Conference Agenda

Introduction

Health literacy has become essential to access, evaluate, and use health information. Efforts to improve health literacy levels of the population are significant, but vary depending on the country, with libraries and education institutions being involved to various extents. In Romania, the actions of libraries and information specialists to enhance the health literacy of the population have been marginal in comparison with the UK, for example, where library services and health education institutions have been very active and have developed a series of tools and courses over the years. Starting with 2009, a series of studies were conducted in Romania regarding information literacy, health literacy and library involvement in teaching the necessary skills, which could empower people to be active in decisions influencing their life and well-being. The aim of this study is to analyse findings of different research conducted in the past years and provide an overview of the health literacy level among patients in Romania and then compare it to the health literacy level of patients in other countries as well as an overview of the challenges patients face when navigating the healthcare system.

Methodology and Outcomes

Research synthesis was used in this study. By analysing and comparing the results of studies regarding health literacy, we intended to uncover new insights and create a better understanding of the current state of health literacy among patients in Romania and future needs for its improvement. The selection of studies aimed to cover various types of patients and the evolution over time of this issue.

Research conducted over the years among patients in Romania, especially surgical and cancer patients, has highlighted a moderate level of health literacy. Proposals and initiatives for the development and implementation of various information literacy programmes by the medical universities in Cluj and Bucharest or by their libraries and isolated actions of some public libraries have proved these institutions are interested and open for a greater involvement in improving health literacy among their communities. However, joint efforts from different institutions, organisations and authorities are needed for successful programmes that could reach all categories of population in society.

Conclusion

Health literacy has proved to play a significant role in the patients’ experience during their disease, leading to a more active engagement in the decision-making process and the entire care process. Until now, libraries’ involvement in health literacy programmes could be considered small, or modest, sometimes even invisible. However, there is potential for a better collaboration between libraries which could contribute to an improvement of health literacy level. Focus on the training of librarians in Romania to support health literacy initiatives and designing a national strategy to involve as many people as possible in health literacy programmes, especially marginalized communities, are necessary steps in the future.

References

Madge, O.-L., Marincaș, A. M., Daha, C., & Simion, L. (2023). Health information seeking behaviour and decision making by patients undergoing breast cancer surgery: A qualitative study. Health Information & Libraries Journal. https://doi.org/10.1111/hir.12480

Naccarella L., & Horwood, J. (2021). Public libraries as health literate multi-purpose workspaces for improving health literacy. Health Promot J Austral., 32(S1): 29–32. https://doi.org/10.1002/hpja.437

Naughton, J., Booth, K., Elliott, P., Evans, M., Simões, M., & Wilson, S. (2021). Health literacy: The role of NHS library and knowledge services. Health Info Libr J., 38(2): 150–154. https://doi.org/10.1111/hir.12371

Sumanu, S. A., & Madge, O.-L. (2023). Health literacy and its impact on cancer care for patients and caregivers in Romania. Qualitative and Quantitative Methods in Libraries (QQML), 12(3): 381–402. Retrieved 21 August, 2025 from https://www.qqml-journal.net/index.php/qqml/article/view/834

Vassilakaki, E., & Moniarou-Papaconstaninou, V. (2023). Librarians’ support in improving health literacy: A systematic literature review. Journal of Librarianship and Information Science, 55(2): 500–514. https://doi.org/10.1177/09610006221093794

Most cancer patients seek information actively (Elkefi & Matthews, 2024) and these activities serve as a crucial coping mechanism: patients gain a sense of control, a better understanding of their condition, and find support resources (Petersen et al., 2021). The preferred information sources may change over time as the patient is diagnosed and treated. In the initial diagnosis phase health care professionals are often the preferred information source whereas during recovery the experiences of other cancer patients can be useful (Jensen et. al., 2022). This study explores the posts shared on social media and how other patients, caregivers, and healthcare professionals benefit from these discussions. We focus on X, as it is an active platform for sharing health related information and experiences (Martinez, 2025). Posts were identified using a set of keywords related to the subjective experiences of cancer patients with different aspects of the disease. The keywords are identified through a qualitative study (Jensen et al., 2022) and are carefully selected to ensure a comprehensive capture of relevant posts. Overall, we collected 118112 Tweets from 1 Jan 2023 until 4 Nov 2024. The posts were analyzed using Continuous Bag of Words (CBOW) models (Church, 2017) and topic modeling (Blei, 2012), to unveil topics and experiences users were exchanging information and resources about. Our preliminary results show that users touched upon a wide range of relevant topics including early detection, side effects, as well as practical suggestions. Moreover, we also found that despite an informed and targeted search, some wild cards and non-relevant discussions were picked up (e.g. water signs). Figure 1 provides a visual representation of our CBOW model.

In conclusion, this study supports earlier findings that social media can be overwhelming even when looking for targeted information. However, we also find that applying methodological filters can provide cancer patients, relatives and health professionals with firsthand experiences and practical advice in the recovery phase.

References

Blei, D. M. (2012). Probabilistic topic models. Communications of the ACM, 55(4): 77–84.

Church, K. W. (2017). Word2Vec. Natural Language Engineering, 23(1): 155–162.

Elkefi, S., & Matthews, A. K. (2024). Exploring Health Information–Seeking Behavior and Information Source Preferences Among a Diverse Sample of Cancer Survivors: Implications for Patient Education. Journal of Cancer Education, 39(6): 650–662.

Jensen, J. G., Petersen, E., & Frandsen, T. F. (2022). Seeking and avoiding information: a qualitative study of the information behaviour of cancer patients. Information Research, 27.

Martinez, L. S. (2025). Twitter and health communication. Health, Media, and Communication, 15: 269.

Petersen, E., Jensen, J. G., & Frandsen, T. F. (2021). Information seeking for coping with cancer: a systematic review. Aslib Journal of Information Management, 73(6): 885–903.

This paper reports on a project that aimed to develop partnerships with marginalised communities in Sheffield to co-produce research priorities for Health Literacy (HL). HL refers to the capacity people have to obtain, process and understand information related to their health and use it to make informed choices, reduce risks and improve their quality of life (Martzoukou & Abdi, 2017). However, low HL is a severe problem in marginalised communities and leads to a range of undesirable outcomes, including poor health and reduced use of preventative healthcare (Stormacq et al., 2020). Community-led interventions to develop HL are empowering and co-creating health information and can help address structural and systemic barriers to health (De Wit et al., 2018). This project engaged members of the Roma, Yemeni and Somali communities in Sheffield, UK. These communities have low levels of English, many are recent immigrants to the UK and are generally recognised as marginalised. Community centres recruited members to participate in co-production workshops. Cycle 1 workshops with 48 participants in total explored perceptions of trustworthy health information sources, and the barriers experienced in gathering suitable health information. Cycle 2 workshops with 20 participants in total focused on potential research foci, methods, and how community members could contribute to data collection and analysis. The workshops featured participatory image-based activities that were designed to be accessible to all.

Despite the unique linguistic and cultural backgrounds of the communities, a number of common themes emerged. The community centre is a trusted social source of health information, and community centre staff play a valuable role in interpreting and mediating health information and services. Participants reported a range of systemic and structural barriers to accessing health information and communicating with health professionals, particularly related to language and the use of interpreters. Digital exclusion was a barrier to engaging with “digital first” services such as the UK’s National Health Service app, and many participants lacked broadband access. Health information was sought and shared in social networks, and “expert” community members with better English provided HL support to others. Despite these challenges, participants demonstrated criticality in evaluating health information, recognising that health information encountered online or through social networks may not be accurate.

Community members expressed a strong desire to be involved in the design and delivery of future HL research. Research priorities focused on building interactive and critical HL (Nutbeam & Lloyd, 2021), such as improving information exchange between communities and the health service, community involvement in training health staff, and co-creating health information resources, for example, videos and leaflets. There was a preference for qualitative research methods, and for community members to be trained as researchers to collect and analyse data. In conclusion, we reflect on the valuable role played by community centre staff acting as information intermediaries (Buchanan et al. 2019) in this information landscape and the need for health service providers to partner with communities to improve information communication, reduce organisational complexity and address social determinants of health (Nutbeam & Lloyd 2021).

References

Buchanan, S., Jardine, C., & Ruthven, I. (2019). Information behaviors in disadvantaged and dependent circumstances and the role of information intermediaries. Journal of the Association for Information Science and Technology, 70(2): 117–129. https://doi.org/https://doi.org/10.1002/asi.24110

De Wit, L., Fenenga, C., Giammarchi, C., Di Furia, L., Hutter, I., De Winter, A., & Meijering, L. (2018). Community-based initiatives improving critical health literacy: A systematic review and meta-synthesis of qualitative evidence. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-017-4570-7

Martzoukou, K., & Abdi, E. S. (2017). Towards an everyday life information literacy mind-set: A review of literature. Journal of Documentation, 73(4): 634–665. https://doi.org/http://dx.doi.org/10.1108/02683940010305270

Nutbeam, D., & Lloyd, J. E. (2021). Understanding and responding to health literacy as a social determinant of health. Annual Review of Public Health, 42(1): 159–173. https://doi.org/10.1146/annurev-publhealth-090419-102529

Stormacq, C., Wosinski, J., Boillat, E., & Van Den Broucke, S. (2020). Effects of health literacy interventions on health-related outcomes in socioeconomically disadvantaged adults living in the community: A systematic review. JBI Evidence Synthesis, 18(7): 1389–1469. https://doi.org/10.11124/jbisrir-d-18-00023

Based on the ACRL’s Framework for Information Literacy for Higher Education (2016) vision of information literacy (IL) as a set of abilities that enables students to both consume and produce information effectively, this study aims to investigate law students’ knowledge practices in digital and AI information environments. The specialised nature of legal information and the dynamic legal environment pose new demands on Croatian law students, legal scholars, and practitioners in terms of understanding, interpreting, and applying the law. In parallel, the development of ICT and digital technologies and the emergence and use of AI tools in legal research present additional challenges for law students. They face an enormous volume of legal information and the rapid spread of misinformation, which can create uncertainty and inaccuracies in finding and applying credible legal information, potentially leading to incorrect law applications. Additionally, studying in such an environment can instil trust in technology, leading to the belief that information obtained using, for instance, AI tools is authoritative and accurate without engaging in critical evaluation of the legal information (Callister, 2024). Therefore, during their education, law students must learn to identify, select, and use trustful legal sources (Kim-Prieto & Kahvecioğlu, 2014). Sources of information are typically chosen and used based on their perceived reliability and trustworthiness (Savolainen, 2007). Trust in information sources is embodied in cognitive authority, which refers to the sources considered competent and trustworthy (Wilson, 1983). While previous studies have examined young people’s trust in information sources more broadly (Karim & Widen, 2023), little empirical research has been done on how law students specifically engage with, evaluate, and construct the cognitive authority of legal information sources in digital and AI-driven environments. This study provides a novel contribution to legal IL by addressing a research gap in understanding Croatian law students’ trust in legal information sources. The research answers the following questions: (1) What knowledge practices do law students use in the context of research assignments? (2) How do law students construct the cognitive authority they attach to the information sources they use?

The study employed a qualitative research method as part of a case study at the Faculty of Law in Rijeka. The phenomenographic interviews combined with a think-aloud method with students sought a holistic description of a phenomenon under study. The sample was intentional and included 12 students. The interviews were conducted until saturation was reached (Yates et al., 2012).

Preliminary results reveal that students engage with various information sources, assigning them varying levels of trust. The results indicate students’ cautious approach to law AI-based sources, echoing Callister’s (2024) warning about whether AI can be a trusted, credible, and reliable legal source. Students primarily consult AI for informational purposes and idea development but do not consider it a cognitive authority; instead, they prioritise legal databases. This research contributes to a better understanding of cognitive authority and how it is constructed in the digital and AI information environment, as well as improved IL programmes at law faculties.

References

ACLR. (2016). Framework for Information Literacy for Higher Education. Retrieved 31 January, 2025 from https://www.ala.org/acrl/standards/ilframework

Callister, P. D. (2024). Generative AI and Finding the Law. https://doi.org/10.13140/RG.2.2.28311.14240

Kim-Prieto, D., & Kahvecioğlu, M. K. (2014). Three faces of information literacy in legal studies: Research instruction and law student information literacy standards in the American common law, British common law, and Turkish civilian legal traditions. International Journal of Legal Information, 42(2): 293–302.

Karim, M., & Widen, G. (2023). Strategies for information source selection: A focus group study on young people in Europe. Journal of Information Science, 01655515231193847.

Savolainen, R. (2007). Media credibility and cognitive authority. The case of seeking orienting information. Information Research, 12(3), paper 319. Retrieved 22 August, 2025 from http://InformationR.net/ir/12-3/paper319.html

Wilson, P. (1983). Second-hand knowledge: An inquiry into cognitive authority. Westport; London: Greenwood Press.

Yates, C., Helen Partridge, H., & Bruce, C. (2012). Exploring information experiences through phenomenography. Library and Information Research 36(112): 96–119. https://doi.org/10.29173/lirg496

Advancements in telecommunication technologies have led to both benefits, including convenient financial transactions and real-time communication, and risks, such as a surge in cybercrime and online fraud. In Thailand, cybercrimes caused approximately 77.36 billion THB (2.2 billion EUR) in losses between March 2022 and November 2024 (Prachatai, 2024). Research indicates that digital literacy is crucial in mitigating these risks (Li et al., 2024). Older adults tend to have lower digital literacy levels (Office of the National Digital Economy and Society Commission, 2023), making them particularly vulnerable. Thailand, now an aged society with 20.92% of its population over 60, urgently needs to improve older adults’ digital literacy for safe and informed digital technology engagement.

As societal changes lead to more older adults living alone, they increasingly rely on media for information and social connections. Drawing on Medium Theory which posits that a medium’s unique characteristics influence user perception and interaction with content (McLuhan, 1967), we investigated the relationship between media consumption patterns and digital literacy in online safety among older adults in Thailand. We hypothesized that older adults with diverse media consumption patterns will exhibit different levels of digital literacy in online safety. Furthermore, media scholars suggest that individuals who integrate multiple media sources into their personal media repertoires tend to develop stronger knowledge and skills, including digital literacy (Hobbs & Frost, 2003). Therefore, we examined whether consuming a variety of media is associated with higher digital literacy in online safety. Finally, to guide effective interventions, our research explored which specific media repertoires were most effective in fostering digital literacy in online safety.

Using a nationally representative dataset (Office of the National Digital Economy and Society Commission, 2023),

we analyzed a subsample of 9,748 individuals aged 58-76. We employed an ordered logit regression to examine the relationship between digital literacy and media consumption patterns while controlling for sociodemographic variables. The findings identified effective media combinations to develop policy initiatives that improve digital literacy in older adults. Enhancing digital literacy among older adults is essential not only for reducing cybersecurity risks but also for bridging Thailand’s digital divide.

References

Hobbs, R., & Frost, R. (2003). Measuring the acquisition of media‐literacy skills. Reading Research Quarterly, 38(3): 330–355.

Li, P., Li, Q., & Du, S. (2024). Does digital literacy help residents avoid becoming victims of frauds? Empirical evidence based on a survey of residents in six provinces of east China. International Review of Economics & Finance, 91, 364–377.

McLuhan, M. (1967). The Medium is the Massage. New York: Bantam Books.

Office of the National Digital Economy and Society Commission. (2023). Media and Information Literacy and Digital Literacy Summary Survey Report Thailand 2023. Retrieved 28 August, 2025 from https://www.nso.go.th/nsoweb/storage/survey_detail/2023/20230918144302_73165.pdf

Prachatai. (2024). Three-year Statistics: Online fraud causes over 70 billion Baht in financial losses. Retrieved 28 August, 2025 from https://prachatai.com/journal/2024/12/111710