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Article

Bystander intervention is a form of helping that occurs when onlookers intercede to provide direct or indirect aid to a victim. When bystanders step in to prevent or reduce harm to others, they act as agents of primary and secondary health prevention. But theory and research suggest the bystander intervention process is complex and multiple social-psychological and situational barriers imperil bystander action. Bystanders are often ill-prepared to intervene when others are at risk for emotional or physical harm. They may not notice that someone needs help due to distraction from self-focus, engagement in social interaction, intoxication, or aspects of the situation like crowding or noise. Due to inadequate knowledge, bystanders may misdiagnose the situation and believe intervention is unnecessary. The negative consequences of nonintervention may be unknown to them such that the situation fails to increase their empathic arousal and motivate their action. Lacking knowledge, they may not recognize the seriousness of the situation and or the potential costs of inaction, and so are insufficiently alarmed. Pluralistic ignorance can arise when multiple uncertain bystanders conceal their concern and hesitate to act, assuming others’ inaction means intervention is inappropriate or unnecessary. When there are multiple witnesses, bystanders may assume their help is unneeded, place intervention responsibility on others, or feel less responsible for helping due to diffusion of responsibility. When the victim is not a member of their in-group, or is assumed at fault for their predicament, they may feel less empathy and a reduced responsibility to help. Or, bystanders may assign responsibility for intervention to the victim’s friends or fellow in-group members, or to those “in charge” of the setting. Even when bystanders realize help is needed and take responsibility for helping, they may not act if they do not know how or lack confidence in their ability to successfully carry out the actions required to help. When they have the skills, they may not help if they perceive the costs of action to outweigh the benefits of action. Audience inhibition arising from group norms supporting inaction and from bystander worry about what others will think about them if they act unnecessarily or ineptly can prevent bystander action by increasing bystanders’ perceived helping costs. Recognition of bystanders as a potentially valuable public health asset has increased interest in promoting bystander intervention. Bystander intervention promotion and communications empower bystander action by combating intervention- and audience-specific barriers to bystander intervention using targeted information, communications, and skills training. Theory and research suggest that effective promotions and communications foster context-specific attitudes, beliefs, norms, and skills such that bystanders: (1) are able to quickly and accurately identify a situation as intervention-appropriate; (2) experience action-motivating arousal (including empathy) in the face of the event; (3) have positive attitudes towards intervention and perceive the benefits of action as outweighing the perceived costs; (4) are empowered to act and feel confident in their ability to effectively intervene (bystander efficacy); and (5) are resistant to evaluation apprehension and norms contraindicating action. Effective bystander intervention promotion draws on social psychology and communications studies, and best practices for health promotion and prevention programs. The application of social marketing and formative and summative program evaluation methods enhance the potential of bystander intervention promotions and communications to empower bystander action.

Article

Health promotion communication interventions invariably raise ethical issues because they aim to influence people’s views and lifestyles, and they are often initiated, funded, and influenced by government agencies or powerful public or private organizations. With the increasing use of commercial advertising tactics in health promotion communication interventions, ethical issues regarding advertising can be raised in health promotion communication when it applies techniques such as highly emotional appeals, exaggerations, omissions, provocative tactics, or the use of children. Key ethical concerns relate to infringing on people’s privacy, interfering with their right to freedom of choice and autonomy, and issues of equity (such as by widening social gaps, where mainly those who are better off benefit from the interventions). Interventions using digital media raise ethical issues regarding the digital divide and privacy. The interventions may have unintended adverse effects on the psychological well-being of individuals or groups (e.g., by inadvertently stigmatizing or labeling people portrayed as negative models). They can also have an effect on cultural aspects of society (e.g., by idealizing particular lifestyles or turning health into a value) and raise concerns regarding democratic processes and citizens’ consent to the interventions. Interventions can have repercussions in multicultural settings since members of diverse populations may hold beliefs or engage in practices considered by health promoters as “unhealthy,” but which have important cultural significance. There are also ethical concerns regarding collaborations between health promoters and for-profit organizations. Identifying and considering ethical issues in the intervention is important for both moral and practical reasons. Several ethical conceptual frameworks are briefly presented that elucidate central ethical principles or concerns, followed by ethical issues associated with specific contexts or aspects of communication interventions.

Article

M. Jeffrey Farrar, Yao Guan, and Kaitlyn Erhardt

Humans live not only in a physical world but also in a mental world. Theory of mind reflects the understanding that the mind is comprised of different mental states, such as intentions, desires, and beliefs. This conception of the mind is a critical achievement in human development because it directly impacts effective communication and social interaction. It allows for the understanding of others’ behaviors by inferring their mental states. The formation of a theory of mind has been a central topic in psychology, neuroscience, cognitive science, and philosophy. It impacts related processes, such as communication skills, perspective-taking ability, and social cognition. Across the life span, the understanding of the mind becomes increasingly complex. Early in development, infants and toddlers can discern the intentions of others. Later, more sophisticated reasoning about the mental states of others becomes possible. For instance, the ability to follow and understand the recursive thought that “Sam believes, that Mary said, that Jose wanted . . .” develops. Additionally, within distinctive developmental time periods, people differ in their ability to take into account mental states. Once people’s beliefs, including their misconceptions, are identified, it is possible to generate effective communication strategies designed to teach, learn, and even reduce risk-taking behaviors.

Article

Critical studies of humanitarian discourses involve the study of the arguments, claims, and evidence that are used to justify intervention or non-intervention in key local, regional, national, or international contexts. These discourses can take the form of arguing over whether we should practice isolationism and not intervene in the sovereign affairs of other countries, or they can take the form of deliberations over the transcend needs of populations that cope with myriad disasters. In some cases these discourses are produced by foreigners who believe that the less fortunate need to be rescued from their misery, while at other times humanitarian discourses can be used in discussions about the human rights of the disempowered. Nongovernmental organizations (NGOs), nation-states, celebrities, medical communications, and militaries are just a few of the rhetors that produce all of these humanitarian discourses.