Chapter 1 introduces the book, outlines its objectives and defines key conceptual terms. The broad objective is to tell a polyvocal story of how the arts intersect with health, illness and healing in Ghana across various levels of social organisation, from local to geopolitical. The story consists of three intersecting strands. The first strand builds on the argument, made by African art historians, that the arts drive African social life, demonstrating that arts are a core feature of communication in Ghanaian healing environments. These dynamic environments are co-constructed by healers and their clients. The second strand examines the value of arts applied to official health communication. Selected case studies show that these interventions use the arts as an add-on, rather than a central feature of health communication. Moreover, the ‘psychopolitics’ of global health models and colonial medicine models can undermine meaningful, safe and sustainable outcomes. The final strand advocates for incorporating Ghanaian arts traditions into official health communication models and interventions. The chapter concludes with brief descriptions of the chapters that follow.

Chapter 3 considers different approaches to data collection. Three case studies are included. The first study involves a purpose-built corpus of news articles about obesity. We focus on theoretical considerations attending to corpus design, as well as practical challenges involved in processing texts provided by repositories such as LexisNexis to make them amenable to corpus analysis. The second study focuses on how corpus linguists might work with existing datasets, in this case, transcripts collected by research collaborators conducting ethnographic research in Australian Emergency Departments. We discuss the ways in which data collected for the purposes of different kinds of analysis is likely to require some pre-processing before it becomes suitable for corpus-based analysis. The third study is concerned with the creation of a corpus of anti-vaccination literature from Victorian England. We discuss the challenges involved in sourcing historical material from existing databases, selecting a principled set of potential texts for inclusion, and using optical character recognition (OCR) software to convert the texts into a format that is appropriate for corpus tools.

Chapter 1 introduces the context and aims of the book, and provides a brief introduction to corpus linguistics for readers unfamiliar with it. It finishes by providing a chapter-by-chapter overview of the book.

Chapter 11 introduces the concept of legitimation in discourse and considers how it might function, and be studied, in the context of health(care) communication. First, we look at how contributors to the online parenting forum Mumsnet use labels denoting attitudes towards vaccinations. We point out how labels that involve opposition to vaccinations, such as ‘anti-vaxxer’ tend to collocate with negation, and then consider how people justify negating the applicability of the label to themselves. This reveals a range of different concerns around vaccinations. We then draw on a study of patient feedback in which we examined how patients legitimate their perspectives and the evaluations they gave in their feedback. For example, this included patients representing themselves as experienced users of healthcare services. Additionally, some patients used aspects of their identities to position themselves as requiring attention, while others used techniques such as employing second person pronouns to imply that their experiences could be generalised to other patients.

Chapter 7 considers how language change over short timespans can be examined using corpus-assisted methods. We present three case studies. The first study involves a corpus of patient feedback relating to cancer care, collected for four consecutive years. A technique called the coefficient of variation was used to identify lexical items that had increased or decreased over time. The second study considered UK newspaper articles about obesity. To examine changing themes over time, we employed a combination of keyness and concordance analyses to identify which themes in the corpus were becoming more or less popular over time. Additionally, the analysis considered time in a different way, by using the concept of the annual news cycle. To this end, the corpus was divided into 12 parts, consisting of articles published according to a particular month, and the same type of analysis was applied to each part. The third case study involves an analysis of a corpus of forum posts about anxiety. Time was considered in terms of the age of the poster and in terms of the number of contributions that a poster had made to the forum, and differences were found depending on both approaches to time.

Chapter 6 shows how it is possible to use demographic metadata to study identities in health-related corpora. We present two case studies, based on research on patient feedback on NHS services in England. The first study compares how cancer patients of different age and sex groups evaluate healthcare services and, specifically, how they use distinct linguistic and rhetorical strategies to do this. The corpus was encoded with demographic metadata which allowed the researchers to explore the language used by people of different age and sex identity groups. For the second study, a different corpus of more general patient feedback was used, one which did not contain demographic information metadata. Instead, targeted searches were used to identify patients’ demographic characteristics based on cases where they made those characteristics explicit within their feedback. In contrasting these case studies, we also evaluate the two different approaches taken, considering the affordances and limitations of both. Taken together, the case studies demonstrate how language and identity can be explored in corpora with and without reliable demographic metadata.

Chapter 5 is concerned with sequential aspects of health-oriented interactions and the challenges this poses for corpus research. Two case studies demonstrate how conventional corpus procedures can be augmented with other linguistic approaches to facilitate a critical examination of the relationships between parts of the data that might otherwise be separated in corpus analysis. The first study is an investigation of a thread from an online forum dedicated to cancer – one that is explicitly dedicated to irreverent verbal play. We show how a corpus approach enabled the identification of humourous metaphors and helped us reveal recurrent lexical and grammatical features that facilitate discussion around sensitive topics, enable a coherent identity, and contribute to a sense of community. In the second study we use an approach that was originally applied to the Spoken BNC 2014 corpus to examine interactional data in terms of functional discourse units. We apply this coding framework to a sample of anxiety support forum data in order to document, quantify, and evaluate how various communicative purposes are formulated in forum posts and are met with different types of response.

Chapter 13 presents a synthesis of the previous chapters, beginning by asking the question – what have our experiences taught us about health communication that we didn’t know? We go on to examine lessons we learnt about carrying out corpus-based research on health communication, offering practical advice and tips for people who might be carrying out similar kinds of studies to the ones described in this book. We then consider the limitations of a corpus-based approach and end by looking to the future – what changes have taken place since we completed our analyses? What kinds of developments in the field of healthcare and in corpus linguistic analysis have occurred recently? And what avenues of research into health care do we believe are potentially interesting to investigate next?

Chapter 2 is concerned with research questions. We discuss the different processes through which research questions can be identified and developed in corpus-based research on health communication. Three case studies are considered. The first study involved the analysis of press representations of obesity. In this study, the researchers developed their own research questions in a variety of ways, including by drawing from the non-linguistic literature on obesity. The second study focused on the McGill Pain Questionnaire – a well-known language-based diagnostic tool for pain. A pain consultant asked the researchers if they could help understand why some patients find it difficult to respond to some sections of the questionnaire. In response, the researchers formulated a series of questions that could be answered using corpus linguistic tools, and identified some issues with the questionnaire that address the pain consultant’s concerns. The third study involved the analysis of patient feedback on the UK’s National Health Service. The researchers were approached by the NHS Feedback Team and given 12 questions that they were commissioned to answer by means of corpus linguistic methods.

Chapter 12 discusses the potential opportunities and challenges associated with disseminating the findings of corpus-based approaches to health communication, which also apply more generally to interdisciplinary research and collaborations between researchers and non-academic stakeholders. We include two case studies. The first case study involves work on patient feedback with members of the NHS who had provided a list of questions for us to work on. We discuss the importance of and challenges around building and maintaining relationships with members of this large, changing organisation, as well as outlining how we approached dissemination of findings, both in academic and non-academic senses, and the extent that we were able to carry out impact. The second case study considers our experiences of disseminating findings from a project on metaphors and cancer, focussing particularly on writing for a healthcare journal, dealing with the media, and going beyond corpus data to create a metaphor-based resource for communication about cancer.

Chapter 4 considers ethical issues in healthcare communication research through two case studies. The first case study looks at a relatively straightforward situation involving a study of the Pain Concern online forum. Data from the forum was provided by Health Unlocked, a company that runs a large number of online communities related to health. One advantage of using their service was that Health Unlocked took care of relevant legal requirements concerning ethics and only shared data from contributors to the forum who had agreed for their posts to be used for research purposes. The second case study relates to the study of dementia and brings into focus the difficulties of working with multiple datasets and a range of stakeholders. The data collection for this project involved public health communication in terms of news media and external communications from support services, including social media. As such, it presents scenarios that are common to studies of health communication and thereby offers instruction in how to navigate related ethical concerns.