An INFO 200 Book Review

Mcknight, J. and Block, P. The Abundant Community: Awakening the Power of Families and Neighborhoods. (2010) Barrett-Koehler Publishers, Inc., San Francisco.

I chose to read The Abundant Community for two reasons. The first being the title itself. It was not only intriguing to me as an aspiring health information professional, but as a citizen yearning to be part of an abundant community both personally and professionally. Secondly, the title denotes a message of physical health within a neighborhood/community as well as its citizens ultimately creating a community that is personally and socially satisfying as a result of eating healthier food and preserving our natural resources.

After reading the first chapter, my first overall impression of The Abundant Community was of skepticism and idealization concerning the possibility of citizens creating an abundant community. As I read, I found it hard not to become nostalgic for the neighborhoods of my youth where kids, parents, and neighbors knew each other and socializing was more spontaneous. Many neighbors would drop by on a whim. In those days, neighbor friends visited our home and would casually exchange information with my parents about each other’s skills and interests and how they could contribute their natural gifts or talents to help each other and each other’s kids. I remember  my mother helping one friend with a cultural project for school and that same friend’s father taking me out for extra driving practice to pass Driver Training.

The authors, John McKnight and Peter Block, while discussing the negative effects of our consumer society on families, neighborhoods, communities, and the environment, assert that community citizens have capabilities to express needs and gifts to contribute to our neighborhoods and to each other in creating a more sustainable and satisfying life while minimizing our dependence on excess material goods in order to validate our overall personal value.

“Community, as defined by the Encyclopedia of Community, is a specific group of people sharing a common interest.” In his book, Community, The Structure of Belonging, Peter Block states that “Communities are human systems given form by conversations that build relatedness” which is also the  premise of The Abundant Community. The authors organize their concepts and proposals into three parts.

In Part I, John McKnight and Peter Block discuss the shift from citizen to consumer, define the consumer way as “lives of scarcity and consumption,” and define the citizen way as “lives of abundance and cooperation.” They further illustrate the “Elements of Satisfaction” which resonated with me since my learning community is health oriented. In regard to health, they emphasize that “Our neighborhoods are the primary source of our health.” These include “…, personal behaviors, social relationships and physical environment.”  The authors poignantly assert that, “Our institutions can offer only service – not care – for care is the freely given commitment from the heart of one to another; it cannot be purchased.” I agree with the authors that while our physicians can examine and treat us and our family members with medications or recommend physical therapy at the minimum, we also need to take responsibility for our health and those of our families into our own hands and seek information on alternate therapies when the initial medicines fail or cease to help.

A final and important observation for this chapter is the authors stating and defining three terms that are not only fundamental to creating an abundant community, but that are fundamental to health learning communities.  These terms are listed and defined as follows:

  • Association: “Three or more people who come together by choice and mostly without pay because of a common interest. The common interest may be simply to be together, or it may be to change the world.”
  • Neighborhood: “The place where you live and sleep. It could be your block or the square mile surrounding where you live. It may or may not have a name.”
  • Community: “A general term to describe what occurs outside systems and institutions.” Similarly, in relation to our class lectures and readings, the authors also state that “it also refers to an aggregation of people or neighborhoods that have something in common. It is both a place and an experience of connectedness.”

In Part Two, McKnight and Block shift their discussion from critiquing the consumer society and its consequential costs to our personal lives, neighborhood and communities to considering the possibilities and actions we as citizens can take to bring our communities back to a more sustainable and satisfying life. These possibilities include “placing hospitality at the center of newly activated communities and the encouragement and empowerment of citizens to utilize share, and exchange their natural gifts of teaching, nurturing caring for the youth, infirmed and elderly, the land and welcome those on the margins” as Elfreda Chatman  focused her doctoral research on the marginalized individual, defined as “someone that lives in two small worlds of culture, which are very different from each other.”

The authors then include and define the terms Association and Associational life that conveniently fit into Peter Block’s definition of community. Association is further defined as “fundamentally, a group of people who have a shared affinity” and further defined as “a primary place in community where individual capacities get expressed.” Associational life, according to the authors, begins with a group of people who are drawn together for some reason, and that reason is what makes it work.” They provide examples of bike clubs, pet clubs and health clubs. Another example belonging to an association or fitting into an associational life regarding my health information community are volunteers working with health information librarians to help and train medical professionals with information seeking strategies and troubleshooting computer issues.

The authors in Part three continue to discuss the value of associations and associational life, their strong relationship and central(ness) to democracy, and giving ourselves power to wean ourselves from our dependency on consumer goods and the consumer society.

Another statement the authors make that resonates with health Information communities is that, “Every association is empowering and powerful, because it acts as the amplifier of the gifts, skills, and talents of each member. It is the principal community means of helping people to give their gifts.”

For an association to empower citizens to utilize and share their gifts, The authors state that to create abundant communities, it is vital to: ”elevate and make more visible people who have connecting capacity and, encourage each of us to discover the connecting possibility in our own selves.”

While I believe these are noble ideas for more functional communities and neighborhoods, I find it idealistic to believe that the “average” person will have the spiritual insight to overlook a major deficiency in character or even a slight disability of someone who is slow in thinking or moving in today’s fast-paced society.  The authors profoundly state that “The greatest community weakness is that we haven’t seen them and felt their loneliness. We have often ignored or even feared them. And yet their gifts are our greatest undiscovered treasure!” They conclude, “Therefore the Connectors’ Table [such as health information professionals, bracketed content mine] need to pay special attention to the people at the edge, the people with the names that describe their empty half rather than their gifted full half. For the strength of our neighborhood as greatest when we all give all our gifts.”

Conclusion

Therefore, library health professionals can take heed, glean and implement many of the inspiring ideas and concepts of the authors, McKnight and Block to enhance their health resource centers and information communities. While health librarians may be knowledgeable, focused and dedicated in their pursuit to find information for physicians and other health professionals, they can develop ways of creating a hospitable and welcoming environment (without disturbing those quietly studying and/or utilizing the Center’s resources) to all who visit, explore and seek information for personal and professional reasons.

One final and very poignant thought by the authors is “every local community of any kind is a group of specially connected people. But the very fact of their special connection necessarily creates outsiders.” One area where health information professionals can create an abundant community is to observe visitors or students that display special talents of helping friends or family members search for information on the Health Resource Center’s online catalog or help a medical professional troubleshoot a glitch. Many community hospitals have auxiliary or volunteer programs where the public can join and share their gifts. El Camino Hospital has such an auxiliary with the Health Resource Center being one of them. With encouragement and effective mentoring by health information professionals, volunteers connected to physicians and health professionals utilizing their gifts of troubleshooting and information seeking strategies may be inspired to study medicine, health information librarianship, or information technology.

References:

Block, P. (2008). Community: the structure of belonging. (2008) Barrett-Koehler Publishers, Inc. San Francisco.

Fulton, C. ““An Ordinary Life in the Round: Elfreda Annmary Chatman” in Libraries and the Cultural Record. (2010) 45(2), p.239

Mcknight, J. and Block, P. The abundant community: awakening the power of families and neighborhoods. (2010) Barrett-Koehler Publishers, Inc., San Francisco.

Information Needs and Information Seeking Behaviors of Health Professionals

While the El Camino Hospital Health Library & Resource Center is open to both the general public, medical and health personnel, I have primarily observed nurses, doctors and medical personnel, and nursing students utilize the electronic and print resources on the days and times I visited the center. As a result of the clientele I have observed, I have chosen to focus on and discuss the information needs and information seeking behaviors of physicians and/or residents, and nurses and/or nurse practitioners.

Information Needs

Wilson “suggested that “information need” was not a fundamental need such as the need for shelter or the need for sustenance, but rather a secondary order need which arose out of the desire to satisfy the primary needs.”(Wilson, T.D. 2000). Wilson also suggests that “it may be preferable to refer to ‘information seeking towards the satisfaction of needs.’”  (Robson, Robinson, 2013). As I observed the various medical  professionals, nurses, and presumably nursing and medical students entering and sitting at the health resource center’s computers to search for information or prepare for tests, each of them had a need to satisfy, albeit cognitive, educational, and/or professional (seeking information on the best medical treatment of a patient).

In one literature review, nurses’ and physicians’ information needs have been defined as “expressions of missing information that is required to accomplish a specific task, which in this case is managing patient care.” (Clarke, 2013)

A number of studies conducted by various researchers have investigated the information needs of resident and attending physicians, nurses, nursing students, and nurse practitioners.

In a recent study conducted by Clarke regarding types of primary care physicians’ and nurses’ needs, several broad categories of needs were determined from 24 journal articles. Seventeen articles discussed information on diagnosis, 15 articles mentioned medications, 14 articles mentioned treatment, 10 articles mentioned prognosis, eight mentioned epidemiology, and seven articles mentioned etiology.

Surveys and questionnaires revealed that resident physicians and attending physicians had the same information needs; their most common being related to diagnosis. The nurses who were surveyed stated that they often seek information regarding protocols and procedures. The one similar information need shared among nurses and physicians was information regarding treatment for patients. What I found interesting, yet not surprising is that while these studies and articles were primarily based in the United States, physicians in other countries shared many of the same information needs such as accessible and timely delivered information sources that can enable nurses and physicians to provide the best patient care. (Clarke, Belden, Koopman, 2013).

Barriers to Information Seeking

Although the term “Information Overload” was not stated specifically by physicians as a barrier to information seeking and retrieval, this syndrome does tie in with time as one of the barriers to physicians’ and nurses’ effective information seeking. According to Bawden et al, “’Information Overload’ occurs when information received becomes more of a hindrance rather than a help when the information is potentially useful.” They further add that “information overload is the result of more information becoming available when new information technologies make this increasing amount of information available to end users.”(Clarke, 2013). When the “information overload” strikes when a health professional has limited time to find the information, the physician or nurse resorts to Zipf’s Principle of Least Effort–“It is human nature to want the greatest outcome for the least amount of work.” According to this principle, “each individual will adopt a course of Action that will involve the expenditure of the probable least average of his work—in other words, the least effort.”(Case, 2012­–Looking for Information). In the health professional’s situation, this can mean consulting with a colleague or a specialist with expertise in a particular field of medicine instead of spending inordinate amounts of time looking for information online or in the hospital library.

Geography in this study was also mentioned as a barrier, but due to time and word limits, this “barrier” may be discussed in future blogs or the term paper.

Information Seeking Behaviors

There are at least three definitions of Information Behavior that can be applied to Information Seeking in the medical care field and its various settings. According to Wilson, Information Behavior, itself, is defined as the “Totality of human behavior in relation to sources and channels of information.” This definition was very applicable to my observations of the medical/health personnel, and students who utilized the hospital’s health resource center. These users not only came to utilize the electronic and print resources available, they seemed to put their very beings into what they were seeking, studying, and learning. While they were always focused in what was on the computer screen, their bodies at times tended to change stance depending on what information they unexpectedly encountered while seeking or how they responded emotionally or cognitively to the information they were reading or learning.

Information Seeking Behavior is defined by Wilson as “purposive seeking of information as a consequence of a need to satisfy a goal.” The needs of physicians and nurses drive their “purposive seeking” of information to satisfy their goal(s) of providing the best treatment for their patients. According to the aforementioned study, health professionals “satisfy their information needs” by utilizing various resources such as specialized professional journals, medical textbooks, and online medical databases and websites to name a few.

Wilson defines “Information Use Behavior” as physical and mental acts involved in incorporating the information found into the person’s existing knowledge base. In addition to the changes in stance as in my observances, the physical entering of keywords and search terms is a vehicle for incorporating the accessed information into the person’s/healthcare professional’s existing knowledge base. The mental acts involve utilizing the existing or basic knowledge that a healthcare professional has about a particular disease or condition and also cognitively utilizes synonyms in alternate search queries to successfully and ultimately access needed information to satisfy their goal.

References

Case, D. O. Looking for Information, United Kingdom: Emerald Publishing Group, Ltd. (2012), p. 175.

Clarke, M. A., Belden, J. L., et. al. “Information-seeking behavior analysis of primary care physicians and nurses: a literature review” in Health Information and Libraries Journal, 30 (2013), p. 184.

Wilson, T. D. “Human Information Behavior” in Informing Science, 3 no. 2 (2000), p. 51.

Robson, A. and Robinson, L. “Building on models of information behavior: linking information seeking and communication” in Journal of Documentation, Emerald Group Publishing, Ltd., 69, No. 2 (2013), p. 179.

Zipf, G. K. “Human behavior and the principle of least effort” in Oxford, England: Addison-Wesley Press Human behavior and the principle of least effort. (1949). xi 573 pp.

My Health Information Community

While many suburban housewives in the 1950s through the 1970s supported and gave advice to pre- and post-natal mothers in their neighborhoods and houses of worship, and eventually watched over each other’s children when needed, the sharing of female or any health concerns among suburban women (unless debilitating or terminal) began to decline as their baby boomer children reached their teenage years.

However, as many youth (especially young women) starting using “The Pill” with at least one sex partner, and other youth were experimenting with the latest recreational drugs, parents who became aware of these activities were hesitant, if not reluctant to share their deepest concerns with close friends for fear of scandal and ostracism in their neighborhoods, social, and religious communities.

When some young people began engaging in pre-marital relations with multiple sex partners, they not only risked or experienced unwanted pregnancies, but many also contracted sexually transmitted diseases. Many youth, for fear of their parents finding out and/or being the cause of scandal in their families, neighborhoods, and religious communities, privately sought solace, advice and treatment and even information regarding their conditions in college health resource centers, Planned Parenthood, and county health clinics.

One of Joan Durrance’s and Karen Fisher’s definition of an information community “includes a group that comes together with a common interest around creation and exchange of distributed information.” An information community in the previously mentioned scenarios “may also be built around different focal points and topics.” Furthermore, in the event that many such youth and their peers will seek information in these health information centers/communities, especially in today’s information age, they may also meet up, connect and exploit the internet and technology to obtain more information for and from each other or communicate with and support each other through online chat, e-mail, or text messaging.

I am still exploring and observing my “Learning Community” at the Health Library and Resource Center at El Camino Hospital in both Mountain View and Los Gatos, CA. At this point, I have observed three of the five characteristics of a learning community that this Health Library demonstrates. These are as follows:

Information communities exploit the information qualities of technology and yield multiplier effects for stakeholders (those affected by actions of the communities). 

During my initial visit to the Health Resource Center, I noticed that there are three database computer terminals available for the public and medical staff to use. These terminals are equipped with:

Medline with full text and are Members-Only databases designed for doctors and provides nearly 3,400 full-text journals.

Health Source Consumer Edition contains a collection of consumer health information available to libraries worldwide where consumers can access information at a public library or remotely through their local library with a library card and PIN number or password.

Up-to-Date (Available only at the Health Resource Center). This is an exceptional resource that provides clinical and patient education.

The Internet also provides access to subscription-only databases specializing in clinical and consumer health. This is a very interesting and informative website and provides online videos that show various surgical procedures such as an Angioplasty and Coronary Artery Bypass Graft.

“By definition, information communities depend on their ability to share information and information resources and “content-rich institutions, such as libraries, not surprisingly, have been system centered, requiring enormous energy to develop and make accessible extensive collections.”

This is definitely true of the El Camino Hospital Health Library and Resource Center. In addition to the information shared on the Internet and medical databases, members have access to a variety of current medical and consumer health books, journals, newsletters, audio/video tapes and DVDs focusing on and explaining various medical conditions. According to their information brochure, the library is open to the public and checkout privileges are available.

The third characteristic, that best distinguishes the Health Resource Center, is “Information Communities foster social connectedness within the larger community.”

As the Health Library and Resource Center is a community health services benefit, it also relies on community support and strongly encourages and appreciates donations in person or online. While browsing the materials, I found, among the many other hospital services brochures, an Auxiliary Services brochure listing the many volunteer opportunities where community members can donate their time, talent, and passion in the following areas:

o  Within the Health Resource Center itself
o  Hospital greeters
o  Drivers
o  Hospital escorts
o  and others

Volunteering in the hospital community not only contributes to the hospital community, visitors, families, and patients, but also provides an enriching experience for the volunteers.

References

Durrance, Joan C. & Fisher, K.E. (2003). Information Communities. Retrieved from (http://libaccess.sjlibrary.org/login?url=http://knowledge.sagepub.com/view/community/n248.xml)

El Camino Hospital Health Library & Resource Center (http://www.elcaminohospital.org/library)

Rielly, Edward J. (2003). The 1960s. Westport, London: Greenwood Press.