The Influence of Everyday Interpersonal Communication on the Medical Encounter: An Extension of Street’s Ecological Model

Abstract

Street's ecological model has shaped the research-examining communication during medical encounters for over a decade. Although the model accounts for the variety of contexts that shape the conversations in which patients and health-care providers engage, the model does not adequately address the way that everyday conversations about health carry over into patient-provider interactions. In this essay, we propose an extension of Street's model that adds the context of everyday communication about health as a contributing factor in the medical encounter. We support the need for this extension by discussing research that points to the ways these conversations with our social network influence communication during the medical encounter and propose new areas for research based on this extension.

Information and Relationship Functions of Communication between Pregnant Women and Their Health Care Providers

“…The results support a recent extension of Street's (2003) ecological perspective, which emphasizes ways that patient-provider interactions exist within and are influenced by other social contexts, such as the health care organization, cultural setting, political climate, and media influences (p. 63-65), as well as interpersonal contexts (Head & Bute, 2018). As Head and Bute (2018) note: "Social networks disseminate health information, information that undoubtedly spurs us to seek health care, prompts us to ask particular questions of our providers, and informs our decision making" (p. 787).…”

“…Pregnant women bring to interactions assumptions and priorities shaped by conversations with friends and family, on social media, through pregnancy apps, etc. Interpersonal interactions can influence clinical interactions in three ways: seeking care, communication during the medical encounter, and making health-care decisions (Head & Bute, 2018). Our sample reported intersections between outside interactions and their conversations with providers, for example, a participant who elected to call her OB's office about swelling in her legs after posting a picture on Facebook and being encouraged by her social network to seek care.…”

A retrospective and prospective look at strategies to increase adolescent HPV vaccine uptake in the United States

“…Researchers are increasingly recognizing the importance of not only the role of media in influencing clinical decisions like vaccination, but also the role of everyday interpersonal communication within social networks. 98 For example, one study looked at parents' social networks (e.g., friends, fellow parents, healthcare providers) and found that those parents less willing to vaccinate had large social networks of people telling them to not conform to vaccination guidelines (e.g., on time vaccination). 99 In addition they tended to consulting more sources of information (e.g., internet, magazine) that also promoted non-adherence to recommended vaccination schedules.…”

Parents’ Communication Work in the Management of Food Allergies

“…campaigns, the present study is informed by the claim that scholars must also attend to the "neglected box" in health communication research (Cline, 2003;2011). That is, we must attend to the vitally important interpersonal conversations that happen outside of the medical encounter, by attending to the talk about health that unfolds in our everyday interactions with relational partners, relatives, and friends (Head & Bute, 2017). Everyday interpersonal communication, whether such conversations involve tasks of household living, managing family events, budget and vacation planning, or other relatively mundane interactions, are exceptionally important in the case of food allergies because a) food allergies are relevant to any situation that involves food and b) conversations about food occur in daily interactions.…”