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Article

Kory Floyd and Colter D. Ray

Affectionate communication comprises the verbal and nonverbal behaviors people use to express messages of love, appreciation, fondness, and commitment to others in close relationships. Like all interpersonal behaviors, affectionate communication has biological and physiological antecedents, consequences, and correlates, many of which have implications for physical health and wellness. Investigating these factors within a biological framework allows for the adjudication of influences beyond those attributable to the environment. In particular, there are observable genetic and neurological differences between individuals with a highly affectionate disposition and those less prone to communicating affection, suggesting that variance in the tendency to engage in affectionate behavior is not entirely the result of environmental influences such as enculturation, parenting, and media exposure. In addition, the expression of affection is associated with markers of immune system competence and appears to help the body to relax and remain calm. The biological effects of affectionate communication are perhaps most pronounced in situations involving either acute or chronic stress. Specifically, highly affectionate individuals are less likely than others to overreact physiologically to stress-inducing events. Whatever stress reaction they do mount is better regulated than among their less affectionate counterparts. Moreover, highly affectionate individuals—or simply those who receive expressions of affection prior to or immediately following a stressful situation—exhibit faster physiological recovery from their elevated stress. Perhaps unsurprisingly, therefore, being deprived of adequate affectionate communication is predictive of multiple physical and psychological detriments, including elevated stress and exacerbated depression, social and relational problems, insecure attachment, susceptibility to diagnosed anxiety and mood disorders, susceptibility to diagnosed secondary immune disorders, chronic pain, and sleep disturbances.

Article

The widespread diffusion of social media in recent years has created a number of opportunities and challenges for health and risk communication. Blogs and microblogs are specific forms of social media that appear to be particularly important. Blogs are webpages authored by an individual or group in which entries are published in reverse chronological order; microblogs are largely similar, but limited in the total number of characters that may be published per entry. Researchers have begun exploring the use and consequences of blogs and microblogs among individuals coping with illness as well as for health promotion. Much of this work has focused on better understanding people’s motivations for blogging about illness and the content of illness blogs. Coping with the challenges of illness and connecting with others are two primary motivations for authoring an illness blog, and blogs typically address medical issues (e.g., treatment options) and the author’s thoughts and feelings about experiencing illness. Although less prevalent, there is also evidence that illness blogging can be a resource for social support and facilitate coping efforts. Researchers studying the implications of blogs and microblogs for health promotion and risk communication have tended to focus on the use of these technologies by health professionals and for medical surveillance. Medical professionals appear to compose a noteworthy proportion of all health bloggers. Moreover, blogs and microblogs have been shown to serve a range of surveillance functions. In addition to being used to follow illness outbreaks in real-time, blogs and microblogs have offered a means for understanding public perceptions of health and risk-related issues including medical controversies. Taken as whole, contemporary research on health blogs and microblogs underscores the varied and important functions of these forms of social media for health and risk communication.

Article

Due to their sheer scope in trying to reach large sections of a population, and the costs necessary to implement them, evaluation is vital at every stage of the health communication campaign process. No stage is more important than the formative evaluation stage. At the formative stage, campaign designers must determine if a campaign is even necessary, and if so, determine what the campaign’s focus needs to be. Clear, measurable, and realistically attainable objectives need to be a primary output of formative evaluation, as these objectives help to guide the creation of all future campaign efforts. The formative stage also includes pilot testing any messages and strategies with the target audience prior to full-scale implementation. Once the campaign is implemented, process evaluation should be performed to determine if the campaign is being implemented as planned (i.e., fidelity), and also to document the dose of campaign exposure. Identifying problem areas during process evaluation can ensure they get fixed prior to the completion of the campaign. Detailed process evaluation also allows for greater ease in replicating a successful campaign attempt in the future, but additionally can provide potential reasons for why a campaign was not successful. The last stage is outcome evaluation—determining if the objectives of the campaign were achieved. While it is the last stage of campaign evaluation, campaign designers need to ensure they have planned for it in the formative stages. If even just one of these stages of evaluation is minimized in campaign design, or relegated to an after-thought, developers need to realize that the ultimate effectiveness of their campaigns is likely to be minimized as well.

Article

At the heart of cancer communication research is an effort both to increase knowledge and to identify practical strategies for improving cancer communication and for improving prevention and control of cancer, as well as for addressing cancer care issues from theoretical and applied communication perspectives across the continuum of cancer care. One important theoretical approach to consider in cancer communication science is taking an intergroup approach to cancer care. The challenge moving forward is to develop cancer communication research programs that combine important theoretical and applied perspectives, focusing on prevention strategies that can help reduce cancer risk, incidence, morbidity, and mortality, and to promote the highest quality of life for people of every age and every background.

Article

Celebrities are famous individuals, well known by many members of the public, who appear frequently in media content. When celebrities appear in the media alongside another cause, be it selling soap or promoting public health, the message becomes a celebrity appeal. Celebrity appeals are messages where a celebrity advocates for or is implicitly associated with a target behavior. In the context of health and risk-related messages, celebrity appeals can take the form of public service announcements, advertisements for health and risk-related products, or even news coverage of a celebrity’s personal struggles with a health issue or risky behavior. Research on celebrity appeals overlaps with the marketing literature investigating the effects of celebrity endorsements on product preferences and purchasing behavior. This work on the persuasiveness of celebrity endorsements demonstrates that celebrities can draw attention to a product or idea, but also that many other factors, like involvement, familiarity, source credibility, and endorser gender can moderate how persuasive a celebrity-based appeal is. Additionally, research on celebrity disclosures of illnesses reveal that these de facto awareness campaigns can elicit emotions in audiences and motivate behavior change. However, media coverage of celebrities has also been associated with harmful effects on lay individuals’ wellbeing, suggesting important caveats for message designers who rely on celebrities to garner attention for a cause or to motivate lay individuals to change their own health and risk-related behaviors. The existing empirical evidence on celebrity appeals and additional theoretical perspectives for understanding their potential persuasiveness provides many insights for message designers.

Article

Amy E. Chadwick

Climate change, which includes global warming, is a serious and pervasive challenge for local and global communities. Communication theorists, researchers, and practitioners are well positioned to describe, predict, and affect how we communicate about climate change. Our theories, research methods, and practices have many potential roles in reducing climate change and its effects. Climate change communication is a growing field that examines a range of factors that affect and are affected by how we communicate about climate change. Climate change communication covers a broad range of philosophical and research traditions, including humanistic-rhetorical analyses, interpretive qualitative studies, and social-scientific quantitative surveys and experiments. Climate change communication examines a range of factors that affect and are affected by how we communicate about climate change. Much of the research in climate change communication focuses on public understanding of climate change, factors that affect public understanding, media coverage and framing, media effects, and risk perceptions. Less prevalent, growing areas of research include civic engagement and public participation, organizational communication, and persuasive strategies to affect attitudes, beliefs, and behaviors related to the climate. In all of these areas, most of the research on climate change communication has been conducted in the United States, United Kingdom, Australia, Canada, and Western European countries. There is a need to expand the climate change communication research into other regions, particularly developing countries. In addition, climate change communication has natural links to environmental and health communication; therefore, communication scholars should also examine research from these areas to develop insights into climate change communication.

Article

Since the 1990s there has been an increasing interest in knowledge, knowledge management, and the knowledge economy due to recognition of its economic value. Processes of globalization and developments in information and communications technologies have triggered transformations in the ways in which knowledge is shared, produced, and used to the extent that the 21st century was forecasted to be the knowledge century. Organizational learning has also been accepted as critical for organizational performance. A key question that has emerged is how knowledge can be “captured” by organizations. This focus on knowledge and learning demands an engagement with what knowledge means, where it comes from, and how it is affected by and used in different contexts. An inclusive definition is to say that knowledge is acquired theoretical, practical, embodied, and intuitive understandings of a situation. Knowledge is also located socially, geographically, organizationally, and it is specialized; so it is important to examine knowledge in less abstract terms. The specific case engaged with in this article is knowledge in hazardous industry and its role in industrial disaster prevention. In hazardous industries such as oil and gas production, learning and expertise are identified as critical ingredients for disaster prevention. Conversely, a lack of expertise or failure to learn has been implicated in disaster causation. The knowledge needs for major accident risk management are unique. Trial-and-error learning is dangerously inefficient because disasters must be prevented before they occur. The temporal, geographical, and social scale of decisions in complex sociotechnical systems means that this cannot only be a question of an individual’s expertise, but major accident risk management requires that knowledge is shared across a much larger group of people. Put another way, in this context knowledge needs to be collective. Incident reporting systems are a common solution, and organizations and industries as a whole put substantial effort into gathering information about past small failures and their causes in an attempt to learn how to prevent more serious events. However, these systems often fall short of their stated goals. This is because knowledge is not collective by virtue of being collected and stored. Rather, collective knowing is done in the context of social groups and it relies on processes of sensemaking.

Article

Roxanne L. Parrott, Amber K. Worthington, Rachel A. Smith, and Amy E. Chadwick

The public, including lay members who have no personal or familial experience with genetic testing or diagnosis, as well as individuals who have had such experiences, face many intrinsic decisions relating to understanding genetics. With the sequencing of the human genome and genetic science discoveries relating genes to cancer, heart disease, and diabetes, the scope of such decisions broadened from prenatal genetic testing related to reproductive choices to genetic testing for contributors to common causes of morbidity and mortality. The decision about whether to seek genetic testing encompasses concerns about stigma and discrimination. These issues lead some who can afford the cost to seek screening through online direct-to-consumer sites rather than in clinical settings. Many who may benefit from genetic testing lack awareness of family health history that could guide physicians to recommend these diagnostic tests. Families may not discuss health history due to genetic illiteracy, with the public’s genetic illiteracy increasing their illness uncertainty and decreasing the likelihood that physicians will engage in conversations about personalized medicine with their patients. Physicians may nonetheless order genetic tests based on patients’ symptoms, during preoperative workups, or as part of opportunistic screening and assessment associated with a specific genetic workup. Family members who receive positive genetic test results may not disclose them to life partners, other family members, or insurance companies based on worries and anxiety related to their own identity, as well as a lack of understanding about their family members’ risk probability. For many, misguided beliefs that genes absolutely determine health and disease status arise from media translations of genetic science. These essentialist beliefs negatively relate to personal actions to limit genetic expression, including failure to seek medical care, while contributing to stereotypes and stigma communication. As medical science continues to reveal roles for genes in health across a broad spectrum, communicating about the relationships that genes have for health will be increasingly complex. Policy associated with registering, monitoring, and controlling the activities of those with genetic mutations may be coercive and target individuals unable to access health care or technology. Communicating about genes, health, and risk will thus challenge health communicators throughout the 21st century.

Article

Religion encompasses many forms of communication: between groups, within groups, and with God (or other deities). Such communication can be especially powerful when group members highly identify with their religious group and the beliefs therein. Equally, it can be divisive, as evidenced by religion-based intergroup conflict and intolerance (which often overlaps along ethnic or political lines). However, not all religious communication is verbal or explicit. Religious individuals also commonly transmit their beliefs, values, and identities through symbols, physical spaces, and music. Likewise, communication with God is often pursued with silent prayer, meditation, or ritual, which also serve to reinforce one’s spirituality alongside religious group boundaries. Taken together, these varying forms of communication have implications not only for religious intergroup relations (e.g., intergroup contact or conflict), but also for intragroup relations (e.g., the strengthening of social ties) and individual health outcomes (e.g., effective communication with health care providers and coping practices). Given the importance of religious identity for many individuals, the benefits for individual well-being and intragroup relations, and yet the intergroup strife that religious group divisions can incite, the ways in which we communicate our religious group identities deserve closer attention.

Article

Robert M. McCann

Research into age and culture strongly suggests that people of different adult generations, regardless of culture, typically regard others and act in ways that display bias in favor of one’s own age group. While people across cultures share some basic patterns of aging perceptions, there is considerable variance in views on older people from one country to the next. Over the past two decades, the tenor of communication and aging research has shifted dramatically. Traditional research into aging across cultures painted a picture of Asia as a sort of communicative oasis for elders, who were revered and communicated to by the younger generations in a respectful and mutually pleasing manner. Compelling evidence now suggests the opposite, which is that (interregion variability in results notwithstanding) elder denigration may be more pronounced in Eastern than Western cultures. Accelerated population aging, rural-to-urban shifts in migration, new technologies, rapid industrialization, and the erosion of cultural traditions such as filial piety, may partially account for these results. Additionally, there are well-established links between communication and the mental health of older people. Specifically, communication accommodation in all of its forms (e.g., over accommodation, nonaccommodation, accommodation) holds great promise as a core predictor of a range of mental health outcomes for older people across cultures.

Article

Janice L. Krieger and Jordan M. Neil

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.

Article

Chris R. Sawyer

Communication scholarship has profited greatly by the rise of social science during the mid-20th century. This scientific progress has been marked by increased outlets for peer-reviewed research, thriving sub-disciplines, and a rapidly accumulating corpus of findings. Social scientists have accomplished this feat largely by conducting tests of empirical models and their associated constructs. Over the same span of time, the discipline’s most prolific researcher, James C. McCroskey, pioneered the study of the construct with which he is most closely associated. Communication apprehension (CA) has impelled generations of scholars to investigate possibly the greatest impediment to successful communication, namely the fear of interacting with fellow humans. Tracing its development reveals that CA meets the standards for theory bridges: truth, abstraction, progress, and applicability. Consequently, describing CA as a bridge construct rests on four interrelated claims. First, the primary aim of CA research is to discover the truth about social anxiety. Studies of CA have outstripped competitor explanations for speaker anxiety by yielding an extensive literature of peer-reviewed articles, books, and doctoral dissertations. These writings are predicated on the presumption that CA taps into the true nature of social anxiety. Second, self-reported measures of CA, such as the PRCA-24, allow for enough abstraction to support scientific generalization. This makes it possible for CA researchers to connect concrete observations to abstract principles. Third, CA research contributes to scientific progress in communication. Explanations for CA have generally reflected theories and perspectives at the horizon of the field. Last, CA research impacts on the quality of everyday life. Ultimately, CA researchers seek to develop treatment and educational strategies for the one-fifth of the general population afflicted with this condition. Taken together, CA has served as a bridge construct that enables scholars to pursue truth, formulate testable generalizations, achieve scientific progress, and potentially improve the quality of human life.

Article

Kami J. Silk, Sarah Sheff, Maria Lapinski, and Alice Hoffman

The environment influences health and risk outcomes, and communication campaigns often strive to reduce risk and promote positive health outcomes by raising awareness, increasing knowledge, influencing attitudes, and impacting intentions and behavior. Communication campaigns should be based on good formative research and theory, and they should be implemented with fidelity and a clear evaluation plan. Communication campaigns that address environmental influences are typically focused on promoting human, animal, or environmental outcomes despite the fact that all three are interconnected and would benefit from being considered in a larger ecological framework. The One Health approach reconceptualizes environmental influences by focusing not just on the environmental but also connections with human and animal health. One Health can be applied to communication campaigns to support efforts that acknowledge and promote the complexity of these relationships. Campaigns about environmental influences on health and risk range from a longstanding campaign built on individual activities to reduce environmental and personal risk to a sun smart campaign to reduce sun exposure risk to a lead-free campaign and an asthma-control campaign concerned about air quality. Other environmental campaigns focus on tobacco prevention, obesity prevention by addressing environmental influences as part of their strategy, climate control, and ocean species preservation—and that is only a sampling of popular campaign topics. These communication campaigns face similar challenges like lack of formative research and evaluation plans as well as atheoretical approaches to influence outcomes.

Article

Sandra Petronio and Rachael Hernandez

Have you ever wondered why a complete stranger sitting next to you on a plane would tell you about a recent cancer diagnosis? Why your parents never disclosed that you were adopted, feeling shocked when you accidently find out as an adult? These and many other actions reflect decisions individuals make about managing their private information. Being aware of how individuals navigate decisions to disclose or protect their private information provides useful insights that aid in the development and sustainability of relationships with others. Given privacy plays an integral role in everyone’s life, knowing more about privacy management is critical. communication privacy management (CPM) theory was first introduced by Sandra Petronio in 2002. CPM is evidence-based and accordingly provides a dependable understanding of how decisions are made to disclose and protect private information. This theory uses plain language to understand privacy management in everyday life. CPM focuses on the relationship people have with each other in communicative contexts, such as face-to-face interactions, on social media, and in dyads or groups. CPM theory is based on a communicative-social behavioral perspective and not necessarily a legal point of view. CPM theory illustrates that privacy is not paradoxical but is sustainable through the process of a privacy management system used in everyday life. The theory of CPM has been employed in a number of contexts shedding light on antecedents, mechanisms, and outcomes of private information management. In addition, a number of researchers across multiple countries, such as the Netherlands, United Kingdom, Japan, Kenya, South Korea, and the United States, have used CPM theory in their research investigations. Learning more about the system of private information management allows for a better understanding of how people navigate managing their private information when others are involved. Literature illustrates patterns of privacy management and demonstrates the challenges as well as the positive outcomes of the way individuals regulate their private information.

Article

Communication privacy management theory (CPM) argues that disclosure is the process by which we give or receive private information. Private information is what people reveal. Generally, CPM theory argues that individuals believe they own their private information and have the right to control said information. Management of private information is not necessary until others are involved. CPM does not limit an understanding of disclosure by framing it as only about the self. Instead, CPM theory points out that when management is needed, others are given co-ownership status, thereby expanding the notion of disclosing information; the theory uses the metaphor of privacy boundary to illustrate where private information is located and how the boundary expands to accommodate multiple owners of private information. Thus, individuals can disclose not only their own information but also information that belongs to others or is owned by collectives such as families. Making decisions to disclose or protect private information often creates a tension in which individuals vacillate between sharing and concealing their private information. Within the purview of health issues, these decisions have a potential to increase or decrease risk. The choice of disclosing health matters to a friend, for example, can garner social support to cope with health problems. At the same time, the individual may have concerns that his or her friend might tell someone else about the health problem, thus causing more difficulties. Understanding the tension between disclosing and protecting private health information by the owner is only one side of the coin. Because disclosure creates authorized co-owners, these co-owners (e.g., families, friends, and partners) often feel they have right to know about the owner’s health conditions. The privacy boundaries are used metaphorically to indicate where private information is located. Individuals have both personal privacy boundaries around health information that expands to include others referred to as “authorized co-owners.” Once given this status, withholding to protect some part of the private information can risk relationships and interfere with health needs. Within the scheme of health, disclosure risks and privacy predicaments are not experienced exclusively by the individual with an illness. Rather, these risks prevail for a number of individuals connected to a patient such as providers, the patient’s family, and supportive friends. Everyone involved has a dual role. For example, the clinician is both the co-owner of a patient’s private health information and holds information within his or her own privacy boundary, such as worrying whether he or she diagnosed the symptoms correctly. Thus, there are a number of circumstances that can lead to health risks where privacy management and decisions to reveal or conceal health information are concerned. CPM theory has been applied in eleven countries and in numerous contexts where privacy management occurs, such as health, families, organizations, interpersonal relationships, and social media. This theory is unique in offering a comprehensive way to understand the relationship between the notion of disclosure and that of privacy. The landscape of health-related risks where privacy management plays a significant role is both large and complex. The situations of HIV/AIDS, cancer care, and managing patient and provider disclosure of private information help to elucidate the ways decisions of privacy potentially lead to health risks.

Article

Jada G. Hamilton, Jennifer L. Hay, and Colleen M. McBride

It was expected that personalized risk information generated by genetic discovery would motivate risk-reducing behaviors. However, though research in this field is relatively limited, most studies have found no evidence of strong negative nor positive psychological or behavioral influences of providing genetic information to improve individual health behaviors. As noted by systematic reviews and agenda-setting commentaries, these null findings may be due to numerous weaknesses in the research approaches taken to date. These include issues related to study samples and design, as well as the motivational potency of risk communications. Moreover, agenda-setting commentaries have suggested areas for improvement, calling for expanded consideration of health outcomes beyond health behaviors to include information exchange and information-seeking outcomes and to consider these influences at the interpersonal and population levels. A new generation of research is adopting these recommendations. For example, there is a growing number of studies that are using communication theory to inform the selection of potential moderating factors and their effects on outcomes in understanding interpersonal effects of shared genetic risk. Researchers are taking advantage of natural social experiments to assess the general public’s understanding of genetics and inform approaches to improve their facility with the information. Additionally, there are examples of risk communication approaches addressing the complexity of genetic and environmental contributors to health outcomes. Although the pace of this translation research continues to lag behind genetic discovery research, there are numerous opportunities for future communications research to consider how emerging genomic discovery might be applied in the context of health promotion and disease prevention.

Article

A community of practice (CoP) situated in a health and risk context is an approach to collaboration among members that promotes learning and development. In a CoP, individuals come together virtually or physically and coalesce around a common purpose. CoPs are defined by knowledge, rather than task, and encourage novices and experienced practitioners to work together to co-create and embed sustainable outputs that impact on theory and practice development. As a result, CoPs provide an innovative approach to incorporating evidence-based research associated with health and risk into systems and organizations aligned with public well-being. CoPs provide a framework for constructing authentic and collaborative learning. Jeanne Lave and Etienne Wenger are credited with the original description of a CoP as an approach to learning that encompasses elements of identity, situation, and active participation. CoPs blend a constructivist view of learning, where meaningful experience is set in the context of “self” and the relationship of “self” with the wider professional community. The result is an integrated approach to learning and development achieved through a combination of social engagement and collaborative working in an authentic practice environment. CoPs therefore provide a strategic approach to acknowledging cultural differences related to translating health and risk theory into practice. In health and risk settings, CoPs situate and blend theory and practice to create a portal for practitioners to generate, shape, test, and evaluate new ideas and innovations. Membership of a CoP supports the development of professional identity within a wider professional sphere and may support community members to attain long range goals.

Article

Clinicians, medical and public health researchers, and communication scholars alike have long been concerned about the effects of conflicting health messages in the broader public information environment. Not only have these messages been referred to in many ways (e.g., “competing,” “contradictory,” “inconsistent,” “mixed,” “divergent”), but they have been conceptualized in distinct ways as well—perhaps because they have been the subject of study across health, science, and political communication domains. Regardless of specific terminology and definitions, the concerns have been consistent throughout: conflicting health messages exist in the broader environment, they are noticed by the public, and they impact public understanding and health behavior. Yet until recently, the scientific evidence base to substantiate these concerns has been remarkably thin. In the past few years, there has been a growing body of rigorous empirical research documenting the prevalence of conflicting health messages in the media environment. There is also increasing evidence that people perceive conflict and controversy about several health topics, including nutrition and cancer screening. Although historically most studies have stopped short of systematically capturing exposure to conflicting health messages—which is the all-important first step in demonstrating effects—there have been some recent efforts here. Taken together, a set of qualitative (focus group) and quantitative (observational survey and experimental) studies, guided by diverse theoretical frameworks, now provides compelling evidence that there are adverse outcomes of exposure to conflicting health information. The origins of such information vary, but understanding epidemiology and the nature of scientific discovery—as well as how science and health news is produced and understood by the public—helps to shed light on how conflicting health messages arise. As evidence of the effects of conflicting messages accumulates, it is important to consider not just the implications of such messages for health and risk communication, but also whether and how we can intervene to address the effects of exposure to message conflict.

Article

Wayne A. Beach, Kyle Gutzmer, and Chelsea Chapman

Beginning with phone calls to an emergency psychiatric hospital and suicide prevention center, the roots of Conversation Analysis (CA) are embedded in systematic analyses of routine problems occurring between ordinary persons facing troubling health challenges, care providers, and the institutions they represent. After more than 50 years of research, CA is now a vibrant and robust mode of scientific investigation that includes close examination of a wide array of medical encounters between patients and their providers. Considerable efforts have been made to overview CA and medicine as a rapidly expanding mode of inquiry and field of research. Across a span of 18 years, we sample from 10 of these efforts to synthesize important priorities and findings emanating from CA investigations of diverse interactional practices and health care institutions. Key topics and issues are raised that provide a unique opportunity to identify and track the development and maturity of CA approaches to medical encounters. Attention is also given to promising new modes of research, and to the potential and challenges of improving medical practices by translating basic and rigorous empirical findings into innovative interventions for medical education. A case is made that increasing reliance on CA research can positively impact training and policies shaping the delivery of humane and quality medical care.

Article

Irina A. Iles and Xiaoli Nan

Counterfactual thinking is the process of mentally undoing the outcome of an event by imagining alternate antecedent states. For example, one might think that if they had given up smoking earlier, their health would be better. Counterfactuals are more frequent following negative events than positive events. Counterfactuals have both aversive and beneficial consequences for the individual. On the one hand, individuals who engage in counterfactual thinking experience negative affect and are prone to biased judgment and decision making. On the other hand, counterfactuals serve a preparative function, and they help people reach their goals in the future by suggesting effective behavioral alternatives. Counterfactual thoughts have been found to influence an array of cognitive processes. Engaging in counterfactual thinking motivates careful, in-depth information processing, increases perceptions of self-efficacy and control, influences attitudes toward social matters, with consequences for behavioral intentions and subsequent behaviors. Although it is a heavily studied matter in some domains of the social sciences (e.g., psychology, political sciences, decision making), counterfactual thinking has received less attention in the communication discipline. Findings from the few studies conducted in communication suggest that counterfactual thinking is a promising message design strategy in risk and health contexts. Still, research in this area is critically needed, and it represents an opportunity to expand our knowledge.