By Helen Osborne, M.Ed., OTR/L
President of Health Literacy Consulting
On Call Magazine, December 4, 2008

Marcia E. Zorn, MA, MLS, helps professionals and the general public find the health information they need. Answering questions is part of her job.

Zorn is a reference librarian at the National Library of Medicine’s (NLM) Reference & Web Services Section. The NLM is part of the U.S. National Institutes of Health. It is the largest medical library in the world and contains numerous databases and electronic resources. All the data and resources, according to Zorn, are available to the public at no cost.

For health professionals who need to gain access to information contained in professional journals, an excellent way to start is to use MEDLINE/PubMed. PubMed is the search system for the database, MEDLINE. This database is created by indexers who read every article published in journals that are selected for MEDLINE. They create a bibliographic citation that includes the author(s) name, article title, source, abstract (if any), address, and contact information. Indexers also assign controlled vocabulary or Medical Subject Headings (MeSH) that can be used for indexing articles in the database and for searching the database.

A PubMed search, though, can return an overwhelming list of resources. And of course, some of them are going to be more relevant than others. In our recent conversation, Zorn explained how the searches can be narrowed and how users can find the specific materials they need more quickly.

Tips for searching MEDLINE/PubMed

To start the search, go to the PubMed home page. At the top of the page you will see two boxes. The first is labeled search. It contains a drop down menu with PubMed as the default selection. In the second box, you can type the terms you want to use for your search. Boolean computer commands such as AND and OR let you either focus or broaden your search. If you use them, they should be capitalized.

For instance, when searching for diabetes health education materials, you would enter “health education AND diabetes.” Then click “Go.” When you do, you’ll get a list of over 10,000 articles. To narrow the results, click the “Limits” tab. Limits let you specify criteria such as author, journal, date, or language that you can use to make the list more manageable. After you’ve set the limits, click “Go” again.

You can cull this list further by looking at each article’s icon and description. Icons are designed to look like a printed page. Those with just a few lines indicate that the document is an abstract only. Icons with lots of lines and a green stripe mean that the article is free with the full text available electronically. An article with its title in brackets is not written in English. Unpublished articles have the notation, “Epub.”

You can learn more about how to search MEDLINE by going to the tutorials listed on the left navigation bar. Zorn especially recommends “Help” and “FAQ.”

How to find health literacy information in PubMed

Health literacy is a complicated subject. It does not have its own MeSH descriptor, according to Zorn. She has, though, created a special health literacy query to help find health literacy information.

Here’s how to search PubMed for health literacy information:

• First go to PubMed. On the left hand side of the page, you will see a heading for “PubMed Services.” Under that heading, is a link for “Special Queries.” Click on that link.
• Next, scroll down to the “Subjects” category and click “Health Literacy.”
• Under the heading “Health Literacy Search,” you’ll see a link for “Medline/PubMed health literacy search.” Clicking that link will bring up a list of more than 2,000 articles related to health literacy.
• You can narrow this list by using the “Limits” tab as described above.

Other sources of health literacy information

There are many other ways to search for and find relevant information about health literacy.

• Google search. Zorn says that the Internet is an amazing resource for scholarly and practical resources. She likes using a search engine such as Advanced Google to limit results by date range or document type. Zorn says that this type of search may not include as many citations as PubMed’s Special Query. But the ones you get are likely to be the most recent.
• Google News Alerts. I have been using this feature for several years and rely on it for the latest health literacy news. To create a Google Alert, enter search words for the topic of interest (such as “health literacy” or “health communication”) and specify the type of search and how often you want alerts emailed to you.
• BHIC (Bringing Health Information to the Community). Zorn describes this blog as “amazing” with all manner of health and health literacy information. Once you register, you get emails about relevant new articles. BHIC is funded by NLM.
• NLM Regional Medical Libraries. For people like me without regular access to a medical library, Zorn recommends contacting the National Network of Libraries of Medicine (NNLM). You can find a listing of local medical libraries that will allow you to access their books and journals by clicking your region of the map on the NNLM site. You can request specific materials through an electronic interlibrary loan service called LoanSome Doc. You can learn about the service and how to use it here .

Other Federal resources for finding health literacy information include:

• MedlinePlus Health Topics: Health Literacy
• NNLM Health Literacy page
• NNLM Health Literacy Toolkit
• The Health Literacy page at HRSA
• ODPHP Health Literacy Improvement page
• Plainlanguage.gov

Getting help

MedlinePlus is an excellent resource for finding up-to-date, easy to read, and highly relevant health information for patients and their families. In addition to providing access to articles and resources from NIH, MedlinePlus also contains links to other agencies such as the American Heart Association and the American Cancer Society. A good way to start looking for information is to use MedlinePlus Health Topics. The topics are arranged alphabetically and contain links to health information in other languages as well as English.

Zorn points out it takes time to browse resources and search for information. But you can get help from a NLM librarian. There is a “Contact Us” button on every page of the NLM site. Or you can go directly to the NLM contact page.

Ways to learn more:

Marcia E. Zorn, MA, MLS, is a reference librarian at the National Library of Medicine’s (NLM) Reference & Web Services Section.

Helen Osborne, MEd, OTR/L, is president of Health Literacy Consulting. She received two “Gold 2008 Plain Language awards from NIH for her work on the NCI booklets “Radiation and You” and “Chemotherapy and You.” Her column appeared regularly in On Call. You can contact her by e-mail at Helen@healthliteracy.com.