Program Helps Libraries Assist Vulnerable Populations

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by Lauren Hertzler, courtesy of PennCurrent

Will Torrence, a librarian at the South Philadelphia (PA) branch of the Free Library of Philadelphia, offers far more than books to the local community. He fields questions all day long, a third of which are about health issues. He listens  to patrons, who often come to the library when they are in need—or even in crisis—and he tries to improvise solutions to their most pressing challenges.
 
“We can’t do everything, but every bit of help we can give makes a difference,” he says.
 
Torrence’s helping hand is typical of many library staff, especially in Philadelphia, the poorest of the nation’s 10 largest cities. The Free Library of Philadelphia, the 13th largest public library system in the United States, has 54 neighborhood locations that host about 6 million in-person visits every year. Many of these patrons are vulnerable: They may be recent immigrants, children, or those experiencing mental illness, substance abuse, or homelessness.
 
“Vulnerable populations tend to really rely on the library as a safety net, helping them stay housed and fed and knowledgeable about their own health,” says Carolyn Cannuscio, director of research for the Center for Public Health Initiatives (CPHI) and an assistant professor of family medicine and community health at the Perelman School of Medicine.
 
About two years ago, Cannuscio led a team from Penn and the Free Library of Philadelphia to form the Healthy Library Initiative. The initiative has documented the significant role of Philadelphia’s libraries, their programs, and the role their staff play in promoting healthy communities. It is also using that information to develop health programming and trainings for employees throughout the library system.
 
The Initiative’s first needs assessment sent a group of researchers and a photographer into South Philadelphia neighborhoods in the fall of 2015. They asked people on the street: “What do you need from your public library?” Typical answers included help with housing, food, employment, and health care. Results were published both on the team’s colorful www.healthylibrary.org website and in a November article in Health Affairs. The study was supported by CPHI, the Office of the Dean at Penn Medicine, and Penn’s Prevention Research Center, which is funded by the Centers for Disease Control and Prevention.
 
“We did community-based participatory research,” Cannuscio says. “The basic principle is that every person has something valuable to teach us.”
 
The research group gathered input from community members within a walkable distance from at least one of the six library branches in South Philadelphia, the neighborhood where the city’s new Community Health and Literacy Center is located. The protocol was then repeated in the spring of 2016 in West Philadelphia with the help of Department of History and Sociology of Science lecturer Andi Johnson and her students.
 
Also interviewed were a group of library staffers, who detailed their day-to-day work and the challenges they face in their jobs.
 
“The library staff are on the front lines. They are very in-tune with what the community needs,” says Cannuscio. “Everything that the community residents said to us that was important to them, the library staff were already very aware of. That was an interesting way to validate that the libraries are responsive institutions.”
 
The research group learned how trusted the libraries are as a resource for the community, putting them in a “great position to respond,” Cannuscio says, “because their doors are open to everyone, and they are free.”
 
Library staff expressed their commitment to serving every person that enters the library, but admitted that they sometimes feel underprepared and stressed when met with profound health and social needs of many library patrons.
 
Taking that feedback to heart, the Healthy Library Initiative now hosts a 12-hour “community health specialist” training program for library staff. Led by Anna Morgan, a physician and Robert Wood Johnson Clinical Scholar, and Heather Klusaritz, a health services researcher in the Department of Family Medicine and Community Health, the in-person training encourages library staff to recognize and communicate productively with vulnerable patrons and direct them to appropriate community-based services.
 
“The training was for all library staff, not just librarians,” says Torrence, from the Free Library. “It was very helpful, very practical information. They targeted things we see all the time, and gave us the phone numbers to call and different resources to hand off to patrons in need.”
 
New funding from the National Library of Medicine will help expand the training, Cannuscio says. She expects at least 30 more library staffers to be trained within the next five months.
 
“The trainings offer in-person practice to build self-efficacy so the library staffers don’t feel so overwhelmed,” says Cannuscio. “We’ve evaluated the training and have shown that this pilot intervention helped library staff feel significantly more comfortable and confident about working with vulnerable patrons.”
 
The Healthy Library Initiative has now expanded its partnerships to include the city’s Public Health and Parks and Recreation departments, as well as colleagues from the Children’s Hospital of Philadelphia and additional departments at Penn.
 
“The library is working in ways that impact health from birth through the end of life,” Cannuscio says. “With these partnerships expanding, the Initiative can really influence cross-sectoral collaborations, connecting the public library to the broader range of resources that people of all ages need.”