Interventions to Address Reproductive Health Disparities among African-American Women in a Small Urban Community: the Communicative Construction of a “Field of Health Action”

Guided by communication infrastructure theory (CIT) and based on analyses of multiple sources of data gathered as part of a four-year intervention to address reproductive health-care disparities among African-American women in a small, disadvantaged urban community in the northeastern USA, this mixed-methods study advances understanding of challenges that such health interventions face in smaller urban settings. Findings suggest that factors in residents’ material environment and their social construction of that environment interact to produce a “field of health action,” within which health-care seeking behavior is enabled and constrained. Four factors emerged as salient: actual availability of and perceptions of access to health-care resources, transportation options, communication resources (including interpersonal, media, and organizational) that aid health-care seeking, and privacy concerns around reproductive health-care seeking. The findings are discussed with regard to their implications for future research and health communication interventions that promote reproductive health-care seeking in small urban communities.