61-80 of 111 Results  for:

  • Keywords: health x
  • Health and Risk Communication x
Clear all

Article

Social Marketing Applied to Health and Risk Messaging  

R. Craig Lefebvre and P. Christopher Palmedo

Many ideas about best practices for risk communication share common ground with social marketing theory and practice: for example, segmentation, formative research, and a focus on behavioral outcomes. Social marketing first developed as a methodology to increase the public health impact of programs and to increase the acceptability and practice of behaviors that improve personal and social well-being. The core concepts of this approach are to be people-centered and to aim for large-scale behavior change. An international consensus definition of social marketing describes it as an integration of theory, evidence, best practices, and insights from people to be served. This integrated approach is used to design programs that are tailored to priority groups’ needs, problems, and aspirations and are responsive to a competitive environment. Key outcomes for social marketing efforts are whether they are effective, efficient, equitable, and sustainable. The 4P social marketing mix of Products, Prices, Places, and Promotion offers both strategic and practical value for risk-communication theory and practice. The addition of products, for example, to communication efforts in risk reduction has been shown to result in significantly greater increases in protective behaviors. The Cover CUNY case demonstrates how full attention to, and consideration of, all elements of the marketing mix can be used to design a comprehensive risk-communication campaign focused on encouraging college student enrollment for health insurance. The second case, from the drug safety communication arena, shows how a systems-level, marketplace approach is used to develop strategies that focus on key areas where marketplace failures undermine optimal information-dissemination efforts and how they might be addressed.

Article

Anger in Health and Risk Messaging  

Claude H. Miller and Reinaldo Cortes Quantip

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

Article

Knowledge and Comprehension  

Ashley R. Kennard, Courtney Anderegg, and David Ewoldsen

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

Article

Source Credibility, Expertise, and Trust in Health and Risk Messaging  

Kristin Page Hocevar, Miriam Metzger, and Andrew J. Flanagin

Our understanding and perceptions of source credibility significantly drive how we process health and risk messages, and may also influence relevant behaviors. Source credibility is believed to be impacted by both perceptions of source trustworthiness and expertise, and the effect of credibility on changes in attitudes and behavior has been studied for decades in the persuasion literature. However, how we understand and define source credibility—particularly the dimension of expertise—has changed dramatically as social media and other online platforms are increasingly used to design and disseminate health messages. While earlier definitions of source credibility relied heavily on the source’s credentials as indicators of expertise on a given topic, more recent conceptualizations must also account for expertise held by laypeople who have experience with a health concern. This shifting conceptualization of source credibility may then impact both why and when people select, as well as how they perceive, process, and judge, health messaging across both novel and more traditional communication contexts.

Article

Communicating Religious Identities  

Renate Ysseldyk

Religion encompasses many forms of communication: between groups, within groups, and with God (or other deities). Such communication can be especially powerful when group members highly identify with their religious group and the beliefs therein. Equally, it can be divisive, as evidenced by religion-based intergroup conflict and intolerance (which often overlaps along ethnic or political lines). However, not all religious communication is verbal or explicit. Religious individuals also commonly transmit their beliefs, values, and identities through symbols, physical spaces, and music. Likewise, communication with God is often pursued with silent prayer, meditation, or ritual, which also serve to reinforce one’s spirituality alongside religious group boundaries. Taken together, these varying forms of communication have implications not only for religious intergroup relations (e.g., intergroup contact or conflict), but also for intragroup relations (e.g., the strengthening of social ties) and individual health outcomes (e.g., effective communication with health care providers and coping practices). Given the importance of religious identity for many individuals, the benefits for individual well-being and intragroup relations, and yet the intergroup strife that religious group divisions can incite, the ways in which we communicate our religious group identities deserve closer attention.

Article

Online Talk About Mental Health  

Joyce Lamerichs and Wyke Stommel

There is a need to focus on research conducted on online talk about mental health in the domains of ethnomethodology, Conversation Analysis (CA), Discursive Psychology (DP), and Membership Categorization Analysis (MCA). We use the notion of “talk” in this article, as opposed to what could be considered a more common term such as “discourse,” to highlight that we approach computer-mediated discourse as inherently interactional. It is recipient designed and unfolds sequentially, responding to messages that have come before and building a context for messages that are constructed next. We will refer to the above domains that all share this view as CA(-related) approaches. A characterizing feature of interactional approaches to online mental health talk is their focus on in-depth analyses of relatively small amounts of data. With this focus at the center of their attention, they sit in the wider field of Discourse Analysis (DA), or Computer-Mediated Discourse Analysis (CMDA) who use language as their lens to understand human interaction. DA and CMDA research include a much wider set of both micro- and macro-analytic language-focused approaches to capture online discourse. Of all the CA(-related) work on online materials, a disproportionally large number of studies appear to deal with (mental) health talk. We aim to answer the question what the field of research on online mental health talk has yielded in terms of findings and methodologies. Centrally, CA (-related) studies of online mental health talk have aimed to grasp the actions people accomplish and the identities they invoke when they address their health concerns. Examples of actions in online mental health talk in particular are presenting oneself, describing a problem, or offering advice. Relevant questions for the above approaches that consider language-as-social-action are how these different actions are brought off and how they are received, by closely examining contributions such as e-mail and chat postings and their subsequent responses. With a focus on talk about mental health, this article will cover studies of online support groups (OSGs, also called online communities), and interaction in online counseling programs, mainly via online chat sessions. This article is organized as follows. In the historiography, we present an overview of CA(-related) work on online mental health talk. We discuss findings from studies of online support groups (OSGs) first and then move to results from studies on online counseling. The start of our historiography section, however, sets out to briefly highlight how the Internet may offer several particularly attractive features for those with mental health problems or a mental illness. After the historiography, we discuss what an interactional approach of online mental health talk looks like and focuses on. We offer examples of empirical studies to illustrate how written contributions to a forum, and e-mails or chat posts that are part of online counseling sessions are examined as interaction and which types of findings this results in. We conclude with a review of methodological issues that pertain to the field, address the most important ethical considerations that come into play when examining online mental health talk, and will lastly highlight some areas for future research.

Article

Risk Perceptions and Risk Characteristics  

Hye-Jin Paek and Thomas Hove

Risk perception refers to people’s subjective judgments about the likelihood of negative occurrences such as injury, illness, disease, and death. Risk perception is important in health and risk communication because it determines which hazards people care about and how they deal with them. Risk perception has two main dimensions: the cognitive dimension, which relates to how much people know about and understand risks, and the emotional dimension, which relates to how they feel about them. Several theoretical models have been developed to explain how people perceive risks, how they process risk information, and how they make decisions about them: the psychometric paradigm, the risk perception model, the mental noise model, the negative dominance model, the trust determination model, and the social amplification of risk framework. Laypeople have been found to evaluate risks mostly according to subjective perceptions, intuitive judgments, and inferences made from media coverage and limited information. Experts try to base their risk perceptions more on research findings and statistical evidence. Risk perceptions are important precursors to health-related behaviors and other behaviors that experts recommend for either dealing with or preventing risks. Models of behavior change that incorporate the concept of risk perception include the Health Belief Model, Protection Motivation Theory, the Extended Parallel Process Model, and the Risk Perception Attitude framework. Public awareness and perceptions of a risk can be influenced by how the media cover it. A variety of media factors have been found to affect the public’s risk perceptions, including the following: (1) amount of media coverage; (2) frames used for describing risks; (3) valence and tone of media coverage; (4) media sources and their perceived trustworthiness; (5) formats in which risks are presented; and (6) media channels and types. For all of these media factors, albeit to varying degrees, there is theoretical and empirical support for their relevance to risk perceptions. Particularly related to media channels and genres, two hypotheses have emerged that specify different kinds of media influences. The impersonal impact hypothesis predicts that news media mainly influence how people see risks as affecting other individuals, groups, nations, or the world population in general (societal-level risk perceptions). By contrast, the differential impact hypothesis predicts that, while news media influence people’s societal-level risk perceptions, entertainment media have stronger effects on how people see risks as affecting themselves (personal-level risk perceptions). As the media environment become increasingly diverse and fragmented, future research on risk perception needs to examine more of the influences that various media, including social media, have on risk perception. Also, the accounts of how those influences work need to be further refined. Finally, since people’s risk perceptions lead them to either adopt or reject recommended health behaviors, more research needs to examine how risk perceptions are jointly affected by media, audience characteristics, and risk characteristics.

Article

Disasters and Communication about Health  

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.

Article

Cancer Communication Science: Intergroup Perspectives  

Lisa Sparks and Gary L. Kreps

At the heart of cancer communication research is an effort both to increase knowledge and to identify practical strategies for improving cancer communication and for improving prevention and control of cancer, as well as for addressing cancer care issues from theoretical and applied communication perspectives across the continuum of cancer care. One important theoretical approach to consider in cancer communication science is taking an intergroup approach to cancer care. The challenge moving forward is to develop cancer communication research programs that combine important theoretical and applied perspectives, focusing on prevention strategies that can help reduce cancer risk, incidence, morbidity, and mortality, and to promote the highest quality of life for people of every age and every background.

Article

Grounded Theory Methodology  

Paul Sebastian Ruppel and Günter Mey

Grounded theory methodology is one of the most widely used approaches to collect and analyze data within qualitative research. It can be characterized as a framework for study design, data collection, and analysis, which aims at the development of middle-range theories. The final result of such a study is called a “grounded theory,” and it consists of categories that are related to each other. Health and risk message design researchers working with grounded theory methodology are explicitly invited to use any kind of data they consider suitable for a particular project. Grounded theory methodology studies were originally based on intense fieldwork data, but in the meantime, interviews have become the most widely used type of data. In addition, there is a growing interest in using visual data such as pictures or film. Grounded theory methodology originated from sociology, but has since been applied in many different disciplines. This widened application went along with modifications, new developments, and innovations, and led to several current variants of grounded theory methodology. Basic features of grounded theory methodology include theoretical sampling, specific coding procedures with a comparative approach to analysis, and memo writing. The strategy of theoretical sampling requires that theoretical insights gained from the analysis of initially collected data guide subsequent data collection. Hence, during the research process data collection and analysis alternate and interact. For data analysis, different ways of coding enable the researcher to develop increasingly abstract conceptual ideas and reflections, first embodied in codes, later in categories. This analytical process allows for a step-by-step development of categories that are grounded in data. Category development entails comparisons at all stages, for example, of different cases during sampling, of different data pieces, and of different codes and categories during analysis. As a result, grounded theory methodology is also known as the constant comparative method. Throughout the research process the researcher writes memos and keeps track of the development of conceptual ideas, methodological reflections, and practical to-dos. Today, many researchers use software specifically developed to assist the process of qualitative data analysis.

Article

A Culture-Centered Approach to Health and Risk Communication  

Mohan Jyoti Dutta

The culture-centered approach (CCA) to health and risk communication conceptualizes the communicative processes of marginalization that constitute the everyday meanings of health and risks at the margins. Attending to the interplays of communicative and material disenfranchisement, the CCA situates health inequalities amidst structures. Structures, as the rules, roles, processes, and frameworks that shape the distribution of resources, constitute and constrain the access of individuals, households, and communities to the resources of health and well-being. Through voice infrastructures cocreated with communities at the classed, raced, gendered, colonial margins of capitalist extraction, the CCA foregrounds community agency, the capacity of communities to make sense of their everyday struggles with health and well-being. Community voices articulate the interplays of colonial and capitalist processes that produce and circulate the risks to human health and well-being, serving as the basis for community organizing to secure health and well-being. Culture, as an interpretive resource passed down intergenerationally, offers the basis for organizing, and is simultaneously transformed through individual and community participation. Culture-centered health communication, rooted in community agency, drawing upon cultural stories, resources, and practices in subaltern contexts, takes the form of organizing for health, mobilizing agentic expressions toward structural transformations.

Article

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.

Article

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.

Article

Entertainment-Education and Health and Risk Messaging  

Suruchi Sood, Amy Henderson Riley, and Kristine Cecile Alarcon

Entertainment-education (EE) began as a communication approach that uses both entertainment and education to engender individual and social change, but is emerging as a distinct theoretical, practice, and evidence-based communication subdiscipline. EE has roots in oral and performing arts traditions spanning thousands of years, such as morality tales, religious storytelling, and the spoken word. Modern-day EE, meanwhile, is produced in both fiction and nonfiction designs that include many formats: local street theater, music, puppetry, games, radio, television, and social media. A classic successful example of EE is the children’s television program Sesame Street, which is broadcast in over 120 countries. EE, however, is a strategy that has been successfully planned, implemented, and evaluated in countries around the world for children and adults alike. EE scholarship has traditionally focused on asking, “Does it work?” but more recent theorizing and research is moving toward understanding how EE works, drawing from multidisciplinary theories. From a research standpoint, such scholarship has increasingly showcased a wide range of methodologies. The result of these transformations is that EE is becoming an area of study, or subdiscipline, backed by an entire body of theory, practice, and evidence. The theoretical underpinnings, practice components, and evidence base from EE may be surveyed via the peer-reviewed literature published over the past 10 years. However, extensive work in social change from EE projects around the world has not all made it into the published literature. EE historically began as a communication approach, one tool in the communication toolbox. Over time, the nascent approach became its own full-fledged strategy focused on individual change. Backed by emerging technologies, innovative examples from around the globe, and new variations in implementation, it becomes clear that the field of EE is emerging into a discrete theoretical, practice, and evidence-based subdiscipline within communication that increasingly recognizes the inherent role of individuals, families, communities, organizations, and policies on improving the conditions needed for lasting social change.

Article

Regulatory Focus and Regulatory Fit in Health Messaging  

Ilona Fridman and E. Tory Higgins

Regulatory Focus Theory differentiates between two motivational orientations: promotion and prevention. Promotion-oriented individuals focus on advancements, growth, and making progress toward their hopes and aspirations, whereas prevention-oriented people are more concerned about safety, security, and fulfilling their responsibilities. Promotion-oriented individuals tend to focus on moving toward a better state ensuring gains and improvements. In contrast, prevention-oriented people tend to focus on ensuring against making mistakes and maintaining a current satisfactory state rather than moving to something worse. When individuals pursue desired ends using their preferred means (ensuring gains for promotion, and ensuring against losses for prevention), they experience regulatory fit, which makes them “feel right” about what they are doing. Regulatory fit is associated with strengthening engagement and intensifying evaluative judgments. The advantages of regulatory fit could be utilized in communications to motivate individuals’ healthy behavior. The messages that encourage healthy behavior could be framed in a way that fits recipients’ personal goal orientations. For instance, to increase motivation among promotion-oriented people for getting vaccinations, the message might state, “A flu vaccine helps you to continue achieving your goals even during a flu season.” This message emphasizes advancements and gains that fit a promotion orientation. To increase motivation among prevention-oriented people to choose healthy options, the messages could instead highlight avoiding losses: “A flu vaccine helps you avoid strength-sapping illness during a flu season.” Past studies on health communications have demonstrated that regulatory fit tends to facilitate participants’ willingness to follow the message and engage in healthy behavior. Could regulatory non-fit messages also work? When individuals pursue desired ends using non-preferred means—ensure gains for prevention-oriented individuals or ensure against losses for promotion-oriented individuals—they experience regulatory non-fit. Non-fit makes them “feel wrong” about what they are doing. Regulatory non-fit is associated with weakening engagement and de-intensifying evaluative judgments. How might a non-fit health message be helpful? What if individuals’ initial attitudes toward a healthy option were negative, even anxiety producing, despite that option serving their interests better than alternative options? It would be better if the individuals could thoughtfully consider the potential benefits of the option without their negative feelings rejecting it. For a thoughtful decision to be made, the intensity of the initial negative feelings could be decreased. A regulatory non-fit message, in this case, could be an effective tool. By making people “feel wrong” about their initial reaction, it could weaken their engagement and de-intensify the negative reactions, for example, reduce anxiety about the option. Thus, the regulatory non-fit message could help an individual to reconsider potential advantages of the initially disliked option. While the ways in which Regulatory Focus and Regulatory Fit theories can be applied to improve health communications are known, important questions remain. For example, are there circumstances when fit or non-fit messages could make people feel that their decision-making autonomy is being threatened? Can fit or non-fit messages create resistance? If so, how can this be avoided? Both fit and non-fit messages are persuasive techniques. Is there a downside to these techniques? What can be done to ensure that these persuasive techniques are not just effective but are also ethical?

Article

Agenda Setting in Health and Risk Messaging  

Karyn Ogata Jones

Since McCombs and Shaw first introduced the theory in 1972, agenda setting has emerged as one of the most influential perspectives in the study of the effects of mass media. Broadly defined, “agenda setting” refers to the ability of mass media sources to identify the most salient topics, thereby “setting the agendas” for audiences. In telling us what to think about, then, mass media sources are perceived to play an influential role in determining priorities related to policies, values, and knowledge on a given topic or issue. Scholars have studied this phenomenon according to both object (issue) salience and attribute salience and along aggregate and individual audience responses. The audience characteristics of need for orientation, uncertainty, relevance, and involvement are advanced as moderating and predicting agenda-setting effects. When agenda-setting theory is applied to the study of messaging related to health and risk communication, scholars have reviewed and identified common themes and topics that generally include media’s role in educating and informing the public about specific health conditions as well as public health priorities and administrative policies. Agenda setting is often examined in terms of measuring mass media effects on audiences. Looking at interpersonal communication, such as that coming from medical providers, opinion leaders, or peer networks, in studies will allow research to examine the combined effects of interpersonal and mass communication. Testing possible interactions among differing sources of information along with assessment of issue and attribute salience among audiences according to an agenda-setting framework serves to document audience trends and lived experiences with regard to mass media, health, and risk communication.

Article

Conflicting Information and Message Competition in Health and Risk Messaging  

Rebekah H. Nagler and Susan M. LoRusso

Clinicians, medical and public health researchers, and communication scholars alike have long been concerned about the effects of conflicting health messages in the broader public information environment. Not only have these messages been referred to in many ways (e.g., “competing,” “contradictory,” “inconsistent,” “mixed,” “divergent”), but they have been conceptualized in distinct ways as well—perhaps because they have been the subject of study across health, science, and political communication domains. Regardless of specific terminology and definitions, the concerns have been consistent throughout: conflicting health messages exist in the broader environment, they are noticed by the public, and they impact public understanding and health behavior. Yet until recently, the scientific evidence base to substantiate these concerns has been remarkably thin. In the past few years, there has been a growing body of rigorous empirical research documenting the prevalence of conflicting health messages in the media environment. There is also increasing evidence that people perceive conflict and controversy about several health topics, including nutrition and cancer screening. Although historically most studies have stopped short of systematically capturing exposure to conflicting health messages—which is the all-important first step in demonstrating effects—there have been some recent efforts here. Taken together, a set of qualitative (focus group) and quantitative (observational survey and experimental) studies, guided by diverse theoretical frameworks, now provides compelling evidence that there are adverse outcomes of exposure to conflicting health information. The origins of such information vary, but understanding epidemiology and the nature of scientific discovery—as well as how science and health news is produced and understood by the public—helps to shed light on how conflicting health messages arise. As evidence of the effects of conflicting messages accumulates, it is important to consider not just the implications of such messages for health and risk communication, but also whether and how we can intervene to address the effects of exposure to message conflict.

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

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.