Chris R. Sawyer
Communication scholarship has profited greatly by the rise of social science during the mid-20th century. This scientific progress has been marked by increased outlets for peer-reviewed research, thriving sub-disciplines, and a rapidly accumulating corpus of findings. Social scientists have accomplished this feat largely by conducting tests of empirical models and their associated constructs. Over the same span of time, the discipline’s most prolific researcher, James C. McCroskey, pioneered the study of the construct with which he is most closely associated. Communication apprehension (CA) has impelled generations of scholars to investigate possibly the greatest impediment to successful communication, namely the fear of interacting with fellow humans. Tracing its development reveals that CA meets the standards for theory bridges: truth, abstraction, progress, and applicability. Consequently, describing CA as a bridge construct rests on four interrelated claims. First, the primary aim of CA research is to discover the truth about social anxiety. Studies of CA have outstripped competitor explanations for speaker anxiety by yielding an extensive literature of peer-reviewed articles, books, and doctoral dissertations. These writings are predicated on the presumption that CA taps into the true nature of social anxiety. Second, self-reported measures of CA, such as the PRCA-24, allow for enough abstraction to support scientific generalization. This makes it possible for CA researchers to connect concrete observations to abstract principles. Third, CA research contributes to scientific progress in communication. Explanations for CA have generally reflected theories and perspectives at the horizon of the field. Last, CA research impacts on the quality of everyday life. Ultimately, CA researchers seek to develop treatment and educational strategies for the one-fifth of the general population afflicted with this condition. Taken together, CA has served as a bridge construct that enables scholars to pursue truth, formulate testable generalizations, achieve scientific progress, and potentially improve the quality of human life.
E. Ann Kaplan and Sally Chivers
Age discrimination, long habitual internationally, is now developing into age panic as longevity becomes the norm. People are increasingly living through their 80s and 90s, threatening social systems—not just health care, but also education, transportation, and economics. A by-product of longevity is Alzheimer’s disease (AD) or dementia more broadly, and this the focus of our essay. Five million people in the United States (the greater part women) currently have Alzheimer’s or dementia, and the figure is projected to grow exponentially as the baby boom generation ages. Fear, and other powerful affects, are generated in the aging Eurocentric public through overwhelmingly negative images of dementia. Prominent circulating AD images portray white, middle-class women and men; they are typically cared for by heroic family members, with the occasional, backgrounded appearances of racialized care workers. Such discourses betray a noticeable ageism, together with gendering, racialization, and medicalization of the illness. The reification of neuroscience studies of AD perpetuates understanding of AD subjects as having lost their subjectivity and as a burden to health-care systems. As the politics of care becomes ever more fraught with the increase in numbers of diagnosed elderly people, media discourses take on particular significance. Largely negative, images have obvious implications for long-term care in discourse and in practice. Since improving care depends on how the AD subject is visualized and conceptualized, critical analyses of works dealing with age panic, and especially how it arises in relation to cultural understandings of dementia, are essential. Critiques by humanists and psychologists may contribute to improving care of AD subjects, both in long-term facilities and “in place.” Improved care can contribute to transforming the popular understanding of a dementia crisis, thus addressing the central impetus of age panic. Meanwhile, new films, fiction, memoirs, and graphic arts projects are powerful complements to psychological studies aimed at developing new ways of seeing AD subjects.
Maria K. Venetis
The degree to which patients are active and communicative in interactions with medical providers has changed in recent decades. The biomedical model, a model that minimizes patient agency in the medical interaction, is being replaced with a model of patient-centered care, an approach that prioritizes the individual patient in their healthcare and treatment decisions. Tenets of patient-centered care support that patients must be understood within their psychosocial and cultural preferences, should have the freedom to ask questions, and are encouraged to disclose health-relevant information. In short, this model promotes patient involvement in medical conversations and treatment decision-making. Research continues to examine approaches to effective patient-centered communication. Two interpersonal processes that promote patient-centered communication are patient question-asking and patient disclosure. Patient question-asking and disclosure serve to inform medical providers of patient preferences, hesitations, and information needs. Individuals, including patients, make decisions to pursue or disclose information. Patients are mindful that the act of asking questions or disclosing information, particularly stigmatized information such as sexual behavior or drug use, could make them vulnerable to perceived negative provider evaluations or responses. Thus, decisions to ask questions or share information, processes essential to the understanding of patient perspectives and concerns, may be challenging for patients. Various theoretical models explain how individuals consider if they will perform actions such as seeking or disclosing information. Research also explains the barriers that patients experience in asking questions or disclosing relevant health information to providers. A review of pertinent research offers suggestions to aid in facilitating improved patient-centered communication and care.
Jada G. Hamilton, Jennifer L. Hay, and Colleen M. McBride
It was expected that personalized risk information generated by genetic discovery would motivate risk-reducing behaviors. However, though research in this field is relatively limited, most studies have found no evidence of strong negative nor positive psychological or behavioral influences of providing genetic information to improve individual health behaviors. As noted by systematic reviews and agenda-setting commentaries, these null findings may be due to numerous weaknesses in the research approaches taken to date. These include issues related to study samples and design, as well as the motivational potency of risk communications. Moreover, agenda-setting commentaries have suggested areas for improvement, calling for expanded consideration of health outcomes beyond health behaviors to include information exchange and information-seeking outcomes and to consider these influences at the interpersonal and population levels.
A new generation of research is adopting these recommendations. For example, there is a growing number of studies that are using communication theory to inform the selection of potential moderating factors and their effects on outcomes in understanding interpersonal effects of shared genetic risk. Researchers are taking advantage of natural social experiments to assess the general public’s understanding of genetics and inform approaches to improve their facility with the information. Additionally, there are examples of risk communication approaches addressing the complexity of genetic and environmental contributors to health outcomes. Although the pace of this translation research continues to lag behind genetic discovery research, there are numerous opportunities for future communications research to consider how emerging genomic discovery might be applied in the context of health promotion and disease prevention.
Joyce Lamerichs and Wyke Stommel
There is a need to focus on research conducted on online talk about mental health in the domains of ethnomethodology, Conversation Analysis (CA), Discursive Psychology (DP), and Membership Categorization Analysis (MCA). We use the notion of “talk” in this article, as opposed to what could be considered a more common term such as “discourse,” to highlight that we approach computer-mediated discourse as inherently interactional. It is recipient designed and unfolds sequentially, responding to messages that have come before and building a context for messages that are constructed next. We will refer to the above domains that all share this view as CA(-related) approaches.
A characterizing feature of interactional approaches to online mental health talk is their focus on in-depth analyses of relatively small amounts of data. With this focus at the center of their attention, they sit in the wider field of Discourse Analysis (DA), or Computer-Mediated Discourse Analysis (CMDA) who use language as their lens to understand human interaction. DA and CMDA research include a much wider set of both micro- and macro-analytic language-focused approaches to capture online discourse. Of all the CA(-related) work on online materials, a disproportionally large number of studies appear to deal with (mental) health talk.
We aim to answer the question what the field of research on online mental health talk has yielded in terms of findings and methodologies. Centrally, CA (-related) studies of online mental health talk have aimed to grasp the actions people accomplish and the identities they invoke when they address their health concerns. Examples of actions in online mental health talk in particular are presenting oneself, describing a problem, or offering advice. Relevant questions for the above approaches that consider language-as-social-action are how these different actions are brought off and how they are received, by closely examining contributions such as e-mail and chat postings and their subsequent responses.
With a focus on talk about mental health, this article will cover studies of online support groups (OSGs, also called online communities), and interaction in online counseling programs, mainly via online chat sessions.
This article is organized as follows. In the historiography, we present an overview of CA(-related) work on online mental health talk. We discuss findings from studies of online support groups (OSGs) first and then move to results from studies on online counseling. The start of our historiography section, however, sets out to briefly highlight how the Internet may offer several particularly attractive features for those with mental health problems or a mental illness.
After the historiography, we discuss what an interactional approach of online mental health talk looks like and focuses on. We offer examples of empirical studies to illustrate how written contributions to a forum, and e-mails or chat posts that are part of online counseling sessions are examined as interaction and which types of findings this results in. We conclude with a review of methodological issues that pertain to the field, address the most important ethical considerations that come into play when examining online mental health talk, and will lastly highlight some areas for future research.
Monique Mitchell Turner
Shame and guilt are distinct emotional experiences that are often confused by lay people as similar. Yet, shame and guilt are aroused by distinct cognitive appraisals and lead to distinct emotional, cognitive, and behavioral outcomes. There are distinctions between shame and guilt in psychology and communication. Differences are correlated with personality and individual proneness for shame and/or guilt.
Brenda L. Berkelaar and LaRae Tronstad
How people negotiate the work–life interface remains a popular topic for scholars and the public. Work–life research is a large body of interdisciplinary scholarship that considers how people experience, navigate, and negotiate different roles, commitments, and boundaries within and across life domains—often with the goal of improving individual, organizational, and social well-being and success. Spurred by demographic, social, economic, and technological changes, scholars take difference perspectives on overlapping research areas which include work–life balance, work–life conflict, work–family conflict, boundary management, work–life enrichment or facilitation, as well as positive or negative spillover. Key issues addressed include the implications of framing work–life as a dichotomy, drivers of work–life outcomes, how ideals shape work–life negotiations, how individuals negotiate everyday work–life challenges and opportunities, and the influence of evolving information and communication technologies on the work–life interface. Research from multiple disciplines highlights the demographic, economic, moral, cultural, and national factors that affect work–life practices, processes, policies, tactics, and outcomes. This multidisciplinary perspective provides relevant insights for generative research and resilient practice for individuals, groups, organizations, or societies.
A Case Study of Sesame Workshop’s Cleaner, Happier, Healthier Intervention in Bangladesh, India, and Nigeria: Reporting on Exposure and Impact
Dina L. G. Borzekowski
The Cleaner, Happier, Healthier hygiene intervention was developed and tested in 2013, featuring the Sesame Workshop characters. Through broadcast television, four public service announcements (PSAs) addressed washing hands with soap, using a latrine, wearing sandals, and drinking clean water. The main audiences were young preschool children and their parents or guardians.
Research occurred in Bangladesh, India, and Nigeria, exploring the reach and impact of these PSAs. Although low percentages, from well-drawn samples of extremely vulnerable populations in these countries, reported awareness and recall of these messages, such percentages can reflect large numbers of viewers. Considering data from the participating children, measures of knowledge and attitudes were associated with engaging in several of the behavioral outcomes. As well, awareness and recall of the PSA messages predicted “all the time” for several of the hygiene behaviors. In contrast, parents’ reports of PSA awareness and recall were not associated with reports of children’s hygiene behaviors.
Conducting reach studies is extremely difficult, especially in developing countries and communities. Despite the challenges, this study is encouraging. Participants reported seeing the messages, and in several models, this “reach” predicted reports of hygiene and health behaviors. Lessons learned from this case study and research can offer valuable insight into the production of future health PSAs, especially with harder-to-reach populations.
Matthew W. Savage, Sarah E. Jones, Jenna E. Reno, and Shari Veil
University students, faculty, and staff are among those most vulnerable to cybersecurity risks due to their reliance on modern technologies, the nature of their online activities, and the open infrastructure of institutional networks. Furthermore, cyberbullying has emerged as a public health concern by the Centers for Disease Control and Prevention (CDC), which first warned of electronic aggression in 2008, or any type of harassment or bullying that occurs via email, chat, instant messaging, websites, blogs, or text messaging. Roberto and Eden emphasized the communicative nature of cyberbullying, defining it as the “deliberate and repeated misuse of communication technology by an individual or group to threaten or harm others” in 2010 (p. 201). In response to serious cybersecurity concerns and growing evidence of cyberbullying behavior, the national Stop.Think.Connect. (STC) campaign was developed to educate Americans on cybersecurity risks and equip citizens with tools for safe, respectful, and appropriate online behavior; however, it lacks targeted messaging for those on university campuses. Formative research is needed to ascertain the specific cybersecurity risks and challenges identified by those living and working on large university campuses. Research by Noar in 2006 demonstrates that formative evaluation leads to more successful campaigns. The process involves learning about target populations, discovering communicative determinants of behavior change, and testing message concepts. To that end, this case study is a first step in targeting STC campaign messages to university students, faculty, and staff. Specifically, we sought to identify the distinct cybersecurity needs faced by university students and personnel, their perceptions of the saliency of the problem, and potential motives for increasing their cybersecurity-enhancing behaviors. These activities are needed to implement the campaign on college campuses and to increase the likelihood of any future outcome evaluation efforts that yield evidence of campaign effectiveness. Currently, we are unaware of any outcome evaluation.
Focus group methodology was conducted to examine the target audiences’ knowledge, interests, needs, and attitudes regarding the management of cybersecurity threats. Additionally, practical recommendations for enhancing STC campaign implementation on university campuses were ascertained. Results emphasized key ways to improve the theoretical underpinnings of the campaign using the Integrated Behavioral Model (IBM). We identified how determinants of behavior change can be utilized to strengthen campaign messaging. Students displayed laissez-faire attitudes toward cybersecurity, while faculty and staff attitudes demonstrated a much higher level of concern. Social norms for personal cybersecurity action taking were notably low among students as well as faculty and staff. Students displayed limited personal agency in regards to enacting cybersecurity measures, while faculty and staff had greater knowledge of steps they could take, but little faith that these actions would be efficacious. Finally, thematic recommendations for implementing an effective cybersecurity campaign on a university campus were identified.
Jen Ptacek, Kirstin N. Dolick, and Marifran Mattson
Advocacy can be defined as the systematic process set in motion by an individual or group of individuals to encourage, support, and empower others surrounding a topic in need of change. Individuals may become an advocacy group in support of an issue, such as health care, civil rights, environment, or labor. Advocacy groups often serve as mediators between vulnerable/underprivileged populations and policymakers or decision-makers. The Health Communication Advocacy Model (HCAM) is a tested advocacy model comprising five phases including assembling the team, formative research, message development, message implementation, and evaluation. HCAM also includes a correction loop allowing for revisions of campaign messages. The HCAM is an adaptable model that offers a perspective in which advocacy groups may be considered a dynamic framework for building successful campaigns. Once the advocacy group is established, members can agree upon goals and responsibilities and craft a position statement. The group can then develop messages to reach the intended target audience(s). Target audiences may include legislators, the population affected by the issue, and media organizations. When crafting messages, care should be taken to ensure messages are stimulating, motivational, culturally consistent, resource contingent, and without barriers. Advocacy groups may use a number of channels to send messages through, such as social media, rallies, press releases, and other media outlets. Overall, advocacy groups must address a variety of needs to effectively reach the target audiences and impact change.