The Health Association Libraries Section Survey : Finding Clues to Changing Roles

The frequent discourse and debate on the roles of librarians generally includes a consensus about the broad position characteristics 1–3 that former Journal of the Medical Library Association (JMLA) Editor T. Scott Plutchak, AHIP, FMLA, summarizes well: “We connect people to knowledge. We bring people together with the intellectual content of the past and present so that new knowledge can be created. We provide the ways and means for people to find entertainment and solace and enlightenment and joy and delight in the intellectual, scientific and creative work of other people” 3. Health association libraries, a unique blend of medical and special libraries, have been surveyed periodically since 1955 (Appendix A, online only). The Health Association Libraries Section (HALS) of the Medical Library Association and its predecessors surveyed health association libraries in 1980, 1996, and 2003 on the status of these libraries and their services (Appendix B, online only). The 1980 survey focused on basic library data about clientele, collections, and staff. Surveys since then have included questions on services, funding, and stability. The surveys captured reasons for library closures, including changes in association leadership, budgets, space, objectives, and staffing. The surveys also captured reasons for success, including the ability of librarians to adapt their services to the needs and objectives of their parent organizations. The data collected from the most recent survey in 2011 helps to illuminate the new and changing roles of health association librarians and provide clues on how health association librarians can position themselves for the future.


INTRODUCTION
The frequent discourse and debate on the roles of librarians generally includes a consensus about the broad position characteristics [1][2][3] that former Journal of the Medical Library Association (JMLA) Editor T. Scott Plutchak, AHIP, FMLA, summarizes well: ''We connect people to knowledge.We bring people together with the intellectual content of the past and present so that new knowledge can be created.We provide the ways and means for people to find entertainment and solace and enlightenment and joy and delight in the intellectual, scientific and creative work of other people'' [3].Health association libraries, a unique blend of medical and special libraries, have been surveyed periodically since 1955 (Appendix A, online only).The Health Association Libraries Section (HALS) of the Medical Library Association and its predecessors surveyed health association libraries in 1980, 1996, and 2003 on the status of these libraries and their services (Appendix B, online only).The 1980 survey focused on basic library data about clientele, collections, and staff.Surveys since then have included questions on services, funding, and stability.The surveys captured reasons for library closures, including changes in association leadership, budgets, space, objectives, and staffing.The surveys also captured reasons for success, including the ability of librarians to adapt their services to the needs and objectives of their parent organizations.The data collected from the most recent survey in 2011 helps to illuminate the new and changing roles of health association librarians and provide clues on how health association librarians can position themselves for the future.

METHODS
In December 2011, HALS conducted an online survey using SurveyMonkey to assess the state of health association libraries and the current roles of health association librarians, with the intention of comparing those results to information gleaned from its previous surveys.More specifically, the purpose of this latest survey was to collect information about health association libraries' status, services, staffing, and technology [4].A team of eight HALS members constructed the survey instrument, using key questions from prior HALS surveys for comparative purposes [5].Team members added new questions that reflected changing technology and new roles for librarians.Questions were designed around activities and roles that had emerged most strongly from the 2003 survey, from team members' personal experiences, and with attention to including ''other'' options intended to elicit entirely new activities and roles.The team incorporated space for comments whenever possible, as comments from prior surveys were a rich source of information.The forty-one-question survey (Appendix C, online only) was field-tested by three HALS members who were not part of the survey team.
Health associations to survey were identified from lists of previous survey respondents, North American directories of associations, and posts to library email discussion lists.Of the 195 organizations targeted for the 2011 survey, 83 organizations (43%) responded, similar to the 2003 response rate of 39%.Of these respondents, 60 had a library and 23 did not [5].This report focuses on data from the 2011 survey that related to changing roles of librarians.The complete survey covers library environment, collections and resources, services, staff work profile, promotion, and measurement of quality and effectiveness of services.Complete 2011 survey results and additional prior survey information are available on the HALS website ,http://www.hals.mlanet.org..

Library environment and services
The 1990s and early 21st century were a turbulent time as many health association libraries experienced downsizing and closing [6,7].The HALS 2011 survey results showed this situation has stabilized, as 54 (90%) of respondents in 2011 were not concerned about downsizing or closing (Q7{).However, the results from the 2003 and 2011 surveys on changes in staffing, budget, services, and space were markedly different.Staffing and budgets were both reported as decreased over the ''past several years'' in 2003 (19, 49%; 18, 53%) but stable in 2011 (32, 53%; 28, 47%).Space was reported as stable by 13 (46%) respondents in 2003, and 34 (57%) in 2011.
The 2011 survey addressed both traditional and nontraditional library services.Results showed that libraries offer the following traditional services: reference services, online searches, document delivery, current awareness, user instruction, research, and fact-checking.Most librarians (34-52 responses, 98%-100%) offer these services to organization staff, but less frequently offer them to members (11-42 responses, 32%-79%), nonmember health professionals (2-21 responses, 6%-40%), and the public (2-22 responses, 6%-42%) (Q25).In 2011, the survey questions differentiated volume and complexity of services, versus in 2003 when they were aggregated.In 2011, 31 respondents (52%) reported increased volume and 37 (62%) reported increased complexity, in comparison to a 37% increase (10) in 2003 (Q6).HALS survey results have indicated that health association libraries often support their parent organizations in myriad ways beyond traditional library services.As one survey respondent noted, ''In this day and age, librarians need to integrate themselves into projects that don't necessarily appear to be library-related.We participate on various staff committees, organize materials for staff, and answer any question asked us.''In 2011, 1 survey question asked which nontraditional services represented more than 10% of total library staff workload.In response to this question, 43 (80%) respondents selected at least 1 category of nontraditional services.The responses, from most to least frequent, were: archives, publications support, advocacy, records management, website, other, and consumer health (Figure 1) (Q32).The following results and discussion focus on these areas.

Publications support
In 2011, 20 (37%) respondents provided support that represented more than 10% of total staff workload for their organizations' publications programs (Q32), while 9 (17%) librarians did not provide support (Q28).Similarly, in 2003, 8 (17%) noted no role.Librarians reported assisting with products including guidelines, standards, and continuing medical education publications.Respondents' comments mentioned other publication-related roles, varying from copyright and permissions management and copyright education, to editing and proofing of publications, and training of nonlibrary staff on fact-checking and reference verification.

Advocacy
In 2003, librarians described multiple services supporting their parent organizations' advocacy efforts, from the traditional (literature searches, current awareness, and document delivery) to the nontraditional (tracking website page views and participating in advocacy training, call campaigns, and industry primer preparation).The 2011 survey question on advocacy (Q29) generated 42 comments on traditional services such as literature searches, document delivery, and knowledge alerts, and 3 comments on nontraditional activities.Five respondents to this question (Q29) stressed that their support for advocacy activities was no different from their support of other activities of the organization.

Records management
The 2011 survey included for the first time questions about the librarians' role in records management.Although only 14 (26%) respondents indicated involvement in these activities (Q19), this number indicated a growing area of responsibility.Just 1 librarian mentioned records management in 2003, and none mentioned it in the 1996 survey.In a somewhat related area, in 2011, 39 (72%) respondents reported they did not use SharePoint, Microsoft's business collaboration platform, in their daily activities (Q31).Many of the librarians who answered positively to working in either area were in the early stages of their efforts.

Website
Responses about website involvement described an arc of activity from 1996 to 2011.In 1996, 10 (20%) librarians were actively involved in planning their parent organization's websites.In 2003, 24 (50%) were involved.By 2011, although 37 (68%) librarians had some involvement (Q30), only 6 (11%) librarians reported more than 10% of their total workload was devoted to website activities (Q32).In earlier surveys, 8 librarians (8% both years) served as webmasters, but by 2011, no librarian with a physical library performed this role.However, some of the 37 respondents involved with websites in 2011 noted new responsibilities, including archiving web content (10, 19%) and providing metadata (5, 9%) (Q30).

Other nontraditional roles
Only 5 (9%) respondents chose ''other'' nontraditional activities (Q32).However, of the 7 comments, only 2-meeting planning and provision of custom data files-did not fit into the categories listed above.

Consumer health
One area where responsibilities were reported less frequently was consumer health.The 2011 survey responses indicated that 28 (52%) librarians provided no consumer health services (Q27) and that only 4 (7%) respondents spent more than 10% of their working hours on consumer health (Q32).Responses and comments from 1996 and 2003 indicated that health association libraries took a stronger role in providing consumer health information.For example, in 2003, only 10 (21%) respondents did not provide consumer health services.

DISCUSSION
A recent article by McGowan reflects on the future of health sciences libraries [7].The 2011 HALS survey has uncovered a number of new roles and activities, some of which are what McGowan refers to as ''skills required to maintain traditional medical library values in a technology-rich environment rather than those skills essential to new roles,'' and some of which are bona fide new roles.Librarians' reported involvement with archives has increased considerably since the 2003 survey.Comments in the 2011 survey indicate these roles are using new data management skills, which is confirmed in the literature [8,9].There is considerable opportunity for increasing health association libraries' role in archives management.The recent article by Welch provides an example of how a library has actively developed new public relations uses for archived historical materials and used innovative digital outreach methods to deliver those materials.[10].
Increasingly, librarians work on intellectual property issues and educate others about them [11,12].Respondents to the 2011 survey left eighteen comments on intellectual property issues in relation to their publications support, advocacy, and website roles.By contrast, only four librarians left comments on copyright in 2003.
Although according to the 2011 survey, website involvement had decreased overall, some librarians specified technical roles, including archiving web content and providing metadata.Archiving web content is an activity that integrates librarians' roles in archives and website management.The increase in the need for metadata librarians has been documented alongside the growth of digital information [13].A 2008 study of association libraries indicated that unless an association library's staff was involved with content on the website, typically the site was directed more toward marketing the association than marketing information [14].
Librarians provided consumer health information less frequently in 2011 than in 2003.Instead, patients and consumers are increasingly going directly online to find health information [15][16][17].The focus of the librarian's role has shifted toward a need to educate consumers on information literacy and to evaluate online health information resources [17,18].
Literature about association libraries is sparse.A notable exception is Madden's mixed methods overview of association libraries in the United Kingdom.
Madden develops an ideal model of an association library and information service that is ''in harmony with company mission, policies and strategy, yet it is not passive as the information staff actively contribute to the company mindset'' [14].In emphasizing the importance of awareness of the organizational culture, Kaarst-Brown notes that association-type libraries must answer directly to the needs of the parent organization: ''These libraries have to be very outward focused.In order to succeed in the parent organization, they need to make sure they meet the needs and are visible and esteemed members of the organization'' [19].HALS survey respondents are a heterogeneous group, evident from the variety of survey responses and comments.What health association libraries have in common is, for survival, the necessity to be forward-thinking and nimbly responsive to their associations' needs.

CONCLUSIONS
Health association libraries currently connect their associations with knowledge in multiple ways that will continue to evolve.They see librarian job posts requiring skills in data management and digital archives production.They work alongside professionals grasping to understand copyright.They respond to members of the public seeking permissions to use their organizations' content.They provide support to government affairs staff, fundraising, and other advocacy efforts, and to their organizations' publications.
As with the current trends of partnering with information customers, health association librarians have demonstrated that they are flexible.Their continued success is linked to their ability to adapt to change to fulfill the needs of their organizations.It is encouraging that more than 80% of survey respondents indicated they could demonstrate that their library services are valuable to the parent organizations.
Health association librarians, one of the oldest types of medical librarians in the United States, will continue to thrive by understanding and adapting to the shifting priorities of their parent organizations, by responding to the changing nature of health care delivery, and by continually demonstrating the unique valuable services they can provide.The next HALS survey will illustrate how their roles have continued to change.

Figure 1
Figure 1 Health association libraries activities, 2011 and 2003