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Article

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.

Article

Erina MacGeorge and Lyn Van Swol

Advice is a recommendation for action that includes both suggestions for behavior and ways of feeling and thinking about the problem. It is a ubiquitous phenomenon in personal and professional settings, and functions as a form of both social support and social influence. Advice often improves coping and decision-making outcomes but can also be perceived as intrusive, threaten recipient’s sense of competence and autonomy, and damage relationships. Although advisors often have expertise that can benefit the recipient, advice recipients often discount and underutilize advice, to their disadvantage. Recipients are more likely to utilize advice from advisors they trust, who engender confidence, and who have more expertise or experience. They are also more likely to seek and use it when they have not thought of solutions independently. Recipients who are overconfident, have more expertise, or have more power than an advisor are much less likely to seek and utilize advice. When giving advice, advisors often consider different factors than they would if they were making decisions for themselves, resulting in advice that is more normative and less tailored to individual preferences. Advice can be delivered in a variety of ways, and this stylistic variation has consequences for recipient outcomes. For example, highly direct or blunt forms of advice underscore the advisor’s implicit claim to status and often generate more negative evaluations of the advice and advisor. Advice message content also influences recipients’ advice evaluation. Content that emphasizes efficacy of the action, feasibility, and limitations of the advice tends to improve evaluation and utilization of advice. This research is synthesized in advice response theory (ART), which indicates that advice outcomes are influenced by message content and style, interaction qualities, advisor characteristics, recipient traits, and features of the situation for which or in which advice is sought. Behaviors that co-occur with advice, such as argumentation, emotional support, and planning, also influence outcomes. The sequencing of advice in interaction also matters; the integrated model of advice (IMA) indicates that advice in supportive interactions is best placed after emotional support and problem analysis. The contexts in which advice are given influence the exchange and outcomes of advice. These include personal and professional relationships, in which relational cognitions and professional norms affect the process and outcomes of advising; groups and organizations, in which advising processes become complex due to the multiplicity of relationships, goals, and expectations; cultures, in which advice-seeking and advice-giving varies in perceived appropriateness; and digital environments, which are often valued for advice that is unobtainable elsewhere.

Article

Social influence processes play an important role in the recovery process for alcoholics who affiliate with Alcoholics Anonymous (AA). Group norms at AA emphasize the sharing of stories about past difficulties with alcohol, the circumstances that led a person to join AA, and how life has changed since achieving sobriety. These narratives serve to increase collective identity among AA members via shared experiences and to reinforce AA ideology. In discussions and interpersonal interactions at AA meetings, AA ideology is also communicated and reinforced through AA literature and the discussion of central tenets, such as the Twelve Steps and Twelve Traditions, the idea that alcoholism is a progressive disease, and the need to be active in one’s sobriety. Moreover, AA meetings provide an opportunity for recovering alcoholics to find others who share similar experiences, an opportunity for greater social comparisons to other alcoholics than are typically available in primary social networks, and group-suggested role obligations that influence commitment to AA and long-term sobriety. These social influence processes have been linked to important health outcomes, including longer abstinence from alcohol use than with other treatment options, reduced stigma associated with alcoholism, reduced stress/depression, increased self-efficacy, and the acquisition of coping skills that are important to the recovery process.

Article

Kory Floyd and Benjamin E. Custer

Affectionate communication constitutes verbal behaviors (e.g., saying “I love you”), nonverbal gestures (e.g., hugging, handholding), and socially supportive behaviors (e.g., helping with a project) that humans employ to develop and maintain close relationships with others. In addition to its relational benefits, affectionate communication contributes to health and wellness for both senders and receivers. Affection exchange theory (AET) addresses the questions of why humans engage in affectionate communication and why diverse benefits are associated with such behaviors. A robust empirical literature supports AET’s contention that both expressing and receiving affectionate behavior are associated with physical and mental health benefits. Despite these contributions, however, some compelling questions about affectionate communication remain to be addressed, and AET can provide a useful framework for doing so.

Article

The widespread diffusion of social media in recent years has created a number of opportunities and challenges for health and risk communication. Blogs and microblogs are specific forms of social media that appear to be particularly important. Blogs are webpages authored by an individual or group in which entries are published in reverse chronological order; microblogs are largely similar, but limited in the total number of characters that may be published per entry. Researchers have begun exploring the use and consequences of blogs and microblogs among individuals coping with illness as well as for health promotion. Much of this work has focused on better understanding people’s motivations for blogging about illness and the content of illness blogs. Coping with the challenges of illness and connecting with others are two primary motivations for authoring an illness blog, and blogs typically address medical issues (e.g., treatment options) and the author’s thoughts and feelings about experiencing illness. Although less prevalent, there is also evidence that illness blogging can be a resource for social support and facilitate coping efforts. Researchers studying the implications of blogs and microblogs for health promotion and risk communication have tended to focus on the use of these technologies by health professionals and for medical surveillance. Medical professionals appear to compose a noteworthy proportion of all health bloggers. Moreover, blogs and microblogs have been shown to serve a range of surveillance functions. In addition to being used to follow illness outbreaks in real-time, blogs and microblogs have offered a means for understanding public perceptions of health and risk-related issues including medical controversies. Taken as whole, contemporary research on health blogs and microblogs underscores the varied and important functions of these forms of social media for health and risk communication.

Article

Vincent Chua and Barry Wellman

“Networked individualism” represents the phenomenon that people are managers of their own personal networks. Networked individualism in an East (and Southeast) Asian context draws attention to the significant role of Asian social institutions and culture in the patterning of personal communities. When compared to Western situations—particularly American—East Asian personal communities are just as vibrant and supportive. They have woven seamlessly with digital media, extend both near and far, and are rich in social support. There are several differences that make East Asian societies unique, such as their strong focus on kinship, the salience of hierarchical social capital, the culture of mutual monitoring occurring through strong ties (e.g., guanxi), and the accelerated rise of digital media in everyday life.

Article

When it comes to health and risk, “place” matters. People who live in lower-income neighborhoods are disproportionately affected by obesity and obesity-related diseases like heart disease, hypertension, and diabetes; asthma; cancers; mental health issues; etc., compared to those that live in higher-income communities. Contributing to these disparities are individual-level factors (e.g., education level, health literacy, healthcare access) and neighborhood-level factors such as the socioeconomic characteristics of the neighborhood; crime, violence, and social disorder; the built environment; and the presence or absence of health-enhancing and health-compromising resources. Social determinants of health—for example, social support, social networks, and social capital—may improve or further complicate health outcomes in low-income neighborhoods. Social support is a type of transaction between two or more people intended to help the recipient in some fashion. For instance, a person can help provide someone who is grieving or dealing with a newly diagnosed health issue by providing emotional support. Informational support may be provided to someone trying to diagnose, manage, and/or treat a health problem. Instrumental support may come in the help of making meals for someone who is ill, running errands for them, or taking them to a doctor’s appointment. Unfortunately, those who may have chronic diseases and require a lot of support or who otherwise do not feel able to provide support may not seek it due to the expectation of reciprocity. Neighborhood features can enable or constrain people from developing social networks that can help provide social support when needed. There are different types of social networks: some can enhance health outcomes, while others may have a more limiting or even a detrimental effect on health. Social capital results in the creation of resources that may or may not improve health outcomes. Communication infrastructure theory offers an opportunity to create theoretically grounded health interventions that consider the social and neighborhood characteristics that influence health outcomes. The theory states that every neighborhood has a communication infrastructure that consists of a neighborhood storytelling network—which includes elements similar to the social determinants of health—embedded in a communication action context that enables or constrains neighborhood storytelling. People who are more engaged in their neighborhood storytelling networks are in a better position to reduce health disparities—for example, to fight to keep clinics open or to clean up environmental waste. The communication action context features are similar to the neighborhood characteristics that influence health outcomes. Communication infrastructure theory may be useful in interventions to address neighborhood health and risk.

Article

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

Rebecca Cline and Andrea Meluch

Health consequences and key communication processes that emerge during disasters vary by type of disaster. The types of disasters that researchers have most investigated are rapid-onset natural disasters and slowly-evolving human-caused disasters. Three types of communication processes occur in disasters that have implications for health. The first set of communication processes involves the social dynamics of affected communities. Communities that experience natural disasters tend to exhibit an emergent altruistic community; community members join together to support each other in the immediate aftermath of the disaster. In contrast, community conflict is the hallmark of slowly-evolving environmental disasters. That conflict triggers a cascade of social dynamics that infests close personal relationships with interpersonal conflict, stigmatization of victims and advocates, and pressures to avoid open communication (i.e., social constraints) regarding the disaster and its traumatic effects. These dynamics contribute to elevated mental health problems. The second set of communication processes focuses specifically on social support. Supportive communication processes and networks are important resources for coping with ongoing disasters and for mitigating their longer-term mental health effects. Due to differences in community-level social dynamics, patterns of social support evolve differently in natural versus human-caused disasters. Natural disasters are typified by immediate intra-community social support. Community members support each other in the immediate aftermath of the disaster. Ultimately this social support is overwhelmed by the disaster’s needs and deteriorates. As a result, communities are largely dependent on internal and external institutional sources to meet community members’ needs. In contrast, slowly-evolving human-caused disasters tend to exhibit the emergence of corrosive communities. In these communities, those most affected by the disasters (those whose health is harmed or who claim other harmful or potentially harmful effects, and those who function as advocates) tend to experience failed or diminished social support. Whereas the community may previously have been altruistic, mutual help either fails to emerge or is withdrawn in the disaster context. Failed social support contributes to the relatively worse mental health consequences of slowly-evolving human-caused disasters when compared to natural disasters. The third set of communication processes relate to institutional responses in disasters. In natural disasters, institutional communication is driven largely by widely disseminated and applied models that are intended to prevent harm and to provide resources to address harm and to reduce further negative consequences to health and well-being. Institutions and their agencies provide resources immediately following the disaster to meet basic human needs and, thereafter, to restore normalcy to the community and thereby protect community members’ physical and mental health. These efforts assume that natural disasters unfold in predictable stages (i.e., preparedness, warning, post-disaster, recovery) and that institutions’ responses should vary according to the stage of the disaster. In contrast, no such response models exist for slowly-evolving human-caused disasters. Moreover, community members experiencing such disasters often encounter what they perceive as institutional failures by both community-based and external responding institutions. Often community institutions (e.g., business, government) are perceived as causing the disaster and/or minimizing it, if not denying its existence or covering it up. As a result, communities experiencing this class of disasters tend to develop substantial distrust for local and responding institutions.