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Mostafa-Moghadam F S, Samouei R, Zare-Farashbandi F. Identifying how to implement and evaluate a health human library: a scoping review. jha 2024; 27 (3) :17-35
URL: http://jha.iums.ac.ir/article-1-4550-en.html
1- aMedical Library and Information Sciences, Isfahan University of Medical Sciences, Isfahan & Central Library, Iran University of Medical Sciences, Tehran, Iran
2- Koushasalamat Roshdafarin, Shahrak Salamat, Isfahan
3- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan , f_zare@mng.mui.ac.ir
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Introduction
The human library was conceptualized in 2000 in Copenhagen. In this project, real people are lent to readers as books [1]. The human library is an emerging concept in the field of library science [2] The human library, or living library, is similar to a traditional library in which humans, as writers, share their life experiences and stories on topics such as stigma, prejudice, addiction, and other misunderstood issues in society, or offer their expertise in a safe space for discussion [3-5]. A human library can be organized as a free one-day event or a series of sessions lasting approximately 15 minutes to an hour, usually hosted in public libraries. A list of anonymous human book volunteers is prepared and made available to readers before the event, so they can pre-select a book of their choice. Human libraries can be organized privately or publicly [3,4,6-12].
Each human library event can have its own rules and procedures, determined by its organizers. [13] If the human libraries are willing, human library events are cataloged, documented, and archived in various electronic formats for future use [2,6,14]. Chung and Tse [15] conducted a study in 2022 to test the effectiveness of a human library intervention in increasing mental health literacy (MHL). The results showed that this intervention significantly reduced stigma and preferred social distance, but had no significant effect on knowledge acquisition. Kwan [16] also noted in his study that the human library has observable efficacy and benefits as an approach to facilitating social inclusion and promoting recovery.
Two previous reviews, conducted with different objectives, databases searched, review period, and keywords, did not fully cover the objectives of the present study. One of these reviews was conducted to identify the purpose of creating a human library, its benefits, and challenges such as barriers to creating a human library and a human book [17]. The second study was conducted to summarize the design, implementation, processes, and results of existing human library programs and to synthesize recommendations for the future implementation of a more effective, ethical, and reasonable human library. Although the method, type of databases searched, and time period studied are different from the present study, there is some overlap with our study in terms of findings related to the implementation of a human library [5], however. the present study focuses on the human library in the health sector. Thus, the purpose of the present study is to identify how to implement, operate, and evaluate a human library in the field of health through a scoping review.

Methods
This scoping review adheres to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Joanna Briggs Institute Reviewers' Manual specifically tailored for scoping reviews [18-20]. To determine the related keywords and their synonyms, a comprehensive approach was employed, involving consultations with MeSH, Embase, ERIC, and LISTA, as well as scientific and technical thesauruses. Additionally, the Web of Science, Scopus, PubMed, LISTA, and Google Scholar databases were searched and insights from librarians and information specialists were utilized. Based on these identified keywords, the following general search strategy was employed to retrieve related studies:
("Human Librar*" OR "Living Librar*")
Retrieval of English-language sources was conducted through databases including the Web of Science, Scopus, PubMed, Embase, ERIC, LISTA and Emerald. In addition, Persian-language sources were sourced from Magiran, SID, Ensani.ir, ISC, Irandoc, Normags, Civilica, and Elmnet. The search for gray literature such as theses and research project reports, was conducted by searching Google Scholar, ProQuest, and MLA. Furthermore, relevant conference articles, particularly from IFLA conferences, were identified through an exhaustive search of related conference proceedings. The reference lists at the end of the final selected articles were also manually reviewed.
Database, grey literature, and manual searches resulted in the identification of 2570 sources. After removing duplicates using EndNote, 2035 sources remained. These sources were screened in two stages. Initially, after screening the titles and abstracts based on study objectives and inclusion and exclusion criteria, 232 sources remained. Then, in the next stage, by referring to the full text of the sources, 188 studies were excluded due to non-compliance with the study objectives and inclusion and exclusion criteria. Finally, 44 studies were selected for review and data extraction. The source selection process was carried out independently by two members of the research team. In case of any disagreement, cases were resolved through consensus or by a third party outside the research team. According to Joanna Briggs' Guide to Scoping Reviews, quality assessment of studies is not necessary for scoping reviews [19]. Therefore, quality assessment of studies was not performed.
Information from each source, including the name of the first author, study title, journal title, year of publication, country of study, study design, study population,    tools      required      for     the    study,
implementation, execution, and evaluation, was extracted according to a researcher-made data extraction form. Data extraction was performed independently by two members of the research team, and disagreements were resolved through consensus. If disagreements could not be resolved through consensus, the opinion of a third person was considered.
The data were synthesized in a narrative format. Accordingly, the data obtained, including the implementation method, execution, and evaluation method of the human library, were combined, grouped, and presented in a tabular format.

Results
The result of screening process is illustrated in the PRISMA diagram (Figure 1), which details the number of identified sources and outlines screening steps that resulted in the final selection of 44 sources. The findings are organized according to research objectives and are comprehensively presented in Tables 1 and 2.

 
Figure 1. PRISMA flow diagram          

Information from 44 articles was included in the study. Most of the articles were published in 2022 and 2023 (5 each), indicating an increase in attention to the subject of the human library. Most of the articles were from the United States (10 cases). In terms of methods, most of the articles were conducted with a qualitative method (14 cases) and the most frequently used data collection method was interviews (35 cases). Additionally, the sample studied was mostly specific individuals (10 cases). To implement and run a human library in the health sector, two main themes were identified, along with its subcategories (Table 1). Furthermore, to evaluate the human library, three main themes along with their sub-categories were identified (Table 2)

Table 1. Implementation of the human library in the health sector
References Examples Sub-categories Main themes
[7, 21] Specify how to advertise Advertisement Introduction and planning
[1, 6, 7, 11, 22-24] Magazines, newspapers, newsletters, student publications, etc.
[1, 6, 9, 21, 22, 25] Social media
[6, 7, 9, 22, 26, 27] Banners, posters, panels (traditional or digital)
[7, 9, 11, 21-23, 25] Library website, university, etc.
[7, 22, 28, 29] Word-of-mouth advertising (people, friends, colleagues, classmates, etc.)
[10, 23, 27, 28] Email
[10, 23] Phone calls
[30] Using artists (actors and singers)
[30] Selling folders introducing the human library project
[24] School
[24] Publishing a list of human books
[23] Associations
[25] Foreign organizations
[10, 29] Obtaining permission to hold a human library event from relevant organizations Necessary permits and coordination
[4, 15, 16, 31] Obtaining ethical approval
[4, 6, 10, 15, 16, 31-33] Obtaining informed consent from readers and the human book
[22] Occupational health and safety requirements
[12, 15] Preparing a practical protocol to protect human books from possible harm
[4, 10, 34-36] Establishing confidentiality of personal information of individuals (books and readers)
[1-3, 7, 9-11, 22, 24, 26, 27, 29, 31] Specifying the date of launching or holding the human library event and its duration (scheduling plan)
[2, 6, 11-13, 21-23, 28, 35, 37] Preparing a list and index of human books and updating it regularly
[7, 12, 13, 22, 24] Coordinating reservations and registration (offline or online) and participation in the event
[2, 4, 6, 7, 10, 11, 23, 38, 39] Documenting, recording, storing and digitizing the event
[27, 38] Sharing recorded photos and videos to further reflect the event
[22, 27, 40] Having a strategic and management plan Regulations and bylaws
[8, 9, 12, 23, 34] Preparing a practical regulation for the human library
[22, 23, 28, 31, 41] Determining the target group (readers)
[1, 2, 6, 9, 11, 13, 14, 21-25, 27-29, 33, 41] Determining how to select and borrow a human book
[4, 9, 10, 15, 16, 31] Determining the conditions and criteria for readers to enter
[2-4, 7, 10, 12, 15, 24, 27, 28, 31, 32] Determining how the human book will respond
[2, 4, 7, 8, 10, 12, 14, 15, 23, 27, 28, 31] Determining how readers will ask questions about the human book
[1, 24, 29, 42] Requirement for human books to wear T-shirts with the human library logo or have name tags during the event
[4, 8, 9, 11, 15, 16, 22, 25, 26, 34, 36] The presence of a communication facilitator and interpreter (such as a social worker, librarian, writer, support worker, teacher, student, translator, library staff and volunteers, students, etc.) Briefing sessions
[28, 31, 36] Conduct briefing sessions for facilitators (to familiarize themselves with the philosophy, goals and resources of the project, location, type of conversations, etc.)
[1, 4, 6-9, 16, 22, 29, 31, 32, 34, 37] Conduct a briefing session for the human book
[1, 4, 16, 23, 31, 32] Conduct briefing sessions for readers
[1, 27] Identifying the location of each human book at the event venue Venue
[21, 24] Layout the event venue
[2, 7, 12, 14, 15, 22-24, 27, 29, 33, 37] Creating a safe and comfortable environment
[1, 11, 12, 28, 43] Libraries and librarians (general) Hosting a human library event
[8, 14, 28, 34, 35] Public libraries
[1, 22, 35] School libraries
[10, 34, 35] University libraries
[1, 14, 35] Festivals and conferences
[6, 14, 21, 34, 35] Community centers (such as exhibitions, museums or art galleries, associations)
[26, 28, 36] Local community
[1, 6, 9, 14, 15, 21, 26, 28] Universities and higher education institutions
[22] Nursing homes
[6, 7, 14, 34] Free service Financial issues
[6, 23, 37] Launch event with sponsorship (college, local community, library, etc.)
[3, 7-9, 15, 22, 26, 27] Minimal cost to hold the event (venue, advertising, food and beverage, transportation, thank-you gifts for the human book)
[25, 28, 44] Use technology such as websites, mobile apps, registration software, and email to promote and manage participation in human library events (e.g., location, time, human book descriptions) Using technology in the human library
[28] Create, update, and delete book titles, descriptions, ratings, reservations, loans, and availability status of human books via mobile apps
[6] Use online video sharing tools, distribution tools, and a relevant, multicultural social program
[2, 32, 36, 44, 45] Use technology to create an online human library
[25] Lack of a single system or platform for requesting human books Challenges
[37] Inconsistency in cataloging or standardization of entries for the human book
[37] The voluntary nature of human books and potential emotional distress
[6] Lack of equipment to record the event (e.g., video cameras)
[43] How to identify and recruit human books
[3] Budgetary constraints
[12] The challenge of preserving human book collections due to their lives and careers
[3, 14, 22, 25, 27] Personal contacts Methods for identifying a human book Issues related to the human library
[24] Contacting organizations related to suitable people for the human book (stigmatized, rejected, etc.)
[25] Introducing human books to other libraries
[3, 22, 25, 27, 28] Advertising on social media and networks
[1, 21, 22, 34] Volunteering
[28] Library
[3, 24] Email
[7, 21, 29] Developing the human book collection (in terms of number, knowledge, subject, professional orientation, etc.)
[6, 27] Human book recruitment and identification committee in the organizing organization
[7, 28] Online form for proposing a human book
[29] Being mentally healthy Criteria for selecting a human book
[4, 7, 14, 21, 27, 31, 41] Having skills, experience or expertise in a specific subject and being a public representative of a specific group
[1, 6, 9, 11, 14, 24, 26, 29-33, 37] Diversity of the human book (in terms of religious, social or ethnic backgrounds, culture, life experiences, etc.)
[3, 31] Being an adult
[1, 23] Openness and honesty of the human book
[4, 10, 23, 25, 46] Individual sessions (private method) How to hold meetings
[1, 7, 24, 31, 32] Sessions of a human book with groups of 2 to 5 people (semi-private method)
[1, 3, 7, 8, 16, 25] Sessions of a human book with a group of readers (public method)
[8] Dedicated human library (only for members of a specific group such as students, police officers and teachers)
[8] Public human library (for all who wish to participate)
[22, 36] Privacy for individual sessions
[1, 7, 9, 23, 24, 31] Informal, unstructured, flexible and open-ended conversations
[4, 8, 12, 13, 15, 22, 26, 28, 31-34, 43] A specific number of human books
[1, 3, 9, 10, 13, 15, 22, 26, 28, 31, 32, 34] A specific number of readers
[1, 4, 8, 12, 13, 15, 26, 29, 32-34, 41] Session duration
[1, 4, 7, 14, 15] Human book uses relevant tools to enhance the conversation and enrich the content
[6, 10, 11, 16, 28, 32, 33] Provide opportunities for sharing human book stories in a variety of ways (e.g. face-to-face, group discussion, short text messages, photos or video conferencing)



Table 2. Evaluation of the human library in the health sector
References Subcategories Main themes
[22] Evaluation through a study of readers' behavior Evaluation objective
[1, 12, 22, 24, 43] Survey to measure the achievement of the Human Library's goals in terms of sharing their differences and ideas
[22] Survey to measure the safety of the environment for participants
[3, 6, 10, 34] Evaluation of the Human Book and reader experience and insight immediately after the event
[13, 21, 31, 43] Evaluation of the quality of the Human Books
[21] Evaluation of the session content by obtaining informative feedback
[12, 24] Preparation of a post-event report for the senior manager
[43] Suggestions for future events
[7, 8, 16, 27, 31, 32] Measuring the impact of the Human Book on changing readers' attitudes
[16] Evaluation of the relevance of the Human Library program in the field of mental health services
[36] Evaluation of the relevance of the Human Library program in education
[1, 7-9, 15, 16, 22, 24, 25, 31, 32, 36, 47] Questionnaire (online or offline) Evaluation tools
[10, 13, 21, 34, 43, 48] Interview
[27] Observation
[32] Focus group
[34] Field notes
[24] Padlet wall
[12, 24, 27] Report
[6] Evaluation via YouTube meeting videos (YouTube internal analytics, number of likes, shares and views)
[25] Determining appropriate criteria for evaluating a human book Evaluation challenges
[25] How to collect feedback from readers
[9, 36] Confidentiality of evaluation
Determining location, time, and host
Determining how to choose a human book according to health subjects
Obtaining necessary authorizations from health organizations
Advertisement
Determining how meetings will be held
Holding necessary briefing sessions
Evaluation
Regulations and bylaws according to health organizations
Specifying financial issues
Determining the event subject according to health sciences

Finally, the proposed process for implementing, running, and evaluating a human library in the health domain can be summarized in Figure 2. This non-linear process shows the step-by-step steps from obtaining the necessary permits to holding a human library in the health domain event and evaluating it. After the evaluation, there may be a return and feedback on the previous steps to refine and optimize the next human library event.

Figure 2. Proposed process for implementing, running, and evaluating a human library in the health domain
Discussion
Researchers have described different ways of advertising for human library events, including word-of-mouth, email, and phone calls [7, 10, 22, 23, 28, 29]. Obtaining the necessary permits and approvals and coordinating the program were consistent with many studies [1-3, 7, 10, 11, 22, 24, 27, 29, 31]. Similar studies have also mentioned the human library being free with financial support from local organizations and communities [3, 6-9, 14, 15, 22, 23, 26, 27, 34, 37]. Based on the results, various methods have been proposed to identify human books, the most common of which is advertising in the media and social networks [3, 22, 25, 27, 28]. Regarding the method of holding meetings, different methods have been proposed by different researchers, including individual meetings (private method), meetings of a human book with groups of two to five people (semi-private method), meetings of a human book with a group of readers (public method) [1, 3, 4, 7, 8, 10, 16, 23-25, 31, 32].
Evaluation through studying reader behavior and surveys to measure the safety of the environment, and measuring the impact of the human book on changing readers' attitudes are important goals of evaluating the human library event, which has been mentioned by many researchers [7, 8, 15, 16, 22, 27, 31, 32]. To conduct the evaluation, a questionnaire (online or offline) has often been used, and other tools include interviews, observations, focus groups, and field notes, which have been mentioned in numerous studies [10, 13, 21, 27, 32, 34, 43].
The challenges of evaluating a human library in the health field include determining appropriate criteria for evaluating a human book and how to collect feedback from readers [25]. Given the importance and sensitivity of the health field, it is necessary to hold a health human library event at the end of each event, which can help correct its possible shortcomings and promote and improve the next event.
Among the limitations of this research are limitations related to the scoping review method, such as the lack of complete comprehensiveness in retrieving and accessing relevant resources and unintentional errors in data analysis.
In conclusion, the results showed that to implement and run a human library in the health sector, first, the necessary preparations and planning should be completed, including obtaining the necessary permits, determining the regulations and bylaws, determining the location and time of the event, advertising, and financial issues. Then, the method of selecting the human book, the type of meeting, and its execution should be decided. Finally, after the event, an evaluation should be conducted so that the activities that need to be corrected can be reviewed and improved for subsequent events. Based on the findings, it can be suggested that the health system authorities, especially in the field of mental health, should launch a human health library.

Declerations
Ethical considerations: This research was conducted with the code of ethics IR.MUI.NUREMA.REC.1402.183 obtained from the ethics committee in biomedical research of the Faculty of Nursing, Management and Rehabilitation- Isfahan University of Medical Sciences.
Funding: This research was carried out with the financial support of Isfahan University of Medical Sciences, Isfahan, Iran with number 3402738. The funder had no role in data collection, data analysis and article writing.
Conflicts of interests: The authors declare that there is no conflict of interest.
Authors’ contribution: R.MM: Conceptualization, study design, data curation, methodology, data analysis, data management, writing- original drafting, writing-review and editing, final approval; R.S: Conceptualization, study design, methodology, data analysis, writing-review and editing, final approval; F.ZF: Conceptualization, study design, data curation, methodology, software, data analysis, data management, writing-review and editing, supervision, project administration, final approval. All authors have read and approved the text of the article.
Consent for publication: None
Data availability: Data access is possible through the corresponding author.
AI deceleration: None
Acknowledgements: This article is the result of a part of the thesis entitled "Identifying how to implement and evaluate the health human library: a scoping review" in the master’s degree in medical librarianship and information science, approved by Isfahan University of Medical Sciences in 2023 with code 3402738.
Type of Study: Review | Subject: Medical Librarianship and Information Science
Received: 2024/08/27 | Accepted: 2025/04/30 | Published: 2025/05/17

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