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In document Health Literacy: (Page 195-200)

Chapter 4 Research Methodology and Method

5.2 Baby Boomers’ health literacy categories of description

5.2.3 Networker

Interpreting and combining the health literacy experiences of the baby boomer participants, a patient-as-networker category emerged that describes intentions, activities, and skills emphasising social and family networks. From the participants’ perspectives the high interactivity embodied in this category of description builds/contributes to health literacy among all the network actors; the network is a context for sharing, dialogue and learning. The networker role does


not emphasise individual decision-making (low to moderate on the self-horizon, refer Section 5.3). Nor is there strong intent regarding the integration of multiple aspects/resources concerning a health condition (moderate compared to the patient-as-manager category, Section 5.2.5). Therefore, the networker category brings to light one way of ‘seeing’, at the same time downplaying other ways of seeing health literacy (Morgan, 2011).

The impact of social and family networks on individuals’ health information and healthcare seeking is nothing new. McClean and Shaw (2005, p. 746) identify how lay people use friends and relatives in their processes to “adopt, mimic, critique, or rewrite expert positions”. Furthermore, Dew, Chamberlain, et al.

(2014) emphasise that households are “…hybrid centres of therapeutic practice…and a central site of health practices and decision-making...” (p. 40), rejecting the notion of the individualised patient in healthcare decision making.

Participants in the current research also described stable networks that were given prominent status in their health literacy; some of the networks being specifically established for health. The patient-as-networker expended effort in participating in these networks. Drawing on marketing literature, this category is typical of

‘market mavens’ (Kontos, Emmons, Puleo, & Viswanath, 2011) who deliberately network for the benefit of other network actors as well as for themselves. These individuals are keen to share their knowledge within their social network and were acknowledged by these baby boomer participants as a person others turned to and respected for their knowledge and advice.35

35 By contrast, ‘market gurus’ are considered just as knowledgeable but their knowledge and information seeking is not for the benefit of the network members.


Table 5.4Summary of Networker category of description

Key meanings Description Illustrative Quotes


Committed to relationships Shared values

So I just took the initiative myself but the key factors for me were talking to my friend and following my gut and my son’s partner, she’s such a cool girl and she said, “Come on ma we’re going and I’ll come with you.” PPFT#24

Normally very often, because my close friends, doctor, some is in XXXX society, some is not but is close friend, we gather together and we discuss about health and everything. AML#41


Shares advice Market maven Altruistic concern for others

[I use] my networks - family and friends, social networks, yeah, professional networks.

People that I know that may have had some similar sort of issue or have mentioned something. But that’s how I work in everything so that’s me. Connected. MiFT#17

…she gave me this information which I’ve kept and I’ve been able to hand it on to other people who’ve got similar things. EFL#11



A shared enterprise Leveraging collective knowledge

…we know how to look after ourselves because sometimes the information we gather is very good because we have a group, we just research how to keep your health good.


…once I’ve thought about what I know and what’s gone past me, I use my networks for a steer, for a recommendation. MiFT#17

Yeah if there’s stuff out there that is available for our people then we try and inform them so that they can try and access it too. PPFT#21


The key meanings interpreted for this category of description are: relating, connecting, and partnering (summarised Table 5.4). These meanings are weaved through the participants’ conceptualisation of health literacy discussed below.

Both men and women participants constructed health literacy in terms of patient-as-networker. Among the research participants the Asian baby boomers clearly demonstrated highly structured and formalised roles as networkers. This contrasted strongly with European baby boomer participants who were often highly-networked but less formally, and the Māori participants who, while indicating considerable variability in their connectedness, were typically networked with their whānau.

The respondents constructed health literacy embedded within a network of referral, information, and advice from family, friends, and colleagues,

I’ve got quite a few friends who still, like they’re doctors and things and if I don’t know I’ll give them a bell, I’ll Facebook them or whatever and I’ll say hey… MiFT#19

My mother first, always comes first and then I go to the doctor.


…she's got great information regarding drugs and everything like that;

antibiotics, I’d just ring up and say, “Well what’s the medication,” I'll tell her and she’ll say, “This will do, da da da da.” I feel lucky in that way. MiFL#36

According to the baby boomer participants the patient-as-networker was a connected identity for whom health literacy was a shared and distributed practice.

The network was an influential part of health information seeking, not always preceding the consultation with a PHCP but often being used to verify options or to develop alternatives. In this role the participant networked with others relying on them as mentor, coach, and referrer, for example,

Sometime I ask Ann [participant’s good friend], she teach me how to talk to doctor. Send email, email come in and I write down, show my doctor, because of sometimes I say something doctor didn’t understand.

INT: You talk to Ann about what’s wrong with you and she gives you the questions to ask?

Yes, yes, give me some questions; I want to say something to my doctor.

So I write down and show my doctor. AFL#34


I do have a very close friend and mentor in town that I see on a regular basis so if things are ever troubling me I drop in and see her. … so I talked to my mate, Sue first and she said, “Mate I told ya, get in and see that acupuncturist.” She’d mentioned it to me before and of course I’ve always had my funny ideas about that. But I went, I went. PPFT#24

I was getting more and more miserable because it was at the point where just doing anything with that side and I’d get electric shock, horrible pains, and I felt very debilitated. And one day a friend said to me, “I haven’t seen you for ages,” and I told her what had been going on. She said, “Has anybody ever suggested to you that your posture might have some issues?” She said, “I’ve noticed that you tend to be a bit more compressed on one side,” or something like that. She told me about this person. So I went to her. We were going away and she had a half hour appointment and I said, “I’ll take it. I’ll do anything. I’m desperate.” EFL#8

Being connected with their networks is a deliberate and reasoned choice made by participants that echoes and overlaps with the categories of seeker and decider, “I value things that she has to say. So she's my other person that I would consult as well…I check them out with her” (MiFL#36). Despite numerous network memberships the participants only rarely mentioned contradictory information, since typically the network members had shared values that reinforced individuals’

health beliefs. For example,

We talk to the family members. There’s plenty of medical knowledge within the family. So there’s plenty of grandmothers who know what’s going on…through talking to family members, “What’s happening;

what do you think it is?” And we know our history. AMT#2

People that I know and I know what they would expect when they were getting information or making decisions or being taken care of or whatever. So it’s that domino thing around that person’s not gonna put up with any [shite] and she’s gonna have done the research. So, “Who do you talk to when you’ve got stuff going on?” MiFT#17

In these cases, the individual ‘weighs up everything’ within their personal yet networked context, overlapping with their experiences as sensemaker (refer Section 5.2.4); participants experience health literacy within their networks of family and friends as shown below,

In document Health Literacy: (Page 195-200)