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Disruption Information Seeking and Processing Model Applied to Health and Risk Messaging  

Joshua A. Braun

The disruption information seeking and processing (DISP) model is a variation on the risk information seeking and processing (RISP) model. While both the DISP and the original RISP models seek to predict how individuals will search for and attend to information in response to a perceived hazard, DISP aims to broaden analysts’ view of the sorts of information individuals may seek in such situations. It does so by expanding the repertoire of social psychology theory on which the model is constructed to include ideas from the literatures on sensemaking and identity maintenance. A major argument of DISP is that on many occasions the information that people seek in response to a risk will not be directly related to the risk itself. For example, if you hear a news bulletin on an outbreak of food poisoning associated with ground beef, the next thing you look for may not be information on the risks of E. Coli, but a recipe for chicken. While the observation that people seek non-risk-related information in response to risks is a broad one, the DISP concerns itself with one particularly important aspect of this idea. Specifically, based on research in the sensemaking and identity maintenance traditions, the DISP model proposes that, for information seekers, the self and the various identities in which individuals are personally invested are often as much the objects in need of interpretation as the hazardous environment. The implication of this is that when faced with a risk, individuals are likely to pay attention not just to information on the risk itself (the sort of information prioritized by RISP), but on the identities impacted by the hazard—for example, how a person’s acceptance of or strategy for coping with the risk might affect her self-image as being a good parent, a conscientious employer, etc. The DISP also proposes that some hazard situations are likely to be more disruptive to individuals’ sense of self than others—namely instances where the individual has a high vested interest in a particular identity that is challenged by the hazard combined with a low sense of self-efficacy with respect to remediating the hazard. A typical example would be a parent who prides herself on keeping her kids safe, who finds out about an environmental risk to children in her neighborhood, but who cannot afford to move. According to the DISP model, in such a circumstance the individual would likely become more attuned to information about the countervailing positive aspects of the neighborhood, such as good schools or a low crime rate. These sorts of information, which do not pertain to the risk directly, but are nonetheless sought as a consequence of the risk, exemplify the manner in which DISP seeks to expand the focus of the original RISP model. In the parlance of DISP, the model adds a “self-relevant” information dimension to RISP’s original focus on “risk-relevant” information. Finally, the DISP model proposes the notion of “norm trumping,” suggesting that individuals experiencing disruption in the face of a hazard—who run afoul of the set of social norms associated with an identity in which they are highly invested—are likely to pay particular attention to self-relevant information that emphasizes alternative sets of norms that help to preserve or reconstitute a desired sense of self. This model has yet to be tested empirically.


Direct-to-Consumer Advertising and Health and Risk Messaging  

Kimberly A. Kaphingst

Direct-to-consumer advertising of prescription drugs (DTCA) is a multibillion-dollar industry in the United States, affecting the health-care landscape. DTCA has been controversial, since a major increase in this type of advertising resulted from re-interpretation of existing regulations in the late 20th century. Health and risk communication research can inform many of the controversial issues, assisting physicians, policymakers, and the public in understanding how consumers respond to DTCA. Prior research addresses four major topics: (1) the content of DTCA in different channels, (2) consumers’ perceptions of and responses to DTCA, (3) individual-level factors that affect how consumers respond to DTCA, and (4) message factors that impact consumers’ responses. Such research shows that the presentation of risk and benefits information is generally not balanced in DTCA, likely affecting consumers’ attitudes toward and comprehension of the risk information. In addition, despite consumers’ generally somewhat negative or neutral perceptions of DTCA, this advertising seems to affect their health information seeking and communication behaviors. Finally, a wide range of individual-level and message factors have been shown to have an impact on how consumers process and respond to DTCA. Consumers’ responses, including how they process the information, request prescription drugs from providers, and share information about prescription drugs, have an important impact on the effects of DTCA. The fields of health and risk communication therefore bring theories and methodologies that are essential to better understanding the impact of this advertising.


Counterfactuals in Health and Risk Messaging  

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.


Mood’s Role in Selective Exposure to Health and Risk Information  

Melissa J. Robinson and Silvia Knobloch-Westerwick

In today’s media-saturated environment, individuals may be exposed to hundreds of media messages on a wide variety of topics each day. It is impossible for individuals to attend to every media message, and instead, they engage in the phenomenon of selective exposure, where certain messages are chosen and attended to more often than others. Health communication professionals face challenges in creating messages that can attract the attention of targeted audiences when health messages compete with more entertaining programming. In fact, one of the greatest obstacles for health campaigns is a lack of adequate exposure among targeted recipients. Individuals may avoid health messages completely or counterargue against persuasive attempts to change their health-related attitudes and behaviors. Once individuals have been exposed to a health message, their current mood plays an important role in the processing of health information and decision making. Early research indicated that a positive mood might actually be detrimental to information processing because individuals are more likely to process the information heuristically. However, recent studies countered these results and suggested that individuals in positive moods are more likely to attend to self-relevant health information, with increased recall and greater intent to change their behaviors. Since mood has the ability to influence exposure to health messages and subsequent message processing, it is important for individuals to be able to manage their mood prior to health information exposure and possibly even during exposure. One way individuals can influence their moods is through media use including TV shows, movies, and music. Mood management theory predicts that individuals choose media content to improve and maintain positive moods and examines the mood-impacting characteristics of stimuli that influence individuals’ media selections. Therefore, an individual’s mood plays an important role in selection of any type of communication (e.g., news, documentaries, comedies, video games, or sports). How can health message designers influence individuals’ selection and attention to health messages when negative moods may be blocking overtly persuasive attempts to change behaviors and a preference for entertaining media content? The narrative persuasion research paradigm suggests that embedding health information into entertainment messages may be a more effective method to overcome resistance or counterarguing than traditional forms of health messages (e.g., advertisements or articles). It is evident that mood plays a complex role in message selection and subsequent processing. Future research is necessary to examine the nuances between mood and health information processing including how narratives may maintain positive moods through narrative selection, processing, and subsequent attitude and/or behavior change.


Anger in Health and Risk Messaging  

Claude H. Miller and Reinaldo Cortes Quantip

Within a range of health communication contexts, anger can be either a detriment to the receptivity of health promotion messages when poorly controlled, or a benefit to information processing when appropriately directed. In the former case, anger can disrupt cognitive processing, leading to a range of negative outcomes, including emotional turbulence and a preoccupation with anger-eliciting events that can severely limit the receptivity of health promotion and risk prevention messages. However, when properly directed and elicited in moderation, anger can motivate greater purpose and resolve in response to health threats, stimulate more active processing of health warnings, sharpen focus on argument quality, and direct greater attention to coping-relevant information concerning harmful health risks.


Social-Ecological Approaches to Health and Risk Messaging  

Kirsty Williamson

Before health and risk messaging can have the best possible effect, there needs to be an understanding of what might influence health and associated risky behaviors. A wide range of elements needs to be considered, given the many possible influences on health habits and risky exposures. Since “ecology” is defined as the relationship between organisms and their environments, ecological models enable this consideration to be made. As a result ecological approaches have been widely used in health behavior, health planning, and health education. Ecological theory, with a communication focus, has also been developed, emerging specifically from the field of “information behavior.” Grounded in the work of Bronfenbrenner, on the experimental ecology of human development, the theory grew out of a study of older adults’ information and communication needs and uses, undertaken in the 1990s. The ecological model, as developed, enabled a wide range of personal and social influences on information seeking and communication to be explored with people aged 60 and older. Analysis of the impact of multilevel factors is facilitated by an ecological approach, increasing its value for the task of designing the content of health and risk messages. The “how” of designing health messaging is not addressed specifically by this approach. Following the study of older adults, the ecological model was broadened, modified, and applied to the study of the information and communication behavior of different community groups, involving a range of topics. The flexibility of the approach is a key strength. A study of information seeking, by women with breast cancer, indicated that several “ecological” elements, such as age, ethnicity, and stage of disease, played a part in the type of information sought and in preferences for how information was communicated. Health and risk avoidance implications emerged from a study of information seeking for online investment, providing another good example of the ways in which the model can be adapted. A range of ecological factors were shown to influence investing behavior, including level of risk taking. A study of people in the Fourth Age (the last stage of life) resulted in a further refined and extended model, as well as making a contribution to the already substantial body of accumulated gerontological knowledge.


Message Sensation Value in Health and Risk  

Jie Xu

Message sensation value (MSV) is defined as the degree to which a message’s format and content features elicit sensory, affective, and arousal responses. MSV research has received considerable scholarly and professional attention for more than two decades. The seminal work, to date, has been conducted by the Kentucky School. MSV was initially operationalized as perceived message sensation value (PMSV). The activation model of information exposure (AMIE) provides the basis for explaining the functional mechanism of MSV and PMSV. The AMIE proposes that exposure is a function of the interaction between an individual’s sensation-seeking tendency and sensation-enhancing attributes of the message itself. There are three primary types of message features that contribute to MSV: (a) the formal video dimension, (b) the formal audio dimension, and (c) the content dimension. There is an important distinction between subjective reactions to the message (PMSV) and the format and content features contributing to these reactions (MSV). In general, messages of high relative to low in sensation value have elicited greater message processing and more favorable evaluations across a range of outcome variables in health communication. Some health communication campaigns have employed high sensation value messages to target high sensation seekers. This sensation-seeking targeting approach, SENTAR, however, has received mixed and limited support. The influence of MSV on message effectiveness might be very similar for the two groups. Recently, some scholars have attempted to situate AMIE in a broader context of persuasion. First, AMIE and the elaboration likelihood model (ELM) offer competing predictions in terms of the role of MSV in persuasion, such that AMIE stresses a straightforward attention-getting effect, whereas ELM predicts a distracting effect of MSV interfering with message’s content. The very few studies conducted thus far reveal limited and mixed findings. Second, in the integration of MSV research with the appraisal theory and excitation-transfer theory, MSV may function as an arousal generator to amplify the influence of discrete emotions on perceived message effectiveness. Third, according to the psychological reactance theory, there are challenges with implementing high sensation value (HSV) messages, in that they potentially could backfire among the target audiences. Messages with HSV may garner better-perceived effectiveness when they tone down the controlling language. Future studies should investigate the relationships between specific MSV-enhancing features and message processing. They can expand the literature by studying the impact of MSV in a variety of media message contexts (e.g., broadcast journalism). Future experiments might also incorporate psychophysiological measures (e.g., skin response and heart-rate deceleration) to complement self-reported measures. Future studies should continue to explore other features (e.g., visual-verbal redundancy) that might affect attention and message processing jointly with MSV, and other individual difference variables, such as need for cognition, trait reactance, locus of control, and etc.



Graham D. Bodie

Listening is recognized as a multidimensional construct that consists of complex (a) affective processes, such as being motivated to attend to others; (b) behavioral processes, such as responding with verbal and nonverbal feedback; and (c) cognitive processes, such as attending to, understanding, receiving, and interpreting content and relational messages. Research in the communication studies discipline has focused most heavily on the cognitive processes of listening with the least attention afforded to behavioral components. Although several models of listening have been put forward, scholars still struggle with basic notions of how best to define listening for research purposes and how to incorporate listening into mainstream theoretical frameworks. Contemporary scholarship explores intersections between listening and cultural studies research as communication scholars come to participate in larger discussions of the auditory environment. At the start of the 21st century, listening research is just one of the many sites where communication studies is making a contribution to interdisciplinary research across the humanities and social sciences.


Knowledge and Comprehension  

Ashley R. Kennard, Courtney Anderegg, and David Ewoldsen

Knowledge and comprehension are essential components of an individual’s understanding of a health text. Whether reading a health pamphlet or watching a health campaign in the form of a public service announcement (PSA), or watching edutainment programming, individuals gain knowledge about the health topic being discussed. Knowledge, however, can only be retained if the individual can also comprehend the text or video. Often comprehension in a health context focuses on health literacy or the degree to which individuals can process and understand health information in order to make informed health decisions. Health literacy is commonly viewed in terms of the readability (e.g., reading level, complexity) of the health text or script. However, in order for individuals to gain knowledge and use that knowledge appropriately and effectively in making health decisions, individuals need to comprehend or understand what the text is conveying. Because comprehension is such an important component of gaining and using health knowledge, we must understand how we store health knowledge in memory. A schema is a mental representation that stores knowledge as interrelated pieces of information. Schemas tend to be a fairly static representation of knowledge. A mental model is a more dynamic mental representation in that we use mental models to process, organize, and comprehend incoming information. In a mental model, there is a correspondence between an external entity and the constructed mental model of that entity that allows people to counterfactually manipulate information and engage in problem solving. A situation model is the most contextualized mental representation because it encompasses a specific event or set of interrelated events. There are several ways in which to examine comprehension processes. One way is to examine the most basic level of comprehension by investigating the importance of language and semantic representation of a text. A more complex way to examine comprehension is to view the activation levels of various words or concepts important in creating a representation of the story structure in memory. One model that specifically examines concept activation is the landscape model. The model posits that greater frequency of activation and the strength of activation of a concept determine the concept’s overall activation level. The higher the activation level of a concept in a text or video, the more likely the concept will be included in the mental representation for the text or video and stored in memory. A third way to study comprehension is to examine how concepts change throughout a text and how the concepts relate to one another. The event-indexing model describes how individuals create situation models based on five dimensions of information: time, space, protagonist, causality, and intentionality. Throughout the process of gaining information, the individual updates the situation models for a text on each of the five dimensions. When events have similar dimensions in common, the events are connected in memory; thus, describing health information with similar dimensions in common (e.g., a protagonist the entire way through the text, events happening in the same amount of time) will be better recalled later. Empirical work on comprehension of both text and video messages has demonstrated the landscape model and event-indexing model’s ability to examine comprehension processes based on the format, language, and organization of the information. Health message design can benefit from utilizing these comprehension models to ensure that knowledge is received by the intended audience and comprehended, and thus able to be used in future experiences.