1. The role of local libraries in improving access to health- related information in rural settings Emanuela Marton-Vasarhelyi, MA Center for Health Policy and Public Health, Babes-Bolyai University Cluj-Napoca, Romania Evidence from Cluj-Napoca, Romania

2. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 Presentation overview 1. Background 2. The Initiative for Health Informational Resources in Rural Areas (IRIS) 3. Study methodology 4. Results 5. Conclusions 6. Acknowledgements 7. Selected references

3. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 1. Background (1)  The role of local libraries in enhancing access to health information in rural areas  Health information seeking behavior (HISB), self-efficacy, and health literacy as key concepts in the development of interventions aiming to improve access to health information in rural and remote settings

4. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 1. Background (2)  Recent findings suggest that libraries, through the help of trained librarians, can meet the health information needs of people living in rural and remote settings

5. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 1. Background (3)  Health information seeking behavior  Self-efficacy  Health literacy

6. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 2. The Initiative for Health Informational Resources in Rural Areas (1)  Participatory-based intervention  Objectives: 1) to offer an institutional framework to facilitate access and 2) to increase community awareness, knowledge and skills to increase accessing of health information.

7. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 2. The Initiative for Health Informational Resources in Rural Areas (2) Population level intervention Institutional intervention Family physicians Local authorities Local libraries Health workshops

8. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 3. Methodology (1)  Study settings  Study population  Data collection  Data analysis

9. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 3. Methodology (2)  Study settings and population Settings : 4 communes in Cluj county: Sînpaul, C ă tina, Tureni, Petretii de Jos Sample : convenience sample Population : adult inhabitants of communes included in the study (n=858)

10. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 3. Methodology (3)  Study design 2010 Formative research Intervention communes Control comune Qualitative methods 5 interviews 2011 Evaluative research Quantitative methods (n=209) Qualitative methods 10 interviews 6 focus groups Quantative methods (n=212) Quantitative methods (n=204) Quantitative methods (n=197)

11. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 3. Methodology (4)  Data collection and analysis  Pre- and post- intervention data was collected in all four communities, by trained operators, in 2010 and 2011.  The main constructs measured were attitudes towards the community library, HISB, self-efficacy, and health literacy.

12. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 4. Results (1) Variable Intervention communes Control communes The role of village library in having a well-informed community on health themes p=.016 Frequency of intending to borrow a book on a health theme p=.012 Frequency of asking about a book on health themes p=.001 Frequency of borrowing a book on a health theme p=.002 The librarian recommended books on health themes p=.000

13. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 4. Results (2) Variable Intervention communes Control communes Seeking health info from any source p=.000 Self-efficacy on reading a pamphlet with health info p=.034 Self-efficacy on reading a book or a paraghraph on health issues p=.004 Understanding writen information regarding their medical condition p=.000 Understanding prospectuses p=.000 Understanding MD’s indications p=.000

14. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 5. Conclusions  The proposed pilot study has been proven effective in enhancing access to health information in rural areas by ensuring the availability of health information and increasing health information seeking behavior of rural residents.  In terms of the pursued strategies, the framework proposed and implemented at the institutional level was successful in supporting the intervention at the population level.

15. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 6. Acknowledgements This research project was financed through the “Access to Health Information in Rural Areas” Grant, funded by the Romanian Ministry of Education and Research, through the PNII-Idei Program, financing contract 2450/2009.

16. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 7. Selected references 1. Rural Healthy People 2010: Identifying Rural Health Priorities and Models for Practice. Larry Gamn, Linnae Hutchison, Gail Bellamy, Betty Dabney. 1, 2002, The Journal of Rural Health, Vol. 18, pp. 9-14. 2. Library outreach: overcoming health literacy challenges. R. Parker, L. Gary Kreps. 4, 2005, J Med Libr Assoc, Vol. 93, pp. S81-S85. 3. Clarann Weinert, Mary Burman. Rural health and health-seekind behaviors. Annual Review of Nursing Research. New York : Springer Publishing Company, 1994, p. 76. 4. Self-efficacy and health. O'Leary, A. 5, 1985, Behav Res Ther, Vol. 23, pp. 437-451. 5. Health lietarcy: a challenge for American patients and their health care providers. Parker, R. 4, 2000, Health Promot Int, Vol. 15, pp. 277-83.

17. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27 th, 2012 Thank you for your attention! Emanuela Marton-Vasarhelyi, MA ema_sirlincan@healthpolicy.ro www.healthpolicy.ro