EAP (print) issn 2055-7752 EAST ASIAN EAP (online) issn 2055-7760 PRAGMATICS Article Medical experts as health knowledge providers: A case study of nutritionists’ identity construction in ‘wemedia’ Xingchen Shen Abstract The rise of wemedia in China has brought challenges to public health communica­ tion (PHC), such as the change in doctor–patient relations and the vulnerability of trust. As few researchers have touched upon the issue of identity construction during PHC in Weibo, this study aims to fill this gap and investigate one health in­ formation provider’s discursive construction of multiple identities in Weibo and its pragmatic effect on trust building. Through this study the author attempts to con­ tribute to the existing scholarship on the dynamics of identity­relation construction in wemedia and the pragmatic construction of trustworthiness in a PHC context. keywords: public health communication; pragmatics; identity; trust; wemedia Affiliation Nanjing University email: [email protected] eap vol 4.2 2019 263–291 https://doi.org/10.1558/eap.37686 ©2019, equinox publishing 264 east asian pragmatics 1. Introduction As an important site of exchanging healthcare information and building health- care community, public health communication (PHC) has been much researched in the past several decades (Kreps, Bonaguro, & Query, 2003). As it is with other communicative activities, PHC evolves along with the evolution of communica- tion media. In China, for example, the past decade witnessed the rising power of ‘New Media’, and their increasing share of the PHC floor (Chen & Liang, 2013; Tian, 2017). While the challenges brought by the new media environment to PHC has been touched upon by researchers in communication studies (e.g., Su, 2015; Hu, 2012), few researchers have investigated the issue of identity construc- tion during PHC in new media, let alone in wemedia like Weibo, although the importance of successful identity construction in public communication has been more and more recognised.1 This study aims to fill this gap and investi- gate a nutritionist’s identity construction and its effect on trust building in Weibo. Through this study I will attempt to contribute to the knowledge on the dynamics of identity construction in wemedia and the pragmatic effect on the building of trustworthiness in a PHC context. 2. Research background 2.1 Identity research in public health communication Public health communication, in a broad sense, refers to communicative activi- ties involving the topic of health, which includes several types: intrapersonal, interpersonal, group and organisational, and societal communication (Rogers, 1994; Kreps, et al., 2003; Zhang, 2005). In a narrow sense, it refers to commu- nication of health information via public media for the purpose of disease pre- vention, health promotion, and also health marketing and health policy making. Since the beginning of the 1970s, PHC as a research area has been established, and varied research methods have been drawn from medical science, commu- nication studies, sociology, psychology, and management science, etc. (Freeman, 1963; Korsch & Negrete, 1972; Kreps et al, 2003; Li, 2009; Rokeach, 1973). Zhang (2005) summarised the research agenda for PHC (in China) into nine directions,2 and most close to the pragmatic perspective is the direction “interpersonal health communication studies focusing on doctor–patient roles and relations” (p. 46). The research topics mainly include the conversational sequences and frames of doctor–patient communication (e.g., Gu, 1996; Kushida & Yamakawa, 2018; Shaw & Kitzinger, 2013; Sun, 2018; Wu, 2017; Yu, 2009) and the discursive con- struction of doctor–patient identities and relations (e.g., Chen, 2015; Barone & Lazzaro-Salazar, 2015; Setchell, Leach, Watson, & Hewett, 2015; Tian, 2017; Xia, 2016; Wang & Xu, 2017; Wang, You, & Ji, 2017; Warmington & McColl, 2017). Of medical experts as health knowledge providers 265 particular relevance to this study is research on the doctor/medical professional’s identity construction. As the past decade witnessed a ‘discursive’ turn in identity research (Benwell & Stokoe, 2006, p. 4), an increasing number of scholars conducted identity research from a social constructionist perspective (e.g., Antaki & Widdicome, 1998; Bucholtz & Hall, 2010; de Fina, Schiffrin, & Bamberg, 2006), which views identity as constructed discursively (Bhatia, 2004) by participants in interaction as part of social activity (Widdicombe, 1998), and which can be negotiated and reworked (Davies & Harré, 1990). The topic of doctors’ discursive identity construction has attracted increasing scholarly attention in the past few years (Barone & Lazza- ro-Salazar, 2015). These studies are mainly concerned with doctors’ (and other medical professionals’) discursive construction of professional and non-profes- sional identities for themselves in real-life doctor–patient communication (e.g., Barone & Lazzaro-Salazar, 2015; Liang, 2014; Setchell, et al., 2015; Tan, 2018; Wang & Xu, 2017; Warmington & McColl, 2017, Xia, 2016), using research methods like conversation analysis method (e.g., Wang & Xu, 2017), member- ship categorisation analysis (e.g., Liang, 2014), critical discourse analysis (Tan, 2018), and discursive approach in general (Xia, 2016, 2017). The theories adopted include Simon’s (2008) self-aspect model of identity, Brewer & Gardner’s (1996) self-representation model, social identity theory (Turner & Oakes, 1986), and the integrated perspective of functional linguistics and critical discourse analy- sis (e.g., Tan, 2018). Apart from studies concerned with doctors’ identity con- struction in healthcare settings as reviewed above, few studies examined doctors’ identity construction in cyberspace; for example, Xia (2016) analysed doctor identities constructed online by both doctors and netizens in the form of online postings within the framework of Simon’s self-aspect model of identity and found that doctors and netizens constructed drastically different identities for doctors. However, as far as the review goes, insufficient attention has been paid to the doctors’/medical professionals’ identity construction with the aim of providing healthcare service in cyberspace, wemedia in particular, and with a special focus on the potential influences of the media on the identity construction practice. In the section that follows, we review briefly research on the influence of new media to PHC. 2.2 Public health communication in the new media Research on PHC in China has mainly been conducted by communication schol- ars, and the topics researched mainly include the working mechanism of health- care communication in new media, communication functions, and potential sequences (e.g., Hu, 2012; Su, 2015; Sun, 2012; Wu & Wu, 2010; Zheng, 2014). However, the web 2.0 era presents health communication with some major chal- lenges which triggers scholarly reflections. For example, Hu (2012) pointed out 266 east asian pragmatics the problems of inefficient public information, a decentralised communication system, and a social media-centred lifestyle, and warned readers against the decentralisation of information providers in healthcare settings, as “everyone has a microphone” (2012, p. 7) in wemedia. Based on these challenges, Hu argues for a paradigm shift in PHC (pp. 8–10), from information to dialogue, from infor- mation flow to relational network, and from mutual interests to shared values. Also, Su (2015) examined the case of a controversial online public health event and discussed the influence of cyberspace on doctor–patient relations and health attitudes and health behaviours of patients. She argues that wemedia like QQ facilitates new modes of role-relations between the health information provider and the receiver (Su, 2015), as the wemedia environment provides patients with substantial information such that they obtain some bargaining power and right of choice. As little research has touched upon the identity work in PHC in new media (but see Xia, 2017), and scarcely any on the identity construction of health informa- tion providers in Weibo and its discursive realisations, this study aims to investi- gate one health information provider’s discursive construction of multiple identi- ties in Weibo and its underlying rationale. 3. Methodology 3.1 Research questions The present study seeks to address the following three research questions: 1. Does the health knowledge provider construct for her/himself a professional iden- tity? If yes, in what ways? 2. Does the health knowledge provider construct for her/himself identities other than professional ones? If yes, what identities and in what ways? 3. Why does the health knowledge provider construct the identities in question? 3.2 Data collection Sina Weibo (in this study simply called ‘Weibo’) is one of the most important wemedia platforms in China, providing the general public with platforms for sharing information and communicating every aspect of life. By September 2017, Weibo had 376 million monthly active users. Originally designed as a Twitter clone (Zhang & Kramarae, 2014), Weibo has many similarities with Twitter, such as the word limit for each post, the ‘addressivity’ function realised by the @ sym- bol, the function of replying, commenting, and reposting messages by other users. But unlike Twitter, Weibo has a complex system for verified accounts which belong variously to celebrities, business leaders, companies, government and organisations, and experts from many
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