Reconceptualizing the 'Patient': Health Care Promotion as Increasing Citizens' Decision-Making Competencies

Moving away from source-oriented models of communication, this article proposes that we reframe our understanding of the patient as an active citizen involved in individual and collective decision making. Citizens' health-related decisions in their physical, social, and mediated environments are examined. The role of the health communication researcher in each of these environments is to increase citizens' decision-making competencies, a task that requires adopting (a) a multilevel concep- tualization of health and (b) a definition of communication that involves the exchange of shared meaning.