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The purpose of this paper is to introduce the articles in the special theme issue.

This paper provides some background and context on health literacy.

Health literacy is a critical constellation of skills. Librarians’ abilities and expertise are well-suited to contributing to the improvement of health literacy for various populations in various settings. Librarians are actively engaging in a wide variety of health literacy initiatives in collaboration with other professionals and organizations.

Specific examples of how librarians are contributing to health literacy are described.

Lack of health literacy is associated with poor health outcomes and increased health costs. Multiple organizations, think tanks and government agencies have called for addressing disparities in health literacy.

This paper provides an overview and introduction to the special issue on health literacy.

The purpose of this paper is to assess the relationship between elderly people's health literacy skills and those people's decision to make use of digital health service platforms. Despite the substantial influence of digitisation on the delivery of healthcare services, understanding how health intervention strategies might help empower elderly people's health literacy skills is critical.

This paper analyses the existing trends in research on the convergence of health literacy, health intervention programmes and digital health service platforms by reviewing 34 studies published between 2000 and 2020.

The findings of the review indicate three primary themes (health literacy skills, health management competency and attitude/confidence), which provide a summary of the current literature, and in all three the results show that health intervention programmes help to enhance health literacy skills of elderly people. Based on the review results and by organising the fragmented status quo of health intervention research, the authors develop a comprehensive research model and identify future research directions for research in this domain.

The findings will be useful to health professionals in two ways: (1) the findings provide practical information about the growing need to implement health literacy intervention programmes to satisfy elderly people's appetite for accessing health services due to cognitive and physiological impairments, and (2) the finding help them to understand that with digital health platforms, elderly people have quicker access to health services, improving the quality of care provided to them.

This paper presents a comprehensive research model for analysing the impact of health literacy skills on older people's ability and intention to access digital health information sources, considering various health intervention approaches.

Research finds that various demographic factors, such as race, gender, education, and income, are associated with disparate health outcomes. Health literacy is an asset that can help consumers exert greater control over their health. The rapidly evolving information landscape can be overwhelming for consumers seeking health information. Users may not be aware of the influence of power, prestige, and money in funding, designing, creating, and disseminating information to consumers. Information professionals have an important role to play in providing health information to their users. Proponents of critical information literacy argue that librarianship must evolve beyond supporting the status quo and assist users in understanding the political and commercial forces that can shape the options available to users. Health-literate individuals can also be empowered to challenge the social determinants of health and support policies that would lead to more significant health equity for the whole of society.

This study sought to explore the needs and challenges of public libraries in meeting their users’ health information needs. The study also investigated participants’ perceptions regarding a public library workshop for consumers on the critical evaluation of health information. The study found that while attendance was low, the attendees rated the workshop positively.

The University of Tennessee Medical Center in Knoxville (UTMC) Preston Medical Library (PML) and Health Information Center (HIC) has provided a novel contribution to increasing consumer health literacy and reducing health disparities in a unique variety of ways. UTMC librarians have used qualitative, quantitative, and practice-based methodology and research to demonstrate what a regional medical library working with internal and community partners can accomplish. At UTMC, there has been a focus on the value of health literacy for the patient, the clinician, and the health care system itself. In 1993, the UTMC PML began a consumer and patient health information service, which was the foundation for increasing consumer health literacy. In 2014, UTMC took a leading role in advancing consumer health literacy through the opening of the HIC, a patient- and family-focused library inside of UTMC. This chapter will focus on the PML’s history as a reliable resource in providing patients, family members, and the community with accurate and trustworthy health information, as well as the librarians’ role related to health literacy and health disparities through various initiatives and projects. Additionally, this chapter will highlight specific suggestions for libraries interested in starting similar initiatives, such as obtaining support from leadership, opportunities for funding, and how to address roadblocks.

The striking number of persons with low levels of literacy in the United States is a major public-health concern. This study examines the relationship between literacy levels and both (1) access to health care and (2) use of specific health care services among adults. The data are collected from in-person interviews with a representative sample of adults aged 18–44 in Portland, Oregon, who are proficient English speakers, and have not completed high school nor have a GED. Adults with lower levels of literacy are less likely to have a usual provider, to have health insurance, and they have trouble understanding written medical directions, more difficulty getting needed care, and poorer health. They also use physician services, overnight hospital stays, and emergency rooms more frequently, controlling for education, access, health, and sociodemographic characteristics. Literacy is conceptually distinct from education and independently affects the way in which adults seek health care.

Low health literacy is a hidden epidemic. Identifying individuals with low health literacy is a formidable barrier to eliminating disparities and improving health care quality and health outcomes. However, screening individual patients for low health literacy can be prohibitively expensive, time consuming, and inefficient. Focusing on communities, rather than individuals, provides opportunities for action. Identifying geographic areas with large numbers of individuals with low health literacy can enable stakeholders to focus interventions in areas of greatest need. Creating such a measure also sheds light on health literacy as a community or neighborhood-level resource that contributes to health disparities and can inform health interventions.

We applied regression coefficients from a predictive model of health literacy to US Census data to estimate health literacy scores for census geographic areas in Missouri. We then created maps displaying the variability in health literacy levels. Finally, we compared areas identified by the predictive model to those identified on the basis of educational attainment alone.

Areas identified by the predictive model as having the lowest health literacy were substantially different from those identified using educational attainment alone, suggesting that a multivariate approach using a limited set of widely available predictors is considerably more accurate.

This study demonstrates a cost-effective and feasible method for estimating and mapping community-level health literacy. Predicting and mapping areas of low health literacy is relatively straightforward and inexpensive and makes complex data readily accessible to many stakeholders. Such maps can also identify and prioritize geographic areas for intervention by health care and public health providers. Moreover, this focus on community-level health literacy may help foster stakeholder collaboration, leading to efficient resource use that is targeted effectively and resulting in a positive return on investment for stakeholders.

Drug Treatment Courts (DTCs) offer a form of alternative sentencing for people who have been convicted of a crime related to drug or alcohol abuse. The work of rehabilitation in DTCs is client-centered, meaning that it takes into account all of the client’s needs that affect their life in regards to completion of the program and rehabilitation. DTCs employ teams of people made up of judges, lawyers, educators, clinicians, and community supervisors. There are specific ways that librarians might become involved with DTCs regarding both literacy and, more specifically, health literacy. Existing programs could be adapted to solve common health literacy problems of participants, and librarians could also forge relationships with DTCs. Training for librarians should include education about the health and literacy problems faced by this population so they can successfully connect DTC participants with people and information that will contribute to their success completing the program and building healthier lives. This chapter looks to established best practices within DTCs and to some current related programs within public libraries to find grounds for expanding services to this population.

Consumer health literacy is a necessary skill in all facets of library work, from reference desk to programming to website development. In this chapter, the authors present key terms in the domain of health literacy; challenges and controversies in research and public library practice; and findings from a recent study of public library workers meeting consumer health information needs. Finally, the authors present examples of National Library of Medicine (NLM) initiatives for public libraries and public librarians focusing on bridging health literacy gaps. Socially disadvantaged groups who are the most affected by health disparities tend to be those who are lower-income, have less education, and are not White. The combined effects of environment and socioeconomic status mean that these communities have particular, highly local challenges in addressing their health issues, as individuals and as a population. Health literacy can serve as the enabling factor in obtaining quality health information, navigating healthcare, and seeking better health. To support the public, NLM and its National Network of Libraries of Medicine have placed a strategic emphasis on public libraries in order to develop long-term partnerships. The goals of these partnerships are to support staff development and programming, and to promote resource-sharing about programs and activities focusing on health information. Public libraries are everywhere and open to all. This makes them the ideal community agency to reach out to the public and implement national information initiatives.

This study aims to understand the eHealth literacy skills of chronic patients and to explore the relations, patterns between eHealth literacy skills and different factors such as demographics, search strategies and health information sources and to explain their effects on eHealth literacy in Turkey in Izmir in COVID-19 outbreak.

A quantitative method was used in the study including a questionnaire. A total of 604 chronic patients responded to the questionnaire who applied the five popularly identified hospitals in Izmir in Turkey. CHAID analysis method was implemented to explore the strongest correlation between eHealth literacy and independent variables.

Using different social media types were correlated with patients’ eHealth literacy scores. Using Facebook, Twitter were the supportive predictors for the eHealth literacy scores. However, digital literacy was highly important for eHealth literacy.

This study shows that the social media channels which provides much more information such as Facebook and Twitter for the chronic patient. This could be beneficial for the eHealth tools and social media content developers in terms of the supply of health information. Moreover, the study gives ideas about the effect of digital literacy and the importance of health information provided.

This study aims at verifying the impact of literacy on over-the-counter (OTC) drug consumer vulnerability as evaluated by health literacy and label comprehension.

The item response theory (IRT) was used to estimate the health literacy of two groups and the two-way analysis of variance tests was used to test the hypotheses for the existence of mean differences between the two populations. The convenience sample involved 188 OTC consumers: 94 (50%) poorly literate and 94 (50%) university students/graduates.

University consumers/graduates have a level of health literacy and label comprehension that is superior to those presented by poor literate consumers. Also, age does not influence the level of health literacy by OTC drug users but has a significant impact on the understanding of OTC drug labels. Finally, the level of schooling and the “age group,” simultaneously, does not impact the understanding of OTC drug labels or health literacy.

This study has added in the field of knowledge by investigating the behavior of poor literate consumers in Brazil, a developing country. The results may be relevant to Marketing professionals, especially those in the pharmaceutical industry, and to police makers, as they help identify the main problems faced by poorly literate consumers.

It is necessary to raise awareness of the dangers of self-medication and wrong use of medications, mainly focused on people with low literacy. As a suggestion, a simple glossary presented along with the label could provide explanations of scientific terms, thus increasing health literacy and reducing the vulnerability of the consumers.

This study showed that when using common words such as gastritis to define a health problem, there is a higher degree of correctness. These results suggest the adoption of a more straightforward language and more precise explanations. By doing that, the pharmaceutical industry and policymakers will improve their social impact by increasing consumer power and taking care of the health of the most vulnerable population: the illiterate people.

This study contributes to the international literature, as it enhances and clarifies the knowledge about the customers’ power and vulnerability in developing countries. It fills a gap by evaluating label comprehension and heath literacy at the same time, giving an academic contribution for pharmaceutical consumers’ studies.