Socioecological and psycholinguistic approaches to multilingual health literacy.

Abstract

Socioecological approaches to communication consider people's language behaviors as nested within multilevel sociocultural systems. In contrast, psycholinguistic approaches consider people's language behaviors as a collection of person-specific experiences and capacities (Itzhak et al., 2017). Both approaches are relevant to understanding real-world communicative needs, such as health literacy in multilingual settings. While health literacy in a first (L1) or second language (L2) is crucial for comprehending health information, the precise determinants that influence health literacy (e.g., text characteristics, reader characteristics, and multilayered socioecological context) remain unclear, particularly for people living within language-discordant contexts (i.e., where the language of the environment differs from one's L1). To address these issues, we review health literacy as it pertains to multilingualism and emphasize the relevance of psycholinguistic studies of written language processing, individual differences in L1 and L2 reading skills, and language experience. Our goal is to synthesize information that could be useful for maximizing health literacy and reducing linguistic barriers, by expanding upon existing health literacy frameworks to the domain of multilingualism.What is the significance of this article for the general public?We review how the socioecological context of multilingualism, and the psycholinguistic behaviors of multilingual people jointly impact health literacy. We address health literacy challenges in multilingual adults, and how psycholinguistic phenomena reported for multilingual adults might address these challenges. We hope this review advances interdisciplinary efforts to characterize and overcome language barriers in health care access.

A new wave of context: Introduction to the special issue on socioecological approaches to psychology.

“…We begin with an article that introduces two explanatory models-orienting the audience to EST and the ecological metaphor from community psychology (Scarpa & Trickett, 2022). Then, we present conceptual articles that apply ecological theory to program development across diverse settings and domains, including communication and psycholinguistics in health care (Hernández-Rivera et al, 2022), training systems for clinical supervision (Terepka et al, 2022), wise interventions in higher education (i.e., theory-based strategies that work alongside existing curriculum to help students navigate their social world; Laiduc & Covarrubias, 2022), and treatment paradigms in the juvenile justice system (Snyder & Duchschere, 2022).…”

“…One barrier to access for some is the dominant language used by the health care system. Hernández-Rivera et al (2022) specifically focus on the comparative challenges that multilingual individuals face when trying to attain health literacy. These authors contend that a truly equitable health care system is informed by the social ecology and needs of consumers whose quality of care should not depend upon their proficiency in the dominant language.…”

Rethinking Multilingual Experience through a Systems Framework of Bilingualism: Response to Commentaries

“…Thus, its provisions have the potential to further compartmentalize people socially who have different language statuses and abilities (e.g., those who are legally obliged to attend French school and those who are legally eligible and choose to attend schools that have other languages of instruction). It is clear from where we sit that such laws, operative at a societal level within the Systems Framework , will have direct and indirect impacts on people's interpersonal and individual psycholinguistic experiences of multilingualism (e.g., reviewed in Ahooja, Brouillard, Quirk, Ballinger, Polka, Byers-Heinlein & Kircher, 2022; Ballinger, Brouillard, Ahooja, Kircher, Polka & Byers-Heinlein, 2020; Hernández-Rivera, Gullifer & Titone, 2022; Itzhak, Vingron, Baum & Titone, 2017). Such impacts are the explicit goal of any language policy.…”