Moving from information transfer to information exchange in health and health care.

Communication in most health and health care settings assumes that information provision is both necessary and sufficient to improve individual behavior and, subsequently, health. This paper examines and challenges commonly accepted practices of information transmission in health settings, demonstrating how such practices are insufficient because they are rooted in a one-way model of information transfer. Three case studies show how this model is pervasive in different health and health care milieus: patient/provider encounters, health promotion programs, and national health policymaking. Drawing on critical theoretical perspectives, the work shows the limits of current information transfer approaches by critiquing the dominant assumptions that underpin current practice. At the same time, it provides empirical examples of the usefulness of critical approaches to identify relations of power in health communication. The paper concludes by suggesting that researchers and practitioners move beyond traditional practices of information transfer (based on a one-way monologue) and toward a more useful and appropriate notion of information exchange (based on two-way dialogue).