Available online at http://www.ijasrd.

org/in

International Journal of Advanced Scientific

Research & Development e-ISSN: 2395-6089
p-ISSN: 2394-8906
Vol. 04, Iss. 03, Ver. II, Mar’ 2017, pp. 114 – 121

HEALTH CARE INFORMATION LITERACY THE ROLE OF

LIBRARIANS
Aramide Femi PhD1 and Tomori Oyinade2
1 Chief Lecturer, Department of General Studies, The Polytechnic Ibadan, The Polytechnic Ibadan,
Oyo State, Nigeria.
2 Chief Librarian, Academic Library Department Aro Psychiatric Hospial, Abeokuta, Ogun State,
Nigeria.

ARTICLE INFO ABSTRACT

Article History: In Nigeria, health information literacy problems have grown
Received: 15 Mar 2017; as health care providers expect patients to assume more
Received in revised form: responsibility for their care, but the complexity of reading
26 Mar 2017;
health information makes it difficult for individuals with low
Accepted: 27 Mar 2017;
Published online: 27 Mar 2017. general literacy skills to understand effectively in health care
information. This paper examined the roles of librarians in
health care information literacy. The findings deduced that
Key words:
librarians are expert in applying criteria to information
Health care,
searches, choosing quality content and teaching users how to
Information,
Librarian Literacy assess quality in health care information. Besides, librarians
support the efforts of health professionals to be lifelong
learners, and facilitate recruitment and retention of health
professionals in underserved areas by serving as access
points and guides to critical health care information. Finally,
there is need for strong relationship between health care
providers, public libraries, schools and healthcare
association.
Copyright © 2017 IJASRD. This is an open access article distributed under the Creative Common Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited.

INTRODUCTION
Health seeking and compliance with treatments require patients to understand and
apply health information. Health literacy is the ability to obtain, process, and understand
health information to make informed decisions about health care (National Institute of
Health, 2012). Health literacy relates to the possession of knowledge about health. It is a
skill-based processes that individual use to identify and transform information into
knowledge. This communication process inherently involves decoding a symbol system such
as medical terms, prescription, spoken language or visual elements and placing that
information into a useful context. Patients with low health and general literacy skills may
have poorer health, higher expenses for health care, a higher rate of hospitalizations, lower
How to cite this article: Femi, A., & Oyinade, T., (2017). “Health Care Information Literacy The Role of Librarians”.
International Journal of Advanced Scientific Research & Development (IJASRD), 04 (03/II), pp. 114 – 121.
Femi et al., (2017)

self-efficacy for preventive care practices and compliance to treatment regimens (Ross,
2007).
Health information literacy problems have grown as clinicians and health care
system providers expect patients to assume more responsibility for their care at a time
when the health system is progressively more fragmented, specialised, complex and
technologically sophisticated. The complexity of reading health information and the
shortage of health information in languages other than English make it difficult for
individuals with low general literacy skills and language differences to understand
effectively in health care information (Zagaria, 2006). A majority of printed health
education materials, regardless of their topic, require relatively high literacy skills that may
not exist among many of their target population (Gal and Prigat, 2005).
In the health care sector, particularly the Nigeria, where printed information is
frequently provided, this may lead to extreme frustration on the part of the patient. People
with speech, language, visual, hearing and intellectual disabilities experience even greater
challenges when they need to apply high-level health information literacy skills (Hester and
Stevens-Ratchford, 2009). The perspective of people towards health information literacy
varies across different healthcare services. A person who functions adequately at home or
work may have marginal or inadequate literacy in healthcare information. With the move
towards a more "consumer-centric" health care system as part of an overall effort to improve
the quality of health care and to reduce health care costs, individuals need to take an even
more active role in health care related decisions. To accomplish this, this paper hereby looks
at the essential roles play of librarians on healthcare information literacy.

1.1 Health Literacy

Literacy, in its most direct definition, is the ability to read, write, listen,
comprehend, and speak a language. Historically it has been a collection of cultural and
communicative practices shared among members of particular groups (National Council of
Teachers of English, 2012). But society inevitably changes and so does literacy. In more
recent times the term literacy has evolved to refer specifically to the ability to read and
write at a level adequate for communication or at a level that lets one understand and
communicate abstract ideas (National Council of Teachers of English, 2012).
Health literacy is an emerging concept that involves the bringing together of people
from both the health and literacy fields (Gillis and Quigley, 2004). Health literacy builds on
the idea that both health and literacy are critical resources for everyday living. Our level of
literacy directly affects our ability to not only act on health information but also to take
more control of our health as individuals, families and communities. While many definitions
for health literacy exist, the definition adopted for this study is, "The degree to which people
are able to access, understand, appraise and communicate information to engage with the
demands of different health contexts in order to promote and maintain good health across
the life-course" (Kwan, Frankish and Rootman, 2006).
According to the Institute of Medicine (IOM) (2004), health literacy results from the
interaction of individuals with the social and informational demands of the health contexts
in their environment, which could include health care contexts, public health contexts
health promotion contexts or chronic disease -management contexts. While they appear to
focus on the individual, the members of the IOM committee agreed that health literacy is,
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"based on the interaction of the individual's skills with health contexts, the health care
system, the education system, and broad social and cultural factors at home, at work, and in
the community" (Parker and Kindig, 2006). This synergy between individuals and contexts
led Rootman to propose another definition for health literacy as "the degree to which there
is a fit between the health information processing demands of different situations and the
skills of individuals in those situations" (Rootman, 2002).
Health literacy is broader than general literacy in that it includes not only the
ability to read, hut the complex health information must be understood and acted upon.
Some specific tasks that are influenced by the level of health care literacy are: the ability to
analyze risks and benefits of proposed treatments, ability to interpret test results, ability to
calculate and measure dosages of medications, and the ability to interpret test results,
ability to calculate and measure dosages of medications, and ability to locate the needed
health information to assist in these tasks. Glassman, (2008) also states that there are
multiple types of literacy needed within the healthcare decision arena: visual literacy or
being able to understand graphs and other visually presented information, computer
literacy, numerical literacy, and information literacy or being able to obtain relevant
information.
Multiple studies that limited healthcare literacy result in poor health and outcomes.
The AMA cited in Glassman, (2008) states that poor health literacy is a stronger predictor
of a person's health than age, income, education level and employment. People with limited
health literacy are more likely to skip preventive health care and wait until they are quite
ill before seeking care. This same source also reports that limited health care literacy is
associated with increased complications resulting from chronic illnesses such as diabetes,
heart disease heart failure, asthma, hypertension, and HIV (Quick Guide to Health
Literacy). Studies show there is a higher rate of hospitalization and use of emergency rooms
by people with limited literacy skills (Quick Guide to Health Literacy). This adds a huge
economic burden to our society and health care system resources. Low health care literacy
results in shame for the people involved and as a result people often try to hide their
literacy deficits. This lack of understanding regarding instructions for care and medications
contributes to a lack of compliance. This leads to continued poor health and morbidity and
even untimely death due to failure to treat and manage potentially treatable conditions.
This is a critical issue that significantly impacts our whole country and economic system.

1.2 Health Information Literacy

Not having the information, we need when we need it leaves us wanting. Not
knowing where to look for that information leaves us powerless. In a society where
information is king, none of us can afford that (Lois Horowitz, 2007). In today's society,
there can be little doubt that acquiring the ability to retrieve and make use of information is
an essential lifelong skill. Information literacy is indeed the root of information, as
individuals need information "in order to achieve educational, social, occupational, and
economic goals" (Lloyd and Williamson, 2008, p.3). While the concept of information literacy
has existed since the 1970s, originating in the workplace, (Lloyd and Williamson, 2008)
differences characteristically arise when it comes to determining theories or best practices
for implementing this term into instructional settings. In our experiences with information
literacy at the University of Calgary Health Sciences Library and the Tom Baker Cancer
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Femi et al., (2017)

Centre, we have shied away from a lecture-based approach, focusing instead on providing
tools for the user (the medical student or healthcare practitioner) to think critically and
apply what has been learned in class towards solving his/her own research problems.
Webber and Johnston (2000) define an information literate person as one who is
"able to recognize when information is needed and have the ability to locate, evaluate, and
use effectively the needed information" (p.382). We echo this notion because our goal is to
allow the user to take control of his/her own learning. Rather than merely memorizing a
pattern of search techniques demonstrated in class, retention of material will be better
attained if the user is able to apply what has been learned.
According to a 2004 report by the Institute of Medicine (IOM), nearly half of all
American adults, about 90 million people, have difficulty reading and using health care
information. A 2003 National Assessment of adult literacy found that 45% of the US
population have basic or below basic skills. Below basic skills consist of being able to sign a
form, add amounts on a bank slip, and search simple text for pre test instructions (Health
Literacy: a prescription to end confusion, 2004). According to most accepted definition,
health information literacy requires a skill set that allows one to: recognize a need for
health information, identify sources for the information and be able to retrieve the relevant
information, assess the quality and applicability to the specific situation, and analyze,
understand and use the information to make good health decisions (Health Information
Literacy Task Force Report, 2005).

1.3 Libraries
According to Libschultz (2004) libraries are both the symbol of stability and the
embodiment of change. In the past, libraries offered a quiet space for reading, study and
reflection. One was surrounded by collections of books, journals and other materials on
many topics. Access to quality healthcare information and material is a prerequisite to
improving health care literacy. In this new era of change and technology, libraries and
librarians have to be creative and assertive to ensure equal access to information that can
enhance learning and decision making particularly in the consumer driven area of health
care information. The implications of a lack of health care literacy in our population and
scope of problem with healthcare literacy are vast in our society and must be addressed.
The Medical Library Association (MLA) formed a task in 2005 to address the issue of
the library and librarian role in promoting health care literacy. MLA believes that
librarians can impact health care literacy by bridging the communication gap between
health care professionals and the public. Librarians are experts in applying criteria to
information searches, choosing quality content and teaching consumers how to assess
quality in health care information (Nestoer, 2008).

1.4 The Roles of the Librarian

Currently librarians perform a valuable service to both healthcare providers and
patients by facilitating quick and easy access to information. It matters little to the
researcher that behind the scenes the librarians are dealing with selection, acquisition,
licences, hardware requirements and software. What really matters are that relevant
information is quickly and easily available to support patients to understand healthcare
information.
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The traditional roles of the librarian in the era of health care information can be defined
as follows.
 Collection development and acquisition of health care materials: to select
and purchase material related to health care -printed journals, abstracts and
indexes, monographs, etc.
 Cataloguing and classification: to organize and provide access to health care
information - physically and via lists and catalogues.
 Circulation: to reserve health care materials for and lend materials to
healthcare providers and patients, and recover materials from them.
 Reference work: to advise health care information users and to provide and
facilitate quick and easy access to health care information.
 Preservation, conservation and archiving: to archive, preserve and conserve
health care information in perpetuity.

1.5 The Roles of Medical Librarians in Healthcare Information Management

Information management skills and networks of information are essential for
efficient and effective delivery of health care. Access to information reduces professional
isolation and improves the quality of decision making. Studies of health professionals have
shown that having access to evidence-based information, improves patient care, reduces
health care costs, and assists in prevention of malpractice litigation.
Health sciences librarians train tomorrow's health care providers and biomedical
researchers to retrieve, manage, and evaluate information effectively. They support the
efforts of health professionals to be lifelong learners, and facilitate recruitment and
retention of health professionals in underserved areas by serving as access points and
guides to critical information.
Availability of information about the patient is of utmost importance in the medical
librarian profession. In order for a medical librarian to provide the patient with the best
possible health care information, it is of utmost importance that, all the information past as
well as present, about the patient is available to him. The American College of Surgeons
recognized the importance of record keeping back in 1928, when the Association of Recode
Librarians of North America was established to maintain the high standards of medical
records in hospital and other related institutions (AHIMA History, 2008). From then
onwards, the quality record keeping and its security has turned into a proper science.
Healthcare management of information systems is defined as follows. It is the study of the
principles and practices of acquiring, analyzing, and protecting digital and traditional
medical information vital to providing quality patient care" (What is health information
management, 200).
The general aims of medical librarians in healthcare information management is to
interlink comprehensive patient information across the country and to ensure its
accessibility in real-time to accomplish on time health care delivery. System interoperability
and data interchange is the need of our times. It is the task of medical librarians to ensure
the creation of data organization, storage and extraction systems in health and related
institutions with the view of providing services across the country (Advocate for Health
Policy, 2008). The regulatory body of HIM, the AHIMA has undertaken the task to "advance
the role of HIM in informing clinical practice, develop standards to improve data quality
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and facilitate information exchange, and help healthcare organizations migrate to the
electronic health record (EHR)."
The Medical Library Association (MLA) and Academic Health Sciences Libraries
(AAHSL) believe that authoritative information is mission-critical to every health care
enterprise. In the spirit of heath care reform, MLA and AAHSL support the following
priorities to ensure the delivery of quality information for improved health.
1. Formally include the health sciences librarian community in the discussion of
health care reform based on their recognized expertise in collecting,
organizing, and disseminating health information to support informed clinical
decisions, biomedical research, and education of professionals and consumers.
2. Provide robust support of the nation’s most important health sciences library on
which all other health sciences libraries depend the U.S. National Library of
Medicine (NLM). Specifically, provide increased funding for NLM's critical national
infrastructure of networks, databases, extramural grant programs, and
information and education services, as well as its support of national Health
Information Technology (HealthIT) efforts. NLM plays a critical role in building and
supporting relationships for sharing all levels of health information.
3. Maintain transparency for federally funded biomedical research through support of
the National Institutes of Health Public Access Policy and the recently re-introduced
Federal Research Public Access Act (FRPAA) (S. 1373) that mandate public access
to the published results of federally funded research. Such access is key to the
advancement of scientific discovery and successful health outcomes by accelerating
the translation of research results "from the bench to the bedside."
4. Ensure that the developing Health environment includes ready and transparent
access to library resources in the Electronic Health Record (EHR) so health care
providers can seamlessly link from a patient's EHR to the knowledge base of
authoritative health information.
5. Support library network access for all health care providers, independent of physical
location, affiliation, or setting. Universal access to quality information supports
informed decision making.
6. Offer incentives to health care institutions to provide knowledge-based information
resources and services through their libraries and librarians in support of local
health care providers and consumers.
7. Support meaningful partnerships between health sciences librarians and a wide
variety of local service organizations and institutions to provide consumers, patients,
and families with access to authoritative resources and services for informed health
care decisions.
8. Mandate that reimbursement plans be structured to include the full cost of providing
information resources that support quality patient care, biomedical research, health
professional education, and consumer health literacy.

RECOMMENDATIONS
Based on the above discussion, the following recommendations were made:
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- Health care librarians should support patients and users of health care information
by developing readable materials for easy understanding.
- Health care providers should develop partnerships with public libraries,' public
and private schools, and health care association so as to promote and expand health
care literacy opportunities for users.
- There is need for health care librarians to carry out research in the areas of best
practice so as to promote health education.
- Librarians should try as much as possible to discharge their duties and roles as a
specialist in information acquisition.
- As a final point, librarians should enlighten the users of health care information on
how to access quality information.

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[11] Rootman. L, (2002). Health Literacy and Health Promotion. Ontario Health Promotion
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