The Free Library of Philadelphia’s latest specialty rentals collection debuted at the end of August, and this one’s aimed at helping patrons in South Philly take control of their health. Just like the neckties, cake pans and musical instruments available at other branches, library patrons can now check out blood pressure monitors and digital food scales from the South Philadelphia Free Library branch for the typical three-week lending period.
The program is part of a broader effort to improve population health in South Philadelphia by a number of groups, especially a collection of researchers and practitioners from the University of Pennsylvania.
According to the Philadelphia Department of Public Health’s 2016 Community Health Assessment, the South Planning District experiences higher rates of diabetes, tobacco use, obesity and adults reporting themselves as in “fair or poor health” than the Central Planning District, which consistently ranks healthiest according to the assessment’s metrics. The rentals program demonstrates both the opportunities and challenges of implementing health programs through the library.
“We were thinking about the unique rental libraries at the other branches, and what would be useful for this branch in particular,” said Katie Daingerfield-Fries, the Health Programs and Partnerships manager at the branch. The library is housed inside the South Philadelphia Health Literacy Center at Broad and Morris — a compound that includes the city’s Health Center 2 and a pediatric center administered by CHOP.
Try before you buy
Daingerfield-Fries worked with Community Health Librarian Will Torrence and Free Library President Siobhan Reardon to identify what pieces of equipment would debut in the collection. “Both of them are pieces of equipment that people can use in a try-before-you-buy capacity,” said Daingerfield-Fries.
“Anyone can rent the items, but they’re intended in particular to be used by library patrons coming from appointments elsewhere in the building.” Torrence mentioned that they’d considered other items as well. “We toyed with the idea of yoga mats,” said Torrence, “But no one could decide who would clean them.”
A number of groups outside the Free Library, including representatives from the University of Pennsylvania and the city’s Division for Chronic Disease Prevention, were involved with the conception of the rentals program, which is part of an ongoing effort to leverage the library to improve population health in South Philadelphia.
In 2015, representatives from Penn and the Free Library formed the Healthy Library Initiative, which conducted a needs assessment of community members and library staff in South Philadelphia to get an idea of what the area wanted from its libraries. The results of the assessment indicated that librarians were frequently helping patrons with health and social issues that they felt underprepared to handle, and in response the Healthy Library Initiative offered training sessions from Penn physicians and researchers to library staff.
Initial conversations developing the rental equipment program included the leadership of the Healthy Library Initiative, representatives from the Penn Medicine Center for Health Care Innovation, and Cheryl Bettigole from the city’s Division of Chronic Disease Prevention.
Reaching people where they are
Dr. Carolyn Cannuscio, who holds leadership roles at CPHI and the Healthy Library Initiative, and whose private foundation funded both Daingerfield-Fries’ position at the library and the purchase of the actual equipment, is excited about the potential of the program. “The library offers the perfect place to implement this kind of health intervention,” she said. “You can conduct randomized experiments, and evaluate endpoints like improved health literacy or fruit and vegetable consumption.”
Cannuscio also mentioned usage statistics from a study conducted by Pew Charitable Trusts in 2012, which paint a compelling picture of the library as a health resource; 51 percent of Philadelphians had visited the library in the last year, and 30 percent visited at least once a month. Among adult library users, the study found that 34 percent were there to find health information. “We want to reach those folks where they are,” said Cannuscio.
To promote the blood pressure monitor and the food scale, Torrence and Daingerfield-Fries have been plugging them in library newsletters and listservs that go out to health professionals across the city, as well as demonstrating the equipment at health fairs and events within the library.
A registered dietitian makes monthly appearances at the library and includes the food scale in their presentations, and Torrence has plans to take the blood pressure monitor with him when he takes out the library’s Book Bike, a bicycle refitted into a portable information booth. “Maybe I’ll monitor my blood pressure while I ride,” he said
Limits of a new program
Since the items have hit the shelves, Daingerfield-fries and Torrence have navigated a number of challenges unique to lending out this type of precision equipment. Unlike books, the equipment can’t be held or transferred to other branches. “We had someone who really wanted to borrow the equipment,” said Torrence, “but she’s homebound, and we didn’t have a way to get it to her. That’s something we’d hope to look at in the future, since that’s a population we’d like to target.”
There’s also the challenge of coordinating between the different groups operating in the South Philadelphia Health and Literacy Center. Daingerfield-Fries wrote in the blog post announcing the collection that “With the Philadelphia Department of Public Health’s Health Center 2 and the Children’s Hospital of Philadelphia’s Primary Care just upstairs, we aim to serve patients using the library before or after their health care appointments.”
But CHOP’s Emily DiTomo pointed out that the rental equipment is only for adult patients, and one month into the program, James Garrow with the Philadelphia Health Department wrote that “we are supportive of the concept, but it’s too early to know how successful it will be,” and declined to comment on how practitioners at Health Center 2 were utilizing the resource.
“Communicating between the different departments in the building is a work in progress,” said Torrence. “There’s a lot of great stuff going on with each of the organizations [in the building], and finding the best way to broadcast that can be kind of elusive.”
Determining the success of the program is also up in the air. “With only five of each object, it’s going to be anecdotal,” said Torrence. “With that small of a population, you’re not going to be looking at statistics.” Cannuscio, however, sees data collection as a vital step in the development of health programs like the rentals library. “[At CPHI] our goal is to be actively engaged in not just putting programs out there, but evaluating those programs,” she said, “and the program is in its infancy in that regard.”
The program’s had just a handful check-outs so far, but Torrence said he is excited about its future. “As an institution, the public library’s in a lot of flux right now,” he said, “and this is another way to integrate it into people’s lives, to meet them where they’re at.”