WHAT HAVE LOW INCOME SMOKERS LEARNED FROM A LIFETIME OF EXPOSURE TO PUBLIC HEALTH PEDAGOGY? A NARRATIVE INQURY

Open Access
- Author:
- Veldheer, Susan J
- Graduate Program:
- Adult Education
- Degree:
- Doctor of Education
- Document Type:
- Dissertation
- Date of Defense:
- January 31, 2018
- Committee Members:
- Robin Redmon Wright, Dissertation Advisor/Co-Advisor
Robin Redmon Wright, Committee Chair/Co-Chair
Karin Sprow Forte, Committee Member
Jonathan A Foulds, Committee Member
Eugene Joseph Lengerich, Outside Member - Keywords:
- Smoking
health disparities
Public Pedagogy
Adult Education
Narrative Inquiry
Public Health Education - Abstract:
- Though the prevalence of smoking continues to decline overall each year, in segments of the population, such as those with low income or low education levels, the prevalence of smoking is almost double that of the general population. The slower rates of decline in these groups are possibly due to the unexpected ways that public health messages are received, understood, and assimilated into the lives of individuals in these groups. This qualitative study used narrative inquiry methods to understand what 15 low income smokers with less than a bachelor’s degree have learned from a lifetime of exposure to public health pedagogical messages and how this learning may have contributed to their smoking behavior. This study was informed by critical theory which assumes that power and influence within society are unequally distributed, and experiential learning and public pedagogy which consider what people learn from public sites. Data were analyzed by using the constant comparative method to code the data into themes and by re-storying the participant narratives. The findings from this study suggest, for the most part, participants were accepting of many public health pedagogies including things such as indoor smoking bans and paying more in cigarette taxes, and they were willing to comply with most messages. However, some of the messages that participants’ received from public health pedagogies and public health professionals were received in unintended ways. Most importantly, they had negative or mis-educative experiences that caused them to either doubt, resist, or rebel. Finally, some experiences prompted participants to distrust public health professionals who they perceived as having power in society and who they felt were treating them unfairly, judging them, or providing them with suboptimal care. Many mis-educative experiences revolved around failing to successfully quit smoking and the participants did not identify any public health pedagogies that challenged these mis-educative experiences. This study makes a contribution to the growing body of public pedagogy literature by suggesting that learning does occur through public sites and that personal experiences can either lead to confirmation or resistance to messages individuals receive. The findings also suggest that public health professionals should work to restore the trust of smokers while also exploring new public pedagogical messages designed to challenge the mis-educative quitting experiences that smokers have accumulated throughout their lives.