Strategic communication is an essential component in the science and practice of recruiting participants to clinical research studies. Unfortunately, many clinical research studies do not consider the role of communication in the recruitment process until efforts to enroll patients in a timely manner have failed. The field of communication is rich with theory and research that can inform the development of an effective recruitment plan from the inception of a clinical research study through informed consent. The recruitment context is distinct from many other health contexts in that there is often not a behavioral response that can be universally promoted to patients. The appropriateness of a clinical research study for an individual is based on a number of medical, psychological, and contextual factors, making it impossible to recommend that everyone who is eligible for a clinical research study enroll. Instead, clinical research study recruitment efforts must utilize strategic communication principles to ensure that messages promote awareness of clinical research, maximize personal relevance, minimize information overload, and facilitate informed choice. This can be accomplished through careful consideration of various aspects of the communication context described in this chapter, including audience segmentation, message content, message channels, and formative, process, and outcome evaluation, as well as the enrollment encounter.
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Communication and Recruitment to Clinical Research Studies
Janice L. Krieger and Jordan M. Neil
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Cybervetting
Brenda L. Berkelaar and Millie A. Harrison
Broadly speaking, cybervetting can be described as the acquisition and use of online information to evaluate the suitability of an individual or organization for a particular role. When cybervetting, an information seeker gathers information about an information target from online sources in order to evaluate past behavior, to predict future behavior, or to address some combination thereof. Information targets may be individuals, groups, or organizations. Although often considered in terms of new hires or personnel selection, cybervetting may also include acquiring and using online information in order to evaluate a prospective or current client, employee, employer, romantic partner, roommate, tenant, client, or other relational partner, as well as criminal, civil, or intelligence suspects. Cybervetting takes advantage of information made increasingly available and easily accessible by regular and popular uses and affordances of Internet technologies, in particular social media. Communication scholars have long been interested in the information seeking, impression management, surveillance, and other processes implicated in cybervetting; however, the uses and affordances of new online information technologies offer new dimensions for theory and research as well as ethical and practical concerns for individuals, groups, organizations, and society.
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“keepin’ It REAL”: A Case History of a Drug Prevention Intervention
Michael L. Hecht and Michelle Miller-Day
Adolescent substance use and abuse has long been the target of public health prevention messages. These messages have adopted a variety of communication strategies, including fear appeals, information campaigns, and social marketing/branding strategies. A case history of keepin’ it REAL, a narrative-based substance abuse prevention intervention that exemplifies a translational research approach, involves theory development testing, formative and evaluation research, dissemination, and assessment of how the intervention is being used in the field by practitioners. The project, which started as an attempt to test the notion that the performance of personal narratives was an effective intervention strategy, has since produced two theories, an approach to implementation science that focused on communication processes, and, of course, a school-based curriculum that is now the most widely disseminated drug prevention program in the world.
At the core of the keepin’ it REAL program are the narratives that tell the story of how young people manage their health successfully through core skills or competencies, such as decision-making, risk assessment, communication, and relationship skills. Narrative forms not only the content of curriculum (e.g., what is taught) but also the pedagogy (e.g., how it is taught). This has enabled the developers to step inside the social worlds of youth from early childhood through young adulthood to describe how young people manage problematic health situations, such as drug offers. This knowledge was motivated by the need to create curricula that recount stories rather than preaching or scaring, that re-story health decisions and behaviors by providing skills that enable people to live healthy, safe, and responsible lives. Spin-offs from the main study have led to investigations of other problematic health situations, such as vaccination decisions and sexual pressure, in order to address crucial public health issues, such as cancer prevention and sex education, through community partnerships with organizations like D.A.R.E. America, 4-H clubs, and Planned Parenthood.
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LGBTQ+ Workers
Elizabeth K. Eger, Morgan L. Litrenta, Sierra R. Kane, and Lace D. Senegal
LGBTQ+ people face unique organizational communication dilemmas at work. In the United States, LGBTQ+ workers communicate their gender, sexuality, and other intersecting identities and experiences through complex interactions with coworkers, supervisors, customers, publics, organizations, and institutions. They also utilize specific communication strategies to navigate exclusionary policies and practices and organize for intersectional justice. Five central research themes for LGBTQ+ workers in the current literature include (a) workplace discrimination, (b) disclosure at work, (c) navigating interpersonal relationships at work, (d) inclusive and exclusive policies, and (e) intersectional work experiences and organizing.
First, the lived experiences of discrimination, exclusion, and violence in organizations, including from coworkers, managers, and customers, present a plethora of challenges from organizational entry to exit. LGBTQ+ workers face high levels of unemployment and underemployment and experience frequent microaggressions. Queer, trans, and intersex workers also experience prevalent workplace discrimination, uncertainty, and systemic barriers when attempting to use fluctuating national and state laws for workplace protections. Second, such discrimination creates unique risks that LGBTQ+ workers must navigate when it comes to disclosing their identities at work. The complexities of workplace disclosure of LGBTQ+ identities and experiences become apparent through closeting, passing, and outing communication. These three communication strategies for queer, trans, and intersex survival are often read as secretive or deceptive by heterosexual or cisgender coworkers and managers. Closeting communication may also involve concealing information about personal and family relationships at work and other identity intersections. Third, LGBTQ+ people must navigate workplace relationships, particularly with heterosexual and/or cisgender coworkers and managers and in organizations that assume cisheteronormativity. Fourth, policies structure LGBTQ+ workers’ lives, including both the positive impacts of inclusive policies and discrimination and violence via exclusionary policies. Fifth and finally, intersectionality is crucial to theorize when examining LGBTQ+ workers’ communication. It is not enough to just investigate sexuality or gender identity, as they are interwoven with race, class, disability, religion, nationality, age, and more. Important exemplars also showcase how intersectional organizing can create transformative and empowering experiences for LGBTQ+ people. By centering LGBTQ+ workers, this article examines their unique and complex organizational communication needs and proposes future research.
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Maternal Emotions and Childrearing in China
Meng Li
Psychological research on maternal emotions often examines how mothers’ emotional expression or regulation may affect children’s development. This perpetual interest in the benefit and harm of mothers’ emotions reflects popular beliefs that women are inherently emotional and, as the primary caregiver of children, mothers must restrain and regulate their emotions in order to raise well-balanced children. Rather than treating maternal emotions as private, intrapersonal feelings, scholars from various disciplines (e.g., sociology, anthropology, communication, women’s and gender studies, etc.) have recognized that many sociocultural forces contribute to the formation and interpretation of emotions. Emotions are not just a primary means through which humans experience the world but are also an avenue for understanding both the individual and the society. The interaction between the psychological and the social is especially salient in societies undergoing radical social transformations, such as China.
In the postsocialist era (1978–present), a mother-responsible, child-centered, and education-oriented childrearing culture has emerged in China, presenting unforeseen challenges to parents. Unlike their parents’ generation who mostly adopted traditional authoritarian styles of childrearing, parents who raise children in the new cultural environment are expected to meet the multifaceted needs of their children while also cultivating intimate bonds with them. Mothers in particular carry the greatest emotional burden of childrearing. To be good mothers, they are told that they must learn how to express their emotions appropriately. Proper expressions of love and intimacy keep the channels of communication open and foster trust between generations. Expressions of negative emotions, conversely, are described by childcare experts as a potential threat to children’s psychological development. But when mothers are confronting a highly competitive education system and an increasingly narrower path for social mobility, negative emotions, such as anger and ambivalence, are inevitable and justified. Mothers from different socioeconomic backgrounds also have different emotional experiences when raising children. While urban middle-class mothers are anxious about food safety, environmental pollution, and their children’s educational achievements, rural–urban migrant mothers feel guilty for leaving their children behind in the countryside to pursue a dependable income. Overall, the Chinese case illustrates how maternal emotions can provide a unique window through which a society’s childrearing culture, intergenerational dynamics, and structural inequalities can be observed.
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Negotiating Work–Life
Brenda L. Berkelaar and LaRae Tronstad
How people negotiate the work–life interface remains a popular topic for scholars and the public. Work–life research is a large body of interdisciplinary scholarship that considers how people experience, navigate, and negotiate different roles, commitments, and boundaries within and across life domains—often with the goal of improving individual, organizational, and social well-being and success. Spurred by demographic, social, economic, and technological changes, scholars take difference perspectives on overlapping research areas which include work–life balance, work–life conflict, work–family conflict, boundary management, work–life enrichment or facilitation, as well as positive or negative spillover. Key issues addressed include the implications of framing work–life as a dichotomy, drivers of work–life outcomes, how ideals shape work–life negotiations, how individuals negotiate everyday work–life challenges and opportunities, and the influence of evolving information and communication technologies on the work–life interface. Research from multiple disciplines highlights the demographic, economic, moral, cultural, and national factors that affect work–life practices, processes, policies, tactics, and outcomes. This multidisciplinary perspective provides relevant insights for generative research and resilient practice for individuals, groups, organizations, or societies.
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Relational Dialectics Theory
Kristina M. Scharp
Relational dialectics theory (RDT) is a postmodern critical theory of meaning. Based on the writing of Russian philosopher, RDT attunes researchers to the ways that discourses (i.e., ideologies) compete to make meaning of particular semantic objects (e.g., identities, phenomena, processes, etc.). Of note, not all discourses hold the same amount of power. Some discourses are dominant (i.e., centripetal) whereas others are marginalized (i.e., centrifugal). RDT researchers, then, are primarily interested in exploring how these discourses, with unequal power, compete. This focus on the competition of discourses for power and the ability of RDT to call out the ideological forces that disenfranchise some groups while enfranchising others holds promise for practical applications such as debunking misconceptions and better understanding where privilege comes from and how it is perpetuated.
When discourses compete, they might do so within or across a set of utterances. Utterances are turns in talk and serve as the primary unit of analysis in RDT research. Utterances, however, are not standalone entities. Rather, they are connected by different links to form an utterance chain. Some links of the utterance chain pertain to time (what has been said before and what response an utterance can anticipate) whereas the other links of the utterance chain pertain to the relationship level (some pertain to the culture at large whereas other only to an idiosyncratic relationship).
Overall, discursive competition takes place across a continuum of interplay. At one end of the continuum is monologue. Monologue represents the absence of meaning. Next are discursive enactments (i.e., closure) that reinforce the dominant discourse and shut down alternatives (see entry for complete list). Diachronic separation occurs when the dominance of a discourse changes across time. Diachronic separation can take two forms: (a) spiraling inversion or (b) segmentation. Synchronic interplay is next and occurs when two discourses compete within a given utterance. When RDT researchers examine a text for synchronic interplay, they often look to see how a marginalized discourse (a) negates, (b) counters, or (c) entertains the dominant discourse. Finally, on the other end of the continuum of interplay, is dialogic transformation. Dialogic transformation occurs through either (a) discursive hybridity or (b) an aesthetic moment whereby discourses suspend their interplay to create new meanings.
Conducted using RDT’s corresponding method, contrapuntal analysis, researchers using this theory work to disrupt hegemonic, taken-for-granted assumptions about how things are and call attention to voices overlooked in the past. To date, this theory has been taken up primarily by family, interpersonal, and health communication scholars, although many scholars have used this theory throughout the discipline.
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Supportive Communication Providers for Chronic Disease Management
Kristin L. Farris and Maureen P. Keeley
Social support in the context of chronic illness management is important, as individuals diagnosed with these conditions and their loved ones often experience increased distress, reduced relational quality, and diminished physical health as a result of coping with these long-term symptoms. Therefore, diagnosed individuals and their close relational partners rely on others to provide support in their time of need. The communication of social support is characterized by “verbal and nonverbal behavior produced with the intention of providing assistance to others perceived of needing that aid” (MacGeorge, Feng, & Burleson, 2011, p. 317). Individuals living with these chronic illnesses and their loved ones often turn to a variety of interpersonal others, including friends, family, health care providers, and support groups to manage the difficulties that accompany their physical symptoms. Although some researchers suggest that diagnosed individuals seek support most frequently from close relational partners, other scholars assert that chronic care support groups (whether meeting face to face or via computer-mediated channels) offer support recipients an opportunity to discuss their challenges and receive help from experientially similar others.
On the one hand, regardless of the support provider, individuals who have been diagnosed with chronic conditions generally perceive effective supportive communication to be messages in which their support providers enact competent tangible assistance in managing the illness, provide an opportunity for them to vent their feelings, and express messages of empathy and affection, among others. Ineffective messages, on the other hand, are those in which diagnosed individuals feel their partners are overly involved in helping them make decisions about their care or portraying negative attitudes or discomfort around them. Overall, research in this area suggests that support recipients and their relational partners have improved emotional, relational, and physical outcomes when they perceive support to be available or receive effective support from these resources.
