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Memory for Media Content in Health Communication  

Soyoon Kim and Brian G. Southwell

Typical discussion about the success of mediated health communication campaigns focuses on the direct and indirect links between remembered campaign exposure and outcomes; yet, what constitutes information exposure and how it is remembered remain unclearly defined in much health communication research. This problem mainly stems from the complexity of understanding the concept of memory. Prolific discussions about memory have occurred in cognitive psychology in recent decades, particularly owing to advances in neuroimaging technologies. The evolution of memory research—from unitary or dichotomous perspectives to multisystem perspectives—has produced substantial implications for the topics and methods of studying memory. Among the various conceptualizations and types of memory studied, what has been of particular interest to health-communication researchers and practitioners is the notion of “encoded exposure.” Encoded exposure is a form of memory at least retrievable by a potential audience member through a conscious effort to recollect his or her past engagement with any particular unit of campaign content. While other aspects of memory (e.g., non-declarative or implicit memory) are certainly important for communication research, the encoded exposure assessed under a retrieval condition offers a critical point at which to establish the exposure-outcome link for the purpose of campaign design and evaluation. The typical methods to assess encoded exposure include recall and recognition tasks, which can be exercised in various ways depending on retrieval cues provided by a researcher to assess different types and levels of cognitive engagement with exposed information. Given that encoded exposure theoretically relies on minimal memory trace, communication scholars have suggested that recognition-based tasks are more appropriate and efficient indicators of encoded exposure compared to recall-based tasks that require a relatively high degree of current-information salience and accessibility. Understanding the complex nature of memory also has direct implications for the prediction of memory as one of the initial stages of communication effects. Some prominent message-level characteristics (e.g., variability in the structural and content features of a health message) or message recipient-level characteristics (e.g., individual differences in cognitive abilities) might be more or less predictive of different memory systems or information-processing mechanisms. In addition, the environments (e.g., bodily and social contexts) in which people are exposed to and interact with campaign messages affect individual memory. While the effort has already begun, directions for future memory research in health communication call for more attention to sharpening the concept of memory and understanding memory as a unique or combined function of multilevel factors.


Faith Communities and the Potential for Health Promotion  

Alice M. Kiger, Donna M. Fagan, and Edwin R. van Teijlingen

Faith communities play an important role in health promotion in some parts of the world, notably North America and sub-Saharan Africa. They appear to be less prominent in the United Kingdom, despite the fact that it is a high-income country with a well-developed national public health system. Faith communities can be instigators of health promotion (faith-based health promotion), or they can provide settings where other agencies can conduct health promotion (faith-placed health promotion). Key opportunities and barriers for faith-based and faith-placed health promotion can be found by drawing on examples from the United States and Africa.


Structuration Theory and Health and Risk Messaging  

Joel Iverson, Tomeka Robinson, and Steven J. Venette

Risk can be defined using a mathematical formula—probability multiplied by consequences. An essential element of risk communication is a focus on messages within organizations. However, many health-related risks such as Ebola extend beyond an individual organization and risk is better understood as a social construction cogenerated within and between systems. Therefore, the process is influenced by systemic and supra-systemic values and predilections. Risk from a structurational perspective allows an understanding of the public as well as organizational responses to risk. Structuration theory provides a useful lens to move beyond seeing organizations as something that flows within an organization to understanding how organizations are enacted through communication. Structuration theory articulates the connections between systems and structures through the action of agents, whose practices produce and reproduce the rules and resources of social life. Within the structuration tradition, organizational communication scholars have shifted to an understanding of the communicative constitution of organizations (CCO). Specifically, one of the theories of CCO is the Four Flows Model. The four flows highlight the ways people enact organizations and provide a means to analyze the various ways communication constitutes organizations. The four flows are membership negotiation, activity coordination, reflexive self-structuring, and institutional positioning. Membership negotiation enacts the inner members and outsiders at a basic level including socialization, identity, and assimilation. Activity coordination produces collective action around a specific goal. Reflexive self-structuring is the decentralized enactment of structures for the organization through the communication of policies. Institutional positioning covers the macro-level actions where people in the organization act as an entity within the environment. When considering the public reaction to Ebola, a simple way to evaluate risk perception is the intersection of dread and control. The U.S. public considered Ebola a serious risk. From a structuration perspective, the viral nature of twitter, media coverage, and public discussion generated resources for fear to be exacerbated. Structuration theory allows us to position the risk beliefs as rules and resources that are reproduced through discourse. The organizational implications fall primarily into the two flows of institutional positioning and reflexive self-structuring. For institutional positioning, U.S. healthcare organizations faced general public dread and perceived lack of control. Within the United States multiple policies and procedures were changed, thus fulfilling the second flow of organizational self-structuring. The Ebola risk had a significant impact on the communicative constitution of health-care organizations in the United States and beyond. Overall, risk is communicatively constituted, as are organizations. The interplay between risk and health-care organizations is evident through the analysis of American cases of Ebola. Structuration theory provides a means for exploring and understanding the communicative nature of risk and situates that risk within the larger systems of organizations.


Using Maps to Display Geographic Risk, Personal Health Data, and Ownership  

Suellen Hopfer and Genesis Gutierrez

Fundamental structural features of risk maps influence how health risk and burden information is understood. The mapping of health data by medical geographers in the 1800s has evolved into the field of geovisualization and the use of online, geographic information system (GIS) interactive maps. Thematic (statistical) map types provide basic principles for mapping geographic health data. It is important to match the nature of statistical data with map type to minimize the potential for communicating misleading messages. Strategic use of structural map features can facilitate or hinder accurate comprehension of health risk messages in maps. A key challenge remains in designing maps to communicate a clear message given the complexity of modern health risk burdens. Various structural map features such as symbols, color, grouping of statistical data, scale, and legend must be considered for their impact on accurate comprehension and message clarity. Cognitive theory in relationship to map comprehension plays a role, as do insights from research on visualizing uncertainty, future trends in developing predictive mapping tools for public health planning, the use of geo-social and “big data,” as well as data ownership.


Social Media for Healthcare Communication  

S. Anne Moorhead

Social media used for communication purposes within healthcare contexts is increasing and becoming more acceptable. The users of social media for healthcare communication include members of the general public, patients, health professionals, and health organizations. The uses of social media for healthcare communication are various and include providing health information on a range of conditions; providing answers to medical questions; facilitating dialogue between patients and between patients and health professionals; collecting data on patient experiences and opinions used for health intervention, health promotion, and health education; reducing stigma; and providing online consultations. With emerging advances over time, including new platforms and purposes, these uses will change and expand, increasing usability and thus providing more opportunities to use social media in connection to healthcare in the future. However, both patients and health professionals may require training to fully maximize the uses of using social media in healthcare. Social media has numerous benefits for healthcare communication, including increased interactions with others; more available, shared, and tailored information; increased accessibility and widening access; and increased peer/social/emotional support. While there may be further benefits of using social media in healthcare, there are many limitations of social media for healthcare communication as well. The main reported limitations include a lack of reliability; quality concerns; and lack of confidentiality and privacy. From the available evidence, it is clear that maintaining patient privacy as well as the security and integrity of information shared are concerns when using social media. As patients and members of the general public use social media widely, some may expect it in healthcare, thus it important for health professionals and organizations to manage expectations of social media in healthcare communication. This results in challenges ranging from encouraging staff to use social media to dealing with user problems and complaints. It is recommended that organizations embrace social media but have a specific purpose for each activity and platform while continually monitoring traffic. Regardless of the nature or size of the healthcare organization, it is time to adopt appropriate guidelines for the use of the social media in healthcare communication to address the challenges and the growing expectations of using social media, especially within healthcare contexts. The key message is that social media has the potential to supplement and complement but not replace other methods to improve communication and interaction among members of the general public, patients, health professionals, and healthcare organizations.


Video Games and Gaming: Reaching Audiences With Health and Risk Messages  

Anthony M. Limperos

Video games are a very popular form of entertainment media and have been the subject of much debate since their meteoric rise to popularity in the 1980s. Similar to the criticisms leveraged against other forms of media, video games have often been scrutinized for their potential to negatively influence those who play them. However, since the beginning of the 21st century, many new genres of video games have emerged and as a result, both public dialogue and research attention have shifted more toward understanding how certain games can be used for prosocial purposes. Exercise-based and active video games (AVGs) are a type of game which requires players to get up and move instead of simply sitting in front of the TV and pushing buttons. These types of games have received a lot of popular press and scholarly attention due to the fact that they encourage movement and may be used as a health intervention tool, especially to combat problems like obesity and overweight. Even though there has been significant research attention focused on the potential health benefits of playing these types of games, there is still much work to be done. While researchers have advanced a general understanding of why certain AVGs are effective or ineffective, there needs to be a greater emphasis on understanding the process by which these games can be motivating and influential. Shedding light on what makes AVGs potentially effective health management and intervention tools will not only be important for motivating people to become more active, but may also help inform research which focuses on how video games may be used in the health domain more generally.


Fatalism and Locus of Control as a Consideration When Designing Health and Risk Messages  

Lijiang Shen

Fatalism is a set of beliefs that encompasses such dimensions as predestination, pessimism, and attribution of one’s health (life events) to luck. Locus of control refers to the extent to which individuals believe they are in control of events that affect them. Individuals with an external locus of control perceive their life is controlled by environmental factors they can’t change, or by chance or fate. Fatalism and external locus of control are both negatively associated with health behaviors and health outcomes; and contribute to health disparities due to the link between culture and socio-economic factors.


Communications Research in Using Genomics for Health Promotion  

Jada G. Hamilton, Jennifer L. Hay, and Colleen M. McBride

It was expected that personalized risk information generated by genetic discovery would motivate risk-reducing behaviors. However, though research in this field is relatively limited, most studies have found no evidence of strong negative nor positive psychological or behavioral influences of providing genetic information to improve individual health behaviors. As noted by systematic reviews and agenda-setting commentaries, these null findings may be due to numerous weaknesses in the research approaches taken to date. These include issues related to study samples and design, as well as the motivational potency of risk communications. Moreover, agenda-setting commentaries have suggested areas for improvement, calling for expanded consideration of health outcomes beyond health behaviors to include information exchange and information-seeking outcomes and to consider these influences at the interpersonal and population levels. A new generation of research is adopting these recommendations. For example, there is a growing number of studies that are using communication theory to inform the selection of potential moderating factors and their effects on outcomes in understanding interpersonal effects of shared genetic risk. Researchers are taking advantage of natural social experiments to assess the general public’s understanding of genetics and inform approaches to improve their facility with the information. Additionally, there are examples of risk communication approaches addressing the complexity of genetic and environmental contributors to health outcomes. Although the pace of this translation research continues to lag behind genetic discovery research, there are numerous opportunities for future communications research to consider how emerging genomic discovery might be applied in the context of health promotion and disease prevention.


Deaf or Hard of Hearing Message Recipient Sociodemographic Characteristics  

Michael McKee

Hearing loss is common, with approximately 17% of the population reporting some degree of a hearing deficit. Hearing loss has profound impacts on health literacy, health information accessibility, and learning. Much of existing health information is inaccessible. This is largely due to the lack of focus on tailoring the messages to the needs of deaf and hard of hearing (DHH) individuals with hearing loss. DHH individuals struggle with a variety of health knowledge gaps and health disparities. This demonstrates the importance of providing tailored and accessible health information for this population. While hearing loss is heterogeneous, there are still overlapping principles that can benefit everyone. Through adaptation, DHH individuals become visual learners, thus increasing the demand for appropriate visual medical aids. The development of health information and materials suitable for visual learners will likely impact not only DHH individuals, but will also be applicable for the general population. The principles of social justice and universal design behoove health message designers to ensure that their health information is not only accessible, but also equitable. Wise application of technology, health literacy, and information learning principles, along with creative use of social media, peer exchanges, and community health workers, can help mitigate much of the health information gaps that exist among DHH individuals.


Persuasive Health Message Design  

Nancy Grant Harrington

The study of persuasive health messages—their design, dissemination, and impact—is ubiquitous in the communication discipline. Words, sounds, and images—alone or in combination—can move people to change their minds and their bodies. Micro-level topics surround questions of message content (argumentation scheme, evidence, qualifying language, and figurative language), structure (message sidedness, standpoint articulation, inoculation, and sequential strategies), and format (channel and audiovisual effects). Macro-level topics in this area include message sensation value, narrative, framing, emotional appeals, and tailoring. Central theoretical frameworks used to guide message design research, include health behavior change theories, information processing theories, and theories/frameworks for message design. In addition, some of the methodoligical issues inherent in message design research are questions of analysis, validity, and measurement. Four streams of past scholarship that inform persuasive health message design research: Greek rhetoric, mass communication research begun during World War II, the development of health communication as a research focus within the communication discipline, and the development of computer and telecommunications technology. Directions and challenges for future research include the need for a clear, coherent, and comprehensive taxonomy to classify message characteristics and attention to several methodological issues.


Global Health and Critical Studies  

Mohan Jyoti Dutta

Amid the large scale inequalities in health outcomes witnessed globally, communication plays a key role in reifying and in offering transformative spaces for challenging these inequities. Communicative processes are integral to the globalization of capital, constituting the economic conditions globally that fundamentally threaten human health and wellbeing. The dominant approach to global health communication, situated within the global capitalist logics of privatization and profiteering, deploys a culturally targeted and culturally sensitive framework for addressing individual behavior. The privatization of health as a commodity creates new market opportunities for global capital. The extraction of raw materials, exploitation of labor, and the reproduction of commoditization emerge on the global arena as the sites for reproducing and circulating health vulnerabilities. By contrast, the culture-centered approach to global health foregrounds the co-creative work of building communicative infrastructures that emerge as sites for resisting the neoliberal transformation of health care. Through processes of grassroots democratic participation and ownership over communicative resources, culture-centered interventions create anchors for community-level interventions that seek to transform unhealthy structures. A wide array of social movements, activist interventions, and advocacy projects emerging from the global margins re-interpret the fundamental meanings of health to create alternative structures for imagining health.


Medical Tourism and Communication  

Alicia Mason

Medical tourism (MT), sometimes referred to as health tourism or medical travel, involves both the treatment of illness and the facilitation of wellness, with travel. Medical tourism is a multifaceted and multiphase process involving many agents and actors that requires careful planning and execution. The coordinated process involves the biomedical, transportation, tourism, and leisure industries. From the communication perspective, the process can be viewed as a 5-stage model consisting of the: (a) orientation, (b) preparation, (c) experiential and treatment, (d) convalescence, and (e) reflection phases. Medical tourism is uniquely situated in a nexus of academic literature related to communication, business and management, travel and tourism, policy and law, healthcare and health administration. Communication permeates and perpetuates the medical tourism process and does so at the levels of interpersonal interactions (provider-patient communication), small group (healthcare teams), organizational (between healthcare providers), and mass and computer-mediated communication (marketing, advertising, and patient social support). This process may, in some cases, involve high rates of international and intercultural variation. Further study of the MT process can help to gain a better understanding of how healthcare consumers evaluate information about medical procedures and possible risks, as well as the specific message features and effects associated with various communication channels and information delivery systems. Continuing scholarly efforts also should focus on the relationship between medical tourism and communication.


Health and Risk Policymaking, the Precautionary Principle, and Policy Advocacy  

Roxanne L. Parrott

Health and risk policymaking focuses on decisions made and actions undertaken to set standards and pass laws to promote healthcare and public health quality, while achieving global health security. Policymakers in governments and institutions deliberate for the purposes of achieving effective and efficient policies, revealing both acceptance and rejection of evidence from health and risk, prevention, and economic sciences, as well as gaps in these domains. Health and risk communicators function implicitly within the boundaries of these decisions and actions, while contributing to prevention science related to strategic messaging and information dissemination. Policymakers face barriers to their efforts residing in the sheer volume of health and risk sciences research; the lack of evidence demonstrating that policies lead to intended outcomes (often, because a policy has not been trialed/implemented); and the absence of economic analyses associated with costs of interventions proposed and undertaken. The precautionary principle (PP) based on adopting caution when evidence is absent, uncertain, or ambiguous regarding possible harm to humans or the environment may function as a guide in some situations. Advocates may draw attention to particular issues in other cases. Policies may be stalled owing to the policy context, including election cycles, legislative and institutional bureaucracies, competing agendas, and fragmented systems of healthcare. Health and risk communicators may collaborate with policymakers and work to translate evidence into useful formats to facilitate the application of evidence to policymaking decisions and actions.


The Biology Of Affection  

Kory Floyd and Colter D. Ray

Affectionate communication comprises the verbal and nonverbal behaviors people use to express messages of love, appreciation, fondness, and commitment to others in close relationships. Like all interpersonal behaviors, affectionate communication has biological and physiological antecedents, consequences, and correlates, many of which have implications for physical health and wellness. Investigating these factors within a biological framework allows for the adjudication of influences beyond those attributable to the environment. In particular, there are observable genetic and neurological differences between individuals with a highly affectionate disposition and those less prone to communicating affection, suggesting that variance in the tendency to engage in affectionate behavior is not entirely the result of environmental influences such as enculturation, parenting, and media exposure. In addition, the expression of affection is associated with markers of immune system competence and appears to help the body to relax and remain calm. The biological effects of affectionate communication are perhaps most pronounced in situations involving either acute or chronic stress. Specifically, highly affectionate individuals are less likely than others to overreact physiologically to stress-inducing events. Whatever stress reaction they do mount is better regulated than among their less affectionate counterparts. Moreover, highly affectionate individuals—or simply those who receive expressions of affection prior to or immediately following a stressful situation—exhibit faster physiological recovery from their elevated stress. Perhaps unsurprisingly, therefore, being deprived of adequate affectionate communication is predictive of multiple physical and psychological detriments, including elevated stress and exacerbated depression, social and relational problems, insecure attachment, susceptibility to diagnosed anxiety and mood disorders, susceptibility to diagnosed secondary immune disorders, chronic pain, and sleep disturbances.


Social Influence Processes and Health Outcomes in Alcoholics Anonymous  

Kevin Wright

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.


Recruiting Opinion Leaders for the United Kingdom ASSIST Programme  

Jo Holliday, Suzanne Audrey, Rona Campbell, and Laurence Moore

Addictive behaviors with detrimental outcomes can quickly become embedded in daily life. It therefore remains a priority to prevent or modify these health behaviors early in the life course. Diffusion theory suggests that community norms are shaped by credible and influential “opinion leaders” who may be characterized by their values and traits, competence or expertise, and social position. With respect to health behaviors, opinion leaders can assume a variety of roles, including changing social norms and facilitating behavioral change. There is considerable variation in the methods used to identify opinion leaders for behavior change interventions, and these may have differential success. However, despite the potential consequences for intervention success, few studies have documented the processes for identifying, recruiting, and training opinion leaders to promote health, or have discussed the characteristics of those identified. One study that has acknowledged this is the effective UK-based ASSIST smoking-prevention program. The ASSIST Programme is an example of a peer-led intervention that has been shown to be successful in utilizing opinion leaders to influence health behaviors in schools. A “whole community” peer nomination process to identify opinion leaders underwent extensive developmental and piloting work prior to being administered in a randomized trial context. Influential students were identified through the use of three simple questions and trained as “peer supporters” to disseminate smoke-free messages through everyday conversations with their peers. In response to a need to understand the contribution of various elements of the intervention, and the degree to which these achieve their aim, a comprehensive assessment of the nomination process was conducted following intervention implementation. The nomination process was successful in identifying a diverse group of young people who represented a variety of social groups, and whom were predominantly considered suitable by their peers. The successful outcome of this approach demonstrates the importance of paying close attention to the design and development of strategies to identify opinion leaders. Importantly, the involvement of young people during the development phase may be key to increasing the effectiveness of peer education that relies on young people taking the lead role.


Media Depictions of Sexual Attitudes  

Keren Eyal

Over the last 3 decades, content analyses have documented large amounts of sexual content in mainstream entertainment media, on television and streaming services as well as in films, music, and video games. Most sexual content is conveyed through conversations about sex and, to a somewhat lesser extent, through the portrayal of sexual behaviors, primarily passionate kissing and suggestive actions. Attitudes—evaluations linking attributes to objects—are often presented in the media and may also be the outcomes of media exposure to sexual content. In the context of sexuality, some commonly studied attitudes include attitudes toward casual or extrarelational sexual encounters, attitudes toward contraception use, and attitudes toward sexual abuse or the acceptance of rape myths. Among the most prominent theoretical perspectives examining the links between media exposure and audience outcomes are theories of script building and activation, theories of a worldview cultivation, and theories of cognitive learning of social behaviors, and the attitudes and emotions that underlie them. Sexual attitudes can be conveyed through mainstream entertainment media content in diverse ways. First, the mere presence of certain topics in the content (e.g., casual sexual encounters) might convey an attitude about the behavior’s importance and relevance to people’s lives. At times, such inclusive depictions can empower audience members. The opposite—the exclusion of certain sexual topics from media content (e.g., sexual minority characters) might undermine the serious attitude with which they should be addressed. Second, attitudes may be conveyed through the focus placed upon them in the mediated content. Sexual health, recognized as intrinsically associated with sexual behaviors in the real world, is largely missing from media depictions. The rise in the prevalence of sexual crime storylines, especially in television law-and-order crime drama series, has introduced diversity in the attitudes conveyed toward this topic in the media. Sexual consent is another topic that has received more attention in entertainment media in the last couple of decades; the attitudes most commonly depicted about sexual consent seem to be the minimization of its importance through the portrayal of either altogether absent or implicit and nonverbal consent cues. Third, sexual attitudes in mainstream entertainment content may be depicted through the portrayal of consequences of sexual references and behaviors and through the depiction of the emotions associated with them. Research finds that portrayals of sexual consequences are relatively rare in entertainment narratives but when present, they tend to focus on the emotional and negative outcomes of sex. Fourth, sexual attitudes are often depicted in the media in the context of humor. Humor in its many forms may communicate a lighthearted, discomfort-easing attitude toward sex, but it might also trivialize the behavior and endorse a less serious attitude toward the decisions it entails. Finally, sexual attitudes are often depicted through stereotypes in media content. Common stereotypes in entertainment media include the narrow and biased presentation of sexual minority characters, which tends to marginalize their sexuality and support a heteronormative attitude. Other stereotypes include sexual gender roles and the sexualization of female characters, both communicating demeaning and nonvalidating attitudes toward women and their sexuality.


Advertisers as Agents for Change in Health and Risk Messaging  

Michael Mackert and Marie Guadagno

Advertising as a field and industry often has a contentious relationship with both health communication and public health due to legitimate concerns about how advertising for certain products, such as alcohol and tobacco, could contribute to less-healthy decisions and behaviors. While acknowledging such concerns, advertisers and their approach to solving communication problems could also provide valuable lessons to those working in health communication. Indeed, advertising agencies are designed to develop creative and effective messages that change consumer behavior—and health communication practitioners and scholars aim to change population-level behavior as well. The perspective and approach of the account planner in the advertising agency—a role whose chief responsibility is to bring the consumer perspective into every step of the advertising development process and inspire effective and creative campaigns—would be particularly valuable to those working in health communication. It was account planning work that shifted traditional milk advertising from promoting it as a healthy drink to the iconic “got milk?” campaign, which positioned milk as a complement that makes other food better—an approach that drove positive sales after years of declining milk consumption. Yet many who work in health communication and public health often know little of how advertising agencies work or their internal processes that might be productively adopted. This lack of understanding can also lead to misperceptions of advertisers’ work and intentions. As an example, one might assume dense medical language in prescription drug advertising is intended to add unnecessary complexity to the advertisements and obscure side effects; instead, advertising professionals who work on prescription drug advertising have often been trained on clear communication—but cannot fully utilize that training because of regulations that require medically accurate terminology that might not be comprehensible to most viewers. Improved understanding of how advertisers can act as agents of change, and increased dialogue between the fields of advertising and health communication, could contribute to improved health communication research, practice, and policy.


Types of Explanations in Health and Risk Messaging  

Katherine E. Rowan

Explanations designed to teach, rather than to support scientific claims in scholarly works, are essential in health and risk communication. Patients explain why they think their symptoms warrant medical attention. Clinicians elicit information from patients and explain diagnoses and treatments. Families and friends explain health and risk concerns to one another. In addition, there are websites, brochures, fact sheets, museum exhibits, health fairs, and news stories explaining health and risk to lay audiences. Unfortunately, research on this important discursive goal is less extensive than is research on persuasion, that is, efforts to gain agreement. One problem is that explanation-as-teaching has not been carefully conceptualized. Some confuse this communication goal and discursive type with its frequent verbal and visual features, such as simple wording or diagrams. Others believe explanation-as-teaching does not exist as a distinctive communication goal, maintaining that all communication is solely persuasive: that is, designed to gain agreement. Explanation-as-teaching is a distinct and important health communication goal. Patient involvement in decision making requires that both clinicians and patients understand options underlying health-care choices. To explore types of explanation-as-teaching, research provides (a) several ways of categorizing health and risk explanations for lay audiences; (b) evidence that certain textual and graphic features overcome predictable confusions, and (c) illustrations of each explanation type. Additionally, explanation types succeed or fail in part because of the social or emotional conditions in which they are presented so it is important to note research on conditions that support patients, families, and clinicians in benefiting from explanations of health and risk complexities and curricula designed to enhance clinicians’ explanatory skill.


Location-Based Ads and Exposure to Health and Risk Messages  

Jonathan van 't Riet, Jorinde Spook, Paul E. Ketelaar, and Arief Hühn

Many of us use smartphones, and many smartphones are equipped with the Global Positioning System (GPS). This enables health promoters to send us messages on specific locations where healthy behavior is possible or where we are at risk of unhealthy behavior. Until now, the practice of sending location-based messages has been mostly restricted to commercial advertisements, most often in retail settings. However, opportunities for health promotion practice are vast. For one, location-based messages can be used to complement environmental interventions, where the environment is changed to promote health behavior. Second, location-based messages incorporate opportunities to tailor these messages to individual characteristics of the recipient, increasing perceived relevance. Finally, location-based messages offer the distinct possibility to communicate context-dependent social norm information. Five preliminary studies tested the effects of location-based messages targeting food choice. The results suggest that sending location-based messages is feasible and can be effective. Future studies should explore which messages are most effective under which circumstances.