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Article

Communicative Decisions in Families  

Rudy C. Pett, Kristina M. Scharp, and Yueyi Fan

Families represent a central relational unit within society and a formative context of interdependence throughout one’s life. How family members individually and collectively navigate communicative decisions therefore illustrates a process offering implications for each member within a family. Although various forms and contexts of decision-making might emerge, decisions guiding how family members communicate remain inevitable. Thus, particular importance emerges in understanding the processes and considerations that guide communicative decisions in families. Some decision-making processes might remain implicit, but several communication theories and models illuminate explicit considerations guiding family members’ communicative decisions. The first set of theoretical perspectives provides insights regarding communicative decisions relevant in contexts of uncertainty. The theory of motivated information management, for example, suggests that family members must make decisions regarding how they wish to manage a lack of information and any resulting uncertainty. However, those decisions likely remain guided by how family members assess their individual (or collective) ability to obtain the desired information, as well as cope with the outcomes of obtaining new information. Relatedly, uncertainty management theory illustrates the ways that family members experiencing uncertainty likely face decisions regarding if, as well as to what extent, they wish to acquire more information related to the source of uncertainty. Communication often serves as an information-seeking behavior family members decide to either enact or avoid, depending on how interested they are in reducing their uncertainty. A second set of theoretical perspectives illustrates the decisions family members face regarding if (and how) they communicate “private” information, as well as secrets. When managing private information, communication privacy management theory outlines decisions family members likely confront related to privacy ownership, privacy control, and privacy turbulence. In terms of secrets, the revelation risk model explicates considerations guiding if (and how) individuals decide to reveal secrets to their family members. These considerations include assessments of potential risk, perceived communication efficacy, and the relational closeness between the family members. The cycle of concealment model also examines decisions to reveal secrets, but this model suggests that these decisions also consider elements such as family interaction histories and, similarly, the quality of the relationship shared between the family members. A final theoretical perspective illuminates how health contexts introduce unique considerations that might dictate if (and how) family members decide to communicate about health-related information. Specifically, the disclosure decision-making model proposes that these types of communicative decisions remain guided by more unique considerations, such as (a) the type of information to be disclosed, (b) the relationships among the family members, (c) how a family member is likely to respond to the disclosure, (d) perceived disclosure efficacy, and (e) available strategies to disclose the information. Collectively, these six theoretical perspectives provide a multifaceted understanding of the central processes and considerations that guide communicative decisions in families.

Article

The Knowledge Deficit Model and Science Communication  

W.J. Grant

The Knowledge Deficit Model represents a key boundary concept in the modern discussion of science communication. In essence, the model asserts an epistemic priority for science and scientific information: that scientific knowledge should be paramount in making decisions on science-related issues, that this knowledge should be communicated from scientists to audiences who do not have this knowledge, that scientists should be in control of this communication flow, that the nonscientific audiences receiving this knowledge will be grateful for this, and that they will make better decisions as a result. To state it simply, the model assumes that nonscientific audiences are in some senses empty vessels suffering from a deficit of scientific knowledge, waiting to be filled with the wisdom of science. Among science communication researchers and those concerned with the relationship between science and society, this model of communication is often considered essentially flawed, in that it affords politically problematic privileges to scientific knowledge and leaves scientists ignorant of the needs and knowledges their audiences, ignorant of the contexts in which decisions will be made, less likely to be viewed as trustworthy by those audiences, and less likely to do good science. The end result of such an approach is only likely to be a greater distrust between science and society, and flawed science. Yet despite these critiques—and a near total absence of evidence in its favor—the model perseveres. Many scientists and science organizations continue to communicate their work in a deficit model style. Understanding why it persists—and what to do about it—remains a key challenge in science communication research.

Article

Medical Tourism and Communication  

Alicia Mason

Medical tourism (MT), sometimes referred to as health tourism or medical travel, involves both the treatment of illness and the facilitation of wellness, with travel. Medical tourism is a multifaceted and multiphase process involving many agents and actors that requires careful planning and execution. The coordinated process involves the biomedical, transportation, tourism, and leisure industries. From the communication perspective, the process can be viewed as a 5-stage model consisting of the: (a) orientation, (b) preparation, (c) experiential and treatment, (d) convalescence, and (e) reflection phases. Medical tourism is uniquely situated in a nexus of academic literature related to communication, business and management, travel and tourism, policy and law, healthcare and health administration. Communication permeates and perpetuates the medical tourism process and does so at the levels of interpersonal interactions (provider-patient communication), small group (healthcare teams), organizational (between healthcare providers), and mass and computer-mediated communication (marketing, advertising, and patient social support). This process may, in some cases, involve high rates of international and intercultural variation. Further study of the MT process can help to gain a better understanding of how healthcare consumers evaluate information about medical procedures and possible risks, as well as the specific message features and effects associated with various communication channels and information delivery systems. Continuing scholarly efforts also should focus on the relationship between medical tourism and communication.

Article

Perceptions of the Childfree  

Elizabeth A. Hintz and Rachel Tucker

Being voluntarily childless (i.e., “childfree”) is a growing trend in the United States and around the world. Although most childfree people know early in life that they do not wish to become parents, the decision to forgo having children is an ongoing process that requires childfree people to construct a life that deviates from the normative family life cycle. Increasing rates of voluntary childlessness is a trend spurred by a variety of shifting social, economic, and environmental factors. Yet despite the increasing normalcy of voluntary childlessness, childfree people (and especially childfree women) face social sanctions for deciding not to become parents, being broadly perceived more negatively than childless people (who do not have children but want them) and parents. Such sanctions include social confrontations in which others (e.g., family members) question or contest the legitimacy of their childfree identity. Media coverage of voluntary childlessness forwards the notion that motherhood and femininity are inseparable and that voluntary childlessness is an issue that primarily concerns and affects women. Furthermore, childfree people face discrimination in health care contexts when seeking voluntary sterilization and in workplace contexts when “family-friendly” policies create unequal distributions of labor for those without children. Members of the childfree community use the Internet to share resources and seek support to navigate challenging interactions with outsiders. Beyond this, although some studies have begun to interrogate the roles of geographic location, race, and sexual orientation in shaping the experience of voluntary childlessness, at present, a largely White, wealthy, able-bodied, cisgender, heteronormative, and Western view of this topic is still perpetuated in the literature.

Article

Media Depictions of Sexual Attitudes  

Keren Eyal

Over the last 3 decades, content analyses have documented large amounts of sexual content in mainstream entertainment media, on television and streaming services as well as in films, music, and video games. Most sexual content is conveyed through conversations about sex and, to a somewhat lesser extent, through the portrayal of sexual behaviors, primarily passionate kissing and suggestive actions. Attitudes—evaluations linking attributes to objects—are often presented in the media and may also be the outcomes of media exposure to sexual content. In the context of sexuality, some commonly studied attitudes include attitudes toward casual or extrarelational sexual encounters, attitudes toward contraception use, and attitudes toward sexual abuse or the acceptance of rape myths. Among the most prominent theoretical perspectives examining the links between media exposure and audience outcomes are theories of script building and activation, theories of a worldview cultivation, and theories of cognitive learning of social behaviors, and the attitudes and emotions that underlie them. Sexual attitudes can be conveyed through mainstream entertainment media content in diverse ways. First, the mere presence of certain topics in the content (e.g., casual sexual encounters) might convey an attitude about the behavior’s importance and relevance to people’s lives. At times, such inclusive depictions can empower audience members. The opposite—the exclusion of certain sexual topics from media content (e.g., sexual minority characters) might undermine the serious attitude with which they should be addressed. Second, attitudes may be conveyed through the focus placed upon them in the mediated content. Sexual health, recognized as intrinsically associated with sexual behaviors in the real world, is largely missing from media depictions. The rise in the prevalence of sexual crime storylines, especially in television law-and-order crime drama series, has introduced diversity in the attitudes conveyed toward this topic in the media. Sexual consent is another topic that has received more attention in entertainment media in the last couple of decades; the attitudes most commonly depicted about sexual consent seem to be the minimization of its importance through the portrayal of either altogether absent or implicit and nonverbal consent cues. Third, sexual attitudes in mainstream entertainment content may be depicted through the portrayal of consequences of sexual references and behaviors and through the depiction of the emotions associated with them. Research finds that portrayals of sexual consequences are relatively rare in entertainment narratives but when present, they tend to focus on the emotional and negative outcomes of sex. Fourth, sexual attitudes are often depicted in the media in the context of humor. Humor in its many forms may communicate a lighthearted, discomfort-easing attitude toward sex, but it might also trivialize the behavior and endorse a less serious attitude toward the decisions it entails. Finally, sexual attitudes are often depicted through stereotypes in media content. Common stereotypes in entertainment media include the narrow and biased presentation of sexual minority characters, which tends to marginalize their sexuality and support a heteronormative attitude. Other stereotypes include sexual gender roles and the sexualization of female characters, both communicating demeaning and nonvalidating attitudes toward women and their sexuality.

Article

Memorable Messages in Families  

Haley Kranstuber Horstman, Ellen Jordan, and Jinwen Yue

Families are (one of) the first and most influential socializing agents of our lives. Among the innumerable messages family members convey to each other, a select few are regarded as “memorable.” Memorable messages are “distinct communication units considered influential over the course of a person’s life.” Those messages that are most memorable are typically brief, direct, oral messages delivered by a higher-status, older, and likable individual to the recipient during their teen or young adult years. Although memorable messages were initially regarded as having positive implications for the receiver’s life, newer research has provided space for the negative implications and perceptions of these messages. Nonverbal communication elements and relational contexts and qualities are influential to the receptivity of memorable messages. Although memorable messages often originate from a family member, the sources of memorable messages can also be friends/peers, teachers, coworkers, or, in some cases, the media. Research on memorable messages has been largely concentrated in health and interpersonal/family communication contexts; organizational and instructional contexts have also been explored. Memorable message research in families has focused much on health topics (i.e., mental health, sexual health, body image and weight), socialization (i.e., around school, work, race, other topics), and coping with hardship. In these studies, memorable messages have largely been investigated through mixed-method survey-based research, but also through purely quantitative (i.e., survey-based) and qualitative (i.e., interview) methods as well. This research has been largely atheoretical but has been grounded in control theory and, more recently, the theory of memorable messages and communicated narrative sense-making theory. Future research and practical applications of family memorable message research include informing health campaigns and family life education programming.

Article

Relational Dialectics Theory  

Kristina M. Scharp

Relational dialectics theory (RDT) is a postmodern critical theory of meaning. Based on the writing of Russian philosopher, RDT attunes researchers to the ways that discourses (i.e., ideologies) compete to make meaning of particular semantic objects (e.g., identities, phenomena, processes, etc.). Of note, not all discourses hold the same amount of power. Some discourses are dominant (i.e., centripetal) whereas others are marginalized (i.e., centrifugal). RDT researchers, then, are primarily interested in exploring how these discourses, with unequal power, compete. This focus on the competition of discourses for power and the ability of RDT to call out the ideological forces that disenfranchise some groups while enfranchising others holds promise for practical applications such as debunking misconceptions and better understanding where privilege comes from and how it is perpetuated. When discourses compete, they might do so within or across a set of utterances. Utterances are turns in talk and serve as the primary unit of analysis in RDT research. Utterances, however, are not standalone entities. Rather, they are connected by different links to form an utterance chain. Some links of the utterance chain pertain to time (what has been said before and what response an utterance can anticipate) whereas the other links of the utterance chain pertain to the relationship level (some pertain to the culture at large whereas other only to an idiosyncratic relationship). Overall, discursive competition takes place across a continuum of interplay. At one end of the continuum is monologue. Monologue represents the absence of meaning. Next are discursive enactments (i.e., closure) that reinforce the dominant discourse and shut down alternatives (see entry for complete list). Diachronic separation occurs when the dominance of a discourse changes across time. Diachronic separation can take two forms: (a) spiraling inversion or (b) segmentation. Synchronic interplay is next and occurs when two discourses compete within a given utterance. When RDT researchers examine a text for synchronic interplay, they often look to see how a marginalized discourse (a) negates, (b) counters, or (c) entertains the dominant discourse. Finally, on the other end of the continuum of interplay, is dialogic transformation. Dialogic transformation occurs through either (a) discursive hybridity or (b) an aesthetic moment whereby discourses suspend their interplay to create new meanings. Conducted using RDT’s corresponding method, contrapuntal analysis, researchers using this theory work to disrupt hegemonic, taken-for-granted assumptions about how things are and call attention to voices overlooked in the past. To date, this theory has been taken up primarily by family, interpersonal, and health communication scholars, although many scholars have used this theory throughout the discipline.

Article

Diffusion of Innovations from the West and Their Influences on Medical Education in Japan  

Mariko Morishita and Miho Iwakuma

In the 19th century, Western medicine spread widely worldwide and ultimately diffused into Japan. It had a significant impact on previous Japanese medical practice and education; it is, effectively, the foundation of contemporary Japanese medicine. Although Western medicine seems universal, its elements and origins as it has spread to other countries show localized differences, depending on the context and time period. Cultural fusion theory proposes that the culture of a host and influence of a newcomer conflict, merge, or transform each other. It could shed light on how Japanese medicine and medical education have been influenced by and coevolved with Western medicine and culture. Cultural fusion is not assimilation or adaptation; it has numerous churning points where the traditional and the modern, the insider (indigenous) and the outsider (immigrant), mix and compete. In Japan, medicine has a long history, encountering medical practices from neighboring countries, such as China and Korea in ancient times, and Western countries in the Modern period. The most drastic changes happened in the 19th century with strong influence from Germany before World War II and in the 20th century from the impact of the United States after World War II. Recently, the pressure of globalization could be added as one influence. Since cultural fusion is ubiquitous in Japanese medical fields, examples showing how the host and newcomers interact and merge can be found among many aspects of Japanese medicine and medical education, such as curricula, languages, systems, learning styles, assessment methods, and educational materials. In addition, cultural fusion is not limited to influence from the West but extends to and from neighboring Asian countries. Examining cases and previous studies on cultural fusion in Japanese medicine and medical education could reveal how the typical notion that Japan pursued Westernization of its medicine and medical education concealed the traditions and the growth of the local education system. The people involved in medicine in the past and the present have struggled to integrate the new system with their previous ideals to improve their methods, which could be further researched.

Article

A Culture-Centered Approach to Health and Risk Communication  

Mohan Jyoti Dutta

The culture-centered approach (CCA) to health and risk communication conceptualizes the communicative processes of marginalization that constitute the everyday meanings of health and risks at the margins. Attending to the interplays of communicative and material disenfranchisement, the CCA situates health inequalities amidst structures. Structures, as the rules, roles, processes, and frameworks that shape the distribution of resources, constitute and constrain the access of individuals, households, and communities to the resources of health and well-being. Through voice infrastructures cocreated with communities at the classed, raced, gendered, colonial margins of capitalist extraction, the CCA foregrounds community agency, the capacity of communities to make sense of their everyday struggles with health and well-being. Community voices articulate the interplays of colonial and capitalist processes that produce and circulate the risks to human health and well-being, serving as the basis for community organizing to secure health and well-being. Culture, as an interpretive resource passed down intergenerationally, offers the basis for organizing, and is simultaneously transformed through individual and community participation. Culture-centered health communication, rooted in community agency, drawing upon cultural stories, resources, and practices in subaltern contexts, takes the form of organizing for health, mobilizing agentic expressions toward structural transformations.

Article

Development and Effects of Internet Addiction in China  

Qiaolei Jiang

Internet addiction is a growing social issue in many societies worldwide. With the largest number of Internet users worldwide, China has witnessed the growth of the Internet along with the development and effects of Internet addiction, especially among the young. Originally reported anecdotally in mass media, Internet addiction has become an issue of great public concern after more than 20 years. The process of Internet addiction as an emerging risk in the Chinese context can be a showcase for risks related to information and communication technologies (ICTs), health, and everyday life. The term Internet addiction was first coined in the Western context and has since been recognized as a technology-driven social problem in China. Plenty of anecdotes, increasing academic research, and public awareness and concerns have put the threat of Internet addiction firmly on the policy agenda. Therefore, for prevention and intervention, research projects, rehab facilities, welfare services, and self-help programs have spread all over the country, and related regulations, policies, and laws have changed accordingly. Although controversies remain, through the staging of, and coping with, Internet addiction, people can better understand China’s digital natives and contemporary life.