Health equity rituals : a case for the ritual view of communication in an era of precision medicine

Abstract

This thesis explores the meaning and implications of a ritual view of communication in the field of public health. This thesis uses the budding field of precision medicine to frame arguments and discoveries, referring back to the Precision Medicine Initiative in chapter introductions, conclusions, and illustrative examples throughout. The introduction presents the script for an interactive online live stream performance summarizing this thesis. Chapter 1 highlights the dominance of a transmission view of communication in public health, which tends to focus on top-down transfer of knowledge from experts to general audiences. This chapter highlights the limitations of such a view, especially when it comes to meeting the needs of medically underserved communities. This chapter highlights the gaps that a ritual view of communication could fill in public health research and practice.

Chapter 2 further examines what a ritual view of communication entails in public health, and how to conceive of it in relation to participatory research frameworks. This chapter closes with the design of a conversational tool to help academic-community partnerships employ a ritual view of communication on a project-level scale. Chapter 3 describes the development of "A People's Guide" community engagement program, employing a ritual view of communication to reconfigure the social roles and power dynamics in public health community engagement. This community engagement program uses workshops and interviews with members of medically underserved communities to publish a zine, which is then the basis of conversation in academic journal club workshops. This chapter uses a developmental evaluation framework to inform the program development process and suggest next steps that can be taken to develop this program further.

Overall, this thesis employs a combination of theory, applied media practices, educational field work, and design to highlight the opportunities that a ritual view of communication presents to advance health equity.