These guidelines were adapted from interviews with Candace Ford Gray and other staff at the Planetree Health Resource Center in San Jose, California, online at www.planetreesanjose.org. Planetree staff are known for their collection development skills and frequently serve as consultants to other health librarians.

Patients often ask oncology nurses for resources, including book recommendations. But how do you decide what to recommend? By word-of-mouth reviews from your patients, other nurses, or other health educators? You might be interested in the resources and criteria used by librarians to select titles.

In general, librarians--whether at public, consumer health, or hospital libraries--are seeing more need for patient education materials. In determining how best to fill these increasing demands, consumer-health librarians evaluate recommendations for health and medical books to order from several sources:

• Library patrons

• Core lists of selected titles from library organizations, which have been prepared by staff or members with expertise in that area

• Reviews from professional journals--Booklist, Library Journal, and others such as Annals of Internal Medicine or NEJM that occasionally evaluate consumer books. They also look at reviews in professional publications, such as those of the consumer health chapter of the Medical Librarians' Association.

Library patrons like a range of titles and approaches--a mix of reading levels, depths, and alternative as well as conventional approaches. The same is probably true of your patients--people's preferences in resources vary.

Libraries order resources on the topics that people ask about most often. For instance, if people frequently ask about alternative therapies, librarians will buy a book to address that need. However, librarians want to make sure that patrons are reading the highest quality, most balanced, and most favorably evaluated book on a given topic.

Other criteria librarians use when considering a book:

• Timeliness: How current is the information and how recently was the edition was published? This is more important in technical areas. Planetree Health Resource Center has some books from the early 1990s and even the 1980s on its shelves, but largely where nothing else on the topic is available.

• Source: Is the publisher reputable--does it typically print soundly researched, well-written books that fulfill readers needs?

• Author: Does the author have a background or credentials in the subject area? Librarians see an MD degree as adding certainty, but usually not good style or writing. Physician authors may also have a narrow point of view, for instance, not looking at the whole person or considering nationwide treatment standards.

• Language: Is the book written in English or is it, instead, geared for non-English collections?

• Place of publication: Some British books are of excellent quality, but spellings, names of conditions, etc., are different.

• Organization: The following elements make a book more useful to the reader:
  • Index (very important)
  • Table of contents
  • List of organizations for people dealing with book's condition
  • Recommended books/bibliography
  • Footnotes, sources, or citations where appropriate

• Format: Does the book make good use of subheads, running heads and footers, introductory paragraphs, and summaries?

• Type: Is the typeface legible and does it have serifs, which help the reader follow the line across the page? Is the size of the type appropriate? People with macular degeneration may not be able to read a book on that subject if it is printed in tiny type.

• Heft: Is the size of the book appropriate? People with arthritis may have a hard time manipulating a book that is large and heavy.

• Clarity of illustrations: Are the illustrations simple? Librarians want illustrations that reproduce easily.

• Effect of illustrations: Some medical books illustrated with full-color photos look like Soldier of Fortune. Or, pictures are of worst-case scenarios, focused on the oddity or problem. Freakish body-part photos are very stressful for patients looking at what's ahead for themselves or loved ones. Sometimes, when an article has gory, full-color photos, Planetree copies a section or chapter for patients instead of loaning them the original: the illustrations are easier to look at in black-and-white.

• Spine: How broad is the book's spine, and how is the book bound? Very thin books and those with spiral bindings can't be identified when they're shelved.

• Presentation
  • Choose a cover that is not alarming or lurid, just as you would avoid gory illustrations.
  • Avoid sensational words like "Miracle," and exclamation points in the title.
  • Avoid negative language.
  • Avoid "cute" chapter titles. People are not in the mood for anything funny or obscure.
  • Fairly plain packaging tends to be comforting.

• Reading level: The longer a document is, the more important it is for the writing to have some variation in sentence length and structure in order to avoid boring and frustrating the reader. At the same time, the material must be written clearly. People who can read adequately are willing to substantially stretch their reading level to understand the specifics of their condition.
• Cost: While libraries generally have the budget for book purchases, they aim to make the most cost-effective use of it. (What they don't have is much of a budget for staff time.)