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The loneliness of the long-distance blogger : using blogs to reach isolated rural health professionals

Don Keast , Research Librarian, Far West Health Library, Sydney University, Department of Rural Health, Broken Hill, NSW, Australia

Presented as part of “Delivering library services to rural health professionals : web 2.0, blogs and the tyranny of distance “ 10th International Conference on Medical Librarianship 2009.

Background. The Greater Western Area Health Service (GWAHS) occupies an area of 444,900 sq. km. or 55.52% of the state of New South Wales. While the health service has 5 small libraries, many users are several hundred kilometres from the nearest one. This paper describes the use of blogging to reach remote users in this vast area.

Using blogs to address remoteness. The GWAHS Libraries Blog was commenced in February 2007 as a means of bringing relevant resources to remote users. It concentrates on resources and events which may be of interest to rural health staff.

The GWAHS Libraries Blog has been emulated by a recent arrival, NCAHS Library Clippings which has attempted to reach isolated users on the NSW North Coast. Other examples of resource-based blogs exist in New Mexico and other isolated areas.

Results. All 5 libraries contribute to the blog, usage continues to increase, and feedback is extremely positive. The library service now receives several queries from remote parts of the health service which had previously been poorly serviced. For many users in remote locations, the blog serves as an up-to-date virtual library of new and relevant resources. However, for many staff in isolated areas, Internet connections are traditionally unreliable, and the use of Internet-based applications is a new way of thinking. There is an ongoing education role regarding use of the blog’s resources. However, in situations where users are too physically remote to visit the library, the blog provides an excellent accessible point of contact with library services.

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Introduction :

What is a blog ? A blog (short for Weblog) is “ a web site which is regularly updated with regular entries of commentary, descriptions of events or other material such as graphics or video. Entries are commonly displayed in reverse-chronological order “ (Wikipedia)

Blogs (or weblogs) are one of the most commonly used web tools today. A Technorati (2008) survey (1) gave the astonishing figures 184 million blogs started wordwide, 1.5 million blogs created in the last 7 days and 900,000 blog posts in 24 hours.

A fascinating LibWorld (2) 2008 survey of library blogging across 35 countries, found, however, that library adoption of blogging technology was, in many countries slow, and while library blogs were multiplying and maturing, the technology still had a huge potential to develop. Peta Hopkins, writing the Australian chapter in this collection, found only 13 library blogs at the time. Her multi-author blog, Libraries Interact (3) maintains a blog roll of Australian library blogs. As of March 2009, it lists 53 personal blogs by library staff, and 41 corporate or library blogs.

This paper will look at the creation of a co-operative library blog by 5 small libraries of the Greater Western Area Health Service in New South Wales, Australia.

Introduction to the Greater Western Area Health Service (GWAHS), New South Wales, Australia.

The Greater Western Area Health Service services an area of 444,900 sq km in Western New South Wales, Australia. This vast area is

 55.52 % of the state New South Wales

 1.5 times the size of Italy

 2.05 times the size of the British Isles

To provide library service to health staff and students in this area, there are 5 small libraries :

Far West Health Library, Broken Hill (University of Sydney)

Dubbo Base Hospital Library

Orange Base Hospital Library

Centre for Rural & Remote Mental Health, Orange (Uni. of Newcastle)

Health Library Service, Bathurst

All of these are small special libraries, with 1.5 FTE staff or less.

There are a large number of remote users amongst the library clientele. Many of these are 500-600 km (or even more) from an actual library, and the library staff are constantly seeking improvements in service to these users. There are 51 hospitals and 62 community health centers throughout the area. Many of these are without medical staff, and medical services are provided by a number of co-partner organizations. The Royal Flying Doctor Service, Aboriginal Health Corporations, Divisions of General Practice and University clinical school and Departments of Rural Health are also amongst the many and diverse library clients.

ORIGINS OF THE GWAHS LIBRARIES BLOG (4)

The library staff of GWAHS (and, indeed library staff everywhere) receive much diverse clinical information. In an area as large as GWAHS, and with a clientele as varied and geographically dispersed, a blog seemed a natural development in order to make information available to all.

GWAHS was formed in 2005 as a merger of three existing health services (Mid Western, Macquarie and Far West Health Services). Networks have been slow to develop in this administrative environment. The process is complicated by information technology which has inadequate server capacity, and the health service has well documented budgetary problems.

The blog was conceived in February 2007 as a way to use the Internet as an alternative method of disseminating information, rather than rely on an overloaded Intranet. Library clients from co-partner organizations could also be reached on the Internet, whereas they were not always reachable by internal means.

USER PROFILE :

The main target audience of the blog is rural health professionals in Western New South Wales. Typically, they are busy people, time poor in their work environment, and in the age range of 25-60.

Their information technology skills vary from extremely basic to very advanced. Many staff are completely unfamiliar with blogs or any web 2.0 tools. Part of this may be ascribed to living and working in an environment where the Internet is slow, wireless broadband non-existent, and computers and software often a long way from the latest model. In an area as remote and vast as GWAHS, all these things are uneven in their provision, and the exposure of staff to blogs and web 2.0 is similarly variable.

Any use of blogs and web 2.0 therefore has to be simple to navigate and basic in its execution. Hayward-Wright, (5) in her excellent review of blogging basics, additionally makes the point that, amongst an audience unfamiliar with blogs, there may even be resistance to the term “blog” itself. She recommends removing the term (and indeed, any specialist jargon) from publicity materials and presentations to lay audiences. At the time of writing (March 2009) this suggestion has been followed in the GWAHS Libraries Blog publicity for some 4 months, during which traffic has increased by 33%.

AIMS AND PHILOSOPHY OF THE GWAHS LIBRARIES BLOG

The blog focuses on resources which may be useful to health staff in rural locations

There is an emphasis on free material available both on the web and elsewhere (although other material is included when relevant).

 The blog is not a “what’s happening in the library” exercise : it is about disseminating useful information, often to clients who are never able to physically visit a library.

There is an emphasis on rural health and indigenous health matters.

Staff of all 5 libraries are authors.

CREATION OF THE BLOG

Open public access software (Blogger) (6) was used so that staff of all libraries can post, and so that all potential users can access the site without use of passwords. Blogger has a number of features which made it an attractive host (Yang [7] discusses Blogger and several alternatives including Xanga, LiveJournal, WordPress etc):

There is no cost for software and hosting.

There is an option of external hosting

WYSIWYG (what you see is what you get) editing requires only basic HTML skill to operate the site.

Multiple authors are easily created.

Posting of slideshows, images and audio-files is easy.

Email alerts and RSS feeds are options.

Search functions are inbuilt.

There are a wide choice of templates from which to choose (or you can design your own)

SOURCES OF BLOG POSTS

Blog posts can literally originate anywhere : from IT-challenged doctors, to breakfast television and the morning newspaper … never underestimate the value of serendipity !. However, there are several reliable sources which provide the blog with regular copy :

List serves often contain items of relevance.

Newsletters, both external and internal, often contain items of interest. More general newsletters, such as the excellent APO online, (8) or the Australian Healthcare and Hospitals Association Newsletter, (9) often highlight reports and web-sites of interest.

Many emails of interest cross one’s desk, but in an area as large as GWAHS, it is often difficult to tell who may find them of interest. Placing them on the blog effectively archives them.

 Journal alerts often highlight things of interest.

 Feeds from other blogs often provide items of a common interest.

 Rural health conference announcements are relevant

Library acquisitions of special interest are sometimes profiled, however, this should be done very sparingly lest the blog become a boring series of rapidly aging lists

 Last, but by no means least, are the frequent contributions from library users

FEATURES

All GWAHS libraries post to the blog. Multiple authors give a much richer perspective to blog content. GWAHS is a diverse catchment : from desert mining towns in the west, through large pastoral tracts in the center, to the rapidly growing cities of Bathurst and Orange in the east. The nature and origin of posts is as diverse as the clientele the blog serves.

Subject tags are used on all posts, to enable subject retrieval.

Monthly blog summaries are sent to GWAHS staff via email. For many staff, blogs are an alien culture. Monthly summaries stimulate staff to use the resources.

  • User surveys (using the open access Survey Monkey [10] website) give feedback .
  • Google Analytics (11) are used to track the origin of users, and to monitor traffic to the site. International users account for 7.35% of time spent on the site.

The blog helps to promote a unified library service to users. Each month library staff receive new queries from new blog users. The majority are from staff seeking to establish contact with the library service, rather than about the content of individual posts.

The blog provides links to individual libraries and to the GWAHS Libraries Catalogue, and greatly enhances networked services.

Posts are comment-enabled, to stimulate discussion and feedback

The blog reduces crowding on overloaded email servers. PDF documents, images, videos etc can be distributed by blog links without any transfer of large files on internal servers.

RESULTS AND FEEDBACK

User surveys have been overwhelmingly positive in their feedback. Much of the feedback has been from staff in isolated areas physically remote from a library.

The blog has proved to be an excellent promotional and marketing tool for the library, establishing contact with many users who had not previously had contact with the area’s libraries.

Usage has continued to steadily increase, and the content has grown to 25-30 postings per month, as the library staff become more expert in sourcing relevant material.

Some sample user comments :

“I have found it to be of huge benefit, and would not have had time to access the info that I have obtained were it not for this!”

“ I think it is excellent – your reviews allow me to decide quickly whether I want to read further”

“There is always something useful in each library blog, please don’t stop !”

“Probably would not visit if the email alerts did not continue – great idea & great info – thanks helps to keep me up to date “

“Great to have access to new documents and resources (or even know that they exist)”

“Thank you for your efforts. I would rarely be able to access a library”

CHALLENGES AND PRACTICAL DIFFICULTIES.

 There is a constant problem in promoting the blog to staff who are unfamiliar with the technology. Only approximately 45% of GWAHS staff have access to the health service email server. In many small health services, there may be only one or two points of access to the Internet. For many staff, use of any online resources is as much a culture change as a learning experience.

 Training remote area staff to use blogs, or Internet technology in general is often hampered by a lack of training rooms, a lack of relief staff and great distances for trainers. Limited access to the Internet renders on-line training extremely difficult.

There is a constant pressure on blog authors to find suitable new posts. For a blog to be interesting, current and relevant, regular posting is essential. Having multiple authors helps to ease this pressure.

Resource based rural health library blogs :

NCAHS Library Clippings (12)

The early success of the GWAHS Libraries Blog led librarians in the New South Wales coastal rural North Coast Area Health Service to form a similar resource-based blog in November 2007, NCAHS Library Clippings.

This blog has also been very successful in attracting health professionals spread throughout a large coastal area of New South Wales. While there are some similarities in this blog’s postings aimed at rural health professionals, the different nature of the rural clientele served has led to different postings which complement, rather than duplicate, the GWAHS Libraries Blog. Feedback has again been very positive and this blog is now a co-operatively authored blog with 5 staff from 4 libraries as authors. The multiple authors from different parts of the health service again enrich the content and broaden the coverage.

”We have found the blog to be a great way of reaching out to library users in a quick and simple way. RSS feeds, subscribing by email and monthly summaries are an excellent way to keep staff up to date. It has raised the library profile and most importantly we are having fun and have learned a new skill along the way.”

- Sally Toms, Librarian, Coffs Harbour Health Campus.

Staying Well. Connected (13)

An interesting, practical multiple author blog aimed at community health workers and health consumers in South Texas and in US/Mexico border communities is Staying Well.Connected emanating largely from the University of Texas Health Science Centre in San Antonio, Texas. This blog features Spanish resources as well as English.

NCAHS Library Clippings and Staying Well. Connected are but two further examples of practical health library blogging.

Conclusion :

Blogging is a tool which any library, anywhere, of any size, can use. The World Wide Web has an immense potential to enable librarians (and others) to overcome distance and isolation and to bring the library to the desk-tops of all clients.

While rural areas may have difficulties in infrastructure and Internet provision, blogs nevertheless can have a currency and immediacy which enable the library service to reach isolated users with topical and relevant information. Blogging technology allows this value-added service to be provided by professionals with only a basic knowledge of HTML, even to users to whom the word “blog” may be a foreign language from a different culture.

Bibliography :

  1. Technorati. The state of the blogosphere 2008, [Online]. 2008 [Cited 2009 14 Mar].Available from URL:
  1. Christian Hauschke, Sarah Lohre & Nadine Ullman,.editors. Library blogging worldwide.[Online] Dortumund-Dusseldorf-Hanover LibWorld., 2008 [Cited 2009 Feb 28] Available from URL:
  1. Libraries Interact [Online] [cited 2009 April 1] Available from URL:
  1. GWAHS Libraries blog : [Online] [cited 2009 April 1] Available from URL:
  1. Hayward-Wright, N. Guidelines for the development of a blog-based current awareness service, Australian Library Journal 2008; 57(4) 406-430
  1. Blogger [Online] [cited 2009 April 1] Available from URL:
  1. Yang, Jonathan The rough guide to blogging, London, Rough Guides; 2006. ISBN 978-1-84353-682-X pp. 29-43
  1. APO (Australian Policy) Online [Online] [cited 2009 April 1] Available from URL:
  1. Australian Hospitals & Healthcare Association [Online] [cited 2009 April 1] Available from URL:
  1. Survey Monkey [Online] [cited 2009 April 1] Available from URL:
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  1. Staying Well. Connected [Online] [cited 2009 April 1] Available from URL: