Social science constructs as spheres of activity
Health literacy and communicative competence in dialogue
Bibliographic Data
| ID | 24220899 |
|---|---|
| Authors | Susy Macqueen (0000-0001-5404-6475, Australian National University) |
| Year | 2026 |
| Volume | 46 |
| Pages | 107-126 |
| Publication date | 2026-03-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Annual Review of Applied Linguistics (BOOK_SERIES) |
| Journal identifiers | ISSN: 0267-1905 • E-ISSN: 1471-6356 |
| Publisher | Cambridge University Press (CUP) (PUBLISHER) |
| DOI | 10.1017/s0267190526100336 |
| OpenAlex | W7169199788 |
| Language | EN |
| References cited | 54 |
Healthcare spaces are “contact zones,” where care may be practised using a lingua franca, or in various configurations of language codes. This paper examines two foundational constructs, communicative competence and health literacy, that are implicated in the contact zones of health care. I propose a heuristic framework of spheres of activity for locating, articulating, and understanding the facets and workings of measured constructs as a basis for a multiperspectival, interdisciplinary research agenda. The framework is applied to a health literacy test to explore the multilayered texture of construct activity. Moving to the applicable world of the hospital ward, I consider what “health literacy” may look like in authentic doctor–patient interaction. Finally, I discuss the relationship between the different activities: what is operationalized in tests, what is wished for in policy, and what is evident in practice. Even though the capacity to communicate is considered a key ingredient in mobilizing health literacy for shared decision-making, communication is barely represented in operationalized constructs. An orientation to the interactional repertoires of health care and the dynamic nature of knowledge co-construction in health decision-making could generate useful development in theory, measurement, and practice.
Communicative competence · Contact zone · Health literacy · health literacy assessment · hospital wards · knowledge co-construction · physician-patient communication · shared decision-making · Health Literacy and Information Accessibility · Interpreting and Communication in Healthcare · Patient-Provider Communication in Healthcare
Authority in Language
Using Language
Communities of Practice
Dynamic assessment of L2 development
Health Literacy and Older Adults
Health Education as Social Policy
Quick Assessment of Literacy in Primary Care
Validating the Interpretations and Uses of Test Scores
The meaning and the measure of health literacy
Health Literacy
Health literacy as a public health goal
Health literacy and public health
Expansive Learning at Work
Health literacy revisited
Modelling Performance
Health literacy as knowledge construction
Interventions to improve participation in health‐care decisions in non‐Western countries
Research directions in medical English as a lingua franca (Melf)
The Causal Pathways Linking Health Literacy to Health Outcomes
Context reconsidered
Complex, dynamic systems
Theoretical Bases of Communicative Approaches to Second Language Teaching and Testing
Test validity and the ethics of assessment
The evolving concept of health literacy
Construct validity in psychological tests
The Ethnography of Infrastructure
| Highly cited | No |
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