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Few concerns in critical-cultural approaches to communication intersect with as many adjacent fields of inquiry as does “space.” To talk about space is to share a conversation with philosophers (Henri Lefebvre, Michel Foucault, Gilles Deleuze, Edward Casey, Bruno Latour, Manuel DeLanda), critical geographers (Derek Gregory, David Harvey, Edward Soja, Doreen Massey), historians (Fernand Braudel, Michel de Certeau), sociologists (Pierre Bourdieu, Lewis Mumford, Jane Jacobs), literary and cultural theorists (Fredric Jameson, Meaghan Morris, Tony Bennett, Lawrence Grossberg, Timothy Morton), media ecologists (Harold Innis, Marshall McLuhan, Walter Ong, James Carey), political theorists (Jane Bennett, Nigel Thrift), and rhetoricians (Carole Blair, Greg Dickinson, Joan Faber McAlister, Jenny Rice, Nathaniel Rivers, Thomas Rickert). To talk about space is thus to talk with a plenitude of others about a plenitude of social practices, landscapes, mediums, objects, and configurations, but at bottom a concern with space is a concern with the kinds and qualities of relations between and among bodies and things. To be concerned with space is to be invested in the emergent scenery of arrangement, how groupings of bodies come to assume particular shapes and orderings and not others. The “how” question, in turn, is the question of communication as it leads to issues of influence and pressure: of the historical processes that shape our habits and modes of persuasion and constellations of power. Communication and space converge where the “how” of influence meets the “where” of historical emergence. While we have always lived and acted in importantly spatial ways, however, the critical-spatial consciousness that pervades the humanities today is itself a recent historical emergence.
Joan Faber McAlister
The phrase “space in rhetorical theory” refers to scholarship that explores the relationships between place and persuasion, location and identity, and/or spatial dimensions of communication and communicative functions of spaces. These relationships have been theorized in a wide variety of ways, from classical conceptions of topos and the agora to recent work on new materialist and mobile rhetorics. Key themes in this research have included (1) settings where rhetoric takes place, (2) spatial metaphors for theorizing rhetoric, (3) rhetorical representations of public places, (4) the role of place in identity, (5) spatial aspects of rhetoric, (6) rhetorical functions of space, and (7) spatial-temporal-material relations.
Rhetorical scholarship on such topics has been shaped by metadisciplinary movements, such as the visual, spatial, and affective “turns” in the humanities and social sciences. Rhetoricians of space have drawn on and contributed to widespread interest in public memory, mobile technologies, national borders, environmental communication, and global flows of capital and labor and tourism. Researchers in this arena of rhetorical studies have also addressed problems taken up by critical/cultural theorists more recently, including collective agency, posthuman subjectivity, and animate matter—each of which poses challenges to conventional distinctions between subjects (as individual human rational actors) and objects (as lifeless things to be acted upon). Reconsidering these categories is important when conceptualizing place-making processes and the forces exerted by living landscapes. In pursuing these topics and questions, rhetorical theorists have contributed to conversations among researchers in multiple areas of specialty within communication studies. Such research also engaged themes of interest to scholars of cultural geography, urban planning, gender and sexuality studies, literary criticism, environmental science, and additional diverse disciplines as well as interdisciplinary movements.
Communication scholars studying precarity, mobility, and other evolving topics are generating promising new contributions to conversations on space and rhetoric each year. However, essential insights regarding space and rhetorical theory are still being mined from postcolonial/decolonial, critical race, feminist, and queer approaches that many critics argue are insufficiently incorporated into the rhetorical theories of space or spatial theories of rhetoric most often applied and taught.
Michael Chouinard and Daniel Cronn-Mills
The words speech and debate hold a variety of connotations. For some, they refer to the dissemination or exchange of ideas in a general sense, while others will be more familiar with speech and debate as co-curricular activities, commonly referred to using the umbrella term forensics. Not to be confused with the modern understanding of forensic science, the term forensics stems from the Latin forensis, which relates to assembly in public forums. Forensic programs can be found at a broad range of secondary and post-secondary institutions. Students prepare speeches, performances, or arguments for tournaments where they can win individual and team awards. Despite the individual nature of many speech and debate events, teams play a vital role in forensics. In fact, numerous studies have indicated critical thinking is a necessary component to succeed in our fast-paced society. According to Allen, Berkowitz, Hunt, and Louden, education in communication enhances critical thinking by 44%. Forensics involvement is the activity most identified for advancing critical thinking abilities. Both in and out of competition, team membership is widely understood to be a key component of forensic participation.
In many ways, speech and debate serve as laboratories for the study of small groups. For scholars of group dynamics and intergroup communication, forensics provides a plethora of avenues for exploration, related to such key group concepts as integration, group identity, team culture, conflict management, leadership, administration, and competition. The competitive nature of forensics plays a vital role in shaping the activity, and contributes to a unique opportunity for the study of groups. While some scholars (such as Burnett, Brand, Meister, Wood, and Rowland-Morin) perceive tension between the competitive and educational objectives of the activity, others remain adamant that much education comes through competition, and as such, the two are harmonious rather than dissonant ideals. Both philosophies acknowledge the important role of competition in forensics. For scholars of group communication, the features of competitive speech and debate teams make them unique and insightful subjects for examination.
The spiral of silence theory provides insight into the ways in which perceptions of public opinion can lead to changes in opinion expression behavior. Conceptualized in a political communication context, the central claim of the theory is that individuals’ fear of social isolation motivates them to continuously evaluate the climate of opinion through both experiences with the media and interpersonal communication. Upon assessment, individuals either find themselves in a situation where their opinion aligns with the majority or minority. Accordingly, those who find their opinion does not align with the dominant opinion are likely to conceal their opinions while those who find their opinion aligns with the majority are more likely to express them.
Empirical research testing the spiral of silence theory has predominately focused on measurement of focal variables and methods of empirical testing. Advances have been made in regard to micro-level factors, such as creating universally applicable measures of psychological attributes. However, limited work has explored macro-level factors, such as appropriateness of issues, application to computer-mediated communication environments, and tools used to identify circumstances vulnerable to spiral of silence effects. Nonetheless, the practical value of the spiral of silence theory for health and risk communicators can be utilized by modifying campaign efforts to anticipate and counteract fluxes in public opinion.
Andrew C. Billings and Fei Qiao
Sports are often the source of our greatest—and clearest—group affiliations; yet, sports are often the most evident examples of outgroup derogation as well through the magnification of differences with rivals and opposing teams. The formation and fusion of sport-based groups explore the core internal issues of leadership and followership as well as issues such as hazing, fanship, and the psychology of difference. The concepts of Basking in Reflected Glory (BIRGing) and Cutting Off Reflected Failure (CORFing), as embodied within sporting circumstances, can be understood using social identity theory and self-categorization as a lens of examination. Moreover, there are many ways in which sport-based groups inform societal structures that are interpersonal, intergroup, and global in nature, along with the theoretical and applied implications of such structures.
Sports journalism is a popular area of contemporary media that has a long history of delivering results, analysis, and opinion to both broad and specialized audiences. Like other media, it has had to adapt consistently with technological developments and demands but continues to gain widespread coverage across print, broadcast, and digital platforms. Sports journalism has often been viewed as “the toy department,” a place of trivial pursuits instead of the chasing of hard news. As a result, its journalists are viewed as having low professionalism and status and are often accused of being controlled by sources. What these criticisms overlook is the value of this significant subfield in relation to the amount of sports content produced across media, the large numbers of journalists involved in producing the news, and its power in attracting readers and viewers. These elements combine to make sports journalism a rich area for academic scholarship. However, in comparison with its place in newsrooms, this topic has also been criticized in research and has not been treated as seriously as a space for scholarship. While there have been recent increases in scholarly work, sport has been described as an underresearched area of the journalistic field.
The field’s literature has streams dedicated to practical, instructional texts and scholarly analysis of contemporary and historical issues. Key areas of investigation involve content within the sports pages, which can involve as much as 30% of editorial material in a media publication, and work exploring the perceptions, routines, and practices of sports journalists. The role of the sports journalist has also been examined, with descriptions often focusing on a tendency to operate as cheerleaders with a home-team bias. However, the position of sports journalist also involves aspects of critical, watchdog-style coverage, including through investigative reporting. Much of the academic work involving sports journalism has been descriptive in scope, which leaves space for greater analysis through a theoretical lens. An important future topic of research is the increasing commercialization of sport, which has implications for journalists, publications, and audiences.
Persuasive messages use statistical evidence in order to convince an audience to accept a conclusion. Statistical evidence represents a compilation of experiences structured and collected in a manner that permits expression in mathematical form. Research demonstrates that the use of statistical evidence increases the persuasiveness of a message, and a message that uses both statistical and narrative evidence generates the greatest persuasiveness.
Statistical evidence can take the form of summarizing the collective opinion of experts on a topic or an expression of the collective set of experiences. The challenge becomes gaining acceptance of statistical expressions of experience versus what is perceived as the narrative or lived experience of the single person. Statistical evidence is often presented using a mathematical expression to indicate the size or force of the evidence.
The accumulation of statistical evidence often involves the use of meta-analysis to reduce Type I (false positive) and Type II (false negative) error. The use of evidence is strategic and can target specific elements of belief by understanding the structure of beliefs and the connectivity among elements. The use of the Subjective Probability Model provides a means to capitalize on the use of evidence by changing probabilities in beliefs to increase the effectiveness of a message campaign.
Statistical evidence, however, may be ineffective under circumstances referred to as the “base-rate fallacy.” The base-rate fallacy occurs when the presentation of statistical information is accepted, but examples are used that contradict the base-rate. The impact of the use of the example is to create a shift in the belief in the typicality of the example, despite knowledge of the base-rate.
Fear appeals provide a particularly useful and important application of statistical evidence in the pursuit of public health campaigns. The tenets of the Extended Parallel Processing Model indicate that message effectiveness relies on a combination of: (a) perceived severity of the threat, (b) perceived vulnerability to the threat, (c) perceived efficacy of the solution, and (d) perceived personal efficacy of the solution. Each element is largely impacted by the application and use of statistical information to make claims. The use of statistics generally outlines the argument and supports the conclusion offered in support of a conclusion offered to the message recipient.
Statistical evidence when used in a message often offers data or information that becomes the justification for a conclusion. A large part of a message becomes gaining acceptance of information by an audience, then explaining (reasoning) to the audience how those facts support a conclusion, often involving some type of recommendation for behavior. Understanding statistical evidence requires understanding how the material functions within the context of the belief system of the individual.
Rachel A. Smith, Xun Zhu, and Madisen Quesnell
Stigmas are profoundly negative stereotypes of a social group and its members that have diffused and normalized throughout a community. Being marked as a member of a stigmatized group does more than designate someone as different: stigmas denote people as discredited, devalued, and disgraced. Stigmas shape health and risk communication and are considered the leading—but least understood—barrier to health promotion.
Communication and stigmas are dynamically connected. Communication is critical to a stigma’s existence, spread, expression, coping, and elimination. Using mediated and interpersonal communication, community members are socialized to recognize and react to stigmatized people. People use communication to enact the devaluation and ostracism of stigmatized people, and stigmatized people use communication to cope with stigmatization. Stigmas also shape communication: stigmas compel non-marked persons to engage in stigmatization and ostracism of marked persons, reduce marked people’s disclosure and encourage secrecy, and shape the characteristics of personal and community networks. Last, campaigns have used communication to attempt to eliminate existing stigmas. The accumulating research, conducted from diverse assumptions about human behavior (cultural determinism, evolutionary, socio-functional), shows how easily and effectively stigmas may be socialized; how challenging they are to manage; how many facets of health and wellbeing are devastated by their existence; and how difficult it is to attenuate them.
While much has been uncovered about stigma, health, and risk, many questions remain. Among these include: How can one design messages that effectively alert the general public about imminent health threats and that successfully promote desirable behavioral changes without evoking stigma processes? How do different reactions to stigmatization influence targets and their social networks? What factors increase resistance or vulnerability to messages containing stigma-inducing content? How can one create an effective, reliable means to eliminate existing stigmas?
Joel Iverson, Tomeka Robinson, and Steven J. Venette
Risk can be defined using a mathematical formula—probability multiplied by consequences. An essential element of risk communication is a focus on messages within organizations. However, many health-related risks such as Ebola extend beyond an individual organization and risk is better understood as a social construction cogenerated within and between systems. Therefore, the process is influenced by systemic and supra-systemic values and predilections. Risk from a structurational perspective allows an understanding of the public as well as organizational responses to risk. Structuration theory provides a useful lens to move beyond seeing organizations as something that flows within an organization to understanding how organizations are enacted through communication. Structuration theory articulates the connections between systems and structures through the action of agents, whose practices produce and reproduce the rules and resources of social life. Within the structuration tradition, organizational communication scholars have shifted to an understanding of the communicative constitution of organizations (CCO). Specifically, one of the theories of CCO is the Four Flows Model. The four flows highlight the ways people enact organizations and provide a means to analyze the various ways communication constitutes organizations. The four flows are membership negotiation, activity coordination, reflexive self-structuring, and institutional positioning. Membership negotiation enacts the inner members and outsiders at a basic level including socialization, identity, and assimilation. Activity coordination produces collective action around a specific goal. Reflexive self-structuring is the decentralized enactment of structures for the organization through the communication of policies. Institutional positioning covers the macro-level actions where people in the organization act as an entity within the environment.
When considering the public reaction to Ebola, a simple way to evaluate risk perception is the intersection of dread and control. The U.S. public considered Ebola a serious risk. From a structuration perspective, the viral nature of twitter, media coverage, and public discussion generated resources for fear to be exacerbated. Structuration theory allows us to position the risk beliefs as rules and resources that are reproduced through discourse. The organizational implications fall primarily into the two flows of institutional positioning and reflexive self-structuring. For institutional positioning, U.S. healthcare organizations faced general public dread and perceived lack of control. Within the United States multiple policies and procedures were changed, thus fulfilling the second flow of organizational self-structuring. The Ebola risk had a significant impact on the communicative constitution of health-care organizations in the United States and beyond. Overall, risk is communicatively constituted, as are organizations. The interplay between risk and health-care organizations is evident through the analysis of American cases of Ebola. Structuration theory provides a means for exploring and understanding the communicative nature of risk and situates that risk within the larger systems of organizations.
Stuart Hall was a Jamaican-born, British-based theorist, critic, and activist, who flourished between the late 1950s and his death in 2014. Known both for his theoretical and empirical work on culture and communication and for his role as a public intellectual, Hall produced scholarly writings and charismatic teaching that were matched by his columns and interviews in magazines and newspapers and appearances on television and radio.
Substance Abuse Prevention Message Generation: Engaging Adolescents in Health Message Planning and/or Production of Health Promotion Messages
Smita C. Banerjee and Kathryn Greene
Adolescent substance use remains a significant public health challenge, with recent approaches to address these problems including actively engaging adolescents in message planning and/or production as a prevention strategy. There are two benefits of this active involvement strategy. First, engaging adolescents in message planning or producing substance prevention messages is a form of participatory research that results in participant-generated messages for use in future intervention efforts. This participatory form of research is increasingly common in a wide range of topics and populations, particularly disenfranchised or stigmatized groups. It is important to focus on the second benefit of engaging adolescents in message planning and prevention: the effect of engaging in planning or producing substance prevention messages on the adolescents themselves. If done properly, the process of engaging adolescents in planning (or producing) anti-substance messages can provide longer-term benefits of delaying onset of substance use (strengthening resistance) as well as changing patterns for those already using. Some examples of this strategy exist with media literacy, although applied with a great deal of variability. The increased popularity of these planning/production approaches requires greater explication of how, when, and why they produce effects for participants. Two different theoretical perspectives address this active involvement intervention approach: narrative engagement theory and the theory of active involvement. Beyond these theories, sensation seeking is positioned as a moderator to explore for active involvement intervention effects.
Kristin L. Farris and Maureen P. Keeley
Social support in the context of chronic illness management is important, as individuals diagnosed with these conditions and their loved ones often experience increased distress, reduced relational quality, and diminished physical health as a result of coping with these long-term symptoms. Therefore, diagnosed individuals and their close relational partners rely on others to provide support in their time of need. The communication of social support is characterized by “verbal and nonverbal behavior produced with the intention of providing assistance to others perceived of needing that aid” (MacGeorge, Feng, & Burleson, 2011, p. 317). Individuals living with these chronic illnesses and their loved ones often turn to a variety of interpersonal others, including friends, family, health care providers, and support groups to manage the difficulties that accompany their physical symptoms. Although some researchers suggest that diagnosed individuals seek support most frequently from close relational partners, other scholars assert that chronic care support groups (whether meeting face to face or via computer-mediated channels) offer support recipients an opportunity to discuss their challenges and receive help from experientially similar others.
On the one hand, regardless of the support provider, individuals who have been diagnosed with chronic conditions generally perceive effective supportive communication to be messages in which their support providers enact competent tangible assistance in managing the illness, provide an opportunity for them to vent their feelings, and express messages of empathy and affection, among others. Ineffective messages, on the other hand, are those in which diagnosed individuals feel their partners are overly involved in helping them make decisions about their care or portraying negative attitudes or discomfort around them. Overall, research in this area suggests that support recipients and their relational partners have improved emotional, relational, and physical outcomes when they perceive support to be available or receive effective support from these resources.
Current communications research takes up the political and ethical problems posed by new surveillance technologies in public space, ranging from biometric technologies adopted by state security apparatuses to self- and peer-monitoring applications for the consumer market. In addition to studies that examine new surveillance technologies, scholars are tracking intensive and extensive expansions of surveillance in the name of risk management. Much of the scholarship produced in the last 15 years looks at how the establishment and expansion of the Department of Homeland Security within the United States and its international counterparts have dramatically altered security, military, and legal practices and cultures. Within this context what were once science fiction dystopias have become funded research and development projects and institutionalized practices aimed at remote data collection and processing, including facial recognition technology and a variety of remote sensing devices. Private-public partnerships between companies like Google and Homeland Security fusion centers have made it possible to use GPS technology to network data that promises to help manage a variety of natural and man-made disasters.
Armin Scholl and Maja Malik
Observing, describing, and analyzing journalism as part of society requires theories on a macro level. Unlike normative theories, which criticize journalism with respect to its achievements and failures within society, systems theory operates with the concept of function in a non-normative sense. Based on the groundwork of Talcott Parsons’ theory of social systems, Niklas Luhmann developed systems theory further and radicalized it by strictly avoiding any kind of structural conservatism. His approach is built on the assumption that social systems operate autonomously on the basis of the functional differentiation to their environment. Macro-level systems, i.e., societal systems, fulfill unique functions for and within society. Functional autonomy and singularity make a modern society highly efficient but force each system to rely on the functional performances of all other societal systems. Hence, societal systems are structurally coupled and interdependent. Epistemologically, systems do not exist as ontological units but are strictly observer-related, be the observer the system itself or an external observer, such as the scientific community is.
In journalism research, Luhmann’s systems theory has been applied to journalism as a societal system. Several competing approaches with different perspectives on the system observed (journalism, the mass media, or the public sphere) have been developed with respect to identifying the basic characteristics on which the system operates. Despite their differences they have this in common: journalism is not considered the sum of individual journalists and their (individual) way of working, instead, the systems-theoretical perspective is holistic. However, compared to theories of professionalism, which is also a holistic concept, systems theory neither identifies journalism with the profession of journalism, nor commits it to professional journalism. Instead, the structure of journalism is flexible, i.e., functionally equivalent, as long as its function is fulfilled. This function can be specified: journalism provides society periodically with current, independent, factual, and relevant information.
Empirically, systems theory helps defining the population of journalists by deducing it from its function. Unlike mere empirical approaches, which arbitrarily draw samples from an unknown population, it is possible to clearly draw distinctions between journalism and other forms of public communication, such as public relations, advertising, propaganda, or lay communication. Still, it is challenging to operationalize such an abstract theory, as it is not specially made for hypothesis-driven research.
As the use of online technologies has grown in recent years, so has the study of computer-mediated communication.
Online communication began in universities through the use of e-mail. Soon, spaces such as multi-user dungeons (MUDs), Listserv, and bulletin boards were developed, which not only allowed people who knew each other offline to interact but also enabled individuals who were not previously acquainted to communicate via the Internet. The development of Web 2.0, which allowed for more user-generated content, led to new and innovative ways of interacting online, most notably thorough social media sites. Social media sites, such as Facebook and Twitter, allow not only for text-based interaction to occur but also for image- and video-based interaction.
Through all these developments, interactional norms and practices have developed. A key factor in these norms is what the medium enables, or affords, participants to do. Features such as whether an interactional platform is synchronous or asynchronous can impact the nature of the interaction. Similarly, the lack of visual or verbal contact when interacting may impact upon the interaction, through the potential for misunderstandings. Participants do, though, develop practices to suit the medium. If we examine these practices in detail, it is possible to also analyze the role which technology plays in the interaction. One method that has been used to do this is conversation analysis, which was developed for and using spoken interaction. Conversation analysis examines conversation in forensic detail to illuminate the norms and practices through which we conduct our everyday lives. In using this method for analyzing online interaction, we can not only understand the practices but also examine the affordances of particular interactional platforms.
Various interactional features of computer-mediated communication (CMC) have been examined from a conversation analytic perspective, including sequential organization, openings, turn-taking, and repair. A common focus of these studies it to explore the interactional patterns but also to understand how these might be impacted by the technology itself. The development of norms for a variety of forms of technologized interaction demonstrates how individuals are capable of adapting their interactional practices for new contexts.
Allison E. Betus, Michael K. Jablonski, and Anthony F. Lemieux
Terrorism employs violence or the threat of violence to diffuse and amplify messages to an audience beyond the immediate target or victim of an attack. Violent acts initiate media coverage, as well as word-of-mouth transmission, functioning as a gateway that draws attention to the terror group and its messages in a manner that increases the salience of the communication; then media provides additional information contextualizing the original act. Media coverage may make the group initiating the communication look more dangerous or powerful than is warranted.
Terrorist communication strategy involves a noteworthy violent act, or threat thereof, that secondarily communicates with multiple audience groups. One audience may be supporters of the terror group who construct identity from the violent act as well as from grievances that the group seeks to advertise. Another may be outgroups sympathetic with the substance of communicated messages. Still another may be foreign countries, which may provide a sense of legitimacy to the actions of the group.
A violent group successfully portrayed as victimized will solidify ingroup cohesion and outgroup hostility while justifying the use of violence as a moral consequence of circumstances. Terrorists often dehumanize the outgroup by stereotyping them in ways they argue will justify violence. People sympathetic with the dehumanization of the outgroup may provide support without actually joining in the perpetration of terror. Some may be radicalized by communication produced by terrorists, such as on social media, to become actors themselves. Counter-terror tactics may disrupt intergroup communication, thus interfering with recruitment or operational capabilities of those supporting or engaging in terrorism.
Jessica Gasiorek and R. Kelly Aune
A majority of the extant literature in health and risk message processing focuses—for obvious reasons—on social influence and compliance-gaining. Interpersonal and relational issues with doctors and patients are a secondary focus. In contrast, research that specifically addresses comprehension of health and risk messaging is somewhat scant. However, other domains (e.g., cognitive psychology, reading studies) offer models and studies of comprehension that address message processing more generally. This material can usefully inform research in a health and risk context.
An important aspect of any communicative event is the degree to which that event allows interactivity. This can be described in terms of a continuum from static messaging to dynamic messaging. Message features may affect simple comprehension (in the former case) and active understanding (in the latter case) of messaging along this continuum. For static messaging, text features are the dominant focus; for dynamic messaging, how communicators cooperate, collaborate, and adjust their behavior relative to each other’s knowledge states is the focus. Moderators of these effects, which include sources’ dual goals informing and influencing targets, are also important to consider. Examples of this include direct-to-consumer-advertising (DTCA) of pharmaceutical medicines and pharmaceutical companies, which must meet the demands of the government regulatory bodies (e.g., fair and balanced presentation of benefits and risks) while simultaneously influencing the message processing experience of the target to minimize negative perceptions of their products. Impediments to creating understanding can arise in both the highly interactive setting of the face-to-face doctor-patient context as well as more static messaging situations such as PSAs, pamphlets, and pharmaceutical package inserts.
Making sense of message comprehension in health and risk communication is complex, and it is complex because it is broad in scope. Health and risk communication runs the gamut of static to dynamic messaging, employing everything from widely distributed patient information leaflets and public service announcements, to interactive web pages and massively connected social networking sites, to the highly interactive and personalized face-to-face meeting between doctor and patient. An equally comprehensive theoretical and methodological tool box must be employed to develop a thorough understanding of health and risk communication.
The ACT2 Program and Eliminating Racial and Ethnic Disparities in HIV and AIDS Clinical Trials: A Case Study in Health and Risk Messaging
Marya Gwadz and Amanda S. Ritchie
It is well documented that African American/Black and Hispanic individuals are underrepresented in biomedical research in the United States (U.S.), and leaders in the field have called for the proportional representation of varied populations in biomedical studies as a matter of social justice, economics, and science. Yet achieving appropriate representation is particularly challenging for health conditions that are highly stigmatized such as HIV/AIDS. African American/Black, and Hispanic individuals, referred to here as “people of color,” are greatly overrepresented among the 1.2 million persons living with HIV/AIDS in the United States. Despite this, people of color are substantially underrepresented in AIDS clinical trials. AIDS clinical trials are research studies to evaluate the safety and effectiveness of promising new treatments for HIV and AIDS and for the complications of HIV/AIDS, among human volunteers. As such, AIDS clinical trials are critical to the development of new medications and treatment regimens. The underrepresentation of people of color in AIDS clinical trials has been criticized on a number of levels. Of primary concern, underrepresentation may limit the generalizability of research findings to the populations most affected by HIV/AIDS. This has led to serious concerns about the precision of estimates of clinical efficacy and adverse effects of many treatments for HIV/AIDS among these populations. The reasons for the underrepresentation of people of color are complex and multifaceted. First, people of color experience serious emotional and attitudinal barriers to AIDS clinical trials such as fear and distrust of medical research. These experiences of fear and distrust are grounded largely in the well-known history of abuse of individuals of color by medical research institutions, and are complicated by current experiences of exclusion and discrimination in health care settings and the larger society, often referred to as structural racism or structural violence. In addition, people of color experience barriers to AIDS clinical trials at the level of social networks, such as social norms that do not support engagement in medical research and preferences for alternative therapies. People of color living with HIV/AIDS experience a number of structural barriers to clinical trials, such as difficulty accessing and navigating the trials system, which is often unfamiliar and daunting. Further, most health care providers are not well positioned to help people of color overcome these serious barriers to AIDS clinical trials in the context of a short medical appointment, and therefore are less likely to refer them to trials compared to their White peers. Last, some studies suggest that the trials’ inclusion and exclusion criteria exclude a greater proportion of people of color than White participants. Social/behavioral interventions that directly address the historical and contextual factors underlying the underrepresentation of people of color in AIDS clinical trials, build motivation and capability to access trials, and offer repeated access to screening for trials, hold promise for eliminating this racial/ethnic disparity. Further, modifications to study inclusion criteria will be needed to increase the proportion of people of color who enroll in AIDS clinical trials.
Kami J. Silk and Daniel Totzkay
The Breast Cancer and Environment Research Program (BCERP) is a transdisciplinary program of research created to investigate environmental exposures and their relationship to breast cancer with a particular focus on puberty as a potential window of increased susceptibility to environmental exposures. A transdisciplinary approach has a strong focus on translating scientific findings into usable health practices as well as health prevention messages so that current research informs practice as well as communication to the lay public. BCERP engaged in communication science to develop health messages for lay audiences, health professionals, and outreach organizations. The precautionary principle, used as a primary guide in regards to message translation and dissemination, yields a useful discussion of the BCERP organizational structure. An exploration of formative communication science efforts in BCERP, areas of sensitivity for creating BCERP messages, and resources created for BCERP toolkits serves to illustrate and describe this one approach to designing health and risk messages.
Catherine Chaput and Joshua S. Hanan
Depending on how you approach it, economic justice is either an extremely old intellectual tradition or a relatively new one. From the first perspective, economic justice is part and parcel of classical political philosophy—Plato’s The Republic and Aristotle’s The Politics, for instance, both discuss property distribution in an ideal society, emphasizing the philosophy of justice over economic precepts. From the second perspective, the one we embrace, economic justice is a uniquely modern inquiry that emerged with the writings of Karl Marx and his revolutionary critique of the capitalist political economy. For Marx, economic justice can be understood as a critical enterprise that attempts to locate contradictions between universal and particular conceptions of human freedom and intervene politically into these contradictions with the aim of creating a more just, equitable, and egalitarian society. So conceived, economic justice liberates the collective potential of humanity from its exploitation and degradation by capitalism as well as the various legal institutions it develops to control human behavior for the purpose of extracting of surplus-value. It is this Marxist perspective and the various historical reformulations that it has authorized that influence the way rhetoricians and scholars of cultural studies conceptualize economic justice in the discipline of communication. While not all of these scholars endorse an explicitly Marxist line of thought, they all attempt to conceptualize economic justice as a normative political category that influences various models of rhetorical agency and social change.