A Social Ecological Approach to Community-based Health Communication Interventions

The field of public health has increasingly recognized that aspects of neighborhoods (or “place”) contribute to health disparities. In this presentation, we discuss findings from two studies—both of which are part of larger, multiyear and multimethod research projects—that explored factors contributing to healthcare access disparities; one in a large Southeastern U.S. city and the other a small Northeastern U.S. city. The first study aimed to redirect non-emergency patients to a primary healthcare clinic in their community. The second study was designed to reduce reproductive health disparities among African American women. Both projects were guided by communication infrastructure theory (CIT), a social-ecological theory that recognizes the important role that communication plays within communities and as determinant of health. According to CIT, every community has a storytelling network comprised of residents, community organizations, and local/ethnic media. Connections to the storytelling network are enabled and/or constrained by factors within the communication environment, known as the communication action context. In this presentation we will discuss four factors associated with the communication infrastructure of the two study communities that shaped healthcare seeking and elaborate on similarities and differences between the two communities. The factors that emerged as salient include: availability of and perceptions of access to healthcare resources, transportation options, communication resources (including interpersonal, media, and organizational) that aid healthcare seeking, and privacy concerns around healthcare seeking. Our presentation will include a discussion of the implications of these findings for future research and health communication interventions that promote primary and reproductive healthcare seeking.