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Optimism and Its Associations with Health Behavior and Responses to Health Communication  

Amanda J. Dillard and Erin M. Ellis

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


Parent–Child Interaction  

Haley Kranstuber Horstman, Alexie Hays, and Ryan Maliski

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


Parents as Agents for Change in Health and Risk Messaging  

Natoshia Askelson and Erica Spies

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


Patterns of Reasoning  

William Mosley-Jensen and Edward Panetta

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


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.


Persuasive Health Message Design  

Nancy Grant Harrington

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


Physiological Measures of Wellness and Message Processing  

Kory Floyd, Corey A. Pavlich, and Dana R. Dinsmore

Research has shown that the expression of affection and other forms of prosocial communication between two or more people promotes wellness and has the potential to increase life expectancy. The human body contains multiple physiological subsystems that all contribute to the overall health and well-being of an individual; the simple act of engaging in prosocial communication has been shown to positively influence one’s health and well-being. The specific benefits of engaging in prosocial communication are not limited to one specific physiological subsystem; it is the pervasiveness of this benefit that is so important. The benefits of prosocial communication range from building the body’s defense systems to increasing the effectiveness of recovery; in essence, prosocial communication increases the body’s overall integrity and rejuvenating power. These benefits have been observed for a variety of prosocial behaviors, including the expression of affection, touch, social support and cohesion, and social influence. The health benefits of prosocial communication point to the importance of considering prosocial communication when designing health and risk messages.


The Politics of Scientific Knowledge  

Elizabeth Suhay

This article discusses the various ways in which political concerns among government officials, scientists, journalists, and the public influence the production, communication, and reception of scientific knowledge. In so doing, the article covers a wide variety of topics, mainly with a focus on the U.S. context. The article begins by defining key terms under discussion and explaining why science is so susceptible to political influence. The article then proceeds to discuss: the government’s current and historical role as a funder, manager, and consumer of scientific knowledge; how the personal interests and ideologies of scientists can influence their research; the susceptibility of scientific communication to politicization and the concomitant political impact on audiences; the role of the public’s political values, identities, and interests in their understanding of science; and, finally, the role of the public, mainly through interest groups and think tanks, in shaping the production and public discussion of scientific knowledge. While the article’s primary goal is to provide an empirical description of these influences, a secondary, normative, goal is to clarify when political values and interests are or are not appropriate influences on the creation and dissemination of scientific knowledge in a democratic context.


Popular Media and Exposure to Health and Risk Messages  

Kimberly N. Kline

Popular media are a source of information, a powerful socializing agent, and generate sociopolitical and sociocultural meanings that impinge on health promotion and/or disease prevention efforts and individual lived experiences. Thus, motivated by the goal of improving individual and social health, multidisciplinary scholars attend to the implications of entertainment and news media with regard to a range of topics such as individual health threats related to prevention, health conditions and illnesses, patient–provider interactions and expectations, public health issues related to crisis management and health recommendations, and public policy. Scholarship in this line of research may approach the study of popular media guided by the social scientific tradition of media effects theory to explain and predict response or by critical theory to consider ideological implications and employ different methodologies to describe and evaluate the images of health and health-related matters to which people are being exposed or that focus on media representations or audience (both individual and societal) response.


Positive Affect Related to Health and Risk Messaging  

Mengfei Guan and Jennifer L. Monahan

Positive emotional appeals can be an important, if often underutilized, component in health campaigns. Research reviewed from advertising, marketing, health communication, and social influence demonstrated how campaigns can promote risk-reduction behaviors by focusing on positive incentives, highlighting positive outcomes, and evoking positive feelings toward the health-related behavior. People who feel good during and after exposure to a health message tend to have favorable attitudes toward the message, which in turn establishes more open, rather than resistant, attitudes toward the issue or risk-reduction behavior promoted in the message. Along with influencing behavior via attitudes, positive affect can have a direct impact on behavior or intention. As suggested by broaden-and-build theory, positive affect broadens attention and thinking processes, increases openness to information, and helps form beliefs that the behavioral change promoted in the message is possible. Relatedly, positive affect tends to activate approach-oriented behaviors through the function of the behavioral activation system. Two primary strategies have demonstrated efficacy at promoting positive feelings: the use of gain-framed appeals and evoking the core relational theme of happiness. Gain-framed appeals emphasize the rewards obtained by following message recommendations and can boost behavioral adoption, particularly of proscriptive behaviors, by highlighting positive outcomes and goal congruency. Happiness occurs when people believe they are making progress toward realizing their goals, and messages can be created to induce positive feelings like happiness by focusing on self-efficacy, response efficacy, and perceived benefits. Positive message appeals are especially useful for counteracting the potential drawbacks of traditional negative appeals in that they can reduce message fatigue, gain attention, and attenuate psychological reactance. Challenges for future research include increasing efforts to systematically understand how and when to best utilize the power of positive messages in campaigns. Another related challenge is to examine how positive affect is aroused at a particular stage of exposure to health risk messages, and how emotions (both negative and positive), flow, evolve, and transit from one to another (e.g., fear to relief, anxiety to happiness) during and after message exposure.


Positive Deviance: A Non-Normative Approach to Health and Risk Messaging  

Arvind Singhal and Lucia Dura

The Positive Deviance (PD) approach is based on the premise that every community has individuals or groups whose uncommon behaviors and strategies enable them to find better solutions to problems than their peers although everyone has access to the same resources and challenges. In contrast to traditional problem-solving approaches that begin with an expert-driven analysis of “what is not working” with people—their explicit needs, deficits, problems, and risks—followed by attempts to plug those gaps, the PD approach focuses on identifying “what is working.” PD offers a systematic framework to identify assets, indigenous knowledge, and home-grown solutions, and to amplify them for wider adoption. The PD approach was operationalized and systematized in the early 1990s in Vietnam to address malnutrition. At the time, 65% of children under five were malnourished. Instead of looking for the causes and applying best practices, PD pioneers looked for children from very poor families who were well-nourished. Through community-led efforts, they determined the existence of positive deviants, identified their behaviors and strategies, and amplified them. The process was replicated across 14 villages—each identifying its own batch of local practices—and malnutrition decreased by 85%. These actions led to PD as we know it today in the form of the “6 Ds”: Define, Determine, Discover, Design, Discern, and Disseminate. PD has been used widely to address a large number of intractable social problems—many of them dealing with health and risk: reducing endemic malnutrition, decreasing neonatal and maternal mortality, reducing goiter and diseases of micronutrient deficiency, boosting organ transplantation rates and cancer screenings, increasing mental well-being and psychological resilience, preventing and controlling malaria and Chagas, and reducing hospital-acquired infections in healthcare. From 2004 to 2008, six U.S. hospitals pioneered the use of PD to address the growing incidence of infections caused by the antibiotic resistant bacteria Methicillin-resistant Staphylococcus aureus (MRSA). PD was used to identify and amplify evidence-based infection prevention practices. Pilot outcomes included a 73% average reduction in healthcare-associated MRSA infections units and a subsequent decrease of between 33 and 84% at the different hospitals. The PD approach to problem-solving holds important implications for public health scholars and practitioners, risk communicators, and message designers. The cases of Vietnam and one of the pilot hospitals are used to illustrate the ways that through language- and action-based strategies PD challenges traditional risk and health messaging, proposing instead an asset-based, participatory, and sustainable framework.


Presumed Media Influence in Health and Risk Messaging  

Shirley S. Ho and Andrew Z. H. Yee

Health communication research has often focused on how features of persuasive health messages can directly influence the intended target audience of the messages. However, scholars examining presumed media influence on human behavior have underscored the need to think about how various audience’s health behavior can be unexpectedly influenced by their exposure to media messages. Two central theoretical frameworks have been used to guide research examining the unintended effects: the third-person effect and the influence of presumed media influence (IPMI). The theoretical explanations for presumed media influence is built on attribution bias, self-enhancement, perceived exposure, perceived relevance, and self-categorization. Even though both the third-person effect and the IPMI share some theoretical foundations, and are historically related, the IPMI has been argued to be better suited to explaining a broader variety of behavioral consequences. One major way that presumed media influence can affect an individual’s health behavior is through the shifting of various types of normative beliefs: descriptive, subjective, injunctive, and personal norms. These beliefs can manifest through normative pressure that is theoretically linked to behavioral intentions. In other words, media have the capability to create the perception that certain behaviors are prevalent, inculcating a normative belief that can lead to the uptake of, or restrain, health behaviors. Scholars examining presumed media influence have since provided empirical support in a number of specific media and behavioral health contexts. Existing findings provide a useful base for health communication practitioners to think about how presumed media influence can be integrated into health campaigns and message design. Despite the proliferation of research in this area, there remains a need for future research to examine these effects in a new media environment, to extend research into a greater number of health outcomes, to incorporate actual behavioral measures, and to ascertain the hypothesized causal chain of events in the model.


Procrastination, Health, and Health Risk Communication  

Fuschia M. Sirois

Whether viewed as a domain-specific behavior or as an enduring tendency, procrastination is a common form of self-regulation failure that is increasingly recognized as having implications for health-related outcomes. Central to procrastination is the prioritization of reducing immediate negative mood at the cost of decisions and actions that provide long-term rewards, such as engaging in health behaviors. Because people tend to procrastinate on tasks they find difficult, unpleasant, or challenging, many health-promoting behaviors are possible candidates for procrastination. As modifiable risk factors for the prevention of disease and disability, health behaviors are often the target of health risk communications aimed at health behavior change and reducing health procrastination. Research has consistently demonstrated the deleterious effects of chronic procrastination on health outcomes, including poor physical health, fewer health promoting behaviors, and higher stress in healthy adults and those already living with a chronic health condition. Examining the factors and psychological characteristics associated with chronic procrastination can provide insights into the processes involved in procrastination more generally, as well as the qualities of the health messages that can promote or prevent procrastination of the targeted behaviors. Low future orientation, avoidant coping, low tolerance for negative emotions, and low self-efficacy need to be considered when designing effective health risk communications to reduce procrastination of health behaviors. Yet, health risk communications aimed at reducing procrastination of important health behaviors such as healthy eating, regular physical activity, screening behaviors, and cessation of risky health behaviors often use fear appeals to motivate taking protective actions to reduce health risks. Such approaches may not be effective because they amplify the negative feelings towards the health behaviors, which can engender maladaptive coping responses and motivate procrastination rather than adaptive responding. This is especially likely among individuals prone to procrastination more generally, or specifically with respect to health. Health risk communication approaches that minimize the negative emotions associated with risk messages and instead highlight short-term benefits of engaging in health behaviors may be necessary to reduce further health behavior procrastination among individuals prone to this form of self-regulation failure.


Public Health and Community Organizing as Agents for Change in Health and Risk Messaging  

Paul W. Speer and Leah Marion Roberts

Agents of change serve as catalysts for stimulating social change, particularly at community and societal levels of analysis. We often think about the characteristics of individuals who act as change agents, such as their capacity to motivate others or their training skills. However, organizations and disciplinary fields can also serve as agents of change. There is an emerging awareness in the fields of public health and community organizing as to how these respective fields can collaborate to leverage their collective insights and skills to become effective agents of change for community health outcomes. Importantly, while public health is concerned with the social determinants that shape health inequities in all communities, community organizing is focused on community issues that residents confront as constraints or problems in their daily lives. There is an inchoate understanding within the fields of public health and community organizing that the social determinants addressed in public health are often the same issues identified and addressed by community organizing groups. Both disciplines work as agents of change through their traditional efforts; however, there is promise in the evolving collaborations between these two fields. Recognition that both fields are addressing the same community phenomena is an important step, but whether collaborations and shared practices become distributed and institutionalized is an open question. Public health possesses research and analytic sophistication capable of identifying different social determinants and the pathways through which such determinants contribute to poor community health outcomes. In contrast, community organizing supplies an understanding of social change that requires the exercise of power through the participation and active engagement by those most directly affected by local issues or social determinants. One tension in this emergent collaborative practice stems from the fact that, at times, these different disciplinary skill sets are at odds. Whereas public health has a deep value of data analysis and expertise, community organizing prioritizes the participation and self-determination of those impacted by community problems. Fundamentally, the tension here is between the value placed on expertise versus the value placed on public participation. Neither value is inherently superior to the other; understanding how these two values can complement one another to address social determinants that shape community health outcomes is critical for realizing the promise of these organizational agents of change.


Public Relations in Health and Risk Communication  

John Lynch

Research on public relations (PR) in health and risk message design and processing is a small but persistent area of publication within the broader fields of science/health journalism, health communication, and public understanding of science. PR scholars define their field as the creation of two-way communication that emphasizes understanding of the organization’s position among stakeholders like journalists or the general public. In health, medicine, and science, PR is understood to be a bridge between scientists or scientific organizations and journalists, who tell scientific stories to the public. Most studies of science-related PR emphasize that it encourages a positive perception of science in general and scientists or scientific organizations in particular. This emphasis on a positive image for the scientific organization leads to mistrust of PR professionals by journalists. PR in health, medicine, and science consists of two areas. The first involves crisis PR, where the PR professional works to either prevent or respond to an emergency situation. This begins with environmental scanning and then creating plans to anticipate potential crises by considering ongoing political, social, environmental, and technological developments. The second area consists of science popularization, where the PR office provides journalists with story ideas and information that they can use to write their stories. Much of this information is provided in the form of press releases. Research has shown that press releases increase the amount of coverage of scientific and medical findings, and scholars are examining the ways in which press releases contribute to journalistic reportage and the situations in which the efforts of PR offices are frustrated.


Publics Approaches to Health and Risk Message Design and Processing  

James E. Grunig and Jeong-Nam Kim

The concept of publics and related notions such as receivers, audiences, stakeholders, mass, markets, target groups, and the public sphere are central to any discussion of formal communication programs between organizations or other strategic communicators and the individuals or groups with which they strive to communicate. The concept explains why individuals and collectivities of individuals are motivated to communicate for themselves (to seek or otherwise acquire information), with similar individuals to form organized groups, and with formal organizations to make demands on those organizations or to shape the behavior of the organizations. Theories of publics originated in the 1920s as the result of debates over the nature of citizen participation in a democracy, the role of the mass media in forming public opinion, the role of public relations practitioners in the process, and the effects of communicated messages on publics, audiences, and other components of society. J. Grunig developed a situational theory of publics in the 1960s that has served as the most prominent theory of publics for 50 years, and J.-N. Kim and J. Grunig recently have expanded that theory into a situational theory of problem solving. These theories have been used to identify and segment types of publics, to explain the communication behaviors of those publics, to conceptualize the effects of formal communication programs, to understand the cognitive processes of members of publics, and to explain the development of activist groups. Other scholars have suggested additions to these theories or alternatives to more thoroughly explain how communication takes place between members of publics and to identify latent publics that are largely ignored in the situational theories.


Public Service Announcements and Exposure to Health and Risk Messages  

William DeJong

Public service announcements (PSAs) emerged after World War II in the United States as a promising strategy for increasing awareness of important social issues and changing beliefs, attitudes, and behavior. Research at that time showed that PSA campaigns had limited success in changing attitudes and behavior. Even so, both in the U.S. and internationally, sponsoring agencies and organizations continued to produce PSAs, hoping they would create significant behavior change. In the 1980s, a more informed view of what PSAs can achieve began to emerge as practitioners of social marketing demonstrated that media campaigns can produce behavior change when they are designed and executed according to the principles and best practices followed by the advertising industry. Beginning in the 1990s, PSA-based campaigns to promote public action through programs and policy change became more common. Research has shown that such campaigns can play a key role in shaping the public agenda, changing perceptions of social norms, reinforcing school- and community-based programs, and building support for and then publicizing changes in public policy, all of which can foster individual behavior change. PSAs and other media executions are best designed using a planning scheme that is grounded in advertising best practices and behavior change theory and that uses those media executions as part of a broader intervention effort. These various elements can be brought together by using a media planning guide that outlines how the campaign will work in sync with other intervention activities and what its key messages will be. In the United States, federal regulations that outlined broadcasters’ public service obligations were loosened in the 1980s, making it increasingly difficult to get donated time for PSAs and other public service messages. More broadly, the increased focus of broadcasters, cable networks, and print publications on generating revenue has magnified this problem. Faced with strong competition, campaign planners need a strategy for convincing media gatekeepers to give priority to their messaging. The rise of social media (e.g., Facebook, Instagram, Twitter) has opened up a new means of putting PSAs before the public. For example, once a message is posted on a video-sharing website such as YouTube, it can be linked to the sponsoring organization’s website, where additional intervention-related material can be found, as well as to websites hosted by other groups. Promotional efforts through national, state, and community organizations can draw an initial audience, with the hope that they will share the link with their social media and email contacts and that eventually the message will “go viral.” PSAs remain a viable media alternative for public communication campaigns, despite the fact that major media outlets do not often provide donated time or space for such advertising. In some cases, a PSA-driven campaign will be supported by a large budget, but while such campaigns have a better chance of success, the resources required are seldom available. The emergence of social media has created a new way to build an audience. Successful examples of social media campaigns are emerging, but why some campaigns take off and others do not requires additional study.


Queer Healthcare Communication  

Nicole Hudak

Queer healthcare communication spans different literature and topic areas. The medicalization of queer bodies has historically and continues to influence how queer individuals interact and communicate within healthcare settings. Further, heterosexism is rampant within medical institutions that perpetuate the idea that all patients are heterosexual. Because of the influence of heterosexism, medical schools are designed to ignore queer bodies. If queer bodies are acknowledged, they are positioned as something exotic and not presented as a typical patient. Heterosexism is further communicated in patient and provider interactions by providers assuming their patients’ heterosexual identity and assuming all queer patients are promiscuous. In turn, queer patients may make decisions about their healthcare based on providers’ heterosexist attitudes. Providers who practice medicine have also demonstrated their limited knowledge about queer patients and how to care for them. The literature on discrimination of queer patients focuses more on how providers have used both verbal and non-verbal forms of communication. In looking at queer discrimination, queer invisibility demonstrates more covert functions of healthcare communication. Due to the invisibility of queer patients, disclosure becomes a site of interest for researchers. While some queer patients try to seek out queer-friendly providers, researchers have given recommendations on how healthcare providers can improve their queer competency. Finally, some notable topics within queer healthcare communication include queer pregnancy, HIV, and why transgender identity should be a separate topic as transgender people have their own healthcare needs.


Queer(ing) Reproductive Justice  

Natalie Fixmer-Oraiz and Shui-yin Sharon Yam

The history, principles, and contributions of the reproductive justice (RJ) framework to queer family formation is the nexus that connects the coalitional potential between RJ and queer justice. How the three pillars of RJ intersect with the systemic marginalization of LGBTQ people—especially poor queer people of color—helps clarify how the RJ framework can elaborate the intersectional understandings of queer reproductive politics and kin.


Queer Safer Sex Communication  

Kami Kosenko

Although communication scholars have been exploring the role of partner communication in sexual health promotion since the 1960s, the term safer sex, and its corollary safer sex communication, emerged in the late 1980s in the wake of the HIV/AIDS epidemic, which was and still is disproportionately affecting queer individuals. Numerous studies, along with some meta-analyses, point to the protective potential of safer sex discussions, defined here as the communicative management of health concerns with sex partners. Despite scholarly agreement regarding its importance, the term safer sex communication has received little explication, and much of what is known about it comes from studies with predominantly heterosexual samples. A review of the literature on queer safer sex communication points to some key issues related to age, race, trauma history, place, and pre-exposure prophylaxis (PrEP), and suggests important considerations for future research efforts.