The need for improved access to high quality public health (PH) information has been echoed in various forums involving public health professionals, librarians, and information professionals since the mid 1990s [1
]. The information needs of the PH workforce have become all the more urgent with the increasing frequency of emergence of new infectious diseases such as severe acute respiratory syndrome (SARS) and Asian bird flu, as well as the increasing concern about acts of bioterrorism, such as spreading anthrax spores via the US Postal Service in 2001.
A major difficulty in meeting these needs is the great breadth of the PH discipline which makes it difficult to identify and collect a body of evidence-based literature to address the growing multitude of specific PH information needs. The PH workforce may be more diverse than any other group of health professionals [6
] and includes professionals trained in dozens of disciplines [3
], ranging from environmental health to veterinary medicine, from sanitary engineering to epidemiology.
Studies of the information needs of PH professionals have addressed information seeking behaviors of PH workers, obstacles to information access, and defining and classifying the specific types of information needed. Reports of studies focusing on how PH workers look for the information they need note that many PH professionals have been slow to adopt electronic information-seeking behaviors, sometimes because of the time required for users to acquire the requisite skills and other times because access to electronic databases is not available [7
]. Studies focusing on obstacles to electronic access to and use of evidence-based information in the PH field [1
] have identified many relevant obstacles including: (1) limited awareness of the importance of evidence-based information to inform practice and lack of encouragement from opinion leaders to seek it; (2) limited awareness of what information is available electronically and from what sources; (3) limited access to computers, the Internet or email; (4) limited skills needed to access the information sources and lack of ease of use; (5) a diverse array of content needs requiring access to databases from many disciplines (and in other languages); (6) limited time to sift through the poorly filtered information that is returned by searches using sets of search terms inadequate for PH concerns; (7) limited ability of decision-makers to appraise the methodological quality of research; and (8) the paucity of systematic reviews of PH topics.
] suggested that information accessing needs among PH professionals often focus on immediate problem-solving and not on answering open-ended academic research questions. Investigators focusing on the kinds of information needed by PH professionals [5
] have noted the need for diverse kinds of information including the grey literature and unpublished studies, practice guidelines, research studies and systematic reviews. These investigators also point out the need for information that is effectively summarized and synthesized. There is also a need for linkages among multiple databases as well as providing access to databases related to best practices, outcome measures, statistical information, policy updates, and information that may be unique to a particular location or region. Nutbeam [4
] has formalized a valuable four-level typology of increasingly informative levels of research knowledge in the PH field. Nutbeam's model does not, however, include grey literature that may be needed to assist PH decision makers when the evidence needed to inform urgent PH issues is incomplete.
Access to evidence-based public health information has become a growing concern for medical librarians. In 1997, the National Library of Medicine along with the Centers for Disease Control and Prevention (CDC) and other agencies launched the Partners in Information Access for the Public Health Workforce project to begin to address this concern. The Evidence-Based Practice for Public Health (EBPPH) Project at the Lamar Soutter Library of the University of Massachusetts Medical School was initiated in 2001. This Project initially focused on identifying resources available to clinical medical practitioners and PH practitioners for locating, summarizing, synthesizing and disseminating evidence-based information. It then compared resources available to clinical medical practitioners to those available to PH practitioners. We found that there were many more types of resources focused on clinical medical practice than on PH practice. The clinical medical resources were based on several different models of information search, summary, synthesis and delivery, and some of the most promising models had little or no presence in the PH arena.
To explore and address this gap, the EBPPH project sought to examine and classify the features of the clinical evidence-based medicine resources, to assess their potential for improving access to the PH literature, and to develop new models that could effectively address the unique needs of PH professionals. EBPPH also works on identifying other existing projects aimed at synthesizing, summarizing or improving access to evidence-based PH information and publishes links to effective evidence-based resources it has identified via its website [15
This article presents the results from a qualitative study undertaken by the EBPPH project that combined three objectives that previous investigators had generally pursued individually: (1) characterization of information needs of PH practitioners, (2) identification of typical information seeking behaviors, and (3) assessment of barriers to information access. We have used the insights gained from the study to inform the construction of an extended classification of the types of information needed by PH professionals and of a hypothetical model for PH information access that could meet their needs for access to diverse credible sources.