Information needs of public health students.

DOI: 10.1111/hir.12082

Information needs of public health students M^ e-Linh L^ e Health Sciences Centre Librarian, Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada

Abstract Background: The number of public health degrees and programmes is growing rapidly. This means that a diverse and multidisciplinary group of students are in need of expert library services to navigate the complicated world of public health information. Objective: To better understand the information needs of public health students, a group that has not previously been studied in the information needs literature. Methods: An online survey. Results: Of the 153 students, 38 responded (25% response rate). Their responses indicated a strong need for more tailored library instruction sessions at the point of need as opposed to general stand-alone sessions offered at the beginning of a term. It was also found that many students were unaware of public health specific resources available that could greatly aid them in their information needs. Suggestions were made on how to improve the library subject guide, specifically in the areas of more instructions related to locating hard to find resources (e.g. statistics, grey literature), and direct linking to resources (e.g. databases and relevant articles). Conclusion: The information needs of public health students are diverse and complex. It is imperative that the library has a solid understanding of their needs and is able to offer them targeted and relevant library services. Keywords: Canada; information literacy; information seeking behaviour; library services; surveys; public health; students, health; Key Messages

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The number of public health programs and schools in Canada, the United States and Europe has increased rapidly in the last 20 years, but library services for public health students has not seen the same amount of development. Stand-alone library instruction sessions once a year are not effective in demonstrating library resources and services; library sessions must be integrated into the curriculum or offered at the point of need. Librarians need to actively and continuously promote public health specific resources and databases to ensure that students are aware of them. Liaison librarians need to provide more training to public health students on how to find difficult to retrieve information, such as statistics, government reports and policy briefings.

Introduction Public health is a vital discipline within the realm of the health sciences. The study and practice of it impacts every single person, regardless of age, Correspondence: Mê-Linh Lê, Health Sciences Centre Librarian, Neil John Maclean Health Sciences Library, University of Manitoba, 727 McDermot Ave, Winnipeg, MB R3E 3P5, Canada. E-mail: [email protected]

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sex, race, geography or social standing. Public health research and policy informs on areas as diverse as bicycle helmet legislation, access to clean drinking water, epidemiological investigations of emerging diseases and the safety of the food we consume. Public health news stories are increasingly common in the media as an awareness of the impact of globalisation on our individual, national and international health grows.

© 2014 The author. Health Information and Libraries Journal © 2014 Health Libraries Journal Health Information & Libraries Journal, 31, pp. 274–292

Information needs of public health students, M^ e-Linh L^ e

Large-scale public health initiatives with long-term goals have become the norm, signalling recognition of the importance of public health on national and international levels. In the United States, Healthy People 2020 has a 10-year agenda of improving the country’s overall health by encouraging collaboration amongst communities, researchers and individuals, empowering individuals to make informed health decisions, and continuous evaluation on the impact of preventative actions.1 On an international level, three of the eight United Nations’ Millennium Development Goals are directly related to public health, including improving maternal health, reducing child mortality and combating major communicable diseases (e.g. AIDS, cholera).2 As a result of the growing and multidisciplinary nature of the field, the information needs of practitioners working in the realm of public health are vast and varied. It is essential that they enter the workforce as information literate individuals able to determine their information needs, access information efficiently, evaluate it critically, incorporate it accordingly and ultimately use information effectively.3 The library has the potential to contribute to the information literacy training of public health practitioners through its instruction, reference and research assistance, and collections. To offer these kinds of services, however, it is first necessary for a librarian to have a solid understanding of what the information needs of public health students are, as this allows for the offering of library services and programming that not only align with professional competencies, but also fulfil the immediate information needs of public health students. As will be highlighted below, while the study of the information needs and behaviours of public health practitioners has received some attention in the literature, public health students have not been studied at all. As such, the primary objective of this study is to better understand the information needs of public health students to offer targeted and more relevant library services. Literature review Discovering the information needs of specific users is a common research area within the field of

librarianship, and for a good reason. Accurately, determining information needs and behaviour can impact every aspect of a typical liaison librarian’s job responsibilities, including collections, instruction, reference and outreach. The advent of anytime–anywhere access to online resources has radically changed the way that patrons interact with the library and librarian, with decreasing reference interactions and gate counts but two examples of this.4–6 It thus makes it more important than ever that liaison librarians truly understand their users’ information needs and how best to serve them. Information needs studies are fairly common in the health sciences, with multiple studies on students and professionals in medicine, nursing, dentistry, pharmacy and allied health. Reviews have focused on the information needs of primary care physicians and nurses,7 health care practitioners around the world,8 rural health care providers9 and physicians’ preference for resources.10 Studies on the health information needs of patients are also common, often typified by a focus on disease/ condition and/or other identifiers (e.g. economic status, nationality, sexual orientation, etc.).11–17 While not as well studied as some of their health professional colleagues, there has been a marked increase over the last few years on better understanding the information needs of public health professionals, although this is not without its own challenges. As noted by the author in a previous study18 and others,19–26 public health information can be extremely difficult to locate and retrieve. The information needs of public health professionals can be quite different from other health professionals due in large part to the diversity of the public health workforce, which includes doctors, veterinarians, epidemiologists, inspectors, nurses, toxicologists, environmental scientists, and more. Information relevant to public health is, in turn, scattered across multiple domains, which makes locating it difficult, as evidence cannot be easily located using one or two key databases. This need for a single repository is echoed throughout the literature; whether it be public health inspectors in Ontario with food safety information needs,27 communicable disease and health promotion experts from the Massachusetts state health department,28 or a variety of public health personnel (including nurses, directors, and


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epidemiologists) from the state public health workforce in Washington.29 Two reviews from within the last 10 years have carried out an excellent job of highlighting other information needs issues within public health. A 2007 literature review on the information needs of public health professionals noted that the majority of studies indicated a need for authoritative, high-quality, and accessible information, with the barriers to that information access being time, reliability, credibility and information overload.30 In 2012, another review noted that the lack of a single public health database as well as the scattered nature of grey literature still hinders access to information; a better indexing system for public health resources is still needed; that librarians and information specialists are needed to assist practitioners in both recognising their information needs and being able to satisfy them; and that additional work is needed on the information needs of public health subgroups.31 As shown above, while information needs studies are available on the public health workforce, there has been little to nothing on public health students. While there will be similarities in the information needs of public health professionals and students, it is not safe to assume that they will be exact. Studies have shown that when comparing students and professionals, students are more technologically savvy, more inclined to use online databases to retrieve information and possess a greater awareness of the variety of information resources available to them.32 Professionals, meanwhile, are more likely to rely on interpersonal sources for information than students.33 As a direct correlation should not be drawn between student and professional information needs, it is hoped that this study will help in part to fulfil the call by Ford for more research on public health subgroups31 by focusing on the library and librarian’s role in better serving public health students, for which there have been no previous studies. Methods Setting Located in Saskatoon, Canada, the University of Saskatchewan (U of S) is a publicly funded research institution. In 2011/12, 16 578

undergraduate students and 2890 graduate students were enrolled in over 17 different colleges including Arts, Law, Business, Medicine, Agriculture, and Engineering, among others. The Health Sciences Library serves the colleges of Medicine, Nursing, Dentistry, Pharmacy and Nutrition, Kinesiology, and the Schools of Public Health and Physical Therapy, which together, in 2011/2012 included 391 academic faculty and 3222 students. The School of Public Health (SPH) is a relatively recent addition to the university. Founded in 2007, it is an interdisciplinary entity with close ties to the Western College of Veterinary Medicine and the Vaccine and Infectious Disease Organization and draws on a range of experts in areas such as medicine, nursing, dentistry, computer science, biology, anthropology and more. The degrees offered include a Master of Public Health (MPH), Collaborative Biostatistics (MSc and PhD), Epidemiology (PhD), and Vaccinology and Immunotherapeutics (MSc and PhD). The MPH students were the primary focus of this research and in 2011/2012 there were 153 students enrolled in the 2-year MPH programme. In addition, at the U of S, the SPH has strongly focused its attention on student recruitment, particularly international students,34 which is not uncommon as it is estimated that up to 50% of public health students in Canada come from outside the country.35 This diversity in background is largely echoed across the continent: at three of the top public health programmes in the United States, international students make up 44% of the student body at Johns Hopkins Bloomberg School of Public Health,36 10% at University of North Carolina – Chapel Hill Gillings School of Public Health,37 and 42% at the Harvard School of Public Health.38 In the UK, at the London School of Tropical Medicine and Hygiene, students from over 120 different countries are represented, and there are extensive programming and support systems in place for international students.39 As the SPH at the U of S was only founded in 2007, there was not a well established library liaison programme set up, and room for growth was possible. In 2010, the author began acting as one of two library liaisons to the school and



during that year, a new subject guide was created http://libguides.usask.ca/publichealth, one-two-hour orientation session was taught in August, and numerous in-office sessions were held with students. Over the course of the 2010/2011 school year, the author noticed she was spending an inordinate amount of time with the MPH students providing in-office library assistance, especially when the small size of the school was considered. These sessions, which typically ran for an hour or more, covered material mentioned in the orientations, but more frequently touched on ‘basics’ such as searching the library catalogue, requesting material from other libraries and proper citation formatting. The beginner nature of some of these topics (e.g. requesting a book online) meant they were not dealt with in depth during the graduate-level orientation as it was assumed that this content had been covered by students’ undergraduate library instruction. Many students also did not have a firm grasp on the basics of writing a paper and avoiding plagiarism. When personally kept statistics on frequency, length of time and content covered was compared between public health students and other health sciences students, it was clear that MPH students were not being well served by current library instruction and offerings. The author decided that more information was needed on what could be done to provide better library services to public health students. Study design To reach as many students as possible, it was determined that an online survey, hosted on FluidSurveys, would be used. Survey questions were based on the information needs the librarian identified during interactions with students. The survey was sent to the SPH Director of Programs for edits and suggestions. Several librarian colleagues evaluated the completed survey to ensure clarity. Ethics approval was granted in the summer of 2011, and survey responses were collected in the spring of 2012. Potential study participants included all students enrolled in the Masters in Public Health programme (153 students) in SPH. Participants were recruited through a variety of methods: all first-year students

were given a link to the survey during their September 2011 orientation session; all students were emailed via the SPH office with a link to the survey; the survey link was sent to the School of Public Health Students Association asking that they distribute it to their members; links to the survey were posted on the Health Sciences Library website and on the Public Health subject guide; and posters were put up in SPH office areas and in the library. The survey was divided into several sections (survey available in Appendix 1): 1 SPH Programme: One question that asked students in which programme (e.g. MPH, PhD, etc.) they were enrolled. All respondents not enrolled in the MPH programme were redirected to a thank-you page but did not fill out the rest of the survey. It was decided that this survey would only focus on the information needs of the MPH programme, as it is the largest and the students had thus far been the primary users of library resources. 2 Demographics: Two questions on gender and age. 3 Degrees: Six questions on the nature of their current degree (online or in-person), how long they had been working on it, and nature and location of previous degrees acquired. 4 Language: Three questions on languages spoken, primary language and confidence level with reading, speaking, writing and understanding English. 5 Library: Nine questions (including five freetext) on previous experience with library resources such as instruction or the subject guide. 6 Research: Eight questions on search skills (e.g. Boolean), information resources used and comfort level with resources. 7 Instruction: Two questions on preferred format and suggestions for library instruction. 8 Flash Drive Survey: At the September 2011 orientation, students were given a flash drive filled with library information and handouts. The results of this part of the survey will be published in a separate article. Completing the survey was voluntary for all students, although the potential of winning a prize


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(a $25 CDN gift card to the university bookstore) was offered to encourage participation. Results There were 153 students enrolled in the MPH programme in 2011/2012. Of the 43 survey respondents, 38 were MPH students, making a response rate of 25%. The total number of participants was 38, but as a requirement of ethics approval from the university requires that no questions be mandatory, the number of respondents varied with each question. The actual number of respondents and the percentage are displayed below. Demographics Of the respondents, 28/37 (76%) were female; 5/ 37 (14%) were 18–24 years old; 23/37 (62%) were 24–34, 7/37 (19%) were 35–44, and 2/37 (5%) were 45–54. Degree The vast majority of students (n = 35/38; 92%) were completing their degree in-person; most were in the first (n = 23/28; 61%) or second (n = 12/ 38; 32%) year of study. As the MPH is a graduate degree, all students were required a previous degree: of 38 respondents (multiple answers were possible), 18 (47%) had a BSc; 10 (26%) had a MD, MBBS, MB or ChB; 8 (21%) had a BA; 2 (5%) had a previous MPH; and one each (3%) had a BComm, BEd, BSW, BHS, MA, MBA or MLIS. Three (8%) also had postgraduate diplomas. The large majority of these degrees were completed in Canada (26/38; 68%), although one to two degrees were also completed in Belgium, China, India, Nigeria, Pakistan, Russia, the UK and the United States. Languages All respondents spoke English (a requirement of entry into the programme) and 7/37 (19%) spoke French. There was a wide variety in terms of other languages spoken, with some respondents speaking up to five languages. 18/37 (49%) spoke an

additional language to English (five individuals listed more than one additional language), including Arabic, Bini, Cantonese (2), Dagaare, Hindi (2), Japanese, Mandarin (2), Marathi, Nepali, Polish, Punjabi, Russian (2), Sindhi, Spanish, Twi, Ukranian, Urdu (3), Vietnamese and Yoruba. When asked to identify their primary language, 30/33 (91%) selected English, with seven other languages also chosen (some respondents selected multiple primary languages). The overwhelming majority strongly agreed with the statement that they were confident reading, speaking, writing and understanding English. Library The library orientation session, which was offered during the August orientation week for SPH students, was attended by 25/36 (69%) of respondents, although 2/36 (6%) could not recall whether they had gone or not. The session was seen as very helpful or helpful by 22/26 (85%); and neither helpful nor unhelpful by 4/26 (15%). There were 21 respondents who offered comments on what made the session either helpful or unhelpful. There were five mentions of the fact that the session itself was helpful but that its timing, well before most students actually begin doing library research, and location, a large lecture hall with no computers, was detrimental to their retention of information. Four noted that learning about specific resources that they had previously been unaware of, such as OVID Medline and RefWorks, was helpful. The session was also found by 13 students to offer a good introduction to the general resources they would need when conducting research, such as tutorials on searching, guidance on literature searches, subject pages and various search engines. Two students indicated that putting a ‘face’ to their subject librarian and their home library was helpful. When asked if additional library sessions would be beneficial, 14/26 (54%) said yes; 7/26 (27%) were unsure; and 5/26 (19%) said no. Students who answered in the affirmative noted that additional sessions would be helpful as they moved through the programme and their information needs would change; that tailored sessions for specific class research would be helpful; and the worry that not



using the lessons learned in the session right away would mean students would forget. One student who felt the one session was enough aptly pointed out that additional help could always be found in the library. When asked about the Public Health subject guide (created in 2010 and one of the most heavily used guides in the library system during the 2011–2012 school year), 44/36 (44%) had used it while 20/36 (56%) had not or were unsure. Due to a flaw in the survey logic, students who indicated that they had never used the LibGuide were still prompted to indicate how often they used it. While this could have thrown off the results, the inclusion of a free-text box in the question meant that respondents simply wrote they did not use the toolkit. The frequency of use did vary, with infrequent to no use dominating; 1/35 (3%) used it every day, 6/35 (17%) used it once a week, 4/35 (11%) used it two to three times a month, 1/35 (3%) used it once a month, 7/35 (20%) used it less than once a month, and 12/35 (34%) did not use it at all. Further questions focused on what students liked about the LibGuide. Multiple responses noted that they appreciated that the LibGuide brought multiple resources to one location, included current public health news items and provided quick links. When asked about what they did not like, several students suggested that poor layout and presentation made it difficult to navigate around the site, with one noting that it took too many ‘clicks’ to get to the databases they wanted. Another student suggested including more articles actually on the LibGuide, as opposed to links to article databases. When asked in a freetext why they did not use the LibGuide, 12/17 (71%) said they had never heard of it, with the remaining 5/17 (29%) listed other reasons, including having access to other resources, forgetting that it was there, or simply not having had a chance to use it yet. Ten free-text responses on ways to make the LibGuide more helpful included: increased awareness of the guide to international students, improving the navigation of the site, an orientation session on the guide and its purpose, adding more databases to the front page, adding more resources to distinguish between policy and clinical papers, and more international content.

Research Respondents most frequently chose Google (10/ 34–29%) and the Library website (10/34–29%) when asked about where they go when they first start their research. In terms of other sources, 6/34 (18%) chose the Public Health LibGuide; 5/34 (15%) chose Google Scholar, 2/34 (6%) chose Medline; and 1/34 (3%) chose government websites. When questioned about the types of information used for their coursework, papers or assignments, of the 34 respondents, 34 (100%) selected journal articles, 26 (76%) selected government reports, 26 (76%) selected statistics, 21 (62%) government reports and 21 (62%) selected books. In terms of ease in locating the above-mentioned resources, as shown in Figure 1, it is clear that students struggle substantially more with finding government reports, statistics and grey literature. When asked about their comfort level with search tools, students were most confident or somewhat confident using keywords (88%), subject headings (58%) limits (54%), Boolean (50%) and focus (52%), when searching. They were less confident with explode (33%) (Figure 2). When asked about frequency of resources used, the results were not surprising. As shown in Figure 3, Google, Google Scholar, PubMed and OVID Medline were used most frequently. Global Health was the only specialised database that was sometimes used. The large majority of students never or rarely use any of the other journal databases, including specialised Public Health databases (e.g. Proquest Public Health, HealthEvidence.ca), or more general health sciences

Figure 1 Level of difficulty in finding resources (n = 34)


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Figure 2 Confidence level when using search tools (n = 34)

Figure 3 Frequency of resource use (n = 34)

databases (e.g. CINAHL, EMBASE, Scopus, HealthEvidence.ca). Students’ self-assessed skill level with resources aligned closely with frequency of use, as shown in Figure 4. The large majority indicated a skill level ranging from intermediate to expert using Google, Google Scholar, Medline and PubMed, while the other resources, such as Global Health and Scopus, were mostly not used. When asked about other resources used for their coursework that were not mentioned in the survey, the only suggestions were for other subscription or free databases (e.g. Web of Sciences, PsycInfo, SSCI, EBSCO, Google Books), or government agency websites (e.g. Statistics Canada, the Public Health Agency of Canada). Instruction Preference format for receiving library instruction was for small groups (10/30–33%), written instructions (7/30–21%), a classroom setting (6/ 30–18%), one-on-one instruction (6/30–18%) and

online videos (4/30–12%). When asked in a freetext question what the Library could do better to help the students find the resources they need, three students indicated that some form of refresher course would be helpful and one student requested the library increase the number of required textbooks available for short-term loan (i.e. reserve material). Discussion Public health is a growing discipline, due in no small part to recent public health crises around the world, including SARS, H5N1 and vaccination controversies. In Canada, the number of public health schools and programmes has increased from five in the 1990s to 17 as of 2013.35,40 In the United States, it has grown from 12 schools in the 1960s41 to 50 schools and 101 programmes in 2013.42 While firm numbers are not available, the same rapid increase in the number of public health programmes is seen in Europe,43 where it is



Figure 4 Self-assessment of skill level with information resources (n = 34)

estimated that there are over 100 different programmes or degrees offered.44 This means that, in addition to the growing number of public health programmes and faculty requiring library services, there is also the need for liaison librarians that are able to recognise and accommodate the needs of a diverse student body who are all trying to access the vast and often poorly organised public health evidence. In addition to specifically improving library services to U of S SPH students, the results of this study will help inform the practice of those librarians working with public health students, in the below areas. Instruction sessions It is clear that a stand-alone library session, particularly one included as part of a informationheavy orientation period, is not sufficient to meet the needs of public health students. While a single session can be helpful as a means of introducing the library and its service to the students, as well as putting a ‘face’ to the library, additional sessions are needed. As indicated by the students, extra sessions that are better integrated into coursework (e.g. a library session on how to search for statistics prior to when an epidemiology assignment was due) are ideal. The ability to see the utility of library resources in action at the point of need cannot be overstated. In addition, it is strongly recommended that all sessions either take place in a computer lab or with students bringing laptops. As with all of the health sciences, the large majority of public health

information is online, so being able to have students access the resources first-hand can be extremely valuable and serve to help students better remember how to find these resources in the future. Subject guides While the U of S public health subject guide (LibGuide) appears to be well used, it is obvious that more could be done to promote the guide to raise awareness. At the U of S, the LibGuide was heavily promoted during the orientation session and during any subsequent reference interactions. In addition, it was linked to on the SPH homepage and on the student association website. Additional marketing, however, such as alerting faculty to its presence and asking for suggestions or content and integration into any course management software (e.g. Blackboard) is strongly recommended. Additionally, changes are suggested to improve navigation and decrease the number of ‘clicks’ necessary to access key resources. It is possible that the guide may benefit from a usability test to truly determine what could be done to improve the layout. Based on student feedback, it is clear that librarians creating new subject guides or modifying older ones may want to take the following into account: one-click access to key information resources; inclusion of links to recently published articles on specific subject areas (e.g. emerging infections, health disparities); and content specific to class assignments (e.g. statistical analysis, citing government reports, locating grey literature, etc.). It is the author’s


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opinion that when writing or speaking, the librarian should use straightforward language that does not rely heavily on slang, jargon or colloquialisms. While the participants in this study did indicate a strong comfort level with English, this does not take away from the fact that for many (admirably) it is their second or third language, and accommodations should be made to ensure that there are limited miscommunications when discussing library resources. Information seeking The information resources identified by students as being most used are not surprising. Health sciences students and professionals frequently cite Google, Google Scholar and PubMed/OVID Medline as key tools. What should be noted, however, are the large number of high-quality information resources aimed specifically at public health students that are not being used or are not known about. Databases such as Proquest Public Health, Global Health and HealthEvidence.ca provide focused collections of public health material that are often not available anywhere else. Instead of searching larger resources (e.g. PubMed) with poor public health indexing, it is much more efficient to search in smaller more targeted resources that are populated with almost all public health content. Both at the U of S and at other institutions, public health liaison librarians must do their best to ensure that students are aware of these tools and their potential benefits. Public health librarians would also be well served by focusing their library instruction and online resources (e.g. LibGuides) on helping students locate those types of resources that are frequently noted as being hard to locate. Using Google, Google Scholar and PubMed/OVID Medline, it is fairly straightforward for most students to locate a journal article. Based on the author’s in-office interactions with students, what is much more difficult is navigating through nongovernmental organisation websites for reports, uncovering health statistics from foreign government databases, or determining the validity or accuracy of a white paper. These higher level searching skills, that are more relevant to the professional practice of public health students, will be much more valuable.

Limitations While the sample size was limited, it is still of a large enough size to offer up valuable insight, particularly in an under-researched area. A response rate of 25% is lower than would be desired, but does align with overall declining rates in survey response rates.45,46 At this point, it is not known what could be done to improve response rate, although potentially shortening the survey or increasing the incentive prize to a more tangible item rather than gift cards has been suggested by recent research.47,48 Indeed, studies have shown that simply increasing the monetary price of the incentive does not necessarily lead to increased response rates.49 It is also possible that poor survey logic that directed students who had answered ‘no’ to a question about whether they used a specific resource to further questions about how they used that resource, may have been frustrating and led to some participants dropping out. Analysis of the completion rate of the study, however, showed that this was not the case as students simply used the free-text portion of the survey to indicate some questions were not applicable. It is also worth noting that while not every question was answered by all respondents this did not cause any large issues during analysis. All of the questions focusing on resource use and preference were answered by either 33 or 34 respondents, and this figure did not change for the entirely of the survey. Conclusion Originally designed as a relatively straightforward means of gaining information on how to improve library services for a specific population, this study and its findings are still relevant to the larger information needs literature. It is clear that the student population of public health programmes are well educated and from a diverse array of professional and personal backgrounds. As such, their information needs and information seeking behaviour will differ from their health sciences colleagues in medicine, nursing, pharmacy, etc., and it is important that libraries and library liaisons are aware of these needs and target library services appropriately.



Ultimately, while this study is relatively small, it does present the first piece of research in the library literature on the information needs of public health students. While none of the responses were particularly surprising or controversial, liaisons working in the area of public health now have access to at least some evidence on what their patron group needs from library instruction, website aids and ongoing support. It is hoped that this pilot study serves as a jumping off point for additional research into the information seeking behaviour of public health students. The growing field of public health and its increasing prominence in the public eye necessitates that the health sciences library have a better understanding of the unique information needs of its students and practitioners. Future studies could potentially include an expansion of this study to a larger sample population (e.g. all public health students in a certain geographic area). As noted by Cobus,50 aligning library instruction and assignments with public health competencies40,51,52 will no doubt aid in the education of public health professionals, and more work is needed to see whether this has begun to occur at other institutions. Finally, in-depth interviews on information seeking behaviour of international students within any health professional would be extremely helpful and valuable, especially as more academic institutions focus on expanding their international enrolment. Source of funding The University of funded this research.

Saskatchewan

generously

Conflict of interest The author declares that they have no conflict of interests. References 1 U.S. Department of Health and Human Services. About Healthy People 2020. Washington, DC, 2011. Accessible at: http://www.healthypeople.gov/2020/about/default.aspx [cited 15 July 2014]. 2 United Nations. Millennium Goals. Geneva: United Nations, 2014. Accessible at: http://www.un.org/millenniumgoals/ [cited 15 July 2014].

3 American Library Association. Information Literacy Competency Standards for Higher Education. Chicago, IL: ALA, 2000. Accessible at: http://www.ala.org/acrl/standards/informationliteracycompetency [cited 3 March 2014]. 4 Martell, C. The elusive user: changing use patterns in academic libraries 1995 to 2004. College & Research Libraries 2007, 68, 435–445. 5 Applegate, R. Whose decline? Which academic libraries are “deserted” in terms of reference transactions? Reference & User Services Quarterly 2008, 48, 176–189. 6 Martell, C. The absent user: physical use of academic library collections and services continues to decline 1995–2006. The Journal of Academic Librarianship 2008, 34, 400–407. 7 Clarke, M. A., Belden, J. L., Koopman, R. J., Steege, L. M., Moore, J. L., Canfield, S. M. & Kim, M. S. Information needs and information seeking behaviour analysis of primary care physicians and nurses: a literature review. Health Information & Libraries Journal 2013, 30, 178–190. 8 Prakasan, P. M. Information needs and use of health care professionals: international perspective. DESIDOC Journal of Library & Information Technology 2013, 33, 465–473. 9 Dorsch, J. L. Information needs of rural health professionals: a review of the literature. Bulletin of the Medical Library Association 2000, 88, 346–354. 10 Haug, J. D. Physicians’ preferences for information sources: a meta-analytic study. Bulletin of the Medical Library Association 1997, 85, 223. 11 Hall, B., Howard, K. & McCaffery, K. Do cervical cancer screening patient information leaflets meet the HPV information needs of women? Patient Education and Counseling 2008, 72, 78–87. 12 Hendry, M., Lewis, R., Clements, A., Damery, S. & Wilkinson, C. “Hpv? Never heard of it!”: a systematic review of girls’ and parents’ information needs, views and preferences about human papillomavirus vaccination. Vaccine 2013, 31, 5152–5167. 13 Kwok, C. & White, K. Perceived information needs and social support of Chinese-Australian breast cancer survivors. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer 2014, 22, 2651–2659. 14 Obeidat, R. & Khrais, H. I. Information needs and disclosure preferences among Jordanian women diagnosed with breast cancer. Journal of Cancer Education: The Official Journal of the American Association for Cancer Education 2014, 1–6. 15 Park, H. & Park, M. S. Cancer information seeking behaviors and information needs among Korean Americans. Studies in Health Technology and Informatics 2014, 201, 401–406. 16 Song, H., Cramer, E. M., McRoy, S. & May, A. Information needs, seeking behaviors, and support among lowincome expectant women. Women and Health 2013, 53, 824–842. 17 Tariman, J. D., Doorenbos, A., Schepp, K. G., Singhal, S. & Berry, D. L. Information needs priorities in patients diagnosed with cancer: a systematic review. Journal of the Advanced Practitioner in Oncology 2014, 5, 115–122.


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nurses and recent nurse graduates. Nurse Education Today 2014, 34, 208–213. Goel, V. & Wilson, D.. Consultation report on the development of the School of Public Health: University of Saskatchewan, 2011. Masse, R., Moloughney, B. & Murray, L. R. New era for schools and programs of public health in Canada. Public Health Reviews 2011, 33, 277–288. Johns Hopkins Bloomberg School of Public Health. Student Demographics 2013. Accessible at: http://www.jhsph.edu/aca demics/degree-programs/master-of-public-health/prospectivestudents/student-demographics.html [cited 30 January 2014]. University of North Carolina - Chapel Hill. Quick Facts 2013. Accessible at: http://sph.unc.edu/resource-pages/quickfacts-3/ [cited 30 January 2014]. Harvard School of Public Health. Student Demographics 2013. Accessible at: http://www.hsph.harvard.edu/master-ofpublic-health-program/prospective-students/student-demograp hics/ [cited 30 January 2014]. Anderson, S., Havala Hobbs, S. & Helm-Murtagh, S. The internationalisation of professional doctorate programmes challenges and opportunities for networking by students of global health leadership. Work Based Learning e-Journal, 2013, 3, 156–165. Public Health Agency of Canada. Core Competencies for Public Health in Canada Release 1.0. Ottawa ON: Public Health Agency of Canada, 2007. Rosenstock, L., Helsing, K. & Rimer, B. Public health education in the United States: then and now. Public Health Reviews 2011, 33, 39–65. Council on Education for Public Health. Accredited Schools & Programs 2013. Accessible at: http://ceph.org/accredited/ [cited 31 January 2014]. Paccaud, F., Weihofen, A. & Nocera, S. Public health education in Europe: old and new challenges. Public Health Reviews 2011, 33, 66–86. The Association of Schools of Public Health in the European Region (ASPHER). About ASPHER 2013. Accessible at: http://aspher.org/pg/pages/view/17/about-aspher [cited 30 January 2014]. Baruch, Y. & Holtom, B. C. Survey response rate levels and trends in organizational research. Human Relations 2008, 61, 1139–1160. Pew Research Center. The Problem of Declining Response Rates 2014. Accessible at: http://www.people-press.org/ methodology/collecting-survey-data/the-problem-of-decliningresponse-rates/ [cited 31 January 2014]. Bailey, S., Carter, V. & Martin, S. Reversing the trend of declining survey response rates: Was it something we did? Library Assessment Conference October 29–31, 2012, Charlottesville, VA. 2012. Laguilles, J., Williams, E. & Saunders, D. Can lottery incentives boost web survey response rates? Findings from four experiments. Research in Higher Education 2011, 52, 537–553. Porter, S. & Whitcomb, M. The impact of lottery incentives on student survey response rates. Research in Higher Education 2003, 44, 389–407.


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52 Gebbie, K., Rosenstock, L. & Hernandez, L. M. Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century. Washington, DC: National Academies Press, 2003. Received 5 March 2014; Accepted 10 September 2014

Appendix 1. Public Health Students Information Needs Introduction You are invited to participate in an online questionnaire that seeks to examine the information needs of Master of Public Health (MPH) students at the University of Saskatchewan. Your input will help answer questions about the types of information MPH staff are using, how they are using it, challenges associated with finding information (search skills, access issues, etc.) and determining whether there are any information needs that are not being met. The anonymity of the participants in our survey will be achieved through the de-identification of data and by separating personal information from responses during the data collection process. In addition, participants’ comments will not be identifiable in any way in publications or reports that result from this study. All data will be kept confidential and will not be accessible to anyone except the researcher through a password-protected Canadian server. Your participation in this study is entirely voluntary, and you may choose not to participate or withdraw from the study at any time. The survey will take approximately 20 min to complete. All survey participants will be entered into a draw to win one of four $25 gift certificates to the University of Saskatchewan bookstore. If you have any questions concerning the research project, please contact the researcher at [email protected] or 306.966.1673. This research project has been granted ethics permission by the University of Saskatchewan Behavioural Research Ethics Board on October 10, 2011. Any questions regarding your rights as a participant may be addressed to that committee through the Ethics Office (306.966.2084). Out-of-town participants may call collect. By clicking ‘Next’ you are indicating that you consent to participate in this study, knowing that your responses will be made anonymous and may be kept for further use after the completion of this study. You may print a copy of this consent form for your own records. Thank you for your time and effort in completing this survey. Background Information 1. ○ ○ ○ ○

Which program are you are currently enrolled in? Collaborative Biostatistics Program – MSc or PhD Epidemiology Program – PhD degree Master of Public Health Program Vaccinology and Immunotherapeutics Program MSc or PhD

Degree Information How are you completing your program? ○ Online ○ In-person © 2014 The author. Health Information and Libraries Journal © 2014 Health Libraries Journal Health Information & Libraries Journal, 31, pp. 274–292

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How long have you been working on your current degree? ○ 0–1 years ○ 1–2 years ○ 2–3 years ○ 3–4 years ○ 4+ years What other degrees do you hold? (Check all that apply) □ BA □ BSc □ BComm □ MA □ MSc □ MPH □ MD, MBBS, MB, or ChB □ PhD □ Other, please specify: ______________________ What was your most recent degree prior to starting your MPH? (Check all that apply) □ BA □ BSc □ BComm □ MA □ MSc □ MPH □ MD □ PhD □ Other, please specify: ______________________ How long has it been since you finished your last degree prior to starting your MPH? ○ Less than a year ○ 1 year ○ 2 years ○ 3 years ○ 4 years ○ 5 years ○ 6–10 years ○ 11+ years Where did you complete your last degree? ○ Afghanistan ○ Albania ○ Algeria ○ Andorra ○ Angola ○ Antarctica ○ Antigua and Barbuda ○ Argentina ○ Armenia ○ Australia . . . 170 additional choices hidden. . . © 2014 The author. Health Information and Libraries Journal © 2014 Health Libraries Journal Health Information & Libraries Journal, 31, pp. 274–292


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United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe

Demographic Information What is your gender? ○ Female ○ Male ○ Prefer Not to Answer What is your age? ○ Under 18 ○ 18–24 ○ 25–34 ○ 35–44 ○ 45–54 ○ 55–64 ○ 65 or Above ○ Prefer Not to Answer What languages do you speak? (Check all that apply) ○ English ○ French ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ What is the primary language you use? (Check all that apply) ○ English ○ French ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ ○ Other, please specify: ______________________ © 2014 The author. Health Information and Libraries Journal © 2014 Health Libraries Journal Health Information & Libraries Journal, 31, pp. 274–292

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I am confident:

Reading English Speaking English Writing English Understanding spoken English

Strongly agree

Agree

Neutral

Disagree

Strongly disagree

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Library Information Have you ever attended a University of Saskatchewan Library Orientation Session? ○ Yes ○ No ○ Not sure/Can’t remember If ○ ○ ○ ○ ○

you answered yes, did you find the session: Very helpful Helpful Neither helpful nor unhelpful Unhelpful Very unhelpful

Please comment on why you found the session helpful/not helpful

Would you benefit from additional library sessions at different points during your degree? Please indicate yes/no/unsure and describe why or why not

The Public Health LibGuide (http://libguides.usask.ca/publichealth) is a Library tool that collects all the best Public Health resources in one place.Have you ever used the Public Health LibGuide? ○ Yes ○ No ○ Unsure/Can’t remember If yes, how often do you use the Public Health LibGuide? ○ Every day ○ Once a week ○ 2 to 3 times a month ○ Once a month ○ Less than once a month ○ Other ______________________ If you use the Public Health LibGuide, what do you like/dislike about it?

If you don’t use the Public Health LibGuide, is there a reason why?



Do you have any suggestions for how to make the Public Health LibGuide more helpful?

RESEARCH NEEDS Where do you go when first starting your research? ○ Google ○ Google Scholar ○ Public Health Subject Guide ○ Library website ○ Colleague/classmate ○ Other ______________________ What types of information do you need for your own coursework, papers, assignments, etc? [Check all that apply] ○ Journal articles ○ Books ○ Government reports ○ Statistics ○ Grey Literature (Grey literature is material not published through traditional means, such as WHO reports, health region statistics, etc) ○ Other (please list) ______________________ How difficult/easy do you find it to locate these resources for your research?

Journal articles Books Government reports Statistics Grey Literature

Very difficult

Difficult

Neutral

Easy

Very easy

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Do you have any suggestions for what would make it easier to learn how to locate any of these resources (e.g., articles, books, statistics)

How comfortable are you using the following when you search for information?

Boolean (AND/OR/NOT) Subject headings (e.g., MeSH) Keywords Focus Explode Limits (e.g., Age, Sex, Language)

Confident

Somewhat confident

Neutral

Somewhat unconfident

Unconfident

Never heard of it

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Indicate how frequently you use the following resources for your Public Health research or classes?

Google Google Scholar Medline Pubmed Global Health Proquest Public Health CINAHL EMBASE Scopus HealthEvidence.ca

Never

Rarely

Sometimes

Often

All the time

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What is your skill level using the following resources?

Google Google Scholar Medline Pubmed Global Health Proquest Public Health CINAHL EMBASE Scopus HealthEvidence.ca

Expert

Advanced

Intermediate

Beginner

Do not use

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Are there any other resources you use for your Public Health research or classes?

LIBRARY INSTRUCTION What is your preferred format for receiving instruction on using Library resources? ○ In a classroom setting ○ One-on-one ○ In small groups ○ Online videos ○ Written instructions ○ Other, please specify: ______________________ Do you have any other comments or suggestions about the Library and how it can better help you find the resources you need?

PART 5: FLASH DRIVE (USB) SURVEY Did you attend the Library Orientation Session in August 2011? ○ Yes ○ No © 2014 The author. Health Information and Libraries Journal © 2014 Health Libraries Journal Health Information & Libraries Journal, 31, pp. 274–292


PART 5: FLASH DRIVE (USB) SURVEY cont’d In your orientation session this year did you receive a Flash Drive (USB) from the instructor? ○ Yes ○ No ○ Don’t remember If no, do you know why not?

Since you received the Flash Drive, how many times have you used it? ○ Everyday ○ Once a week ○ 2 to 3 times a month ○ Once a month ○ Less than once a month ○ Never ○ Lost the Flash Drive How do you use the Flash Drive? [check all that apply]? □ For school related work □ For personal use □ I do not use the Flash Drive □ Other, please specify: ______________________ How much of the pre-loaded content on the Flash Drive did you view? ○ All of the files ○ 1–2 files ○ 3–4 ○ 5–10 files ○ None of the files ○ I did not know there were files on the Flash Drive How helpful did you find the following files?

Link to Public Health Subject Guide Ways to Get Help Health Sciences Library Brochure Health Sciences Library Floor Plan U of S Library Map How to Cite Books and Articles Library Orientation Powerpoint How to Search for Articles How to Search for Books Starting Your Research Using RefWorks and Endnote

Very helpful

Helpful

Unhelpful

Very unhelpful

Did not view

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Do you have any suggestions for what types of information might be useful that were not included?


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Do you have any comments on the use of the Flash Drive as a free resource for Public Health students?

Do you see this as a useful tool for future incoming Public Health students? ○ Yes ○ No ○ Unsure ○ Other, please specify: ______________________ Thank you for participating in this survey. Please enter your email address here if you would like to be entered into a draw for one of four $25 gift cards to the University Bookstore. Your email address will be separated from the rest of the survey and kept confidential.

Thank you for completing this survey. Your participation is appreciated.


Copyright of Health Information & Libraries Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.

An integrated and sustainable EU health information system: national public health institutes' needs and possible benefits.

Applications of health information exchange information to public health practice.

Variation in information needs and quality: implications for public health surveillance and biomedical informatics.

Health information systems and users' needs.

Habits and attitudes of public health students.

Information needs and seeking behaviour among health professionals working at public hospital and health centres in Bahir Dar, Ethiopia.

Public health professionals and prison health care needs.

Information needs of health sciences libraries using OCLC: a survey.

Health information technology needs help from primary care researchers.

Initial external validation of REGRESS in public health graduate students.

Preparing Students to Engage in Public Health Research of Consequence.

Patterns of marijuana use among public health students.

Web-based surveillance of public information needs for informing preconception interventions.

Management information systems for public health nursing services.

Survey of profession's information needs.

Students' trust judgements in online health information seeking.

Advising Undergraduate Public Health Students: A Phased Approach.

Public Health Staff Development Needs in Informatics: Findings From a National Survey of Local Health Departments.

The health information seeking behaviour and needs of community health workers in Chandigarh in Northern India.

Understanding the Health Needs and Barriers to Seeking Health Care of Veteran Students in the Community.

Information empowerment: predeparture resource training for students in global health.

Meeting the health information needs of prostate cancer patients using personal health records.

Correction: The Grand Convergence: Closing the Divide between Public Health Funding and Global Health Needs.

Cultural competency training for public health students: integrating self, social, and global awareness into a master of public health curriculum.