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Article

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.

Article

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.

Article

Location-Based Ads and Exposure to Health and Risk Messages  

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

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

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

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

Cross-Cultural Adaptation  

Young Yun Kim

Countless immigrants, refugees, and temporary sojourners, as well as domestic migrants, leave the familiar surroundings of their home culture and resettle in a new cultural environment for varying lengths of time. Although unique in individual circumstances, all new arrivals find themselves in need of establishing and maintaining a relatively stable working relationship with the host environment. The process of adapting to an unfamiliar culture unfolds through the stress-adaptation-growth dynamic, a process that is deeply rooted in the natural human tendency to achieve an internal equilibrium in the face of adversarial environmental conditions. The adaptation process typically begins with the psychological and physiological experiences of dislocation and duress commonly known as symptoms of culture shock. Over time, through continuous activities of new cultural learning, most people are able to attain increasing levels of functional and psychological efficacy vis-a-vis the host environment. Underpinning the cross-cultural adaptation process are the two interrelated experiences of deculturation of some of the original cultural habits, on the one hand, and acculturation of new ones, on the other. The cumulative outcome of the acculturation and deculturation experiences is an internal transformation in the direction of assimilation into the mainstream culture. Long-term residents and immigrants are also likely to undergo an identity transformation, a subtle and largely unconscious shift from a largely monocultural to an increasingly intercultural self-other orientation, in which conventional, ascription-based cultural categories diminish in relevance while individuality and common humanity play an increasingly significant role in one’s daily existence. Central to this adaptation process are one’s ability to communicate in accordance to the norms and practices of the host culture and continuous and active engagement in the interpersonal and mass communication activities of the host society.

Article

The ACT2 Program and Eliminating Racial and Ethnic Disparities in HIV and AIDS Clinical Trials: A Case Study in Health and Risk Messaging  

Marya Gwadz and Amanda S. Ritchie

It is well documented that African American/Black and Hispanic individuals are underrepresented in biomedical research in the United States (U.S.), and leaders in the field have called for the proportional representation of varied populations in biomedical studies as a matter of social justice, economics, and science. Yet achieving appropriate representation is particularly challenging for health conditions that are highly stigmatized such as HIV/AIDS. African American/Black, and Hispanic individuals, referred to here as “people of color,” are greatly overrepresented among the 1.2 million persons living with HIV/AIDS in the United States. Despite this, people of color are substantially underrepresented in AIDS clinical trials. AIDS clinical trials are research studies to evaluate the safety and effectiveness of promising new treatments for HIV and AIDS and for the complications of HIV/AIDS, among human volunteers. As such, AIDS clinical trials are critical to the development of new medications and treatment regimens. The underrepresentation of people of color in AIDS clinical trials has been criticized on a number of levels. Of primary concern, underrepresentation may limit the generalizability of research findings to the populations most affected by HIV/AIDS. This has led to serious concerns about the precision of estimates of clinical efficacy and adverse effects of many treatments for HIV/AIDS among these populations. The reasons for the underrepresentation of people of color are complex and multifaceted. First, people of color experience serious emotional and attitudinal barriers to AIDS clinical trials such as fear and distrust of medical research. These experiences of fear and distrust are grounded largely in the well-known history of abuse of individuals of color by medical research institutions, and are complicated by current experiences of exclusion and discrimination in health care settings and the larger society, often referred to as structural racism or structural violence. In addition, people of color experience barriers to AIDS clinical trials at the level of social networks, such as social norms that do not support engagement in medical research and preferences for alternative therapies. People of color living with HIV/AIDS experience a number of structural barriers to clinical trials, such as difficulty accessing and navigating the trials system, which is often unfamiliar and daunting. Further, most health care providers are not well positioned to help people of color overcome these serious barriers to AIDS clinical trials in the context of a short medical appointment, and therefore are less likely to refer them to trials compared to their White peers. Last, some studies suggest that the trials’ inclusion and exclusion criteria exclude a greater proportion of people of color than White participants. Social/behavioral interventions that directly address the historical and contextual factors underlying the underrepresentation of people of color in AIDS clinical trials, build motivation and capability to access trials, and offer repeated access to screening for trials, hold promise for eliminating this racial/ethnic disparity. Further, modifications to study inclusion criteria will be needed to increase the proportion of people of color who enroll in AIDS clinical trials.