Civic Engagement and Public Health Issues: Community Support for Breastfeeding Through Rhetoric and Health Communication Collaborations¹

As the U.S. public faces a discursive climate characterized by incivility and partisanship, scholars have the opportunity to productively influence public discourse, especially the deliberations of leaders and other community members (Carcasson, 2011). How might rhetorical studies of health improve their public position regarding civic engagement and community problem-solving? We argue that rhetorical studies of health can productively engage the public through scholars’ participation in collaborative community problem-solving and deliberation about public concerns. In working to improve the public significance of rhetorical studies of health, some important considerations include collaboration within and outside of the academy, the dual roles of the citizen-scholar, spheres of argument, and making public scholarship visible and valuable.

Background

The Brookings Supports Breastfeeding project is a case study for how to make rhetorical studies of health salient to the public. This project’s goal was to create a public deliberation event about supporting breastfeeding in businesses in Brookings, SD. Funded through a Community Innovation grant from the Bush Foundation, the project was a community-based research partnership across three institutions: South Dakota State University, Brookings Health System, and the Brookings Area Chamber of Commerce. The grant team included the following members: four faculty trained in different disciplines and subfields (including rhetoric, public deliberation, health communication, and nursing), the obstetrics director of the local hospital, the marketing and public relations (PR) director from the local hospital, the executive director of the area Chamber of Commerce, and two lactation consultants.

The year-long project had two phases. First, we conducted focus groups with breastfeeding mothers and business leaders to identify challenges, strengths, and community assets regarding breastfeeding support in local businesses. We used this research to create a public deliberation guide. Second, our team held a free public deliberation event to deliberate three approaches to address the issue in our community. Using the public deliberation guide as a starting point, participants discussed how to prioritize necessary and preferred steps to encourage breastfeeding support. They then brainstormed individual and group actions in the Brookings community. Understanding this local context, we now turn to specific aspects to consider in doing the public work of rhetoric (Ackerman & Coogan, 2010).

Collaboration in Rhetorical and Health Communication Research

A collaborative approach to rhetorical studies of health is essential to implementing a project that engages the public and provides varied expertise on the issue. Our research team included both faculty and community members who used a collaborative approach to designing, promoting, and implementing a public deliberation event. The team’s faculty members had disciplinary training in a variety of subfields in the academy. For example, Becky is co-principal investigator (Co-PI) and has experience in rhetorical methods and community advocacy. Another author, Sara, has professional experience in public deliberation, facilitation, and rhetorical methods. The final author and Co-PI, Jenn, conducts quantitative and qualitative health communication research and does related consulting work in the community. The final faculty member of our grant team is an associate professor of nursing and certified lactation consultant. The diverse training of the grant team’s faculty allowed for collaborative innovation in research methods across different phases. We used qualitative (i.e., focus groups with community members) and quantitative (i.e., surveys on civic engagement) methods to collect formative data prior to the event. We then used rhetorical methods to interpret and organize the formative data into a public deliberation guide that participants used to frame their conversations at the public deliberation event.

Our project also used collaboration with community partners. By drawing on institutional resources and relationships, our project garnered more interest from the community. We relied on community leaders’ networks to maximize participation at the public deliberation event. The obstetrics director knew the city mayor, for example, and she invited him to give opening remarks at our event. During the first phase of the project, the executive director of the area Chamber of Commerce recruited business leaders for our focus groups. The lactation consultants helped recruit breastfeeding mothers. Finally, the hospital’s marketing and PR director connected the Co-PIs with local media and leaders of community organizations such as Kiwanis and the Boys and Girls Club. As a result of these connections, the Co-PIs spoke to eight different community organizations and were featured in local, state, regional, and online (national and international) news outlets in the months leading up to the public deliberation event (e.g., Curley, 2014).

Dual Roles of the Citizen-Scholar

A second aspect to consider is the joint positionality of the citizen-scholar (Ackerman & Coogan, 2010). As scholars, we conduct grant-funded, community-based research, such as hosting public deliberation events, to foster spaces for and conversations leading to social change. This research helps us better engage democracy and its challenges. From its inception in ancient Greece, rhetoric has been linked to the development of citizenship and the pursuit of public life. Yet any survey of contemporary public discourse leaves many citizens concerned about how we communicate—or fail to communicate—about important public issues. Recently, scholars have called for reinvigorating and expanding the civic traditions of rhetorical studies (Hogan, 2010; Kuehl, 2014; McDorman & Timmerman, 2008). As academics interested in improving the quality and character of local discourse on important public problems, we use both the skills and theories of rhetoric to create opportunities for civic engagement. We analyze public problems and strategically present those issues in a way that encourages community problem-solving (Carcasson, Black, & Sink, 2010). As part of this project, for instance, we produced a Brookings Supports Breastfeeding public deliberation guide and analytical conversation report, both of which created opportunities for public deliberation and civic engagement.

The dual roles of the citizen-scholar connect to the historical struggle of public speaking as a skill, or practicing rhetoric, and public speaking as an art, or evaluating eloquence (Keith, 2007). Scholars have long debated the skills versus art dialectic of public speaking, including the separation from English in 1914, with scholars arguing the benefits and limitations for each approach. The skills component of public speaking emerges from the rhetorical tradition’s history of elocution and physical education that are part of the history of the communication discipline. For example, the earliest evidence of a speech department at South Dakota State University is in 1904 with the Department of Elocution and Physical Culture. This tension in the history of public speaking as a skill versus an art continues to be a challenging historical context in practicing rhetoric in our communities today.

We see the dual roles as complementary but also involving a tension in our identities. As scholars, we are used to analyzing and evaluating public discourse, whether through rhetorical criticism, building on rhetorical theory, or through evaluating health communication. For instance, we evaluated the discourse from the business leaders’ focus groups on breastfeeding support and published this account through peer-reviewed scholarship in a breastfeeding journal (Anderson et al., 2015). Beyond this scholarly role, we simultaneously adopted a position of a citizen doing rhetoric and health communication. One possible rhetorical role of the citizen is to create opportunities for public deliberation that encourage social change. This role of the citizen-scholar involves a belief in the responsibility of rhetoric to help us practice advocacy in our communities (Ackerman & Coogan, 2010, p. 7). This could include participating in the actions from a public deliberation event or teaching students the theories and skills of public deliberation for use outside of the classroom.

Spheres of Argument in Public Deliberation

As citizen-scholars, we are also in a position to recognize different spheres of argument in public deliberation. The public especially faces a struggle in taking up technical spheres of public argument (Goodnight, 1982). One tension lies in community members’ personal experiences with the issue and how those experiences are not always reflected in technical sphere arguments. For the issue of breastfeeding support in businesses, participants commented on how their personal need to breastfeed or pump at work did not match the policy at their workplace, even though The Break Time for Nursing Mothers provision of the Affordable Care Act states that breastfeeding mothers are entitled to time and space to pump breast milk at work (United States Department of Labor, 2015). How does one enact change in this situation? Employees with personal experiences may feel they lack the knowledge or agency to do something. Additionally, they may not have the technical expertise or power to create policy. Leaders with technical expertise might not understand how to create a policy related to breastfeeding support because of a lack of personal experience (Anderson et al., 2015). When faced with a public problem, neither citizens nor experts alone can enact long-term, sustainable change in our communities. Therefore, various stakeholders need to clearly communicate about this issue together, drawing on arguments from personal, public, and technical spheres to have a holistic public deliberation and move forward on actions.

Additionally, personal sphere arguments are often what bring people to the community conversation in the first place. Even we, as facilitators of these public deliberations, have personal experiences that motivate us in discussing this public health issue. For instance, Becky and Jenn recently faced challenges on professional, emotional, and physical levels regarding breastfeeding. Our personal experiences helped us relate to fellow citizens and gave us additional insight for research. Our personal connections to these public health issues affect our roles as citizens who also take part in public deliberations and as scholars conducting research.

Making Public Scholarship Visible and Valuable

In order for public deliberation to become a more widely used method in rhetorical studies of health and other forms of health communication research, public scholarship must be visible. In our project, we first accomplished this through strategic local presentations, media appearances, and brief reports. Our presentations to groups like the City Council and the Brookings Economic Development Corporation led to requests for media appearances on local radio programs and in our city’s newspaper, as well as state and regional news outlets, community partner websites, and various breastfeeding-related websites. These media appearances were important to making rhetorical studies of health matter to the public and/or to persuade them to attend the event. As noted above, we also produced a public deliberation guide before the event. Afterward, we wrote an analytical report that is an important public record of the community conversation for community leaders and businesses, especially in moving forward together on actions.

Increasing the visibility of public scholarship also comes with challenges. For example, with the widespread media coverage of our project, many citizens engaged in conversations about the issue prior to the public deliberation event and may not have been motivated to participate in the planned, formal deliberation process. Our team effort was quite successful and visible, but now the challenge lies in communicating to both our community and our team members that this team is not a permanent entity. We must communicate to the community that they are now responsible for enacting the changes suggested through public deliberation. Similarly, we must communicate to our team that the team composition and trajectory may shift as we move into future projects.

Finally, as citizen-scholars, we feel a responsibility to engage with our community to bring about positive change through public deliberation. However, we must also maintain a focus on producing scholarship that will be recognized and valued in the academy. Community-based action research demands a great deal of time and produces many important outputs (i.e., community reports) that are not traditionally considered scholarly works. This can discourage young or pre-tenure scholars from pursuing such important community work. We therefore encourage academic institutions and disciplines to look for ways to encourage and reward this type of work that connects scholars to citizens and communities.

Conclusion

Rhetorical studies can engage the public through scholars’ research and participation in community collaboration and deliberation about public health issues. However, this work involves navigating tensions in our positionality as citizen-scholars as well as negotiating community relationships. Scholarship about and participation in public deliberation has implications for improving the quality of public discourse in communities, enhancing civic engagement, and for participating in social change as rhetorical practitioners and critics. We believe such public work of rhetoric can productively influence the discursive climate in the U.S. public sphere. We suggest other scholars take up this work to engage in social change alongside fellow health communication researchers and community members.

Additional information

Notes on contributors

Rebecca A. Kuehl

Rebecca A. Kuehl is an Assistant Professor in the Department of Communication Studies and Theatre at South Dakota State University.

Sara A. Mehltretter Drury

Sara A. Mehltretter Drury is an Assistant Professor in the Rhetoric Department at Wabash College.

Jenn Anderson

Jenn Anderson is an Assistant Professor in the Department of Communication Studies and Theatre at South Dakota State University.

Notes

This study was funded by a Community Innovation grant from the Bush Foundation.