Shannon-weaver Model and Communication in Health Literacy

Introduction

To understand information theory, we have to start where it all began. The idea of information theory has, in fact, been around since 1948. Created by Claude Shannon, a mathematician, and Warren Weaver, an electrical engineer, in 1948 the theory has come to be known as the “mother of all models”, Shannon-Weaver model or simply “information theory.” Their theory was introduced in an article titled, “A Mathematical Theory of Communication” for Bell System Technical Journal.

The premise of the information model is based on six (6) key concepts: sender, encoder, channel, noise, decoder, and receiver (Shannon, 1948) Each concept plays an important role in the delivery of information whether it’s humans talking to one another, humans listening to the radio or watching television, or other species communicating with each other. We will look at the concepts of the theory and how they impact communication and healthcare informatics.

Key Concepts of Shannon-Weaver Information Theory

Basic communication can be observed among the animal kingdom every day. One animal transmits some type of encoded information to another animal, and once the message is received, some action or reaction must occur. That’s communication at its core: the sharing of information. “Information is encoded into a signal by one individual. When received by another animal, the information undergoes decoding while still retaining a specifiable relationship to the encoded information” (Owren, 2010). While the Shannon-Weaver theory’s application initially dealt with phone lines and their transmission capability, it came to be applied to communication and the delivery of information. Basically, the idea is that an event can “carry” information, or signals, about another event. These signals can then be informative because they allow the receiver to draw conclusions about the environment around them. Of course, humans are intentional with language because they take various factors about their listeners into account when speaking, so their communication is more effective than members of the animal kingdom who do not possess that capability.

As we continue to navigate the 21st century, we must realize we are living in a wondrous time with seemingly unlimited possibilties, especially when it comes to communication. Today, we can access information faster, anytime we choose, and in just about any medium we choose. Perhaps we are now in the Communication Age – a new era with unlimited potential for what communication can do. Communications impacts all aspects of our lives, every day. The study of communications encompasses all features of a communication system, including its technical, personal, social, and organizational forms. Models are important tools for studying communication (Al-Fedaghi, 2012).

In fact, the Shannon-Weaver model is the most commonly used communications model for technical information, even though it’s not really a model of communication. Actually, it is a model for the flow of information through a medium. When dealing with data transmission, you have to know something about format and type of data being transferred. The sender and receiver also must use the same format for proper transmission of the data.

Shannon used entropy, or degree of disorder or randomness, to explain and mesaure the technical amount of information in a message. The amount of information in a message is measured by the extent to which the message decreases the entropy. (Staggers, 2018). The unit of measure is a bit and is represented by a zero (0) or a one (1). Ultimately, computer codes were built on the concept of bits of information.

The measure can be used by a communications engineer to consider how a message should be encoded in order to be transmitted electronically (Wise, 2012). Symbols need to be represented by a code and the more symbols there are, the longer the code will be. However, the measure doesn’t account for two factors: are the symbols correct, and do they have any meaning. So, based on entropy, different messages can have the same information content simply because they contain the exact same same symbols. For example: the dog is brown and ogt bis rhw eon. The second message has no meaning at all, but based on the coding and assigning value, they are considered to have the same content. Thus the need to verify data for accuracy, as well as clear meaning.

Application of Shannon-Weaver Model

Weaver added the interpretation for understanding semantics in messaging. He used Shannon’s theory to explain the correlation to interpersonal communications. If someone is sharing information that is unfamiliar or unknown to the other person, then the problem is with the method of delivery. If the person hearing the message has hearing challenges, then the issue is with the receiver (the person’s ear) rather than the message itself.

Mistakes do occur in communications. Speakers make errors quite often, but how much impact should those errors have on the interactions between parties in the conversation? It depends on how the parties involved cope with those errors. Errors can happen with the choice of the message or in how the signals are generated. Sometimes, communication only occurs one way: from speaker to addressee, with no feedback loop. That means the hearer has to decide on the meaning or take action. Clarification requests are a kind of feedback which allows the addressee to communicate that he did not fully understand the utterance (Benz, 2012). If communication models would allow for more interactions, then we can assume that the speaker and hearer can observe the outcome and adjust as needed.

What we need to be concerned with is errors that occur when sharing information concerning a patient’s health, medications, procedures, etc. Shannon’s original work acknowledged that errors happen when one symbol is transmitted but a different one was supposed to be used. This situation be dealt with, but only with additional information to help detect the errors. So, error will result in more information being transmitted and thereby result in additional disorder or randomness (entropy).

Importance of Health Literacy

Health literacy is an important component to improved health and patients’ use of health systems. A study done in 2017 with health literacy leaders in the areas of academics, clinical, education, and administration found that most problems with health literacy had to do with the message and the system components, followed by communication tools and action (Kim, 2017). This suggests that there is a definite need for improved delivery of health information and additional education to build literacy skills. While the need for improvement is being acknowledged, medical experts have not truly weighed in with their opinions about health literacy in general. Additionally, they are not voicing their concerns about their patients’ needs as opposed to what is being offered. Providers must take an active role in advocating for improved health literacy for their patients. This partnership can have positive impacts on patient outcomes and overall health, as well as positive impacts for providers who will see an increase in reimbursements from CMS.

The message is central to improving health literacy, so it is the first step in defining what health literacy is today. Not just the words, but the nature of the message, the quality of the information, and how it is designed for delivery are vitally important to these efforts.

Equally important is whether or not the patients understand the information being shared. Per the Shannon-Weaver model, we have to factor in noise in the communication process and whether it will influence the capacity to receive the information. This is the next step in defining and developing health literacy: an individual’s capacity to understand and act on information they have received that emphasizes information-based action. (Jeesun Kim, 2017).

Conclusion

Finally, we must also consider the attributes of the systems when we are defining health literacy. As the need for interactive communicaiton tools increases, that is a huge factor in the increase and development of health literacy. The correct channel is a huge part of the communication process. There is an increase in the growth of “online health seekers” as noted in a 2013 study by Fox & Duggan. They found that 72% of Internet users seek health information online. We must meet the patients’ needs where they are in the presentation and delivery of their health information.

References

1. Al-Fedaghi, S. (2012). A Conceptual Foundation for the Shannon-Weaver Model of Communication. International Journal of Soft Computing.
2. Benz, A. (2012). Errors in Pragmatics. Journal of Logic, Language, and Information: The Interplay Between the Speaker's and the Hearer's Perspective. Vol. 21, No. 1, 97-116.
3. Jeesun Kim, Y. L. (2017). What's in a Name? Health Literacy Leaders Say Plenty! Howard Journal of Comunications, Vol. 28, No. 3, 234-248.
4. Michael J. Owren, D. R. (2010). Redfining animal signaling; influence versus information in communication. Biology Philosophy, Vol, 25, 755-780.
5. Shannon, C. E. (1948, February 13). A Mathematical Theory of Communication. The Bell System Technical Journal, 379-423, 623-656. Retrieved from ResearchGate: https://www.researchgate.net
6. Staggers, R. N. (2018). Health Informatics An Interprofessional Approach. St. Louis, MO: Elsevier, Inc.
7. Wise, S. (2012). Information entropy as a measure of DEM quality. Computers & Geosciences, Vol. 48, 102-110.