Penn’s Melanie Mariano to Turn Public Libraries Into Hubs of Health Information

This is the third in a series of features introducing the 2016 Penn President’s Engagement Prize winners.

Public libraries serve communities in myriad ways, providing places where people gather to read, learn a new language, access the internet, pick up tax forms or apply for jobs.

During the next year, with leadership from University of Pennsylvania student Melanie Mariano, Philadelphia’s public libraries will also become hubs of health information and preventive health for the city’s residents.

“The library is a place of social capital, it's a place people see as a safe haven,” Mariano says. “If I can provide library visitors something similar to what a health clinic can provide in a less-intimidating environment, then why shouldn’t a nurse be there?”

Mariano, a senior nursing student from Bergenfield, N.J., is a winner of a Penn President’s Engagement Prize, which will support her efforts with as much as $100,000 for project expenses and $50,000 for living expenses. The largest of their kind in higher education, the President’s Engagement Prizes were launched by Penn President Amy Gutmann in 2015 and are supported by Trustee Judith Bollinger and William G. Bollinger, Trustee Lee Spelman Doty and George E. Doty Jr. and Emeritus Trustee James S. Riepe and Gail Petty Riepe.

This past fall semester, Mariano took a required community health nursing course during which she and her fellow students implemented health programming in the Paschalville Branch of the Free Library of Philadelphia system in Southwest Philadelphia. The outreach program was aimed at children, but, while there, Mariano had brief interactions with adults from the neighborhood that resonated with her.

One man she encountered, who had recently left a juvenile detention facility, queried her about where to get HIV testing and how his girlfriend could obtain contraception. Another day, Mariano used her conversational Spanish to chat with a recent immigrant about the stress and difficulties of leaving behind his family to move to the United States.

“So then you start to question, are these people getting access to things that many of us take for granted,” Mariano says, “like the availability of a therapist, for example, or just quality health information from a source they can trust.”

These encounters sparked her thinking about how many city residents lack access to reliable health information.

“If I’m having these small interactions in this six-week period,” she says, “I can only imagine how many stories go untold and how many individuals fall through the cracks, by no fault of their own.”

Mariano reached out to her course instructors, School of Nursing faculty members Briana Ralston, Christine Brewer and Monica Harmon to flesh out ways to transform the course’s community engagement component into “something a little more permanent and a little more prevalent,” she says.

With their help, Mariano began to outline her vision and reached out to see if the Free Library of Philadelphia might partner in helping meet the health information needs of library visitors. She ended up meeting with Siobhan Reardon, the Free Library’s president and director, and Autumn McClintock, strategy coordinator.

“Our focus at the library has been on health literacy, getting information to people,” says McClintock. “Adding in this element of person-to-person care really provides another layer of depth to our services.”

With further guidance and advice from Nursing faculty Julie Sochalski and Terri Lipman, as well as from last year’s PEP winner from the School, Jodi Feinberg, Mariano pulled together a proposal to bring continuity to the nursing school’s involvement in the libraries.  

The result is Mariano’s PEP-winning project, Living HEALthy: Health Expansion Across the Libraries. Beginning after graduation, Mariano will embed herself in the Free Library’s Central Branch, acting as a source of reliable health information as well as providing a place for visitors to receive health assessments, screening tests and perhaps eventually even first aid and vaccinations. As the project evolves, she would like to expand across the city to involve nurses from neighborhood clinics who would spend time in other Free Library branches.

“I see Melanie’s project as a way to answer the call, not only to have health information in the library,” says Harmon, Mariano’s advisor for the PEP project, ”but to have someone who can show you, is it the right information, and can help you with resources to take the next step.”

The initiative will provide health-related services to library patrons. Among them, Mariano envisions helping individuals determine what kind of care they might need to address existing health concerns, providing preventive care tips and offering in-house screenings for blood pressure, height, weight, vision and hearing, along with advice on what to do if the results turn out to be out of normal ranges. She also hopes to take advantage of existing programs for low-income people, such as providing referrals to clinics that offer free mammograms to women who cannot afford them.

“Ideally down the line we would be able to partner with a clinic and be able to give first aid and immunizations as well,” she says.

Mariano comes from a family of health professionals. Her mother and brother are nurses, her father is a surgical technician and her sister is a respiratory therapist. Yet in high school, Mariano thought she would pursue a career in business or finance.

“I used to hate needles, blood, everything,” she says. “I was very averse to everything related to hospitals.”

That changed after a day spent shadowing a nurse practitioner her senior year.

“The nurse practitioner sort of humanized hospitalization for me,” Mariano says. “That was the moment I was like, okay, I can see myself being a nurse.”

At Penn, Mariano “fell more and more in love with the practice of nursing” and is now submatriculated into the Nursing School’s Family Nurse Practitioner Program. After her postgraduate year working on Living HEALthy, Mariano would like to continue pursuing the project while working as a nurse before returning to Penn to finish her nurse practitioner studies. Ultimately she’d like to work as a nurse practitioner in a community clinic setting, possibly with a focus on adolescents.

She credits the President’s Engagement Prize with supporting her in pursuing her passion.

“I really think that if this opportunity wasn’t available I would have just had this idea and figured there was no way to implement it,” she says. “The availability of the Prize is telling students, ‘What you see as important is important and you have every right to pursue it.’”

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