摘要：In 2010, the New England Region–National Network of Libraries of Medicine at University of Massachusetts Medical School received funding to improve information access for public health departments in 6 New England states and Colorado. Public health departments were provided with desktop digital access to licensed e-resources available through special pricing. In January through mid-April 2012, we evaluated the effectiveness of providing access to and training for using e-resources to public health department staff to motivate usage in practice. We found that additional strategies are needed to accomplish this. Access to scientific evidence is vital to evidence-based public health and evidence-based decision-making, yet access is underutilized, limited, or both. 1,2 Many public health departments (PHDs) have no access to evidence-based resources beyond those provided by the National Library of Medicine or its funding. 3,4 Factors influencing evidence-based practice include information access, training, skills, leadership vision, and organizational change. 5–9 By 2009, tools giving access to evidence-based information to policymakers existed but all were underutilized, as was training or technical assistance to enhance uptake. 2 By 2012 many PHDs experienced massive reductions in staff or resources resulting in variable awareness of the value of using evidence to inform decision-making. 8 Barriers to information access include competing responsibilities, lack of full-text access, credibility of information retrieved, and infrequent training on information searching. 1 Better methods of indexing, searching, and filtering information through single portal access, archiving information, and early notification of relevant information can improve access and movement toward evidence-based practice. 10 Beginning in 2010, University of Massachusetts Medical School Library received National Network of Libraries of Medicine funding for its Public Health Information Access (PHIA) project, which provides (1) direct electronic access to full-text scientific literature to a convenience sample of state PHDs in 6 New England states and Colorado, (2) training, and (3) a pilot for a sustainable business model to expand access nationwide. Resources selected (see the Box on page e2) for a digital library were based on national initiatives, 11,12 suggestions from PHD grant partners, and metrics on resource use from publishers. The PHIA project adds journals as it identifies articles frequently requested through subsidized delivery service (Loansome Doc; National Library of Medicine, Bethesda, MD). The 7 PHDs customized the digital library template on their intranet or used shared file capability with links to e-resources. Hospital and academic medical libraries in each state provide resources not available through the digital library. Example of Resources Provided to Public Health Departments by the Public Health Information Access Project Single-title e-journals available through the digital library page included • American Journal of Tropical Medicine and Hygiene • Health Affairs • Journal of Agricultural Health and Safety • Journal of Food Protection • Journal of Medical Entomology • Journal of Public Health Policy • Journal of Studies on Alcohol and Drugs • Journal of Wildlife Research • New England Journal of Medicine • Pediatrics • Public Health Reports Publisher packages included access to an additional 97 e-journals: • Annual Reviews (n = 8) • American Society for Microbiology (n = 12) • Centers for Disease Control and Prevention (n = 3) • Mary Ann Liebert (n = 11) • Oxford University Press (n = 25) • Sage (n = 8) • Springer (n = 24) • University of Chicago Press (n = 6) A limited number of copies of EndNote, subsidized by Thomson Reuters, were distributed to public health departments to encourage saving information for use and reuse. Seven hours of hands-on training included practice locating, appraising, and saving information with their own digital library pages. About 18 public health professionals per site attended. Open in a separate window Note . Resources included specialized databases (notably PubMed), other licensed databases, e-books, journals, and notable reports provided through Internet Protocol address authentication and enterprise licensing for all public health departments. Databases included an e-book collection through STAT!Ref, CABI’s Global Health, and The Cochrane Library. Resources are reviewed and updated depending on usage and cost of use.
