300 percent of the poverty guidelines.

• Latino or Hispanic users have odds of seeking information about medical procedures higher than non-Latino and non-Hispanic users by a factor of 1.64.

Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries | 107

• Women have greater odds of seeking medical procedure information than men by a factor of 1.23.

• The odds for seeking information about medical procedures is higher for people from households in which a language other than English is spoken than in English-only households by a factor of 1.72.

One example of the use of library computers to look for information about medical procedures comes from Jasmine in Fayetteville, a 24-year-old unemployed woman working toward her GED and recently recovered from substance abuse. She talked about using library computers to look for

information about a medical procedure for someone else. She recounted:

A friend of mine was recently diagnosed with heart problems, and she asked me if I can look up her specific case, and I was able to get her more information for her health… She has a shunt; they had to put a shunt in her heart because one of the valves was not working properly.

She was able to talk to her doctor a lot smoother, she was able to voice her concerns or questions, so I think that kind of helped her a little bit.

Medical procedures can be confusing and frightening. Some public access technology users also use library computers to view videos on medical procedures. One librarian from Oakland, California, explained how access to Medline, an Internet portal maintained by the National Library of Medicine, helped a patron prepare for surgery by actually watching the surgical procedure he was about to undergo. She goes on to explain, “He was particularly nervous, especially because he was going to have to be under a general anesthetic. He just wanted to know what was going to be happening.” The high bandwidth requirements for viewing videos, as well as access to help from librarians and additional print and electronic resources, may help explain some of why seeking information about medical procedures is among the top Getting Information about Medications activities reported by public access technology users.





Seeking information about prescription and over-the-counter medications is also another high-use area with similar patterns to the use of library computers for other health and wellness purposes. Overall, 51 percent of users in the health and wellness area use library computers and Internet connections to look for information about prescription or over-the-counter medications (Appendix Table 46). As a result of the information these users find using public access technology, 68 percent of these users report that that they were able to make a decision about whether to use a medication (Appendix Table 47). Additionally, 108 | Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries 18 percent of these users actually use library computers to purchase a prescription or over-the-counter medication (Appendix Table 48).

Medications: 51 percent of users looking for health and wellness information use library computers and Internet connections to find out about prescription or over-the-counter medications.

Of all library online service users, those most likely to look for information on

medications are:

• People with household incomes below the poverty guidelines;

• Latinos or Hispanics;

• Those 75 and older; and

• People who speak languages other than English at home.

→Outcome: 68 percent of the users who indicated using library computers for this purpose report that using library technology helped them decide whether to use a medication.

→Outcome: 18 percent of these users used a library computer or Internet connection to purchase a prescription or over-the-counter medication.

Further analysis shows that the odds of seeking information about medication

are higher among patrons with certain characteristics:

• The odds of seeking information about medications increases as income decreases, with those with household income below the federal poverty guidelines higher by a factor of 1.46 than those with income more than 300 percent of the poverty guidelines.

• Latino or Hispanic users have greater odds of searching for information about medications than non-Latinos or non-Hispanics by a factor of 1.57

• Users who speak a language other than English at home have odds of seeking information about prescription or over-the-counter drugs higher than users from English-only households by a factor of 1.42.

Although differences in race, gender, and education did not significantly change the odds of using library computers to seek information about medications, age was a factor: the odds of looking for this type of information steadily increases with advanced years.

As is the case with many other activities concerning health and wellness, looking for information on medication is sometimes used to help others. Baltimore user Chloe, described previously, talked about the value of having access to the Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries | 109 library on the weekend to help her find information for her father who was

hospitalized because of a bad reaction to a new medication:

He said the doctor gave it to him and it had made him sick. And he had called me that same night because his doctor wasn’t there on that Saturday. He went to the hospital on a Friday and I looked up the medication…I came to the library, and I’m glad that they are open on Saturdays too because I went to the library on Saturday and looked up that medication for him and called him that morning and told him what it was. [After I read it to him] he said that he was allergic to it, what he’d been taking. That’s why it made him sick.” Avoiding bad reactions to medication by looking for information about sideeffects and drug interactions was also mentioned by several users at the case study libraries, as well as in comments left by survey respondents.

Finding and Using Health Care Providers Seeking out preventative care or treatment for an illness often involves finding a new health care provider, specialist, or resources for support or complementary care. In addition, prior to getting care, many people must first get insurance or other health plans to help with paying medical bills and prescription medications. For many Americans, library technology is used to help fulfill these

Finding a Doctorsteps to getting medical attention.

About 37 percent of users engaging in health and wellness activities using library computers and Internet connections looked for information on doctors and other practitioners (Appendix Table 50). Of users who looked for information on health care providers, a number followed through, with 49 percent making an appointment (Appendix Table 51). Of those who made an appointment, 93 percent reported actually receiving the care they needed (Appendix Table 52).

110 | Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries Health care providers: 36 percent of users pursuing health and wellness information through their library’s online services seek information about doctors or health care providers.

Of all users of library computing services, those most likely to look for information on

medical providers are:

• People with household incomes below the poverty guidelines;

• 45–64 year olds and those older than 75;

• Women; and

• People who speak languages other than English at home.

→Outcome: 49 percent of users seeking information about health care providers report that after using library technology for these purposes, they made an appointment with a doctor or other health care provider.

→Outcome: 93 percent of users who made appointments reported that they received the care they needed.

The odds of seeking information about doctors or other health care providers

are higher among public access technology users with certain characteristics:

• The odds of users with income below 100 percent of the federal poverty guidelines finding out about health care providers using library computers and Internet connections are higher by a factor of 1.59 compared with those earning more than 300 percent of the poverty guidelines. The odds for users earning between 100 and 300 percent of the poverty guidelines were likewise higher than those with incomes above 300 percent of the poverty guidelines, but the odds ratios were less than those in poverty.

• Women have greater odds of looking for information about health care providers than men by a factor of 1.18.

• The odds of users who speak a language other than English at home seeking information about doctors are higher than users from Englishonly households by a factor of 1.88.

There is no statistically significant difference in the odds of use for looking for information about doctors and other health care providers related to race or education. However, users between the ages of 45 and 64 years have slightly greater odds of using library computers for seeking this type of information than both older and younger people than those over 75, and those over 75 have higher odds than all other age groups except those between 45 and 64.

–  –  –

112 | Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries Health insurance: 28 percent of users seeking health and wellness through public library computers learn about health insurance or drug discount plans.

Of all library online users, those most likely to seek out this type of information are:

• People with household incomes below 300 percent of the poverty guidelines;

• Latinos or Hispanics;

• 45–64 year olds; and

• People who speak languages other than English at home.

→Outcome: 63 percent of users seeking information about health insurance or drug discount plans decided to purchase health insurance or enroll in a drug discount plan.

Further analysis shows that the odds of seeking information about health insurance or drug discount plans is higher among public access technology users

with certain characteristics:



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