Strategic communication is an essential component in the science and practice of recruiting participants to clinical research studies. Unfortunately, many clinical research studies do not consider the role of communication in the recruitment process until efforts to enroll patients in a timely manner have failed. The field of communication is rich with theory and research that can inform the development of an effective recruitment plan from the inception of a clinical research study through informed consent. The recruitment context is distinct from many other health contexts in that there is often not a behavioral response that can be universally promoted to patients. The appropriateness of a clinical research study for an individual is based on a number of medical, psychological, and contextual factors, making it impossible to recommend that everyone who is eligible for a clinical research study enroll. Instead, clinical research study recruitment efforts must utilize strategic communication principles to ensure that messages promote awareness of clinical research, maximize personal relevance, minimize information overload, and facilitate informed choice. This can be accomplished through careful consideration of various aspects of the communication context described in this chapter, including audience segmentation, message content, message channels, and formative, process, and outcome evaluation, as well as the enrollment encounter.
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Communication and Recruitment to Clinical Research Studies
Janice L. Krieger and Jordan M. Neil
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Diffusion of Concepts of Masculinity and Femininity
Rebecca S. Richards
For much of human history, “femininity” and “masculinity” were unknown terms. But that does not mean that the concept of gender did not exist. Indeed, many societies in recorded history had conceptions of what it means to be a gendered person—most often noted in the binary of “man” and “woman”—but these conceptions were normative and perceived as intrinsic to human behavior and culture. Masculinity and femininity were naturalized concepts, assumed to be the ways in which men and women should act, look, or communicate.
In the 19th and 20th centuries, scholars and activists noted that femininity and masculinity are social constructions of a gendered society, often denoting the ways in which people, objects, and practices conform to or transgress gendered expectations. Both terms are highly contingent upon the cultural, historical, and geopolitical locations in which they are used, meaning that they can only be accurately understood or defined for a given time or context; it is impossible to define either term in a universal manner. Femininity, as an articulated concept, has a longer history of being visible and enforced by communities. Masculinity, on the contrary, historically elided critique or visibility because its attributes were often the normative and prized values and characteristics of a given social context. However, feminist movements and intellectual projects have brought masculinity to light, showing the ways in which masculinity, just as much as femininity, is a learned and enforced way of viewing actions, people, and things.
In communication studies, current scholarship on masculinity and femininity examine how they circulate in a globalized world, picking up new definitions and often restructuring people’s lives. Even though both terms are abstractions with shifting definitions and applications, they create the conditions for people’s sense of identity and limit or enhance their ability to engage in communicative acts. Differently stated, while abstract concepts, they have material consequences. To understand how an abstract social construction creates material consequences, communication scholars have looked at several research locations where masculinity and femininity most obviously manifest, such as leadership and authority, media representations, rhetorical style and delivery, and interpersonal communications.
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The Global Open Society: Dialogue in Communication
Algis Mickunas
Dialogue and its extension to polylogue are presented as an intersubjective basis of communication. The intersubjective aspect cannot be explained by any discipline without a contradiction, since any explanation would require intersubjective awareness. While necessary, dialogue requires a third aspect: dialogue about something, a theme, a subject matter, a problem, a point of disagreement, such that the topic sets a limit to the dialogical partners. This third aspect shifts the discussion away from subject-to-subject encounter as inadequate and moves to the subjects as partners who first are engaged in a dialogue about something. While speaking to someone about something, there is a mutual exchange of awareness and a broadening of horizons of both, with an addition of others who are co-present even if they are not empirically available. To speak to someone of physical laws is also to speak with Newton, Einstein, Planck, and others who form a polylogical field—forming an extension of the awareness of dialogical partners. The issue that arises is whether the individual can form her own position, or whether she is dominated by a historical tradition of interpretation. The dialectical debate between Habermas and Gadamer shows the problem, which is finally resolved by an extension of dialogue through education. The final and most concrete aspect of dialogical communication is present at the level of praxis as bodily activity which is equally intercorporeal. We build our world and thus our history and form a depth of intercorporeal communication of what we can do.
While the dialogical domain is the focus of this research, it also includes suggestions on critical evaluation of specific theories and mutual controversies among theorists, e.g., Habermas and Gadamer. Such controversies are necessary to show how dialogical procedures not only posit different theoretical positions but help such positions to become clearer and more articulated.
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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.
