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.
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Video Games and Gaming: Reaching Audiences With Health and Risk Messages
Anthony M. Limperos
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Physiological Measures of Wellness and Message Processing
Kory Floyd, Corey A. Pavlich, and Dana R. Dinsmore
Research has shown that the expression of affection and other forms of prosocial communication between two or more people promotes wellness and has the potential to increase life expectancy. The human body contains multiple physiological subsystems that all contribute to the overall health and well-being of an individual; the simple act of engaging in prosocial communication has been shown to positively influence one’s health and well-being. The specific benefits of engaging in prosocial communication are not limited to one specific physiological subsystem; it is the pervasiveness of this benefit that is so important. The benefits of prosocial communication range from building the body’s defense systems to increasing the effectiveness of recovery; in essence, prosocial communication increases the body’s overall integrity and rejuvenating power. These benefits have been observed for a variety of prosocial behaviors, including the expression of affection, touch, social support and cohesion, and social influence. The health benefits of prosocial communication point to the importance of considering prosocial communication when designing health and risk messages.
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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.
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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.
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Social-Ecological Approaches to Health and Risk Messaging
Kirsty Williamson
Before health and risk messaging can have the best possible effect, there needs to be an understanding of what might influence health and associated risky behaviors. A wide range of elements needs to be considered, given the many possible influences on health habits and risky exposures. Since “ecology” is defined as the relationship between organisms and their environments, ecological models enable this consideration to be made. As a result ecological approaches have been widely used in health behavior, health planning, and health education.
Ecological theory, with a communication focus, has also been developed, emerging specifically from the field of “information behavior.” Grounded in the work of Bronfenbrenner, on the experimental ecology of human development, the theory grew out of a study of older adults’ information and communication needs and uses, undertaken in the 1990s. The ecological model, as developed, enabled a wide range of personal and social influences on information seeking and communication to be explored with people aged 60 and older. Analysis of the impact of multilevel factors is facilitated by an ecological approach, increasing its value for the task of designing the content of health and risk messages. The “how” of designing health messaging is not addressed specifically by this approach.
Following the study of older adults, the ecological model was broadened, modified, and applied to the study of the information and communication behavior of different community groups, involving a range of topics. The flexibility of the approach is a key strength. A study of information seeking, by women with breast cancer, indicated that several “ecological” elements, such as age, ethnicity, and stage of disease, played a part in the type of information sought and in preferences for how information was communicated. Health and risk avoidance implications emerged from a study of information seeking for online investment, providing another good example of the ways in which the model can be adapted. A range of ecological factors were shown to influence investing behavior, including level of risk taking. A study of people in the Fourth Age (the last stage of life) resulted in a further refined and extended model, as well as making a contribution to the already substantial body of accumulated gerontological knowledge.
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Presumed Media Influence in Health and Risk Messaging
Shirley S. Ho and Andrew Z. H. Yee
Health communication research has often focused on how features of persuasive health messages can directly influence the intended target audience of the messages. However, scholars examining presumed media influence on human behavior have underscored the need to think about how various audience’s health behavior can be unexpectedly influenced by their exposure to media messages. Two central theoretical frameworks have been used to guide research examining the unintended effects: the third-person effect and the influence of presumed media influence (IPMI). The theoretical explanations for presumed media influence is built on attribution bias, self-enhancement, perceived exposure, perceived relevance, and self-categorization. Even though both the third-person effect and the IPMI share some theoretical foundations, and are historically related, the IPMI has been argued to be better suited to explaining a broader variety of behavioral consequences. One major way that presumed media influence can affect an individual’s health behavior is through the shifting of various types of normative beliefs: descriptive, subjective, injunctive, and personal norms. These beliefs can manifest through normative pressure that is theoretically linked to behavioral intentions. In other words, media have the capability to create the perception that certain behaviors are prevalent, inculcating a normative belief that can lead to the uptake of, or restrain, health behaviors. Scholars examining presumed media influence have since provided empirical support in a number of specific media and behavioral health contexts. Existing findings provide a useful base for health communication practitioners to think about how presumed media influence can be integrated into health campaigns and message design. Despite the proliferation of research in this area, there remains a need for future research to examine these effects in a new media environment, to extend research into a greater number of health outcomes, to incorporate actual behavioral measures, and to ascertain the hypothesized causal chain of events in the model.
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Worry and Rumination as a Consideration When Designing Health and Risk Messages
Tamara D. Afifi, Ariana Shahnazi, and Kathryn Harrison
Rumination is typically thought of as pessimistic, repetitive thinking or mulling that is deleterious for one’s health. Rumination, however, can take several forms and is not always harmful. In fact, it could actually be helpful in certain circumstances. It is common and often helpful when something stressful happens, like a health scare or problematic health diagnosis, for people to ponder or reflect on why it happened and brainstorm potential solutions to it. This is referred to as reflective rumination. Rumination affects people’s risk perceptions related to their personal and relational health and decision-making about their health. Research on negative rumination and health and positive rumination and health focuses on the impact of these patterns of thinking on health outcomes such as mental health, physical health, and relational health and as perceptions of health messages and risk likelihood.
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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.
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Affection Exchange Theory
Kory Floyd and Benjamin E. Custer
Affectionate communication constitutes verbal behaviors (e.g., saying “I love you”), nonverbal gestures (e.g., hugging, handholding), and socially supportive behaviors (e.g., helping with a project) that humans employ to develop and maintain close relationships with others. In addition to its relational benefits, affectionate communication contributes to health and wellness for both senders and receivers. Affection exchange theory (AET) addresses the questions of why humans engage in affectionate communication and why diverse benefits are associated with such behaviors. A robust empirical literature supports AET’s contention that both expressing and receiving affectionate behavior are associated with physical and mental health benefits. Despite these contributions, however, some compelling questions about affectionate communication remain to be addressed, and AET can provide a useful framework for doing so.
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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.
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Adherence and Communication
Teresa L. Thompson and Kelly Haskard-Zolnierek
Patient adherence (sometimes referred to as patient compliance) is the extent to which a patient’s health behavior corresponds with the agreed-upon recommendations of the healthcare provider. The term patient compliance is generally synonymous with adherence but suggests that the patient played a more passive role in the healthcare professional’s prescription of treatment, whereas the term adherence suggests that the patient and healthcare professional have come to an agreement on the regimen through a collaborative, shared decision-making process. Another term related to the concept of adherence is persistence (i.e., taking a medication for the recommended duration). Some patients are purposefully or intentionally nonadherent, whereas others are unintentionally nonadherent due to forgetfulness or poor understanding of the regimen. Patients may be intentionally nonadherent because of a belief that the costs of the regimen outweigh the benefits, for example. Nonadherence behaviors in medication taking include never filling a prescription, taking too much or too little medication, or taking a medication at incorrect time intervals. Patient adherence is relevant not only in medication-taking behaviors, but also in health behaviors such as following a specific dietary regimen, maintaining an exercise program, attending follow-up appointments, getting recommended screenings or immunizations, and smoking cessation, among others.
A number of factors predict patient adherence to treatment, but the relationship between provider-patient communication and adherence to treatment will be stressed. Focusing on recent research, the article examines the concept of patient adherence, describes how provider-patient communication can enhance patient adherence, explains what elements of communication are relevant for adherence, and illustrates how interventions to improve communication can improve adherence.
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Inoculation Theory Applied in Health and Risk Messaging
Bobi Ivanov
Referred to as the “most consistent and reliable method for conferring resistance to persuasion” by Miller et al. in 2013, over the past 50 years inoculation has exerted significant influence in shaping theoretical and contextual resistance research and message design. Used as a message strategy, inoculation elicits threat, or realized attitudinal/behavioral vulnerability, which motivates individuals to shore up attitudinal/behavioral defenses by providing both material and guided practice aiding the process of effective counterarguing, which in turn increases individuals’ resistance to attitudinal/behavioral challenges. The motivation is responsible for sustaining the inoculation effect over an extended period of time. Inoculation messages, however, do much more than just inspire a robust defense. They motivate individuals to engage others regarding the attitudinal/behavioral topic in an attempt to reassure and advocate their positions, thus diffusing the inoculation message over social networks. The attitudinal/behavior protection elicited by inoculation messages is not limited to the message’s target attitude/behavior, but instead spreads over related attitudes/behaviors as well, thus increasing the pragmatic utility of this message strategy. Inoculation’s effectiveness extends beyond the realm of resistance, as inoculation messages are also effective in both shaping and changing attitudes/behaviors.
Because of its success, inoculation-based message strategies have been applied in numerous contexts researchers and clinicians beganand with numerous topics. Some of inoculation’s applied contexts include commercial, instruction/education, interpersonal, political, corporate, public relations, cross-cultural, health, and risk. More specifically, in the health and risk contexts, inoculation has been applied in promotion or prevention capacity on topics such as politically-motivated violent acts, smoking, drinking, unprotected sex, vaccination, and health-related policy, with current research exploring its efficacy in addiction interventions and indoor tanning-bed usage prevention. Inoculation may also be used as a strategy to reduce recidivism in criminal prison inmates and preventing verbal aggression in schools. Additional promising areas for application of inoculation-based strategies may include the promotion and protection of healthy eating habits as well as positive attitudes/behaviors toward mammograms, colonoscopies, breastfeeding, and regular exercise, just to name a few. As Ivanov suggested, the “application of the strategy [is] boundless.”
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Mood’s Role in Selective Exposure to Health and Risk Information
Melissa J. Robinson and Silvia Knobloch-Westerwick
In today’s media-saturated environment, individuals may be exposed to hundreds of media messages on a wide variety of topics each day. It is impossible for individuals to attend to every media message, and instead, they engage in the phenomenon of selective exposure, where certain messages are chosen and attended to more often than others. Health communication professionals face challenges in creating messages that can attract the attention of targeted audiences when health messages compete with more entertaining programming. In fact, one of the greatest obstacles for health campaigns is a lack of adequate exposure among targeted recipients. Individuals may avoid health messages completely or counterargue against persuasive attempts to change their health-related attitudes and behaviors. Once individuals have been exposed to a health message, their current mood plays an important role in the processing of health information and decision making. Early research indicated that a positive mood might actually be detrimental to information processing because individuals are more likely to process the information heuristically. However, recent studies countered these results and suggested that individuals in positive moods are more likely to attend to self-relevant health information, with increased recall and greater intent to change their behaviors.
Since mood has the ability to influence exposure to health messages and subsequent message processing, it is important for individuals to be able to manage their mood prior to health information exposure and possibly even during exposure. One way individuals can influence their moods is through media use including TV shows, movies, and music. Mood management theory predicts that individuals choose media content to improve and maintain positive moods and examines the mood-impacting characteristics of stimuli that influence individuals’ media selections. Therefore, an individual’s mood plays an important role in selection of any type of communication (e.g., news, documentaries, comedies, video games, or sports).
How can health message designers influence individuals’ selection and attention to health messages when negative moods may be blocking overtly persuasive attempts to change behaviors and a preference for entertaining media content? The narrative persuasion research paradigm suggests that embedding health information into entertainment messages may be a more effective method to overcome resistance or counterarguing than traditional forms of health messages (e.g., advertisements or articles). It is evident that mood plays a complex role in message selection and subsequent processing. Future research is necessary to examine the nuances between mood and health information processing including how narratives may maintain positive moods through narrative selection, processing, and subsequent attitude and/or behavior change.
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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.
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Forgiveness Communication and Health
Douglas L. Kelley, Bianca M. Wolf, and Shelby E. Broberg
Research on forgiveness and its health-related effects has steadily increased since the late 20th century. Most of the forgiveness-health literature demonstrates that forgiveness indirectly influences health through a variety of psychosocial affective factors. Common distinctions in this research are reflected in studies focused on reduction of negative affect and, thus, negative health effects, and studies focused on preventative and health-promoting implications of forgiveness (e.g., increased positive affect). While a lack of clarity exists regarding health implications stemming from reductions in unforgiveness (as distinct from increases in forgiving responses), current research supports the notion that forgiveness, as opposed to unforgiveness, affects psychological, physical, and relational health in overridingly beneficial ways. More specifically, forgiveness, and/or the moderation of unforgiveness, is associated with the exhibition of positive affect (e.g., sympathy, empathy, and optimism), improved self-esteem, higher life satisfaction, and better mental health ratings. Physical health effects of forgiveness include enhanced bioregulation in response to transgression stressors, as well as better self-rated health status and the exhibition of positive health behaviors. Limitations in the current literature most commonly relate to disparate definitional, methodological, and interpretative issues typical of transdisciplinary forgiveness and health research. Current trends and future directions for forgiveness-health research include consideration of additional variables thought to be associated with forgiveness processes, including religiosity, empathy, and social support. Additionally, research that focuses on communicative and relational aspects of health and well-being is warranted. Suggestions for research opportunities in forgiveness-health research framed by a communicative lens are offered.
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Rhetorical Approaches to Health and Medicine
Jennifer A. Malkowski, J. Blake Scott, and Lisa Keränen
Rhetoric, commonly understood as the art, practice, and analysis of persuasion, has longstanding connections to medicine and health. Rhetorical scholars, or rhetoricians, have increasingly applied rhetorical theories, concepts, and methods to the texts, contexts, discourses, practices, materials, and digital and visual artifacts related to health and medicine. As an emerging interdisciplinary subfield, the rhetoric of health and medicine seeks to uncover how symbolic patterns shape thought and action in health and medical texts, discourses, settings, and materials.
In practice, rhetoricians who study health and medicine draw from the standard modes of rhetorical analysis, such as rhetorical criticism and rhetorical historiography, as well as from social science methods—including participant observation, interviewing, content analysis, and visual mapping—in order to deepen understanding of how language functions across health and medical objects, issues, and discussions. The objects of analysis for rhetorical studies of health and medicine span medical research, education, and clinical practice from laboratory notes to provider–patient interaction; health policymaking and practice from draft policies through standards of care; public health texts and artifacts; consumer health practices and patient advocacy on- and offline; public discourses about disease, death, bodies, illness, wellness, and health; online and digital health information; popular entertainments and medical dramas; and alternative and complementary medicine. Despite its methodological breadth, rhetorical approaches to science and medicine consistently involve the systematic examination and production of symbolic exchanges occurring across interactional, institutional, and public contexts to determine how individuals and groups create knowledge, meanings, identities, understandings, and courses of action about health and illness.
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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.
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Critical Food Studies
Helene A. Shugart
If food studies is an inherently interdisciplinary field of enquiry, communication is central to its uptake in any scholarly context, for food is inherently relational, symbolic, and deeply cultural, a powerful discourse in its own right and imbricated in a host of other discourses. Accordingly, while food studies is a relatively new area of study within the communication discipline, scholarship in that vein has had rather seamless entrée into the broader scholarly arena and has proliferated along the same general lines of investigation that characterize the field in general.
Originally rooted in cultural anthropology, early studies of the cultural significance of food assessed how food both reflects and accomplishes social identity and status, a focus that has been sustained and expanded in more contemporary studies as relevant to how food signals and mobilizes particular identities, such as race/ethnicity, nation, class, gender, and sexuality. Matters of identity are sometimes apparent in studies of the role(s) of food in global flows, including globalization, colonization, immigration, diaspora, and tourism. Much of this scholarship also or instead takes up food in terms of production and consumption, assessing the politics, economics, and geographies of food. Endeavors in this vein, in global, national, and local contexts, examine food policies and patterns of industry and how they privilege certain interests while disenfranchising others: food safety, security, and justice feature prominently in these investigations. These motifs are reflected, as well, in scholarship that examines social movements around food that seek to disrupt or resist problematic industry and farming policies and/or practices as relevant to, for example, environmental exigencies, animal welfare, eradication of the local, and availability of and/or access to safe, healthy foods.
The mediation of food is perhaps a natural subject of study for communication scholars, ranging from representations of food in film to food packaging and advertising. The recent rise of “foodie” culture has generated a proliferation of media fare, signaled by indices ranging from the now recognized genre of “food films,” to multiple television networks devoted to food, to the rise of “celebrity chefs”; food is, moreover, an increasing presence on the Internet, proliferating especially across social media. The imaginaries of authenticity and egalitarianism and the materialities of class that frequently drive foodie culture have been the focus of much of this scholarship, and they have been further identified as figuring prominently in urban practices ranging from the establishment of farmers’ markets to gentrification.
Even within the communication discipline, food studies is a wide-ranging topic, but it is not simply a diverse subject of study for communication scholars. The inherently liminal and malleable nature of food renders it difficult if not impossible to engage or theorize in terms of conventional binaries or rifts that characterize many if not most fields, such as subject/object and self/other; perhaps most salient for the communication discipline, food denies the particularly nettlesome materiality/discursivity binary. Accordingly, food studies holds considerable promise for the field relevant to theoretical innovation and expansion.
