title: Health Literacy: A Hermeneutic Study of New Zealand Baby Boomers

authors: Davey, Janet

subjects: Health literacy

abstract: Health literacy has traditionally been conceptualised as individual skills in a health context. Although there is growing consensus that health literacy is a multidimensional construct, interacting with socio-cultural contextual influences, such aspects are under-researched. In particular, there is limited research regarding the interrelationships between individuals’ and primary healthcare professionals’ (PHCPs) health literacy beliefs and experiences. Despite the predicted impact of the ageing population on healthcare costs and services, little empirical research has been conducted in New Zealand (NZ) on the health-related behaviour of the influential baby boomer cohort. The purpose of this thesis is to explore the phenomenon of health literacy among NZ baby boomers and PHCPs.  

Using hermeneutics as both the theoretical lens and the research method, this research draws on in-depth interviews to understand the participants’ constructions of health literacy and how their constructions influence healthcare goals and service encounters. The research takes a broad perspective of health literacy to answer the overarching research question, How are the roles and practices of health literacy perceived/constructed and performed in primary healthcare?

This thesis makes an original contribution to knowledge as the first empirical investigation of health literacy of NZ baby boomers (46 participants) and NZ primary healthcare professionals (11 participants). Specifically, this research contributes to health literacy knowledge in a geographic area (NZ) and among individuals within a generational cohort not defined by health condition or health risk. 

NZ baby boomers construct health literacy as a highly contextualised social practice linked to [a]symmetries in health-related information, power, autonomy, and patient-practitioner roles. These participants stress the importance of an individual’s personal health context, capabilities, relational processes, and networks in health literacy. Interpreting these baby boomers’ health literacy behaviours leads to five categories of description - seeker, decider, networker, sensemaker, and manager, which are appropriately framed within two horizons of self and interactivity, providing conceptual space within which individuals move and adapt their health literacy roles, responsibilities, and behaviours. 

In the PHCPs’ experiences regarding baby boomers’ health literacy there are underlying power and information imbalances, conflicting authority concerns, and [de-]professionalisation issues. Using categories of description, the PHCPs’ health literacy behaviours are described as – knowledge broker, ethical agent, and enabler. Iteratively drawing on pre-understandings, these meanings are theorised in a collective notion of managed empowerment that implies a negotiated balance between PHCP expert control and professional expertise, and patient-consumer autonomy and expertise. 

This study extends the understanding of health literacy by presenting an empirically-based conceptual framework, depicting health literacy operating across multiple levels, relationships, and networks, variably influenced by contextual factors of the postmodern health context; the communication and information revolution; and neo-liberalism and consumerism. The thesis contributes to health literacy knowledge by illustrating the fundamental role of relational processes in co-producing individuals’ health literacy and in subsequently reaching individuals’ health goals. Primary healthcare service providers, policy makers, and health promotion advocates can benefit from this study as it reveals particular health literacy roles and behaviours likely to be influential in encouraging individuals’ authentic involvement in their healthcare.

text: Health Literacy: A Hermeneutic Study of New Zealand Baby Boomers Health literacy has traditionally been conceptualised as individual skills in a health context. Although there is growing consensus that health literacy is a multidimensional construct, interacting with socio-cultural contextual influences, such aspects are under-researched. In particular, there is limited research regarding the interrelationships between individuals’ and primary healthcare professionals’ (PHCPs) health literacy beliefs and experiences. Despite the predicted impact of the ageing population on healthcare costs and services, little empirical research has been conducted in New Zealand (NZ) on the health-related behaviour of the influential baby boomer cohort. The purpose of this thesis is to explore the phenomenon of health literacy among NZ baby boomers and PHCPs.  

Using hermeneutics as both the theoretical lens and the research method, this research draws on in-depth interviews to understand the participants’ constructions of health literacy and how their constructions influence healthcare goals and service encounters. The research takes a broad perspective of health literacy to answer the overarching research question, How are the roles and practices of health literacy perceived/constructed and performed in primary healthcare?

This thesis makes an original contribution to knowledge as the first empirical investigation of health literacy of NZ baby boomers (46 participants) and NZ primary healthcare professionals (11 participants). Specifically, this research contributes to health literacy knowledge in a geographic area (NZ) and among individuals within a generational cohort not defined by health condition or health risk. 

NZ baby boomers construct health literacy as a highly contextualised social practice linked to [a]symmetries in health-related information, power, autonomy, and patient-practitioner roles. These participants stress the importance of an individual’s personal health context, capabilities, relational processes, and networks in health literacy. Interpreting these baby boomers’ health literacy behaviours leads to five categories of description - seeker, decider, networker, sensemaker, and manager, which are appropriately framed within two horizons of self and interactivity, providing conceptual space within which individuals move and adapt their health literacy roles, responsibilities, and behaviours. 

In the PHCPs’ experiences regarding baby boomers’ health literacy there are underlying power and information imbalances, conflicting authority concerns, and [de-]professionalisation issues. Using categories of description, the PHCPs’ health literacy behaviours are described as – knowledge broker, ethical agent, and enabler. Iteratively drawing on pre-understandings, these meanings are theorised in a collective notion of managed empowerment that implies a negotiated balance between PHCP expert control and professional expertise, and patient-consumer autonomy and expertise. 

This study extends the understanding of health literacy by presenting an empirically-based conceptual framework, depicting health literacy operating across multiple levels, relationships, and networks, variably influenced by contextual factors of the postmodern health context; the communication and information revolution; and neo-liberalism and consumerism. The thesis contributes to health literacy knowledge by illustrating the fundamental role of relational processes in co-producing individuals’ health literacy and in subsequently reaching individuals’ health goals. Primary healthcare service providers, policy makers, and health promotion advocates can benefit from this study as it reveals particular health literacy roles and behaviours likely to be influential in encouraging individuals’ authentic involvement in their healthcare.

year: 2015

title: Exploring Timorese family funds of knowledge and their use in education

authors: Soares Pinto, Zulmira Da Cruz

subjects: Timorese families

abstract: There are many factors that contribute to children’s development, including their social and cultural background. Families play a significant role in children’s development and the funds of knowledge that reside within a family and the wider community can be utilised in a preschool setting to make strong connections for children between their home and the preschool. Research suggests that including families’ funds of knowledge in the preschool curriculum can enhance a child’s engagement in the learning environment and lead to positive educational outcomes. Drawing on Moll and Amanti’s concept of funds of knowledge and using a qualitative methodology, this thesis examines notions of funds of knowledge in preschool settings in Timor Leste. Through the exploration of what funds of knowledge are held by Timorese families and how these may be used in a preschool classroom by teachers, the thesis argues that there is a need for further understanding and acceptance by teachers of the importance of recognising and including families’ funds of knowledge in the preschool classroom. The findings indicate that traditional attitudes about teachers being the authority in learning tend to prevail and this limits parents’ ability to contribute knowledge and assistance to the preschool classroom. There is clear evidence of family and communities’ holding a range of funds of knowledge that could be beneficial for children’s learning if included in classroom practices by teachers. The thesis calls for extensive professional opportunities for teachers to develop understanding about funds of knowledge and how they might make preschools more welcoming for parents.

text: Exploring Timorese family funds of knowledge and their use in education There are many factors that contribute to children’s development, including their social and cultural background. Families play a significant role in children’s development and the funds of knowledge that reside within a family and the wider community can be utilised in a preschool setting to make strong connections for children between their home and the preschool. Research suggests that including families’ funds of knowledge in the preschool curriculum can enhance a child’s engagement in the learning environment and lead to positive educational outcomes. Drawing on Moll and Amanti’s concept of funds of knowledge and using a qualitative methodology, this thesis examines notions of funds of knowledge in preschool settings in Timor Leste. Through the exploration of what funds of knowledge are held by Timorese families and how these may be used in a preschool classroom by teachers, the thesis argues that there is a need for further understanding and acceptance by teachers of the importance of recognising and including families’ funds of knowledge in the preschool classroom. The findings indicate that traditional attitudes about teachers being the authority in learning tend to prevail and this limits parents’ ability to contribute knowledge and assistance to the preschool classroom. There is clear evidence of family and communities’ holding a range of funds of knowledge that could be beneficial for children’s learning if included in classroom practices by teachers. The thesis calls for extensive professional opportunities for teachers to develop understanding about funds of knowledge and how they might make preschools more welcoming for parents.

year: 2018

title: Māori and community news constructions of Meningococcal B: the promotion of a moral obligation to vaccinate

authors: Groot, Shiloh Ann Maree

subjects: psychology

abstract: News media communicate various risks of disease, showcase medical breakthroughs and disseminate texts that both reflect and renegotiate shared cultural understandings of health and illness. Little is known about the role of Māori and community news media in the social negotiation of health and illness in Aotearoa. To address this gap in the literature, this paper reports findings from a study of news reporting on Meningococcal B by the Māori Television Service and two community newspapers serving Māori communities. Findings document how news works to position vaccination as a ‘common sense’ practice that whānau have a moral obligation to undergo. Neglected are wider socio-structural considerations that impact the prevalence of illness among Māori.

text: Māori and community news constructions of Meningococcal B: the promotion of a moral obligation to vaccinate News media communicate various risks of disease, showcase medical breakthroughs and disseminate texts that both reflect and renegotiate shared cultural understandings of health and illness. Little is known about the role of Māori and community news media in the social negotiation of health and illness in Aotearoa. To address this gap in the literature, this paper reports findings from a study of news reporting on Meningococcal B by the Māori Television Service and two community newspapers serving Māori communities. Findings document how news works to position vaccination as a ‘common sense’ practice that whānau have a moral obligation to undergo. Neglected are wider socio-structural considerations that impact the prevalence of illness among Māori.

year: 2007