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Patterns and predictors of health information seeking in Romania: A national cross-sectional survey
ABSTRACT
Background:
The internet and Artificial Intelligence (AI)-based tools are increasingly shaping how individuals access and interpret health information. In Romania, nationally representative evidence on health information-seeking behavior remains limited, particularly regarding the use of conversational chatbots.
Objective:
This study aimed to characterize health information-seeking (HIS) behavior among adults in Romania by examining overall seeking frequency, the active use of specific information sources, and the adoption of online HIS strategies—including AI-based chatbots— as well as their socio-demographic and health-related determinants.
Methods:
A cross-sectional national survey was conducted in 2025 among Romanian adults aged 20–65 years using a hybrid design combining computer-assisted web interviewing and tablet-assisted personal interviewing. HIS frequency was measured using the Health Information Seeking Frequency Score (HISFS). Multivariable linear and binary logistic regression models identified predictors of overall seeking frequency, active use of 8 information sources, and use of 5 online strategies (search engines, websites, social media, YouTube, and chatbots). Latent class analysis (LCA) was performed to identify distinct patterns of source use and online strategy adoption. Weighted descriptive and regression analyses were conducted; LCA was conducted without sampling weights.
Results:
We evaluated 1,031 adults. The mean HISFS was 18.9 (SD = 5.7; theoretical range 8–32). Physicians (34.6%) and the internet (31.9%) were the most frequently used sources (reported as “often”), followed by family members (22.4%); all other sources were reported as often by ≤12% of respondents. Among online seekers, Google was used by 79.2%, followed by chatbots (31.2%), websites (29.8%), YouTube (23.9%), and social media (20.2%). Chronic disease burden was the most consistent correlate across behavioral domains and was associated with higher seeking frequency (B = 4.932; 95% CI, 3.378–6.486; P < .001), broader source repertoires, and adoption of most online strategies. Overall, seeking frequency was higher among younger adults, women, and urban residents. Socio-demographic predictors showed channel-specific rather than uniform associations. AI-based chatbots emerged as the most socially patterned online strategy. LCA identified 5 profiles of information source use and 5 profiles of online strategy adoption, ranging from selective to broad, multi-source engagement, including a chatbot-centric class.
Conclusions:
Health information seeking among Romanian adults is a heterogeneous practice shaped by health need, social position, and access to diverse information channels. Individuals engage in patterned combinations of sources and strategies rather than relying on a single mode. The emergence of chatbot-centric engagement underscores the growing role of AI-based tools, with implications for clinical communication, public health strategies, and digital health governance.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.