Responsive health literacy assessments: engaging culture and community for sustained wellness in African diasporic contexts

• In Event: Dissertation workshop session
  In Special Session: Development/NGOs

Proposal

University of Pennsylvania Graduate School of Education
Dr. Vivian Gadsden

I plan to study how health literacy is defined, assessed, and improved upon in African diasporic contexts. There is still much debate about what it means to be “literate” in personal, community, and environmental health. Less is known about how communities of color (often the target of health literacy campaigns) define for themselves what it means to be health literate (Stewart et al., 2008; Parker, 2009). I am interested in how different definitions from researchers, practitioners, and community members work together within health literacy interventions for African diasporic communities (primarily in the US and Barbados for this study). Since much of the health literacy literature focuses on our relationship with food, I center my analysis on the the sustainable food movement. The hope is that this inquiry will help us better understand how and why people engage (or disengage) with their personal, community, and environmental health.

Research questions
How is health literacy defined and assessed within African diasporic communities and contexts?
What are the gaps, overlaps, and intersections regarding how different stakeholders in these contexts define and assess what it means to be “literate” in the sustainable food movement?

Current health literacy assessments do not always account for the interactional and critical components of health literacy (Berkman et al., 2011; Guzys et al., 2015). Community perspectives play a major role in improving and enhancing responsive assessments, and a serious commitment to engaging these perspectives is an important prerequisite for designing responsive and formative assessments that promote continuous and collaborative learning (Gadsden et al., 2006; Johnston, 2005; Laing & Kamhi, 2003; Moll, 2010; Paris & Alim, 2017). Looking closely at how these perspectives interact with the perspectives of participating policy makers, researchers and practitioners can help reveal gaps, overlaps, and intersections in health literacy interventions.

I draw from Multiliteracies frameworks which go beyond common notions of literacy as autonomous and neutral skills (Street, 1988; Freebody & Luke, 1990). Multiliteracies analysis centers how “values, attitudes, feelings and social relationships” (Street, 1993, p. 12) affect interactions with text, acknowledges that there are multiple literacies associated with multiple contexts, and highlights different media and modalities of literacy (New London Group, 2000). Although health literacy was originally defined as the basic writing and reading skills needed in healthcare settings, various health literacy frameworks have expanded this notion. Nutbeam’s (2000) “critical health literacy” highlights the skills needed to critically interrogate information for empowerment. Stokols (1996) engages Social Ecological theory to take into account the dynamic interplay between biological, social, and environmental determinants of health. Stewart et al. (2008) promote for indigenous perspectives on “healing as a process that achieves a balanced relationship with the self, Mother earth, and the natural world” (p.182). These are major strides forward towards expanding the narrow definitions of health literacy upon which the field was built.
I plan to use ethnographic and case study design elements. Data will be collected through interviews, focus groups, observations, field notes, and surveys. Because I aim to work from a Multiliteracies orientation, in which multimodality is a primary focus, I also plan to collect multimodal (media and arts-based) data (Street and Health, 2008; Chilisa, 2012). This study will also use a “vertical case study” design in order to further interrogate gaps, overlaps, and intersections. This includes a “vertical” axis across micro, meso, and macro levels, a “horizontal” axis focusing on how themes unfold in different locations; and a “transversal” axis that looks at change over time (Bartlett Vavrus, 2014, p.131). This promotes an “understanding of the microlevel” as “part and parcel of larger structures, forces, and policies about which the researcher must also develop a full and thorough knowledge” (Vavrus & Bartlett, 2006, p. 96). I am currently reading up on techniques such as content and thematic analysis (Bowen, 2009), constant comparative analysis (Frost et al., 2010), and process tracing (Maxwell, 2012; Dryden-Peterson & Mulimbi, 2017) to prepare for strategic and iterative data analysis.

I have not yet begun the official data collection stage, but I have conducted pilot interviews with researchers, practitioners, and community leaders. Emergent themes include the importance of effective resource management, social cohesion, and cultural competence in community health interventions. It is for this reason I focus on formative and responsive health literacy assessments, as these can be useful tools in addressing these needs.

I am currently in the dissertation proposal writing phase, though by the time of the conference I will have proposed my dissertation and will be beginning the data collection phase.

Author

• OreOluwa Badaki, University of Pennsylvania