Health risk messages may appeal to the responsibility of individuals or members of interdependent dyads for their own or others’ health using many different message strategies. Health messages may also emphasize society’s responsibility for population health outcomes in order to raise support for health policy changes, and these, too, take many different forms. Message designers are inherently interested in whether these appeals to personal, interdependent, and societal responsibility are persuasive. The central question of interest is therefore whether perceptions of responsibility that result from these messages lead to the desired message outcomes. A growing body of empirical research does suggest that there is a direct persuasive effect of perceptions of personal responsibility and interdependent responsibility on health intentions or behaviors, as well as indirect persuasive effects of responsibility on intentions or behaviors via anticipated emotions, specifically regret, guilt, and pride. Research also suggests that perceptions of societal responsibility increase support for public health policy (i.e., the desired message outcome in societal responsibility messages). Important to this area of research is a conceptual definition of responsibility that lends itself toward identifying specific message features that elicit perceptions of responsibility. Specifically, attributions of causation and solution, obligation, and agency are identified as effect-independent message features of responsibility.
Amber K. Worthington
The design and dissemination of health and risk messages invariably involves moral and ethical issues. The choice of the topics, the focus on particular recommended practices, the choice of particular groups to be the intended recipients of the messages and their inclusion in or exclusion from the message development process, all raise ethical issues. Further, the persuasive tactics used to influence people to change their attitudes and beliefs and to adopt recommended changes in their lives also raise ethical concerns. For example, persuasive tactics may infringe on people’s privacy when people view images they may find intrusive, offensive, or cause them distress. Tactics that “tug” at people’s emotions may infringe on their unhindered ability to make a conscientious decision. Employing digital media and sophisticated advertising and marketing tactics also elicits ethical challenges both related to their manipulative potential and their differential reach: all of which may contribute to social and health disparities. In addition, the practices recommended in health and risk messages may conflict with values people cherish. For example, people could be urged to change the way they communicate with their spouses on intimate issues, relinquish the consumption of favorite traditional foods—or messages may raise issues that recipients find taboo according to their culture or religious beliefs. Health and risk messages may have unforeseen and unintended adverse effects that could affect people’s emotional and physical aspects by inadvertently contributing to people’s sense of guilt through shaming or stigmatization. Also, on the cultural and social level, such messages may contribute to an idealization of a certain lifestyle or commercialization of products and celebrities associated with the messages. Philosophical and ethical frameworks typically used in communication ethics, bioethics, communication campaigns, and social marketing literature emphasize the central guiding principles of personal autonomy and privacy with the aim to ensure equity and fairness. The obligation to avoid “doing harm” includes concerns regarding labeling, stigmatizing, and depriving; the obligation to help; the obligation to respect people’s autonomy to make free choices, particularly concerns regarding persuasion tactics and manipulations and the use of threat tactics, provocative appeals, distressing images, framing tactics, cultural sensitivity, and moral relativism; the obligation to obtain consent; the obligation to truthfulness; the obligation to sincerity; the obligation to correctness, certitude, and reliability; the issue of personal responsibility; equity obligations including concerns regarding segmentation and “targeting”; the obligation to comprehensibility; the obligation of inclusion; utility and efficiency considerations; the “harm reduction” approach; and concerns regarding social value priorities and “distortions,” which includes prosocial values as moral appeals.
Since the earliest years of the film industry, journalists and journalism have played a leading role in popular culture. Scholars debate whether journalism films—and by extension television programs, plays, cartoons, comics, commercials, and online and interactive stories and games—are a distinct genre, or whether journalists are featured in a variety of genres from dramas to comedies and satires to film noir. They also debate whether a film needs to feature a journalist doing journalism as a primary character or whether having a journalist as a secondary character still counts as a “journalism” film. Regardless, research into depictions of journalists in popular culture is important because the depictions influence public opinion about real-world journalists, as well as the credibility and public trust of the journalism field. Indeed, the influence might be greater even than the actual work performed by real-world journalists. Popular culture cultivates legend and myth, and this cultivation is especially true for a field such as journalism because the majority of the public will never see the inside of an actual newsroom. Popular culture myths about journalism focus on its normative role. Journalistic heroes are the foreign correspondents and investigative reporters who stand for community and progress. Journalistic villains are the lovable rogues, remorseful sinners, and unrepentant scoundrels who break journalistic norms and roles. A wide range of heroes and villains have been depicted on the big and small screen. For every Woodward and Bernstein working tirelessly to expose a corrupt presidential administration in All the President’s Men, there is a Chuck Tatum hiding an injured man in order to keep an exclusive in Ace in the Hole. For every Murphy Brown, a prominent and award-winning investigative journalist and anchor, there is a Zoe Barnes in House of Cards who has sex with sources and knowingly publishes false information. Many of the most interesting depictions, however, feature a character who has aspects of heroism and villainy. For example, Megan Carter in Absence in Malice attempts to be a watchdog reporter but destroys lives with her mistakes. Viewers ultimately are left with the idea that Carter will become a better journalist because of the lessons she has learned during the course of the film. Due to the potential impact of these depictions, entertainers must hold themselves to a higher standard to fulfill their discursive role within the broader republic. Entertainment programming needs a positive ethical code because it helps inform citizens by raising questions, offering incisive observations, and voicing marginalized perspectives. The code is in its nascent stages, but it is past time for media ethicists to develop a social responsibility theory for entertainment and amusement, the dominant role of almost all media.
Siebert, Peterson, and Schramm’s Four Theories of the Press has been a powerful influence on scholarship on comparative press systems and normative press theories in the years since its publication in 1956. Its appeal comes from the way it combined a history of Western development with a normative schema that is simple and teachable. Critics have pointed out the shortcomings of both its historical accounts and its theoretical structure, charging that the book expressed a Cold War mentality, elided non-Western and nonliberal theories and practices, and neglected the complicating dimensions of race, class, gender, and ethnicity. Critics also note that actual press systems are usually governed by hybrid norms, and that press systems are increasingly interconnected, overlapping, and global. Yet, Four Theories of the Press retains significant influence despite these criticisms. One reason is that no real replacement has appeared and it is unlikely that a new map of normative theories will win acceptance. The work emerged at a unique moment of Western liberal global hegemony and a successor would require a similar hegemonic moment.
Scientific advances, technological development, and changes in risk consciousness have led to stronger demands on society to manage and control various kinds of risks. Risks should be assessed, prevented, controlled, and communicated in order to prevent negative impacts. Risks related to the environment and health are probably some of the most research-dependent examples. It is primarily scientific experts that provide knowledge to authorities, organizations, and citizens about environmental and health risks and thus exert considerable influence on the understanding and management of risk. At the same time, there are actors in society—especially citizen and interest organizations—that question whether risk regulation is reliable and relevant. There are also demands that citizens should have more transparency and control over risk regulation. The current situation is characterized thus by a paradox: Issues relating to environment and health are seen as increasingly expert dependent while citizens simultaneously demand increased influence over them. This development is especially noticeable in the European Union, with its strong emphasis on the rights of citizen and consumers to have access to information about risk and also opportunities to influence their regulation. In response to this situation, risk governance has been put forward. It refers to a body of ideas for how to more responsibly and efficiently deal with complex risks issues, where there are different interests and standpoints about how to regulate them. Fundamental ideas of risk governance are openness, transparency, participation, inclusion, deliberation, and reflexivity; that experts involved should be open to questioning the situation; should not conceal issues of uncertainty and pluralism (that there exist different legitimate understandings, evaluations, and recommendations); and should be receptive to the input and participation of other stakeholders. This means that risk regulation should no longer be organized into three discrete activities: risk assessment, risk management, and risk communication (aiming at a one-way transfer of knowledge from the regulators to the public).
Jessica Gasiorek and R. Kelly Aune
A majority of the extant literature in health and risk message processing focuses—for obvious reasons—on social influence and compliance-gaining. Interpersonal and relational issues with doctors and patients are a secondary focus. In contrast, research that specifically addresses comprehension of health and risk messaging is somewhat scant. However, other domains (e.g., cognitive psychology, reading studies) offer models and studies of comprehension that address message processing more generally. This material can usefully inform research in a health and risk context. An important aspect of any communicative event is the degree to which that event allows interactivity. This can be described in terms of a continuum from static messaging to dynamic messaging. Message features may affect simple comprehension (in the former case) and active understanding (in the latter case) of messaging along this continuum. For static messaging, text features are the dominant focus; for dynamic messaging, how communicators cooperate, collaborate, and adjust their behavior relative to each other’s knowledge states is the focus. Moderators of these effects, which include sources’ dual goals informing and influencing targets, are also important to consider. Examples of this include direct-to-consumer-advertising (DTCA) of pharmaceutical medicines and pharmaceutical companies, which must meet the demands of the government regulatory bodies (e.g., fair and balanced presentation of benefits and risks) while simultaneously influencing the message processing experience of the target to minimize negative perceptions of their products. Impediments to creating understanding can arise in both the highly interactive setting of the face-to-face doctor-patient context as well as more static messaging situations such as PSAs, pamphlets, and pharmaceutical package inserts. Making sense of message comprehension in health and risk communication is complex, and it is complex because it is broad in scope. Health and risk communication runs the gamut of static to dynamic messaging, employing everything from widely distributed patient information leaflets and public service announcements, to interactive web pages and massively connected social networking sites, to the highly interactive and personalized face-to-face meeting between doctor and patient. An equally comprehensive theoretical and methodological tool box must be employed to develop a thorough understanding of health and risk communication.