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Article

The turn of the 21st century has seen an explosion of frameworks that account for individuals’ decisions to seek or avoid information related to health risks. The four dominant frameworks are Risk Perception Attitude Framework, the Risk Information Seeking and Process model, the Planned Risk Information Seeking Model, and the Theory of Motivated Information Management. A comparison of the constructs within each and an examination of the related empirical tests reveal important insights into (a) factors that have consistently been shown to shape these decisions across these approaches and (b) constructs in need of additional theorizing and empirical testing. Specifically, the analysis suggests that uncertainty, efficacy, affect, risk perceptions, and subjective norms all play crucial roles in accounting for decisions to seek or avoid risk-related information. However, inconsistencies in the direction of influence for uncertainty or information discrepancy, risk perceptions, and negative affect argue for the need for considerably more theoretical clarity and empirical rigor in investigations of the ways in which these experiences shape decision making in these contexts.

Article

The disruption information seeking and processing (DISP) model is a variation on the risk information seeking and processing (RISP) model. While both the DISP and the original RISP models seek to predict how individuals will search for and attend to information in response to a perceived hazard, DISP aims to broaden analysts’ view of the sorts of information individuals may seek in such situations. It does so by expanding the repertoire of social psychology theory on which the model is constructed to include ideas from the literatures on sensemaking and identity maintenance. A major argument of DISP is that on many occasions the information that people seek in response to a risk will not be directly related to the risk itself. For example, if you hear a news bulletin on an outbreak of food poisoning associated with ground beef, the next thing you look for may not be information on the risks of E. Coli, but a recipe for chicken. While the observation that people seek non-risk-related information in response to risks is a broad one, the DISP concerns itself with one particularly important aspect of this idea. Specifically, based on research in the sensemaking and identity maintenance traditions, the DISP model proposes that, for information seekers, the self and the various identities in which individuals are personally invested are often as much the objects in need of interpretation as the hazardous environment. The implication of this is that when faced with a risk, individuals are likely to pay attention not just to information on the risk itself (the sort of information prioritized by RISP), but on the identities impacted by the hazard—for example, how a person’s acceptance of or strategy for coping with the risk might affect her self-image as being a good parent, a conscientious employer, etc. The DISP also proposes that some hazard situations are likely to be more disruptive to individuals’ sense of self than others—namely instances where the individual has a high vested interest in a particular identity that is challenged by the hazard combined with a low sense of self-efficacy with respect to remediating the hazard. A typical example would be a parent who prides herself on keeping her kids safe, who finds out about an environmental risk to children in her neighborhood, but who cannot afford to move. According to the DISP model, in such a circumstance the individual would likely become more attuned to information about the countervailing positive aspects of the neighborhood, such as good schools or a low crime rate. These sorts of information, which do not pertain to the risk directly, but are nonetheless sought as a consequence of the risk, exemplify the manner in which DISP seeks to expand the focus of the original RISP model. In the parlance of DISP, the model adds a “self-relevant” information dimension to RISP’s original focus on “risk-relevant” information. Finally, the DISP model proposes the notion of “norm trumping,” suggesting that individuals experiencing disruption in the face of a hazard—who run afoul of the set of social norms associated with an identity in which they are highly invested—are likely to pay particular attention to self-relevant information that emphasizes alternative sets of norms that help to preserve or reconstitute a desired sense of self. This model has yet to be tested empirically.

Article

Direct-to-consumer advertising of prescription drugs (DTCA) is a multibillion-dollar industry in the United States, affecting the health-care landscape. DTCA has been controversial, since a major increase in this type of advertising resulted from re-interpretation of existing regulations in the late 20th century. Health and risk communication research can inform many of the controversial issues, assisting physicians, policymakers, and the public in understanding how consumers respond to DTCA. Prior research addresses four major topics: (1) the content of DTCA in different channels, (2) consumers’ perceptions of and responses to DTCA, (3) individual-level factors that affect how consumers respond to DTCA, and (4) message factors that impact consumers’ responses. Such research shows that the presentation of risk and benefits information is generally not balanced in DTCA, likely affecting consumers’ attitudes toward and comprehension of the risk information. In addition, despite consumers’ generally somewhat negative or neutral perceptions of DTCA, this advertising seems to affect their health information seeking and communication behaviors. Finally, a wide range of individual-level and message factors have been shown to have an impact on how consumers process and respond to DTCA. Consumers’ responses, including how they process the information, request prescription drugs from providers, and share information about prescription drugs, have an important impact on the effects of DTCA. The fields of health and risk communication therefore bring theories and methodologies that are essential to better understanding the impact of this advertising.

Article

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.

Article

Communication research has recently had an influx of groundbreaking findings based on big data. Examples include not only analyses of Twitter, Wikipedia, and Facebook, but also of search engine and smartphone uses. These can be put together under the label “digital media.” This article reviews some of the main findings of this research, emphasizing how big data findings contribute to existing theories and findings in communication research, which have so far been lacking. To do this, an analytical framework will be developed concerning the sources of digital data and how they relate to the pertinent media. This framework shows how data sources support making statements about the relation between digital media and social change. It is also possible to distinguish between a number of subfields that big data studies contribute to, including political communication, social network analysis, and mobile communication. One of the major challenges is that most of this research does not fall into the two main traditions in the study of communication, mass and interpersonal communication. This is readily apparent for media like Twitter and Facebook, where messages are often distributed in groups rather than broadcast or shared between only two people. This challenge also applies, for example, to the use of search engines, where the technology can tailor results to particular users or groups (this has been labeled the “filter bubble” effect). The framework is used to locate and integrate big data findings in the landscape of communication research, and thus to provide a guide to this emerging area.

Article

The degree to which patients are active and communicative in interactions with medical providers has changed in recent decades. The biomedical model, a model that minimizes patient agency in the medical interaction, is being replaced with a model of patient-centered care, an approach that prioritizes the individual patient in their healthcare and treatment decisions. Tenets of patient-centered care support that patients must be understood within their psychosocial and cultural preferences, should have the freedom to ask questions, and are encouraged to disclose health-relevant information. In short, this model promotes patient involvement in medical conversations and treatment decision-making. Research continues to examine approaches to effective patient-centered communication. Two interpersonal processes that promote patient-centered communication are patient question-asking and patient disclosure. Patient question-asking and disclosure serve to inform medical providers of patient preferences, hesitations, and information needs. Individuals, including patients, make decisions to pursue or disclose information. Patients are mindful that the act of asking questions or disclosing information, particularly stigmatized information such as sexual behavior or drug use, could make them vulnerable to perceived negative provider evaluations or responses. Thus, decisions to ask questions or share information, processes essential to the understanding of patient perspectives and concerns, may be challenging for patients. Various theoretical models explain how individuals consider if they will perform actions such as seeking or disclosing information. Research also explains the barriers that patients experience in asking questions or disclosing relevant health information to providers. A review of pertinent research offers suggestions to aid in facilitating improved patient-centered communication and care.

Article

Media users exercise control over their information and entertainment environments. Selective exposure to media allows individual to choose channels and messages that satisfy their interests and motivations. A variety of selective exposure studies have assessed selective exposure to messages about ingroup versus outgroup members. Relevant theoretical perspectives include information seeking, confirmation bias, informational utility, self and affect management, reinforcing spirals, boundary expansion, exemplification, and social comparison. Each of these theories of selective exposure identifies an attitudinal or self-conceptual basis for media use yet also allows for the role of social identity or beliefs about intergroup members and interactions. In addition, the distinction between selective exposure and selective avoidance is critical for understanding intergroup media contact, as is the distinction between positive and negative portrayals of relevant social groups. Applicable findings from survey and experimental studies illustrate that age identity, sex and gender identity, and race and ethnicity all produce patterns of selective exposure in which ingroups are generally favored. Information about outgroups is more likely to be selected if it suits the situational or dispositional needs of the individual. Partisan selective exposure is also examined from an intergroup perspective, as is selective exposure to information about aspirational future selves and self-expansion. Depictions of persons that exemplify social groups or allow for social comparison are also discussed, yet little direct evidence exists about exposure to outgroup members in these processes. Finally, interpersonal new media are considered with regard to intergroup contact. Immersive media such as virtual reality provide interactive contact with outgroups, and social identity plays an important role in the distribution of user-generated content, the cultivation of online social networks, and the ongoing convergence between mass and social media. Selective exposure researchers are increasingly considering intergroup contact as an important type of media content relevant to their theories, and intergroup contact researchers are increasingly accounting for the selectivity factor in media processing and effects. Integrating key findings and building a more programmatic approach to this topic will enhance the understanding of individuals’ self-selected exposure to media about (and produced by) outgroups. Indeed, for intergroup media contact to be successful in producing less stereotyping, more positive attitudes, and more intergroup harmony, media users must first choose to come into contact with messages about outgroup members, specifically messages that can convey and produce beneficial effects for intergroup relations.

Article

The concept of publics and related notions such as receivers, audiences, stakeholders, mass, markets, target groups, and the public sphere are central to any discussion of formal communication programs between organizations or other strategic communicators and the individuals or groups with which they strive to communicate. The concept explains why individuals and collectivities of individuals are motivated to communicate for themselves (to seek or otherwise acquire information), with similar individuals to form organized groups, and with formal organizations to make demands on those organizations or to shape the behavior of the organizations. Theories of publics originated in the 1920s as the result of debates over the nature of citizen participation in a democracy, the role of the mass media in forming public opinion, the role of public relations practitioners in the process, and the effects of communicated messages on publics, audiences, and other components of society. J. Grunig developed a situational theory of publics in the 1960s that has served as the most prominent theory of publics for 50 years, and J.-N. Kim and J. Grunig recently have expanded that theory into a situational theory of problem solving. These theories have been used to identify and segment types of publics, to explain the communication behaviors of those publics, to conceptualize the effects of formal communication programs, to understand the cognitive processes of members of publics, and to explain the development of activist groups. Other scholars have suggested additions to these theories or alternatives to more thoroughly explain how communication takes place between members of publics and to identify latent publics that are largely ignored in the situational theories.

Article

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.

Article

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

Brenda L. Berkelaar and Millie A. Harrison

Broadly speaking, cybervetting can be described as the acquisition and use of online information to evaluate the suitability of an individual or organization for a particular role. When cybervetting, an information seeker gathers information about an information target from online sources in order to evaluate past behavior, to predict future behavior, or to address some combination thereof. Information targets may be individuals, groups, or organizations. Although often considered in terms of new hires or personnel selection, cybervetting may also include acquiring and using online information in order to evaluate a prospective or current client, employee, employer, romantic partner, roommate, tenant, client, or other relational partner, as well as criminal, civil, or intelligence suspects. Cybervetting takes advantage of information made increasingly available and easily accessible by regular and popular uses and affordances of Internet technologies, in particular social media. Communication scholars have long been interested in the information seeking, impression management, surveillance, and other processes implicated in cybervetting; however, the uses and affordances of new online information technologies offer new dimensions for theory and research as well as ethical and practical concerns for individuals, groups, organizations, and society.