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Article

Simon Zebregs and Gert-Jan de Bruijn

Meta-analyses are becoming increasingly popular in the field of health and risk communication—meta-analyses allow for more precise estimations of the magnitude of effects and the robustness of those effects across empirical studies in a particular domain. Despite its popularity, most scholars are not trained in the basic methods involved with meta-analyses. There are advantages to meta-analysis in comparison to other forms of research synthesis. An overview of the methods involved in conducting and reporting meta-analytical research is helpful. However, the methods involved with meta-analyses are not as clear-cut as they may first appear. Numerous issues must be considered and various arbitrary decisions are required during the process. These issues and decisions relate to various topics such as inclusion criteria, the selection of sources, quality assessments for eligible studies, and publication bias. Basic knowledge of these issues and decisions is important for interpreting the outcomes of a meta-analysis correctly.

Article

Metaphor equates two concepts or domains of concepts in an A is B form, such that a comparison is implied between the two parts leading to a transfer of features typically associated with B (called source) to A (called target). Metaphor is evident in written, spoken, gestural, and pictorial modalities. It is also present as latent patterns of thought in the form of conceptual mappings between domains of experience called conceptual metaphor. Metaphor is found commonly in a variety of health and risk communication contexts, including public discourse, public understanding and perceptions, medical encounters, and clinical assessment. Often metaphor use is beneficial to achieving desired message effects; however, sometimes its use in a message can lead to unintended undesirable effects. There is a general consensus, although not complete agreement, that metaphors in messages are processed through engagement with corresponding conceptual mappings. This matching process can be taken as a general principle for design of metaphor-based health and risk messages.

Article

People who communicate health and risk information are often trying to determine new and innovative ways to reach members of their target audience. Because of the nearly ubiquitous use of mobile phones among individuals in the United States and the continued proliferation of such devices around the world, communicators have turned to mobile as a possible channel for disseminating health information. Mobile health, often referred to as mHealth, uses mobile and portable devices to communicate information about health and to monitor health issues. Cell phones are one primary form of mHealth, with the use of cell phone features such as text messaging and mobile applications (apps) often used as a way to provide health information and motivation to target audience members. Text messaging, or short message service (SMS), is a convenient form for conveying health information, as most cell phone owners regularly send and receive text messages. mHealth offers benefits over other channels for communicating health information, such as convenience, portability, interactivity, and the ability to personalize or tailor messages. Additionally, mHealth has been found to be effective at changing attitudes and behaviors related to health. Research has found mobile to be a tool useful for promoting healthy attitudes and behaviors related to a number of topic areas, from increased sexual health to decreased alcohol consumption. Literature from health communication and research into mHealth can provide guidance for health communicators looking to develop an effective mHealth intervention or program, but possible concerns related to the use of mobile need to be considered, such as concerns about data security and participant privacy.

Article

Melissa J. Robinson and Silvia Knobloch-Westerwick

In today’s media-saturated environment, individuals may be exposed to hundreds of media messages on a wide variety of topics each day. It is impossible for individuals to attend to every media message, and instead, they engage in the phenomenon of selective exposure, where certain messages are chosen and attended to more often than others. Health communication professionals face challenges in creating messages that can attract the attention of targeted audiences when health messages compete with more entertaining programming. In fact, one of the greatest obstacles for health campaigns is a lack of adequate exposure among targeted recipients. Individuals may avoid health messages completely or counterargue against persuasive attempts to change their health-related attitudes and behaviors. Once individuals have been exposed to a health message, their current mood plays an important role in the processing of health information and decision making. Early research indicated that a positive mood might actually be detrimental to information processing because individuals are more likely to process the information heuristically. However, recent studies countered these results and suggested that individuals in positive moods are more likely to attend to self-relevant health information, with increased recall and greater intent to change their behaviors. Since mood has the ability to influence exposure to health messages and subsequent message processing, it is important for individuals to be able to manage their mood prior to health information exposure and possibly even during exposure. One way individuals can influence their moods is through media use including TV shows, movies, and music. Mood management theory predicts that individuals choose media content to improve and maintain positive moods and examines the mood-impacting characteristics of stimuli that influence individuals’ media selections. Therefore, an individual’s mood plays an important role in selection of any type of communication (e.g., news, documentaries, comedies, video games, or sports). How can health message designers influence individuals’ selection and attention to health messages when negative moods may be blocking overtly persuasive attempts to change behaviors and a preference for entertaining media content? The narrative persuasion research paradigm suggests that embedding health information into entertainment messages may be a more effective method to overcome resistance or counterarguing than traditional forms of health messages (e.g., advertisements or articles). It is evident that mood plays a complex role in message selection and subsequent processing. Future research is necessary to examine the nuances between mood and health information processing including how narratives may maintain positive moods through narrative selection, processing, and subsequent attitude and/or behavior change.

Article

The turn of the 21st century has seen an explosion of frameworks that account for individuals’ decisions to seek or avoid information related to health risks. The four dominant frameworks are Risk Perception Attitude Framework, the Risk Information Seeking and Process model, the Planned Risk Information Seeking Model, and the Theory of Motivated Information Management. A comparison of the constructs within each and an examination of the related empirical tests reveal important insights into (a) factors that have consistently been shown to shape these decisions across these approaches and (b) constructs in need of additional theorizing and empirical testing. Specifically, the analysis suggests that uncertainty, efficacy, affect, risk perceptions, and subjective norms all play crucial roles in accounting for decisions to seek or avoid risk-related information. However, inconsistencies in the direction of influence for uncertainty or information discrepancy, risk perceptions, and negative affect argue for the need for considerably more theoretical clarity and empirical rigor in investigations of the ways in which these experiences shape decision making in these contexts.

Article

Narcissism is a personality trait characterized by perceptions of grandiosity, superiority, and the need for attention and admiration. There has been an increase in focus on examining the development of narcissism and how the trait influences a range of social and health behaviors. A key feature of narcissism is that it is characterized by high self-esteem with a simultaneously fragile ego that requires continual monitoring and manipulation. Therefore, much of the behaviors narcissists engage in are linked to the drive to maintain perceptions of superiority and grandiosity. In the area of health and well-being, narcissism has been positively correlated with psychological health, a relationship that may be accounted for by self-esteem. However, there has been less research on the relationship between narcissism and physical health and well-being. There is some evidence that narcissism is linked to a variety of physical appearance-oriented health behaviors (i.e., behaviors that could affect body weight or other aspects of physical appearance, including eating and exercise). Narcissism has also been positively linked to risk-taking behaviors, including use of substances, as well as risks that could significantly impact others, including sexual behaviors and risky driving. The relationship between narcissism and health is therefore complex, with some positive correlates (e.g., physical activity), but also various health risk behaviors. In considering how narcissism might interact with health messages, communicators have to keep in mind that narcissists seem to have some deficits in judgment and decision-making, such as overconfidence and a narrow focus on rewards associated with behaviors. Their behaviors tend to be driven by managing their own ego and by drawing attention and admiration from others to maintain perceptions of superiority and grandiosity. In turn, health communicators may need to rely on creative strategies that tap into these domains of narcissism in order to effectively modify health behaviors among narcissistic individuals. Further research on the influence of narcissism in healthcare seeking and related preventive behaviors would also help to provide a more detailed understanding for how the trait influences health decisions, information that would be useful for both health researchers and practitioners.

Article

In health and risk communication, evidence is a message feature that can add credibility, realism, and legitimacy to health and risk messages. Evidence is usually defined into two types: statistical or narrative. Statistical evidence employs quantifications of events, places, phenomena, or other facts, while narrative evidence involves stories, anecdotes, cases, or testimonials. While many health and risk messages employ statistical or factual information, narrative evidence holds appeal for health and risk communication for its utility in helping individuals learn their risks and illnesses through stories and personal experiences. In particular, narratives employed as evidence in a health or risk message especially hold value for their ability to communicate experiences and share knowledge, attitudes, beliefs, and ideas about complex health issues, propose behavior change, and assist individuals coping with disease. As a result, the personal experiences shared, whether they are from first-hand knowledge, or recounting another’s experience, can focus attention, enhance comprehension for risks, and recall of health and risk information. Furthermore, readers engage with the story and develop their own emotional responses which may align with the purpose of the health and risk message. Narratives, or stories, can occur in many ways or through various points of view, but the stories that “ring true” to readers often have a sense of temporality, coherence, and fidelity. As a result, formative research and pre-testing of health and risk messages with narratives becomes important to understand individual perceptions related to the health issue and the characters (or points of view). Constructs of perceived similarity, interest, identification, transportation, and engagement are helpful to assess in order to maximize the usefulness and persuasiveness of narratives as evidence within a health and risk message. Additionally, understanding the emotional responses to narratives can also contribute to perceptions of imagery and vividness that can make the narrative appealing to readers. Examining what is a narrative as evidence in health and risk messages, how they are conceptualized and operationalized and used in health and risk messages is needed to understand their effectiveness.

Article

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.

Article

When it comes to health and risk, “place” matters. People who live in lower-income neighborhoods are disproportionately affected by obesity and obesity-related diseases like heart disease, hypertension, and diabetes; asthma; cancers; mental health issues; etc., compared to those that live in higher-income communities. Contributing to these disparities are individual-level factors (e.g., education level, health literacy, healthcare access) and neighborhood-level factors such as the socioeconomic characteristics of the neighborhood; crime, violence, and social disorder; the built environment; and the presence or absence of health-enhancing and health-compromising resources. Social determinants of health—for example, social support, social networks, and social capital—may improve or further complicate health outcomes in low-income neighborhoods. Social support is a type of transaction between two or more people intended to help the recipient in some fashion. For instance, a person can help provide someone who is grieving or dealing with a newly diagnosed health issue by providing emotional support. Informational support may be provided to someone trying to diagnose, manage, and/or treat a health problem. Instrumental support may come in the help of making meals for someone who is ill, running errands for them, or taking them to a doctor’s appointment. Unfortunately, those who may have chronic diseases and require a lot of support or who otherwise do not feel able to provide support may not seek it due to the expectation of reciprocity. Neighborhood features can enable or constrain people from developing social networks that can help provide social support when needed. There are different types of social networks: some can enhance health outcomes, while others may have a more limiting or even a detrimental effect on health. Social capital results in the creation of resources that may or may not improve health outcomes. Communication infrastructure theory offers an opportunity to create theoretically grounded health interventions that consider the social and neighborhood characteristics that influence health outcomes. The theory states that every neighborhood has a communication infrastructure that consists of a neighborhood storytelling network—which includes elements similar to the social determinants of health—embedded in a communication action context that enables or constrains neighborhood storytelling. People who are more engaged in their neighborhood storytelling networks are in a better position to reduce health disparities—for example, to fight to keep clinics open or to clean up environmental waste. The communication action context features are similar to the neighborhood characteristics that influence health outcomes. Communication infrastructure theory may be useful in interventions to address neighborhood health and risk.

Article

Frank Tutzauer and Thomas Hugh Feeley

A network is a collection of nodes that are somehow connected to each other. Typically, the pattern of ties among nodes is of central interest to scholars in communication and the allied social sciences, with particular salience for health and risk communication. Network analyses of patterns of communication began in the 1940s in work done at the Massachusetts Institute of Technology (MIT) and was popularized in the early 1980s in the communication discipline with the work of Everett Rogers, Larry Kincaid, and others. Networks are measured by using self-report or observational procedures to determine the presence and/or strength among nodes in a given structure. If there is a tie or relation between a pair of nodes, it is said that the two are adjacent to one another or that the two nodes are neighbors, and the neighborhood of a node consists of all nodes adjacent to this first node. Several measures describe networks, including measures of position and measures of the entire network. Positional measures consider the position of any given node in relation to others in the network, and centrality is a popular measure to account for one’s level of influence in a network. Density is an overall network measure of level of activity among network pairs. Finally, network measures allow researchers to compare dependent and independent networks. Network analysis represents one of the more powerful and elegant procedures for measuring small-group, organizational, and international communication patterns among nodes or actors of interest in health and risk communication.

Article

Priscila G. Brust-Renck, Julia Nolte, and Valerie F. Reyna

The complexity of numerical information about health risks and benefits places demands on people that many are not prepared to meet. For example, much information about health is communicated numerically, such as treatment risks and effectiveness, lifestyle benefits, and the chances of side effects from medication. However, many people—especially the old, the poor, and the less educated—have difficulty understanding numerical information that would enable them to make informed health decisions. Some evidence also suggests cultural and gender differences (although their causes have been disputed). The ability to use and understand numbers (i.e., numeracy) plays an important role in how information should be displayed and communicated. Measuring differences in numeracy provides a standard to guide one’s approach when communicating risk. Several surveys have been developed to allow for a descriptive assessment of basic and analytical mathematical skills in nationally representative samples (e.g., NAEP, NAAL, PISA, PIACC). Other measures assess specific skills, such as perception of numbers (e.g., number line, approximation, dots tasks), individual perception of one’s own ability (i.e., Subjective Numeracy Scale), and arithmetic computation ability (i.e., Objective Numeracy Scales, Abbreviated Numeracy Scale, and Berlin Numeracy Test). Difficulties associated with low numeracy extend well beyond the inability to understand place value or perform computations. Understanding and remediating low numeracy requires getting below the surface of errors in judgment and decision making to the deeper level of scientific theory. Despite the relevance of numbers in decision making, there is a certain level of disagreement regarding the psychological mechanisms involved in numeracy. Studies show that people have a basic mental representation of numbers in which the discriminability of two magnitudes is a function of their ratio rather than their difference (psychophysical approaches). Numerical reasoning has been identified with quantitative and analytical processes, and such computation is often seen as an accurate and objective way to process information (traditional dual-process approaches as applied to numeracy). However, these approaches do not account for the contradictory evidence that reliance on analysis is not sufficient for many decisions and has been associated with worse performance for some decisions. Studies supporting a more recent dual-process approach—one that accounts for standard and paradoxical effects of numeracy on risk communication—emphasize the role of intuition: this is a kind of advanced thinking that operates on gist representations, which capture qualitative understanding of the meaning of numbers that is relevant in decision making (Fuzzy Trace Theory). According to Fuzzy Trace Theory, people encode both actual numbers (verbatim representations) and qualitative interpretations of their bottom-line meaning (gist representations) but prefer to rely on the qualitative gist representations when possible. Thus, potential difficulties in decision making arising from deficits in numeracy can be resolved through meaningful communication of risk. Creating narratives that emphasize the contextually relevant underlying gist of risk and using methods that convey the meaning behind numeric presentations (e.g., use of appropriate arrays to communicate linear trends, meaningful relations among magnitudes, and inclusion relations among classes) improve understanding and decision making for both numerate and innumerate individuals.

Article

It has been since 1990 that the landmark Nutritional Labeling Education Act (NLEA) was passed in the United States, and since 1969 that the first White House Conference on Food, Nutrition and Health occurred. In the time since these important events, considerable research has been conducted on how U.S. consumers process and use nutritional labeling. An up-to-date review of nutritional labeling research must address key findings on the processing and use of nutrition facts panels (NFPs), restaurant labeling, front-of-pack (FOP) symbols, health and nutrient content claims, new labeling efforts (e.g., for meat products), and claims not regulated by the U.S. Food and Drug Administration (FDA). Message structure mediates the ways in which consumers process nutritional labeling while moderating conditions affect research outcomes associated with labeling efforts. The most recent policy issues and problems to be considered (e.g., by the FDA) include nutritional labeling as well as identifying opportunities for consumer research in helping to promote healthy lifestyles and reducing obesity in the United States and throughout the world. For example, several unanswered research questions remain regarding how the proposed changes to the NFPs—beef, poultry, and seafood labeling; restaurant chain calorie labeling; alternative FOP formats; and regulated and unregulated health and nutrient content claims—will affect consumers. Researchers have yet to examine not only these different labeling and nutrition information formats, but also how they might interact with one another and the role of key moderating conditions (e.g., one’s motivation, ability opportunity to process nutrition information) in affecting consumer processing and behavior.

Article

May O. Lwin, Jerrald Lau, Andrew Z. H. Yee, and Cyndy Au

Populated by a diverse spread of cultures, Southeast Asia is represented by the Association of Southeast Asian Nations (ASEAN), a regional organization comprising some 622 million people in ten countries. While food and beverage labeling policies differ across ASEAN member states, organizations such as the ASEAN Food and Beverage Alliance (AFBA) have pushed for standardization in the interest of facilitating interregional trade. Set against this backdrop of economic growth, nutrition labeling as a means of influencing consumer choices has become a significant area of focus for health authorities and researchers over the past two decades due to rising chronic disease levels within the region’s increasingly urbanized communities. Food retail trends facing Southeast Asia challenge the state of existing regulations governing, as well as research on food labeling practices in the region. Two main points stand out. First, legislation has remained disparate among the ASEAN nations despite repeated calls for standardization by academics as well as other relevant bodies, with only Malaysia adopting mandatory regulations on food labeling and nutritional claims. Second, existing nutrition labeling research in ASEAN is sorely lacking. In addition, there is a lack of theoretical and methodological diversity in existing studies, leading to an incomplete understanding of nutritional label use in Asia and a crucial research gap that remains to be filled.

Article

Responding to health messages about environmental risks and risky behaviors requires adjustments to what individuals do: how they organize and perform occupations, and their understanding of what occupations mean—for themselves and others. Encouraging people to make a change means influencing what they want to do, the possibilities open to them, and societal support and demand for healthful ways of life. Bringing an occupational perspective to the design of risk messages will generate new insights into the complexities of everyday occupations, revealing the dynamic territory into which health messages are targeted. Occupation, or everyday doing, is described as the means by which people experience their very nature, become what they have the potential to be, and sustain a sense of belonging in family, community and society. To influence what people do, designers of health messages are encouraged to consider what engages people in occupations and keeps them engaged; the identity and cultural meanings expressed through occupation; the exhilaration of challenge and risk; the satisfactions of competence and flow experiences that keep people engaged in what they are doing; whether or not people are fit and prepared for the occupations they embark on and what happens when they are not; and the pull of habits and routines, which hold existing patterns of occupation in place. Equally, health message designers need to engage with the occupational science literature, which recognizes how people are shaped toward particular occupations and occupational identities by social policy, institutional practices, and media messages. That means questioning the rhetoric that occupations are freely chosen, rather than shaped and patterned by the historical, sociocultural, political, and geographic context. Simultaneously, health message designers need to recognize that individuals incorporate specific occupations and occupational patterns into their lifestyle and sense of self, believing they have a measure of control over what they do while rationalizing failure to make health-supporting changes.

Article

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.

Article

When individuals are asked whether they will someday own their own home, enjoy a productive career, or develop a myriad of diseases, many are optimistic. Generally, they think they will experience more good than bad outcomes in life and they view themselves as more likely than similar others to experience the good things and less likely than others to experience the bad things. In the area of health behavior and communication, there are three primary types of optimism that have been defined and operationalized: (1) Dispositional optimism is the generalized positive expectancy that one will experience good outcomes. (2) Comparative optimism refers to the belief that one is either more likely than others to experience positive events or less likely than others to experience negative events. (3) Unrealistic optimism refers to an underestimation of one’s actual risk of experiencing some negative event. Although the three types of optimism may be correlated, their associations may be modest. Also, unlike dispositional optimism, which is an individual difference, comparative and unrealistic optimism are often risk perceptions about specific events and therefore can be defined as accurate or inaccurate. For this reason, the latter two types of optimism have sometimes been labeled the optimistic bias. Research on all three varieties of optimism affords opportunities to understand how optimism influences information processing in a health message or one’s behavioral intentions following the message.

Article

Haley Kranstuber Horstman, Alexie Hays, and Ryan Maliski

The parent–child relationship is one of the most influential, important, and meaningful relationships in an individual’s life. The communication between parents and children fuels their bond and functions to socialize children (i.e., gender, career and work, relationship values and skills, and health behaviors), provide social support, show affection, make sense of their life experiences, engage in conflict, manage private information, and create a family communication environment. How parents and children manage these functions changes over time as their relationship adapts over the developmental periods of their lives. Mothers and fathers may also respond differently to the changing needs of their children, given the unique relational cultures that typically exist in mother–child versus father–child relationships. Although research on parent–child communication is vast and thorough, the constant changes faced by families in the 21st century—including more diverse family structures—provides ample avenues for future research on this complex relationship. Parent–child communication in diverse families (e.g., divorced/stepfamilies, adoptive, multiracial, LGBTQ, and military families) must account for the complexity of identities and experiences in these families. Further, changes in society such as advances in technology, the aging population, and differing parenting practices are also transforming the parent–child relationship. Because this relationship is a vital social resource for both parents and children throughout their lives, researchers will undoubtedly continue to seek to understand the complexities of this important family dyad.

Article

Natoshia Askelson and Erica Spies

Parents can be the target of health and risk messages about their children and can be a channel by which children hear health messages. This dual role can make parents powerful agents for change in children’s health. Parents receive health messages from a variety of sources including health care providers, schools, the media, the government, and family. Parents tend to be a more frequent target for health messages when their children are infants or young. They receive many messages related to keeping their children safe. Most of these messages are not developed as part of a rigorous data-driven and theory-based intervention and often lack sophisticated message development and design. Furthermore, instead of segmenting parents and tailoring messages, parents are frequently treated as a monolith, with no diversity related to behavior or communication. As children age, parents can become the channel by which children can hear a health message. Parents of school-age children and adolescents are continually communicating messages to their children and are often targeted to communicate messages related to health or risk behaviors. Intentional efforts to encourage parents to talk to their children are often related to risk behaviors among older children. Specifically, parents are asked to convey messages about sexual health, alcohol and drug use, and driving. Evidence points to parent–child communication in general and communication about specific risk behaviors as protective for children. Research has also suggested that adolescents want to hear health messages from their parents. Parents are a natural choice to communicate about health and risk throughout childhood and adolescence due to the parent–child relationship and the influence parents can have over children. However, this special relationship does not automatically translate into parents having good communication skills. Messages designed to encourage parents to communicate with their children about a health topic have often been developed with the assumption that parents know what to communicate and how to effectively communicate with their children. Deficits in communication skills among parents have been recognized by some campaign developers, and an emphasis on developing those skills has been a significant part of some messages targeting parents. Health communication campaigns have been developed to inform parents about when and how to talk to their children about health issues such as alcohol, drugs, and sex. Unfortunately, not all parent–child communication is positive or effective and this can have potential unintended consequences. Treating parents as an audience in a more nuanced manner, with greater emphasis on evidence-based message development, could result in more effective messages and better health outcomes.

Article

William Mosley-Jensen and Edward Panetta

Health professionals and the public puzzle through new or controversial issues by deploying patterns of reasoning that are found in a variety of social contexts. While particular issues and vocabulary may require field specific training, the patterns of reasoning used by health advocates and authors reflect rhetorical forms found in society at large. The choices made by speakers often impact the types of evidence used in constructing an argument. For scholars interested in issues of policy, attending to the construction of arguments and the dominant cultural modes of reasoning can help expand the understanding of a persuasive argument in a health context. Argumentation scholars have been attentive to the patterns of reasoning for centuries. Deductive and inductive reasoning have been the most widely studied patterns in the disciplines of communication, philosophy, and psychology. The choice of reasoning, from generalization to specific case or from specific case to generalization, is often portrayed as an exclusive one. The classical pattern of deductive reasoning is the syllogism. Since its introduction to the field of communication in 1957, the Toulmin model has been the most impactful device used by critics to map inductive reasoning. Both deductive and inductive modes of argumentative reasoning draw upon implicit, explicit, and affective reasoning. While the traditional study of reasoning focused on the individual choice of a pattern of reasoning to represent a claim, in the last 40 years, there has been increasing attention to social deliberative reasoning in the field of communication. The study of social (public) deliberative reasoning allows argument scholars to trace patterns of argument that explain policy decisions that can, in some cases, exclude some rhetorical voices in public controversies, including matters of health and welfare.

Article

Nancy Grant Harrington

The study of persuasive health messages—their design, dissemination, and impact—is ubiquitous in the communication discipline. Words, sounds, and images—alone or in combination—can move people to change their minds and their bodies. Micro-level topics surround questions of message content (argumentation scheme, evidence, qualifying language, and figurative language), structure (message sidedness, standpoint articulation, inoculation, and sequential strategies), and format (channel and audiovisual effects). Macro-level topics in this area include message sensation value, narrative, framing, emotional appeals, and tailoring. Central theoretical frameworks used to guide message design research, include health behavior change theories, information processing theories, and theories/frameworks for message design. In addition, some of the methodoligical issues inherent in message design research are questions of analysis, validity, and measurement. Four streams of past scholarship that inform persuasive health message design research: Greek rhetoric, mass communication research begun during World War II, the development of health communication as a research focus within the communication discipline, and the development of computer and telecommunications technology. Directions and challenges for future research include the need for a clear, coherent, and comprehensive taxonomy to classify message characteristics and attention to several methodological issues.