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Transtheoretical Model and Stages of Change in Health and Risk Messaging  

Seth M. Noar

The Transtheoretical Model (TTM) is an integrative health behavior change theory that describes the process of how people change their behavior. The central organizing construct in the theory is stages of change, which are five distinct stages of readiness to change behavior, ranging from not ready to change (precontemplation), thinking about change (contemplation), preparing to change (preparation), changing (action), and maintaining the change (maintenance). Movement through the stages may be nonlinear, and cycling and recycling through the stages is viewed as a natural part of the change process. Other model constructs explain what drives individuals forward through the stages of change. Decisional balance involves a weighing of pros and cons of changing behavior, while self-efficacy involves situation-specific confidence that one can change. Increases in pros, deceases in cons, and increases in self-efficacy propel people forward through the stages of change. The processes of change are experiential and behavioral strategies that people use to change their behavior. In early stages of change, people use experiential strategies while they use behaviorally oriented strategies in later stages of change. The TTM holds significant implications for message design. Most notably, messages should be targeted and tailored to stages of change, and where possible, to other model variables as well. Studies indicate that the TTM has been successfully applied to health communication campaigns, and to a larger extent, to computer-tailored interventions to change health behavior. Meta-analyses indicate that scores of computer-tailored interventions have been efficacious, including many based upon the TTM and stages of change. New applications of the model include a focus on novel health behaviors, multiple behavior change, and advancing an understanding of message design in the context of the TTM in combination with other theoretical approaches.

Article

Critical Cultural Approaches to Gender and Sex  

Claire Sisco King

Within the field of communication studies, critical cultural scholarship examines the interarticulation of power and culture. Drawing from critical theory and cultural studies, this research offers analysis of texts, artifacts, practices, and institutions in order to understand their potential to promote or preempt equality and social justice. Critical theory, which has Marxist origins, uses theory as a basis for critiquing and challenging systems of domination or oppression. The field of cultural studies focuses on social formations with a particular emphasis on media texts and the reception practices of audiences. Both critical theory and cultural studies emphasize the important interrelationship between ideology, or structures of belief, and the material conditions in which people live. Critical cultural research examines discourse and representation, including language and visual culture, as well as social relations, institutional structures, material practices, economic forces, and various forms of embodiment. Central to critical cultural scholarship is attention to the construction, regulation, and contestation of categories of identity, including race, ethnicity, gender, sexuality, ability, and class. A significant branch of critical cultural studies examines how ideas about gender and sex develop and circulate, asking how and why some constructions of gender and sex become normative and gain hegemony—or, cultural privilege—in a particular context. For example, such scholarship might critique the idealization of certain performances of masculinity and the attendant devaluation of femininity or other subordinated masculinities; or, this research might consider how particular iterations of masculinity or femininity may be counter-hegemonic, operating in opposition to prevailing ideologies of gender and sex. Critical cultural approaches also emphasize the intersectionality of gender and sex with other categories of identity. For instance, ideas about masculinity or femininity can rarely be separated from assumptions about race and/or sexuality; as such, prevailing ideologies of gender and sex often reflect the presumed normativity of whiteness and heterosexuality.

Article

Critical Perspectives on Humanitarian Discourses  

Marouf Hasian Jr.

Critical studies of humanitarian discourses involve the study of the arguments, claims, and evidence that are used to justify intervention or non-intervention in key local, regional, national, or international contexts. These discourses can take the form of arguing over whether we should practice isolationism and not intervene in the sovereign affairs of other countries, or they can take the form of deliberations over the transcend needs of populations that cope with myriad disasters. In some cases these discourses are produced by foreigners who believe that the less fortunate need to be rescued from their misery, while at other times humanitarian discourses can be used in discussions about the human rights of the disempowered. Nongovernmental organizations (NGOs), nation-states, celebrities, medical communications, and militaries are just a few of the rhetors that produce all of these humanitarian discourses.

Article

Military Families and Communication  

Steven R. Wilson and Leanne K. Knobloch

Since the terrorist attacks on U.S. soil on September 11, 2001, communication scholars have turned their attention to understanding family communication processes across the deployment cycle. Military families are composed of service members as well as their spouses/partners, children, and extended family members. In 2012, U. S. Department of Defense statistics indicate that 53% of U.S. military personnel are married and 44% have children. Although scholars from fields such as family studies, psychology, and sociology have been studying military families since World War II, family communication scholars are relative newcomers to this topic. There are several reasons why communication scholars have spent the past decade investigating how service members, spouses, and children interact with each other as well as their larger social networks. One reason is the length and scope of the post 9/11 conflicts, such that millions of families in the U.S. and abroad have been impacted by these wars. A second is that the conflicts in Afghanistan and Iraq represent the first time the U.S. has fought two wars simultaneously with an all-volunteer force. This has meant that the burden of service has fallen on a small percentage of the U.S. public, which sometimes has left military families feeling isolated from their civilian counterparts. Third, communication technologies have evolved in comparison to prior conflicts, such that service members often have had the opportunity to interact regularly with family via multiple channels (e.g., phone, video, email, and social networking sites as well as letters/packages) during recent deployments. A fourth reason is that deployments create a context in which families are faced with choices and potential dilemmas about communicating. From the time that deployment orders are received, throughout months of separation, and after the service member returns home, military families must decide what to talk about (or avoid talking about) openly. During deployment, family members must find ways of maintaining their relationships while coping with new stressors. After the service member returns home, families often must manage relational uncertainty while renegotiating routines. In cases where service members have difficulty readjusting to civilian life, family members must find ways of navigating dilemmas that can arise when they attempt to voice their concerns. Most military families display remarkable resilience in responding to these communicative transitions and tensions. By conducting research framed by a number of theories, family communication scholars have worked towards better understanding the experiences of military families and producing knowledge useful for those serving with military families. Although comparative work on military families in other countries is starting to emerge, most research on communication processes has focused on U.S. military families. Research grounded in the relational turbulence model, communication privacy management theory, multiple goals theories, relational dialectics, and intergroup communication theories has helped clarify how military families communicatively navigate the process of having a service member deployed.

Article

Public Culture  

Robert Hariman

The concept of public culture refers most broadly to the dynamic negotiation of beliefs, values, and attitudes regarding collective association through media and other social practices that are defined by norms of open access and voluntary response. The concept is a recent innovation and applies primarily to modern societies, where public culture is the envelope of communication practices within which public opinion is formed; those practices can include news, entertainment, the arts, advertising, social media, and many other means for representing and judging any individual, institution, or custom having collective significance. The term “public” emphasizes relatively unrestricted communication across civil society regarding governance and other matters affecting the general welfare. The term “culture” emphasizes that public opinion depends on contextual factors that emerge through multiple media and embodied responsiveness. These considerations provide a basis for analysis of distinctively modern relationships across civil society, media technologies, and political action in a global context.

Article

Rhetorical Approaches to Health and Medicine  

Jennifer A. Malkowski, J. Blake Scott, and Lisa Keränen

Rhetoric, commonly understood as the art, practice, and analysis of persuasion, has longstanding connections to medicine and health. Rhetorical scholars, or rhetoricians, have increasingly applied rhetorical theories, concepts, and methods to the texts, contexts, discourses, practices, materials, and digital and visual artifacts related to health and medicine. As an emerging interdisciplinary subfield, the rhetoric of health and medicine seeks to uncover how symbolic patterns shape thought and action in health and medical texts, discourses, settings, and materials. In practice, rhetoricians who study health and medicine draw from the standard modes of rhetorical analysis, such as rhetorical criticism and rhetorical historiography, as well as from social science methods—including participant observation, interviewing, content analysis, and visual mapping—in order to deepen understanding of how language functions across health and medical objects, issues, and discussions. The objects of analysis for rhetorical studies of health and medicine span medical research, education, and clinical practice from laboratory notes to provider–patient interaction; health policymaking and practice from draft policies through standards of care; public health texts and artifacts; consumer health practices and patient advocacy on- and offline; public discourses about disease, death, bodies, illness, wellness, and health; online and digital health information; popular entertainments and medical dramas; and alternative and complementary medicine. Despite its methodological breadth, rhetorical approaches to science and medicine consistently involve the systematic examination and production of symbolic exchanges occurring across interactional, institutional, and public contexts to determine how individuals and groups create knowledge, meanings, identities, understandings, and courses of action about health and illness.

Article

Sequence Organization  

Chase Wesley Raymond

The adjacency pair is the most basic and normatively accountable sequential structure in interaction. This structure can be expanded through pre-sequences, insert-sequences, and post-expansions, which can be seen to be relevantly oriented to by interactants themselves. Various forces drive this normative organization, including issues related to epistemics, intersubjectivity, progressivity, and affiliation. Larger structures—for example, sequences of sequences, overall structural organization, and storytelling—also exist in interaction but are nonetheless composed of smaller units of talk. While potentially open to a certain amount of cultural variation, sequence organization exists cross-linguistically and cross-culturally as a general structural feature of human social interaction.

Article

Antonio Gramsci and Communication Studies  

Marco Briziarelli and Eric Karikari

The strong affinity between the work of Antonio Gramsci and communication is based on several Gramscian communication-related themes and particular modes of his thought that significantly resonate with this field of studies. They include his drawing on the rhetorical tradition inspired by Vico, his assumptions of the constitutive role of language in creating an intersubjective reality that shapes common sense, and the fact that language provides the conditions of possibility for a hegemonic project. The strong tie between communication and Gramsci’s thought creates a vantage point for understanding both how Gramsci developed his political theories based on communication concerns and how those theories in turn advanced the field of communication. On the one hand, Gramsci by his intellectual formation, as well as via life experiences, became extremely receptive of theories that linked language, culture, and society. Those theories can help illuminate Gramsci’s key ideas, such as hegemony, common sense, national popular, the strategic concept of translation, and the relational nature of concepts. On the other hand, Gramsci’s own reflection on the nexus between language and history significantly contributes to a theorization of language as a cultural practice resisting hypostases, an important qualification of Saussurian structural linguistics, and finally can offer the basis for a materialist approach to communication. Thus, the common denominator of a Gramscian perspective on communication must be found in the consistent use of dialectical thinking, which mediates binarisms like diachronic–synchronic, stability–change, individual–collective, unity–diversity, and symbolic–material. This article discusses the above-mentioned connection between Gramsci and communication in more detail. First, it explicates the ways in which Gramsci’s work was influenced by communication concerns, and then it analyzes how Gramsci’s work influences the realm of human communication today.

Article

Big Data and Communication Research  

Ralph Schroeder

Communication research has recently had an influx of groundbreaking findings based on big data. Examples include not only analyses of Twitter, Wikipedia, and Facebook, but also of search engine and smartphone uses. These can be put together under the label “digital media.” This article reviews some of the main findings of this research, emphasizing how big data findings contribute to existing theories and findings in communication research, which have so far been lacking. To do this, an analytical framework will be developed concerning the sources of digital data and how they relate to the pertinent media. This framework shows how data sources support making statements about the relation between digital media and social change. It is also possible to distinguish between a number of subfields that big data studies contribute to, including political communication, social network analysis, and mobile communication. One of the major challenges is that most of this research does not fall into the two main traditions in the study of communication, mass and interpersonal communication. This is readily apparent for media like Twitter and Facebook, where messages are often distributed in groups rather than broadcast or shared between only two people. This challenge also applies, for example, to the use of search engines, where the technology can tailor results to particular users or groups (this has been labeled the “filter bubble” effect). The framework is used to locate and integrate big data findings in the landscape of communication research, and thus to provide a guide to this emerging area.

Article

Communication Campaigns that Emphasize Environmental Influences on Health and Risk  

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.