Health Communications

ICIC has made significant contributions to improvements in healthcare through its linguistic and intercultural communication research. Research at the Center is based on the premise that “disease and illness cannot be understood apart from their cultural context” and that effective communication comes from engaging cultural context through linguistics (Connor 2011). Using an interdisciplinary-interdepartmental team science approach, we have identified language and culture-based factors and forms of interaction that impact patient adherence, decision making, and successful disease management.

Our multi-modal research methodology engages healthcare providers and patients as research partners, and thus results in the development of unique linguistic interventions. The goals of such evidence-based interventions are to facilitate patient understanding of written medical information (health literacy) and to create tailored patient-centered messaging for healthcare professional use (healthcare communication).

Dr. Ulla Connor and an interdisciplinary-interdepartmental team have authored and presented widely on the topic of health literacy and healthcare communication.

Development of the CoMac Descriptor and Related Tools

ICIC began its transdisciplinary research in 2005 by involving scholars from the IU School of Medicine and Law at IUPUI (now IU Indianapolis) and the School of Pharmacy at Butler University in an intercultural project on medication labeling. Results of our research indicated that understanding medication instructions depends on not only the quality of the writing but also on the ability of the patient (Connor et al. 2008, Wolf et al. 2006).

To better understand the language/ability connection, from 2007 to 2010, ICIC directed a project with funding from Eli Lilly and Company Foundation to examine disease management of patients living with diabetes through studying patients’ own narratives. A team science approach was used to understand individuals’ worldviews and health beliefs that affect adherence: knowledge, confidence to act, attitudes, and emotions. We examined the words and language structures used by English, Spanish, and Chinese speakers. Three key insights emerged from this study:

1. People see the world differently and have different perceptual views;
2. People with different perceptual views use different language to describe the event;
3. If you know how patients see themselves, then you can use differential language to communicate back to them in a more effective manner regardless of their native language.

The research produced a linguistic feature system, translatable to different languages; comparisons of language use and adherence patterns between native English-speaking patients and Latino patients; and recommendations for tailored communication strategies for health care providers working with patients suffering from chronic illness. ICIC’s transdisciplinary team of internal and external research fellows have produced a number of publications born out of this 2007-2010 funded research. In addition to a book-length volume (Antón & Goering, 2015), our research team co-authored four peer-reviewed articles and three book chapters. Team members have made over thirty presentations at national and international conferences on the subject.

Influenced by these findings, ICIC went on to develop the CoMac Descriptor™, a survey that effectively segments patients into distinct clusters based on established linguistic parameters of locus of control, agency, and affect. A Patient Profile™ and Points of Emphasis™ were subsequently developed for healthcare providers (HCPs) to use in communicating with patients. These psycholinguistically informed communication tools include language cues that provide HCPs with communication strategies tailored to patient segmentation, allowing providers to talk to patients in ways matching patient worldviews and enhancing communication (Clark et al., 2012; Connor et al., 2015; Ellis et al., 2014). The CoMac related tools are commercially available and have been licensed in multiple research studies focusing on multiple conditions (e.g., diabetes, hypertension, ADHD, kidney disease). See www.comacanalytics.com for more information.