Health service literacy: complementary actor roles for transformative value co-creation

Purpose Although health-care features prominently in transformative service research, there is little to guide service providers on how to improve well-being and social change transformations. This paper aims to explore actor-level interactions in transformative services, proposing that actors' complementary health service literacy roles are fundamental to resource integration and joint value creation. Design/methodology/approach In-depth interviews with 46 primary health-care patients and 11 health-care service providers (HSPs) were conducted focusing on their subjective experiences of health literacy. An iterative hermeneutic approach was used to analyse the textual data linking it with existing theory. Findings Data analysis identified patients' and HSPs' health service literacy roles and corresponding role readiness dimensions. Four propositions are developed describing how these roles influence resource integration processes. Complementary service literacy roles enhance resource integration with outcomes of respect, trust, empowerment and loyalty. Competing service literacy roles lead to outcomes of discredit, frustration, resistance and exit through unsuccessful resource integration. Originality/value Health service literacy roles - linked to actor agency, institutional norms and service processes - provide a nuanced approach to understanding the tensions between patient empowerment trends and service professionals' desire for recognition of their expertise over patient care. Specifically, the authors extend Frow et al.'s (2016) list of co-creation practices with practices that complement actors' service literacy and role readiness. Based on a service perspective, the authors encourage transformative service researchers, service professionals and health service system designers, to recognize complementary health service literacy roles as an opportunity to support patients' resources and facilitate value co-creation.