Health Communication Theory. Группа авторов

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the discursive space of HIV/AIDS in Indian newspapers (de Souza 2007); and (iii) functional theories of stigma to acknowledge the role of medical power, discrimination, and authority in healthcare encounters with transgender patients (Poteat, German, and Kerrigan 2013). Further, as a well‐known health communication scholar specializing in feminist and grounded theory methodologies, Laura Ellingson has advocated for studies that embrace a continuum approach across social science methodologies. From this approach – which Ellingson (2009) deemed crystallization – grounded theory, which is typically represented in traditional research report genres, can be creatively paired with more artistic representation, including photovoice techniques (e.g. Evans‐Agnew, Boutain, and Rosemberg 2017) and poetic transcription (e.g. Ellingson 2011).

      Although narrative is a broad term that encompasses a multidisciplinary collection of theories and methods, the maturation of health narrative theorizing speaks to enduring and emerging issues of concern for health communication scholars (Harter et al. 2020). To illustrate, Lynn Harter, one of the premiere narrative theorists in health communication, launched Defining Moments, a forum in Health Communication and a complementary podcast dedicated to showcasing the social and material power of storytelling. In the first 10 years, authors of the collective essays narrated “myriad maladies, infirmities, and oddities of the human condition” and storied a vast number of topics with particular import for fostering well‐being, humanizing healthcare, and advocating for change (Harter et al. 2020, p. 262).

      Illness as a Call for Stories

      Illness narratives are generated in response to a rupture or turning point in a person’s life (Bruner 1990) and are told in and through the body (Frank 1995), meaning “the body is simultaneously cause, topic, and instrument of whatever story is told” (Sparkes and Smith 2008, p. 302). Inherently, narratives of health and illness are embodied and dialogic, calling upon listeners (or readers, viewers, touchers) to join with tellers (or writers, filmmakers, artists) in the creation and re‐creation of meaning (Harter et al. 2020). Narrative theorists (Frank, 1995; Kleinman, 1988) underscore the importance of reciprocity for bearing witness to individual or community suffering and trauma. Storytellers have the moral responsibility to guide others who may follow, just as storylisteners have the moral – and often uncomfortable – obligation to listen and respond to that suffering.

      Core dimensions of narrative theorizing from health communication scholars encompass the functions (e.g. identity construction and community building), grammars (e.g. emplotment and temporality), and types (e.g. institutional and societal stories) of narrative activity (Harter et al. 2005). Narratives endow experience with meaning by organizing events across space and time, identifying characters and their relationships, and determining causes and effects (Harter 2013). Personal narratives provide a way of sensemaking in uncertain or chaotic circumstances and enable a sense of control in the face of threat or disorder. They help transform personal identities regarding how individuals view themselves and are perceived by others, and they help create identification among people experiencing similar problems, thereby building a sense of community in place of social isolation (Sharf and Vanderford 2003; Sharf et al. 2011). Finally, narratives increase public awareness, challenge master narratives (i.e. stories that underlie, reflect, and perpetuate predominant cultural values), and propel health advocacy and social activism (Sharf 2001; Zoller 2005). Sharf et al. (2011) envision the latter contributing to new directions in health communication scholarship, namely “a parallel continuum of stories of illness to stories of prevention, healing, and mobilizing resources” (p. 42).

      Narrative Problematics

      In their seminal collection of health and illness narratives, Harter et al. (2005) advanced a typology of what they consider core dimensions – or vital problematics (i.e. assumptions) – of narrative theorizing that are pervasive but often unarticulated in the way scholars do narrative work. First, the problematic of knowing and being foregrounds how individuals narratively co‐construct and understand personal and social life. As one example, Yamasaki and Hovick (2015) revealed how African American older adults characterize their understandings of health‐related conditions from storied family histories and then rationalize their motivations and constraints for sharing that information with current family members. Second, the problematic of continuity and disruption, which “concerns disorder and the human desire for coherence” (Harter et al. 2005, p. 14), describes how storytellers construct and weigh “the past/present/future flow of continuity and disruption to give force to some understanding of the distinction between ‘now’ and ‘then’” (pp. 15–16). To illustrate, Pangborn (2019) poignantly demonstrated how teenagers at a family bereavement camp rely upon aesthetic and embodied narrative experiences to reject confining scripts for “appropriate” grief, acknowledge the value of their perspectives, and reengage in life in affirming ways.

      Next, the problematic of creativity and constraint “foregrounds the human struggle to be individuated (i.e. assert creativity) and still identify with a group (i.e. respond to social and institutional constraints),” emphasizing connections between the personal and cultural (Harter et al. 2005, p. 19). Health communication scholars have engaged this problematic in studies that explore how “narratives emerge as contested terrains, open to challenge by those who seek to reshape perceptions of health issues and construct alternate narratives” (Harter et al. 2005, p. 23), including embodied, aesthetic stories that transform meanings of age (e.g. Sharf 2017; Yamasaki 2014), disability (e.g. Harter et al. 2006; Quinlan and Harter

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