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Article

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.

Article

Queer Safer Sex Communication  

Kami Kosenko

Although communication scholars have been exploring the role of partner communication in sexual health promotion since the 1960s, the term safer sex, and its corollary safer sex communication, emerged in the late 1980s in the wake of the HIV/AIDS epidemic, which was and still is disproportionately affecting queer individuals. Numerous studies, along with some meta-analyses, point to the protective potential of safer sex discussions, defined here as the communicative management of health concerns with sex partners. Despite scholarly agreement regarding its importance, the term safer sex communication has received little explication, and much of what is known about it comes from studies with predominantly heterosexual samples. A review of the literature on queer safer sex communication points to some key issues related to age, race, trauma history, place, and pre-exposure prophylaxis (PrEP), and suggests important considerations for future research efforts.

Article

Migrants and Migrant Workers  

Cheng Zeng

Massive migration both within and between countries has been witnessed over the last two centuries. Migration is a multifaceted event with significant socioeconomic, cultural, political consequences for both receiving and sending countries/regions. Migrants typically move to a more developed region with the hope of obtaining better employment and living standards. Migrants, a cheap labor source with high achievement motivation, seem to be the ideal workforce for aging societies that have an urgent need for working populations. Despite migrants being needed for local economic growth, migrant workers are often marginalized in host societies. In addition, lacking human, social, and cultural capital, migrants are more disadvantaged in the job markets, especially during economic downturns. Life establishment in host societies is by no means an easy task for migrants who are also confronted with issues such as cultural differences and extra socioeconomic pressures. Institutionalized and daily discrimination from host societies also have significant negative impacts on migrants’ professional and everyday lives. Thus, migrants often report lower levels of happiness, job satisfaction, and health than their local counterparts. It is urgent to facilitate migrants’ integration and diminish social division between migrants and locals to improve migrant workers’ life quality in the host societies.

Article

Communication Accommodation Theory and Intergroup Communication  

Yan Bing Zhang and Makiko Imamura

Group memberships provide a system of orientation for self-definition and self-reference in the process of relating to and managing social distance with others, and the use of language and communication serve central roles in the processes. In the nearly four decades since its inception as speech accommodation theory, communication accommodation theory has been used in multidisciplinary, multilingual, and multicultural contexts for understanding when, how, and why we, as speakers, accommodate to each other’s languages and styles of communication. In CAT’s theoretical domain, accommodation refers to the ability, willingness, and strategies to adjust, modify, or regulate individuals’ language use and communication behaviors. Specifically, approximation strategies such as convergence, divergence, maintenance, and complementarity are conceptualized in the earlier developmental stages of CAT, with other strategies such as interpretability, discourse management, and interpersonal control added to the list at later stages. With its strong intergroup features, CAT is a robust theory that offers explicit motivational analysis to account for intergroup communication behaviors and intergroup relations. Blossomed initially in a multilingual and multicultural context in Quebec, Canada in the 1970s, CAT connects well with other existing theories on cultural adaptation, intergroup contact, and intergroup relations. Yet, CAT distinguishes itself from other theories as it attends to the interactive communication acts and processes and relates them to other sociocultural constructs, while interpreting and predicting the social, relational, and identity outcomes.

Article

Communication Privacy Management Theory and Health and Risk Messaging  

Sandra Petronio and Maria K. Venetis

Communication privacy management theory (CPM) argues that disclosure is the process by which we give or receive private information. Private information is what people reveal. Generally, CPM theory argues that individuals believe they own their private information and have the right to control said information. Management of private information is not necessary until others are involved. CPM does not limit an understanding of disclosure by framing it as only about the self. Instead, CPM theory points out that when management is needed, others are given co-ownership status, thereby expanding the notion of disclosing information; the theory uses the metaphor of privacy boundary to illustrate where private information is located and how the boundary expands to accommodate multiple owners of private information. Thus, individuals can disclose not only their own information but also information that belongs to others or is owned by collectives such as families. Making decisions to disclose or protect private information often creates a tension in which individuals vacillate between sharing and concealing their private information. Within the purview of health issues, these decisions have a potential to increase or decrease risk. The choice of disclosing health matters to a friend, for example, can garner social support to cope with health problems. At the same time, the individual may have concerns that his or her friend might tell someone else about the health problem, thus causing more difficulties. Understanding the tension between disclosing and protecting private health information by the owner is only one side of the coin. Because disclosure creates authorized co-owners, these co-owners (e.g., families, friends, and partners) often feel they have right to know about the owner’s health conditions. The privacy boundaries are used metaphorically to indicate where private information is located. Individuals have both personal privacy boundaries around health information that expands to include others referred to as “authorized co-owners.” Once given this status, withholding to protect some part of the private information can risk relationships and interfere with health needs. Within the scheme of health, disclosure risks and privacy predicaments are not experienced exclusively by the individual with an illness. Rather, these risks prevail for a number of individuals connected to a patient such as providers, the patient’s family, and supportive friends. Everyone involved has a dual role. For example, the clinician is both the co-owner of a patient’s private health information and holds information within his or her own privacy boundary, such as worrying whether he or she diagnosed the symptoms correctly. Thus, there are a number of circumstances that can lead to health risks where privacy management and decisions to reveal or conceal health information are concerned. CPM theory has been applied in eleven countries and in numerous contexts where privacy management occurs, such as health, families, organizations, interpersonal relationships, and social media. This theory is unique in offering a comprehensive way to understand the relationship between the notion of disclosure and that of privacy. The landscape of health-related risks where privacy management plays a significant role is both large and complex. The situations of HIV/AIDS, cancer care, and managing patient and provider disclosure of private information help to elucidate the ways decisions of privacy potentially lead to health risks.

Article

Creating Authentic and Lasting Community Relationships to Enhance Awareness and Understanding of Cancer Research  

Linda Fleisher, Evelyn González, and Armenta Washington

Building and sustaining relationships fundamentally requires mutual trust based on authentic and reciprocal communication. Successful academic and community partnerships require a deep understanding of the needs of all stakeholders facilitated through dialogue and ongoing communication strategies. This dialogue is especially crucial to address health disparities and bridge the divide between academics and other professionals and the communities they serve. Innovative and sound health communications and community engagement approaches can help to address this divide. For those working with communities to improve health, Community Based Participatory Research (CBPR) principles can serve as a compass to guide those efforts of building on the strengths and resources within the community and ensuring co-learning to address social inequities. Moreover, using innovative and interactive health communication strategies, such as community forums, photovoice projects, and the development of culturally sensitive and relevant messaging, can empower and engage the community, facilitating long-lasting relationships between the academic institutions and communities that ultimately address the unique concerns and values of those most in need.

Article

Active Involvement Interventions in Health and Risk Messaging  

Kathryn Greene, Smita C. Banerjee, Anne E. Ray, and Michael L. Hecht

Results of national epidemiologic surveys indicate that substance use rates among adolescents remain relatively steady or even show slight declines; however, some substance use rates, such as electronic cigarettes, are actually rising. Thus, the need for efficacious drug prevention efforts in the United States remains high. Active Involvement (AI) interventions are a promising avenue for preventing and reducing adolescent substance use, and they create opportunities for adolescents to experience a core feature of engagement that is common to these interventions, such as producing videos, posters, or radio ads; or generating themes and images for messages such as posters. Existing interventions grounded in theories of Active Involvement include programs delivered face-to-face and via e-learning platforms. Narrative Engagement Theory and the Theory of Active Involvement guide the components of change in AI interventions. Youth develop message content during participation in Active Involvement interventions. Advanced analytic models can be applied to address new research questions related to the measure of components of AI interventions.

Article

Narcissism as a Consideration When Designing Health and Risk Messages  

Erin M. Hill

Narcissism is a personality trait characterized by perceptions of grandiosity, superiority, and the need for attention and admiration. There has been an increase in focus on examining the development of narcissism and how the trait influences a range of social and health behaviors. A key feature of narcissism is that it is characterized by high self-esteem with a simultaneously fragile ego that requires continual monitoring and manipulation. Therefore, much of the behaviors narcissists engage in are linked to the drive to maintain perceptions of superiority and grandiosity. In the area of health and well-being, narcissism has been positively correlated with psychological health, a relationship that may be accounted for by self-esteem. However, there has been less research on the relationship between narcissism and physical health and well-being. There is some evidence that narcissism is linked to a variety of physical appearance-oriented health behaviors (i.e., behaviors that could affect body weight or other aspects of physical appearance, including eating and exercise). Narcissism has also been positively linked to risk-taking behaviors, including use of substances, as well as risks that could significantly impact others, including sexual behaviors and risky driving. The relationship between narcissism and health is therefore complex, with some positive correlates (e.g., physical activity), but also various health risk behaviors. In considering how narcissism might interact with health messages, communicators have to keep in mind that narcissists seem to have some deficits in judgment and decision-making, such as overconfidence and a narrow focus on rewards associated with behaviors. Their behaviors tend to be driven by managing their own ego and by drawing attention and admiration from others to maintain perceptions of superiority and grandiosity. In turn, health communicators may need to rely on creative strategies that tap into these domains of narcissism in order to effectively modify health behaviors among narcissistic individuals. Further research on the influence of narcissism in healthcare seeking and related preventive behaviors would also help to provide a more detailed understanding for how the trait influences health decisions, information that would be useful for both health researchers and practitioners.

Article

Lay Risk Management  

Erik Löfmarck

How do individuals relate to risk in everyday life? Poorly, judging by the very influential works within psychology that focus upon the heuristics and biases inherent to lay responses to risk and uncertainty. The point of departure for such research is that risks are calculable, and, as lay responses often under- or overestimate statistical probabilities, they are more or less irrational. This approach has been criticized for failing to appreciate that risks are managed in relation to a multitude of other values and needs, which are often difficult to calculate instrumentally. Thus, real-life risk management is far too complex to allow simple categorizations of rational or irrational. A developing strand of research within sociology and other disciplines concerned with sociocultural aspects transcends the rational/irrational dichotomy when theorizing risk management in everyday life. The realization that factors such as emotion, trust, scientific knowledge, and intuition are functional and inseparable parts of lay risk management have been differently conceptualized: as, for example, bricolage, in-between strategies, and emotion-risk assemblage. The common task of this strand is trying to account for the complexity and social embeddedness of lay risk management, often by probing deep into the life-world using qualitative methods. Lay risk management is structured by the need to “get on” with life, while at the same time being surrounded by sometimes challenging risk messages. This perspective on risk and everyday life thus holds potentially important lessons for risk communicators. For risk communication to be effective, it needs to understand the complexity of lay risk management and the interpretative resources that are available to people in their lifeworld. It needs to connect to and be made compatible with those resources, and it needs to leave room for agency so that people can get on with their lives while at the same time incorporating the risk message. It also becomes important to understand and acknowledge the meaning people attribute to various practices and how this is related to self-identity. When this is not the case, risk messages will likely be ignored or substantially modified. In essence, communicating risk requires groundwork to figure out how and why people relate to the risks in question in their specific context.

Article

Using Quotations in Health and Risk Message Design  

Rhonda Gibson

Quotations, something that a person says or writes that is then used by someone else in another setting, have long been a staple of news stories. Reporters use quotations—both direct and paraphrased—to document facts, opinions, and emotions from human and institutional sources. From a journalistic standpoint, quotations are beneficial because they add credibility to a news report and allow readers/viewers to consider the source of information when evaluating its usefulness. Quotations are also valued because they are seen as adding a “human” element to a news report by allowing sources to present information in their own words—thus providing an unfiltered first-person perspective that audiences may find more compelling and believable than a detached third-person summary. Research into the effects of news report quotations has documented what journalists long assumed: Quotations, especially direct quotes using the exact words of a speaker, draw the attention of news consumers and are often attended to in news stories more than statistical information. Studies show that the first-person perspective is considered both more vivid and more credible, a phenomenon that newspaper and website designers often capitalize on through the use of graphic elements such as the extracted quote. Quotations in news stories have also been found to serve as a powerful persuasive tool with the ability to influence perception of an issue even in the face of contradictory statistical information. This is especially true when the topic under consideration involves potential risk. Direct quotations from individuals who perceive high levels of risk in a situation can sway audience perceptions, regardless of whether the quoted risk assessments are supported by reality. The power of quotations remains strong in other forms of communication involving risk, such as public service, health-related, or promotional messages. The vivid, first-person nature of quotes draws the attention of audiences and makes the quoted information more likely to be remembered and to influence future judgments regarding the issue in question. This presents the message creator, whether it be a journalist or other type of communicator, with a powerful tool that should be constructed and deployed purposefully in an effort to leave audiences with an accurate perception of the topic under consideration.

Article

Message Convergence Framework Applied to Health and Risk Messaging  

Kathryn E. Anthony, Timothy L. Sellnow, Steven J. Venette, and Sean P. Fourney

Much current scholarship in the realm of information processing and decision making, particularly in the context of health risks, is derived from the logical-empiricist paradigm, involving a strong focus on cognition, routes of psychological processing of messages, and message heuristics. The message convergence framework (MCF), derived heavily from the writings of Perelman and Olbrechts-Tyteca, contributes to this body of literature by emphasizing the fact that people make decisions on health risks while being exposed to arguments from multiple sources on the same topic. The MCF offers an explanation for how people reconcile myriad messages to arrive at decisions. MCF differs from other theories of message processing because of its distinct and unique focus on arguments, messages, and the ways various arguments interact to create “convergence” in individuals’ minds. The MCF focuses on the ways that multiple messages converge to create meaning and influence in the minds of listeners. Convergence occurs when messages from multiple sources overlap in ways recognized by observers, creating perceptions of credibility and influencing their risk decisions. Perelman and Olbrechts-Tyteca explain that convergence occurs when “several distinct arguments lead to a single conclusion.” Individuals assess the strengths and weaknesses of the claims, and according to the scholars, the “strength” of the arguments “is almost always recognized.” Three key propositions focusing on message convergence articulate that audiences recognize message convergence, that they actively seek convergence in matters of concern, such as health risk, and that this convergence is potentially fleeting as new messages are introduced to the discussion. Conversely, Perelman and Olbrechts-Tyteca also discuss message divergence, and the rationale for wanting to intentionally create divergence among interacting arguments. Divergence is particularly appropriate in the realm of health and risk messages when scholars must challenge potentially harmful beliefs or correct misinformation. Some strategies for invoking divergence in include: dissociation, in which the speaker attempts to reframe the argument to create novel understandings; identification of the stock, hackneyed, and obsolete, where the speaker attempts to make existing claims appear commonplace or obsolete to the listener; refutation of fallacies, where the speaker points out the fallacious reasoning of the opponent; clash of interpretation, where the speaker publicly articulates that individuals have understood the convergence to mean different things; weakening through reaction, which involves the speaker’s attempting to incite a reactionary approach by the opponent; and finally, highlighting the consequence of invalid convergence, where the speaker describes the negative outcomes that may occur from following a false convergence based on incorrect information. For message design, environmental scanning enables scholars and practitioners to assess the messages in a particular health-risk context. This assessment can assist practitioners in emphasizing or building convergence among reputable sources and in introducing divergence in cases where misunderstanding or a lack of evidence has contributed to an unproductive perception of convergence. Ultimately, the MCF can assist practitioners in scanning their health-risk environments for opportunities to establish or bolster convergence based on credible evidence and for introducing divergence to challenge inaccurate or misleading interpretations and evidence.

Article

Narratives in Health and Risk Messaging  

Julie E. Volkman

In health and risk communication, evidence is a message feature that can add credibility, realism, and legitimacy to health and risk messages. Evidence is usually defined into two types: statistical or narrative. Statistical evidence employs quantifications of events, places, phenomena, or other facts, while narrative evidence involves stories, anecdotes, cases, or testimonials. While many health and risk messages employ statistical or factual information, narrative evidence holds appeal for health and risk communication for its utility in helping individuals learn their risks and illnesses through stories and personal experiences. In particular, narratives employed as evidence in a health or risk message especially hold value for their ability to communicate experiences and share knowledge, attitudes, beliefs, and ideas about complex health issues, propose behavior change, and assist individuals coping with disease. As a result, the personal experiences shared, whether they are from first-hand knowledge, or recounting another’s experience, can focus attention, enhance comprehension for risks, and recall of health and risk information. Furthermore, readers engage with the story and develop their own emotional responses which may align with the purpose of the health and risk message. Narratives, or stories, can occur in many ways or through various points of view, but the stories that “ring true” to readers often have a sense of temporality, coherence, and fidelity. As a result, formative research and pre-testing of health and risk messages with narratives becomes important to understand individual perceptions related to the health issue and the characters (or points of view). Constructs of perceived similarity, interest, identification, transportation, and engagement are helpful to assess in order to maximize the usefulness and persuasiveness of narratives as evidence within a health and risk message. Additionally, understanding the emotional responses to narratives can also contribute to perceptions of imagery and vividness that can make the narrative appealing to readers. Examining what is a narrative as evidence in health and risk messages, how they are conceptualized and operationalized and used in health and risk messages is needed to understand their effectiveness.

Article

Message Tailoring in Health and Risk Messaging  

Mia Liza A. Lustria

In today’s saturated media environment, it is incumbent for designers of health education materials to find more effective and efficient ways of capturing the attention of the public, particularly when the intent is to influence individual behavior change. Tailoring is a message design strategy that has been shown to amplify the effectiveness of health messages at an individual level. It is a data-driven and theory-informed strategy for crafting a message using knowledge of various factors that might influence the individual’s responsiveness to the message, such as their information needs, beliefs, motivations, and health behaviors. It also enhances the persuasiveness of a message by increasing its perceived relevance, drawing attention to the message, and encouraging deeper elaboration of the information. Tailoring content based on known antecedents of the intended behavioral outcomes has been shown to enhance tailoring effectiveness. Compared to generic messages, tailored messages are perceived to be more personally relevant, command greater attention, are recalled more readily, and encourage more positive evaluations of the information overall. Various meta-analyses have demonstrated the effectiveness of tailored interventions promoting a number of health behaviors, such as smoking cessation, healthy diet and nutrition, physical activity, and regular recommended health screenings. Advances in information and communication technologies have led to more sophisticated, multimodal tailored interventions with improved reach, and more powerful expert systems and data analysis models. Web technologies have made it possible to scale the production and delivery of tailored messages to multiple individuals at relatively low cost and to improve access to expert feedback, particularly among hard-to-reach population groups.

Article

Immersive Virtual Environments, Avatars, and Agents for Health  

Sun Joo (Grace) Ahn and Jesse Fox

Immersive virtual environments (IVEs) are systems comprised of digital devices that simulate multiple layers of sensory information so that users experience sight, sound, and even touch like they do in the physical world. Users are typically represented in these environments in the form of virtual humans and may interact with other virtual representations such as health-care providers, coaches, future selves, or treatment stimuli (e.g., phobia triggers, such as crowds of people or spiders). These virtual representations can be controlled by humans (avatars) or computers algorithms (agents). Embodying avatars and interacting with agents, patients can experience sensory-rich simulations in the virtual world that may be difficult or even impossible to experience in the physical world but are sufficiently real to influence health attitudes and behaviors. Avatars and agents are infinitely customizable to tailor virtual experiences at the individual level, and IVEs are able to transcend the spatial and temporal boundaries of the physical world. Although still preliminary, a growing number of studies demonstrate IVEs’ potential as a health promotion and therapy tool, complementing and enhancing current treatment regimens. Attempts to incorporate IVEs into treatments and intervention programs have been made in a number of areas, including physical activity, nutrition, rehabilitation, exposure therapy, and autism spectrum disorders. Although further development and research is necessary, the increasing availability of consumer-grade IVE systems may allow clinicians and patients to consider IVE treatment as a routine part of their regimen in the near future.

Article

Behavioral Journalism in Health and Risk Messaging  

Alfred McAlister

Behavioral journalism is a term used to describe a theory-based health communication messaging strategy that is based on conveying “role model stories” about real people and how they achieve healthy behavior changes. The aim is to stimulate imitation of these models by audiences of their peers. Theoretical foundations for the strategy itself are in Albert Bandura’s social cognitive theory and Everett Rogers’s model of diffusion of innovations, but it can be used flexibly to convey various kinds of theory-driven message content. Behavioral journalism emerged as an explicit health communication technique in the late 1970s and was developed as a distinct alternative to the social marketing approach and its focus on centrally generated messages devised by experts. It has been used subsequently to promote smoking cessation, improvements in nutrition and physical activity, avoidance of sexually transmitted diseases and unplanned pregnancy, reduced intergroup hostility, advocacy for healthy policy and environmental changes, and many other diverse health promotion objectives. Formats used for behavioral journalism include reality television programs, broadcast and print news media, printed newsletters for special audiences, documentary film and video, digital and mobile communication, and new social media. Behavioral journalism is intended for use in concert with community organization and actions to prompt and reinforce the imitation of role models and to facilitate and enable behavior change, and its use in that context has yielded many reports of significant impact on behavior. With citations of use growing steadily in the past two decades, behavioral journalism has proven to be readily adaptable to new and emerging communication technologies.

Article

Blogging, Microblogging, and Exposure to Health and Risk Messages  

Stephen A. Rains

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

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.

Article

Ambiguity Intolerance Considerations when Designing Health and Risk Messages  

Adrian Furnham

The concept of ambiguity tolerance (TA), variously called Uncertainty Avoidance, Ambiguity Avoidance, or Intolerance, can be traced back nearly 70 years. It has been investigated by many different types of researchers from clinical and differential, to neuro- and work psychologists. Each sub-discipline has tended to focus on how their variable relates to beliefs and behaviors in their area of expertise, from religious beliefs to reactions to novel products and situations. The basic concept is that people may be understood on a dimension that refers to their discomfort with, and hence attempts to avoid, ambiguity or uncertainty in many aspects of their lives. There have been many attempts to devise robust and valid measures of this dimension, most of which are highly inter-correlated and require self-reporting. There remains a debate as to whether it is useful having just one or more dimensions/facets of the concept. Using these tests, there have been many correlational studies that have sought to validate the measure by looking at how those high and low on this dimension react to different situations. There have also been some, but many fewer, experimental studies, which have tested very specific hypotheses about how TA is related to information processing and reactions to specific stimuli. There is now a welcomed interest by neuroscientists to explore the concept from their perspective and using their methodologies. These studies have been piecemeal, though most have supported the tested hypotheses. There has been less theoretical development, however, of the concept attempting to explain how these beliefs arise, what sustains them, and how, why, and when they may change. However, the concept has continued to interest researchers from many backgrounds, which attests to its applicability, fecundity, and novelty.

Article

Message-Induced Self-Efficacy and Its Role in Health Behavior Change  

Nichole Egbert and Foluke Omosun

Self-efficacy is the personal belief in one’s ability to meet a goal or perform a specific task. Although it can be applied to any type of human endeavor, the construct of self-efficacy is thought to be central to changing behaviors to improve health outcomes. For this reason, message designers have been attempting to understand how messages detract from or enhance self-efficacy. Persuasive messages have and can be used to enhance perceived self-efficacy related to health and risk behavior. Self-efficacy-strengthening messages and interventions in health promotion can be assessed in general or specfically in regards to fear appeals. Other aspects of self-efficacy interventions include collective efficacy and professional self-efficacy.

Article

Gender as a Consideration When Designing Health and Risk Messages  

E. Michele Ramsey

Given the impact of gender on health, healthcare decisions, and treatments for illness, as well as the increased inequities encountered by non-white men and women, messages about health and health risks are affected by purposeful assumptions about gender identity. While the term sex denotes the biological sex of an individual, gender identity is about the psychological, cultural, and social assumptions about a person associated with that person because of his or her sex. Gender and health are intimately connected in a number of ways, and such connections can differ based on race, ethnicity, age, class, religion, region, country, and even continent. Thus, understanding the myriad ways that notions of gender affect the health of females and males is fundamental to understanding how communicating about risks and prevention may be tailored to each group. Gender role expectations and assumptions have serious impacts on men’s health and life expectancy rates, including self-destructive behaviors associated with mental health and tobacco use, self-neglecting behaviors linked to the reluctance of men to seek treatment for ailments, reluctance to follow a physician’s instructions after finally seeking help, and risk-taking behaviors linked to drug and alcohol use, fast driving, guns, physical aggression, and other dangerous endeavors. Because gender role expectations tend to disfavor females, it is not surprising that gender generally has an even greater impact on women’s health than on men’s. Even though biological factors allow women, on average, to live longer than men worldwide, various gendered practices (social, legal, criminal, and unethical) have serious impacts on the lives and health of women. From sex discrimination in research and treatment regarding issues linked to reproductive health, depression, sexual abuse, alcohol and drug abuse, the sex trade, and normalized violence against women (such as rape, female genital mutilation, forced prostitution/trafficking, and domestic violence), women’s lives across the globe are severely affected by gender role expectations that privilege males over females. While some general consistencies in the relationships between gender, women, and health are experienced worldwide, intersections of race, ethnicity, class, age, country, region, and religion can make for very different experiences of women globally, and even within the same country. The recent years have seen an increasing call to reconsider the binary means by which we have defined sex and gender. Advances in our understandings of lesbian, gay, bisexual, intersex, and transgendered individuals have challenged traditional notions and definitions of sex and gender in important and complex ways. Such an important shift warrants a stand-alone discussion, as well as the recognition that sexual orientation should not be automatically linked to discussions of sex and gender, given that such categorization reifies the problematic sex/gender binaries that ground sexist and homophobic attitudes in the first place.