Early Literacy Research Library (ELRL) - Article

Survey of Public Library Use in the Ambulatory Clinic in the Children’s Hospital Winnipeg

Burns, J., Sharma, A.K., Borland, K., Rodd, C.J. (2021) Survey of Public Library Use in the Ambulatory Clinic in the Children's Hospital Winnipeg. Paediatrics & Child Health, 27(1), 25-31.,

Access: FREE/Open Access

Publication year


study description

Structured interview study.

core topic(s)

Early Literacy , Pediatric Primary Care

Population Characteristics

International , Poverty/Low-Income

Exposures, Outcomes, Other

Community , COVID-19 and Pandemic Impact , Disparity/Adversity , Home Language/Literacy/Learning Environment , Libraries and Public Resources


Our primary objective was to determine the percentage of Children's Hospital Winnipeg Ambulatory Clinic's patients who had ever used a public library.

outcomes evaluated

Public library use.


Children's Hospital Winnipeg Ambulatory Clinic's that has a longstanding early-childhood literacy program and serves remote communities and low-income Winnipeg families.


A structured survey was administered to parents or legal guardians by the first author. It explored library barriers and covariates that might affect library use. Analysis included descriptive statistics and a logistic regression model for predictors of library use.

sample size

n=97 (surveys)


Measure of Library Use: survey was created by modification of questions from two existing surveys, previously administered to Indigenous young adults in Winnipeg and from Indiana, including variables like: gender of caregiver, number of children in household, education, knowledge about library services.


Ninety-seven nearly consecutive surveys were administered, half prior to the COVID-19 pandemic. Most respondents were female, from Winnipeg, and in the two lowest neighbourhood income quintiles. Roughly half (46.4%) of children had used a library. Most respondents wanted health care providers to promote literacy and provide information about public libraries, and more supported in-clinic distribution of books. The number of children per household positively predicted library use, possibly a proxy for experience with community resources. About 2/3 of respondents believed that library fines should be abolished. Most identified other barriers, for example, inconvenient hours, distance, or concerns about COVID-19.


Less than half of surveyed families used public libraries, citing multiple barriers, including fines. Moreover, not all health care providers can offer new books and anticipatory guidance. Clinics that promote use of public libraries may therefore represent a low-cost, stand-alone alternative.


Unfortunately, we are not sure how generalizable our study is to similar early childhood literacy programs in Canada because our clinic has a mandate to provide general paediatric care for this impoverished inner-city area and remote fly-in northern communities. Due to practical clinic limitations, we could not obtain some individual information (age of caregivers or children, car ownership, parental use of library, etc.) that might have provided additional insights. For ethical reasons, we were not allowed to capture the postal codes or family characteristics of those that refused or were unable to fully respond. Other potential biases are selection (interviewing only those adults who are fluent in English), recall, or desirability biases.