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Article

Yulia A. Strekalova and Janice L. Krieger

Risk is a social construction, and its understanding by information consumers is shaped through interaction with messages, opinions, shared and learned experiences, and interpretations of the characteristics of risk. Social actors and information flows can provide heuristic cues about risks, their relative importance and unimportance, and the attention that an information consumer ought to pay to a particular risk. Social cues can also accentuate particular characteristics of risk, further amplifying or attenuating attention to it and shaping behaviors. This, in turn, can generate secondary and tertiary effects resultant from the public’s reaction to risk. The process of social amplification of risk, therefore, has structural components that include the social elements that get enacted in the process of the translation of risk information. Risk amplification is also affected by message factors, which can dramatize information, increase attention and uncertainty, and generate shared signals and symbols. And finally, social amplification of risks results in reactions that can shape pathways for risk assessment and management, frame views, fuel intergroup dynamics in response to risk, contribute to the accumulation of experiential knowledge and signals of different risk situations, and label and stigmatize some groups or outcomes as undesirable.

Article

Priscila G. Brust-Renck, Julia Nolte, and Valerie F. Reyna

The complexity of numerical information about health risks and benefits places demands on people that many are not prepared to meet. For example, much information about health is communicated numerically, such as treatment risks and effectiveness, lifestyle benefits, and the chances of side effects from medication. However, many people—especially the old, the poor, and the less educated—have difficulty understanding numerical information that would enable them to make informed health decisions. Some evidence also suggests cultural and gender differences (although their causes have been disputed). The ability to use and understand numbers (i.e., numeracy) plays an important role in how information should be displayed and communicated. Measuring differences in numeracy provides a standard to guide one’s approach when communicating risk. Several surveys have been developed to allow for a descriptive assessment of basic and analytical mathematical skills in nationally representative samples (e.g., NAEP, NAAL, PISA, PIACC). Other measures assess specific skills, such as perception of numbers (e.g., number line, approximation, dots tasks), individual perception of one’s own ability (i.e., Subjective Numeracy Scale), and arithmetic computation ability (i.e., Objective Numeracy Scales, Abbreviated Numeracy Scale, and Berlin Numeracy Test). Difficulties associated with low numeracy extend well beyond the inability to understand place value or perform computations. Understanding and remediating low numeracy requires getting below the surface of errors in judgment and decision making to the deeper level of scientific theory. Despite the relevance of numbers in decision making, there is a certain level of disagreement regarding the psychological mechanisms involved in numeracy. Studies show that people have a basic mental representation of numbers in which the discriminability of two magnitudes is a function of their ratio rather than their difference (psychophysical approaches). Numerical reasoning has been identified with quantitative and analytical processes, and such computation is often seen as an accurate and objective way to process information (traditional dual-process approaches as applied to numeracy). However, these approaches do not account for the contradictory evidence that reliance on analysis is not sufficient for many decisions and has been associated with worse performance for some decisions. Studies supporting a more recent dual-process approach—one that accounts for standard and paradoxical effects of numeracy on risk communication—emphasize the role of intuition: this is a kind of advanced thinking that operates on gist representations, which capture qualitative understanding of the meaning of numbers that is relevant in decision making (Fuzzy Trace Theory). According to Fuzzy Trace Theory, people encode both actual numbers (verbatim representations) and qualitative interpretations of their bottom-line meaning (gist representations) but prefer to rely on the qualitative gist representations when possible. Thus, potential difficulties in decision making arising from deficits in numeracy can be resolved through meaningful communication of risk. Creating narratives that emphasize the contextually relevant underlying gist of risk and using methods that convey the meaning behind numeric presentations (e.g., use of appropriate arrays to communicate linear trends, meaningful relations among magnitudes, and inclusion relations among classes) improve understanding and decision making for both numerate and innumerate individuals.

Article

Ann Bostrom

Mental models of health risks are the causal beliefs that comprise one’s inference engines for the interpretation and prediction of health and illness experiences and messages. Mental models of health risks can be parsed into a handful of common elements, including beliefs about causes, consequences, and cures as well as identifying information such as symptoms and timing. Mental models research deriving from a risk and decision analysis framework emphasizes exposure sources and pathways as part of causal thinking as well as how interventions may reduce or increase the risk. Mental models can be developed as a function of one’s goals or the problem in a specific context, rather than as coherent, stable knowledge structures in long-term memory. For this reason they can be piecemeal and inconsistent in the absence of expertise or experience with the risk. Derived often by analogy with more familiar risks, mental models of health risks can lead to effective health behaviors but also to costly inaction or misplaced action. Assessing mental models of hazardous processes can contribute to the design of effective risk communications by identifying the concrete information message recipients need to cope with health risks, thereby making or strengthening common-sense links between risk and action representations. Although a wide variety of research methods are used to investigate mental models, achieving this level of specificity requires attention to substantive details. Researchers are beginning to better understand the interactions between mental models of risk and their social, cultural, and physical contexts, but much remains to explore.

Article

Jada G. Hamilton, Jennifer L. Hay, and Colleen M. McBride

It was expected that personalized risk information generated by genetic discovery would motivate risk-reducing behaviors. However, though research in this field is relatively limited, most studies have found no evidence of strong negative nor positive psychological or behavioral influences of providing genetic information to improve individual health behaviors. As noted by systematic reviews and agenda-setting commentaries, these null findings may be due to numerous weaknesses in the research approaches taken to date. These include issues related to study samples and design, as well as the motivational potency of risk communications. Moreover, agenda-setting commentaries have suggested areas for improvement, calling for expanded consideration of health outcomes beyond health behaviors to include information exchange and information-seeking outcomes and to consider these influences at the interpersonal and population levels. A new generation of research is adopting these recommendations. For example, there is a growing number of studies that are using communication theory to inform the selection of potential moderating factors and their effects on outcomes in understanding interpersonal effects of shared genetic risk. Researchers are taking advantage of natural social experiments to assess the general public’s understanding of genetics and inform approaches to improve their facility with the information. Additionally, there are examples of risk communication approaches addressing the complexity of genetic and environmental contributors to health outcomes. Although the pace of this translation research continues to lag behind genetic discovery research, there are numerous opportunities for future communications research to consider how emerging genomic discovery might be applied in the context of health promotion and disease prevention.

Article

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

Rocio Garcia-Retamero, Dafina Petrova, Adam Feltz, and Edward T. Cokely

Graphical displays generally facilitate the communication of complex information and are ubiquitous in media. Unfortunately, people differ in their ability to extract data and meaning from graphical representations of quantitative information (i.e., graph literacy). This means that for some people, even well-designed, simple graphs will cause confusion and misunderstanding. Research on the psychology of graph comprehension focuses on two instruments that efficiently assess fundamental graph literacy among diverse adults. The Objective Graph literacy scale is a well-established instrument with good psychometric properties that measures skill via cognitive performance testing (e.g., interpreting and evaluating various graphs). The recently developed Subjective Graph Literacy scale is a brief self-report of graph literacy that can outperform the objective test in notable ways, while reducing text anxiety. Emerging applications in clinical research and practice, including computerized decision aids, can personalize content as a function of one’s graph literacy.

Article

Fundamental structural features of risk maps influence how health risk and burden information is understood. The mapping of health data by medical geographers in the 1800s has evolved into the field of geovisualization and the use of online, geographic information system (GIS) interactive maps. Thematic (statistical) map types provide basic principles for mapping geographic health data. It is important to match the nature of statistical data with map type to minimize the potential for communicating misleading messages. Strategic use of structural map features can facilitate or hinder accurate comprehension of health risk messages in maps. A key challenge remains in designing maps to communicate a clear message given the complexity of modern health risk burdens. Various structural map features such as symbols, color, grouping of statistical data, scale, and legend must be considered for their impact on accurate comprehension and message clarity. Cognitive theory in relationship to map comprehension plays a role, as do insights from research on visualizing uncertainty, future trends in developing predictive mapping tools for public health planning, the use of geo-social and “big data,” as well as data ownership.

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

Kathryn E. Anthony, Timothy L. Sellnow, Steven J. Venette, and Sean P. Fourney

Much current scholarship in the realm of information processing and decision making, particularly in the context of health risks, is derived from the logical-empiricist paradigm, involving a strong focus on cognition, routes of psychological processing of messages, and message heuristics. The message convergence framework (MCF), derived heavily from the writings of Perelman and Olbrechts-Tyteca, contributes to this body of literature by emphasizing the fact that people make decisions on health risks while being exposed to arguments from multiple sources on the same topic. The MCF offers an explanation for how people reconcile myriad messages to arrive at decisions. MCF differs from other theories of message processing because of its distinct and unique focus on arguments, messages, and the ways various arguments interact to create “convergence” in individuals’ minds. The MCF focuses on the ways that multiple messages converge to create meaning and influence in the minds of listeners. Convergence occurs when messages from multiple sources overlap in ways recognized by observers, creating perceptions of credibility and influencing their risk decisions. Perelman and Olbrechts-Tyteca explain that convergence occurs when “several distinct arguments lead to a single conclusion.” Individuals assess the strengths and weaknesses of the claims, and according to the scholars, the “strength” of the arguments “is almost always recognized.” Three key propositions focusing on message convergence articulate that audiences recognize message convergence, that they actively seek convergence in matters of concern, such as health risk, and that this convergence is potentially fleeting as new messages are introduced to the discussion. Conversely, Perelman and Olbrechts-Tyteca also discuss message divergence, and the rationale for wanting to intentionally create divergence among interacting arguments. Divergence is particularly appropriate in the realm of health and risk messages when scholars must challenge potentially harmful beliefs or correct misinformation. Some strategies for invoking divergence in include: dissociation, in which the speaker attempts to reframe the argument to create novel understandings; identification of the stock, hackneyed, and obsolete, where the speaker attempts to make existing claims appear commonplace or obsolete to the listener; refutation of fallacies, where the speaker points out the fallacious reasoning of the opponent; clash of interpretation, where the speaker publicly articulates that individuals have understood the convergence to mean different things; weakening through reaction, which involves the speaker’s attempting to incite a reactionary approach by the opponent; and finally, highlighting the consequence of invalid convergence, where the speaker describes the negative outcomes that may occur from following a false convergence based on incorrect information. For message design, environmental scanning enables scholars and practitioners to assess the messages in a particular health-risk context. This assessment can assist practitioners in emphasizing or building convergence among reputable sources and in introducing divergence in cases where misunderstanding or a lack of evidence has contributed to an unproductive perception of convergence. Ultimately, the MCF can assist practitioners in scanning their health-risk environments for opportunities to establish or bolster convergence based on credible evidence and for introducing divergence to challenge inaccurate or misleading interpretations and evidence.

Article

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.

Article

Patric R. Spence, David Westerman, and Robert G. Rice

Humans often prefer representations that are cognitively easier to store, and such representations are easier to retrieve later to make judgments about the social world. Exemplification theory draws on physiological memory mechanisms and argues that simple, iconic, concrete, and emotionally arousing depictions of events (exemplars) are favored and thus more likely to be stored and used than are abstract, inconsequential depictions or representations. Inconsequential information or representations are forgotten because they are not processed as being essential for survival. Exemplified events vary on a continuum of how accurately they represent a larger occurrence of events. Through specific uses of pictures, quotes and other depictive strategies, concrete, iconic, and emotionally arousing information is often added to a story. Research has documented the strength of specific exemplars in creating inaccurate estimations of events and perceptions of severity and susceptibility. Moreover, in the presence of a risk, portrayals with exemplars have been shown to motivate individuals to intend to change behavior. Exemplification is a strong theory that is understudied and underutilized. The theory has strong explanatory, predictive, and organizing power, and it has application to phenomena in contexts such as media effects, persuasion, crisis and risk communication, health communication and public relations.

Article

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.”

Article

Rolf Lidskog

Scientific advances, technological development, and changes in risk consciousness have led to stronger demands on society to manage and control various kinds of risks. Risks should be assessed, prevented, controlled, and communicated in order to prevent negative impacts. Risks related to the environment and health are probably some of the most research-dependent examples. It is primarily scientific experts that provide knowledge to authorities, organizations, and citizens about environmental and health risks and thus exert considerable influence on the understanding and management of risk. At the same time, there are actors in society—especially citizen and interest organizations—that question whether risk regulation is reliable and relevant. There are also demands that citizens should have more transparency and control over risk regulation. The current situation is characterized thus by a paradox: Issues relating to environment and health are seen as increasingly expert dependent while citizens simultaneously demand increased influence over them. This development is especially noticeable in the European Union, with its strong emphasis on the rights of citizen and consumers to have access to information about risk and also opportunities to influence their regulation. In response to this situation, risk governance has been put forward. It refers to a body of ideas for how to more responsibly and efficiently deal with complex risks issues, where there are different interests and standpoints about how to regulate them. Fundamental ideas of risk governance are openness, transparency, participation, inclusion, deliberation, and reflexivity; that experts involved should be open to questioning the situation; should not conceal issues of uncertainty and pluralism (that there exist different legitimate understandings, evaluations, and recommendations); and should be receptive to the input and participation of other stakeholders. This means that risk regulation should no longer be organized into three discrete activities: risk assessment, risk management, and risk communication (aiming at a one-way transfer of knowledge from the regulators to the public).

Article

Jessica Gall Myrick and Robin L. Nabi

Fear is a negatively valenced discrete emotional state that is an inherent part of the human experience. With strong evolutionary roots, fear serves important functions, including alerting people to present threats and motivating action to avoid future threats. As such, fear is an emotion that frequently attracts the attention of scholars and message designers who hope to persuade audiences to change their behavior in light of potential threats to well-being and public safety. Several theories have aimed to describe the effects of fear-based appeals on audiences, focusing largely on the cognitive correlates of fear (i.e., severity and susceptibility) and their subsequent impacts on persuasive outcomes. However, more recent theorizing has returned to a focus on the influence that the emotion of fear itself has on attitude and behavior change. Given that many health-oriented fear appeals have been shown to evoke multiple emotions, including anger, disgust, and sadness, current theorizing has taken a mixed-emotions or emotional flow perspective to provide a deeper understanding of fear appeal effects. Further, individual differences have been considered to determine who is most likely to experience fear during and after message consumption. In addition to fear appeals that purposefully aim to scare audiences to motivate attitude and behavior change, recent work suggests that fear can be generated by other forms of messages (e.g., news accounts, social media posts, interpersonal conversations) that may influence receivers’ approaches to health issues. Moreover, research also suggests that fear may motivate social sharing of messages, which can in turn allow for more widespread influence of fear-based messages.

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

Quotations, something that a person says or writes that is then used by someone else in another setting, have long been a staple of news stories. Reporters use quotations—both direct and paraphrased—to document facts, opinions, and emotions from human and institutional sources. From a journalistic standpoint, quotations are beneficial because they add credibility to a news report and allow readers/viewers to consider the source of information when evaluating its usefulness. Quotations are also valued because they are seen as adding a “human” element to a news report by allowing sources to present information in their own words—thus providing an unfiltered first-person perspective that audiences may find more compelling and believable than a detached third-person summary. Research into the effects of news report quotations has documented what journalists long assumed: Quotations, especially direct quotes using the exact words of a speaker, draw the attention of news consumers and are often attended to in news stories more than statistical information. Studies show that the first-person perspective is considered both more vivid and more credible, a phenomenon that newspaper and website designers often capitalize on through the use of graphic elements such as the extracted quote. Quotations in news stories have also been found to serve as a powerful persuasive tool with the ability to influence perception of an issue even in the face of contradictory statistical information. This is especially true when the topic under consideration involves potential risk. Direct quotations from individuals who perceive high levels of risk in a situation can sway audience perceptions, regardless of whether the quoted risk assessments are supported by reality. The power of quotations remains strong in other forms of communication involving risk, such as public service, health-related, or promotional messages. The vivid, first-person nature of quotes draws the attention of audiences and makes the quoted information more likely to be remembered and to influence future judgments regarding the issue in question. This presents the message creator, whether it be a journalist or other type of communicator, with a powerful tool that should be constructed and deployed purposefully in an effort to leave audiences with an accurate perception of the topic under consideration.

Article

Narcissism is a personality trait characterized by perceptions of grandiosity, superiority, and the need for attention and admiration. There has been an increase in focus on examining the development of narcissism and how the trait influences a range of social and health behaviors. A key feature of narcissism is that it is characterized by high self-esteem with a simultaneously fragile ego that requires continual monitoring and manipulation. Therefore, much of the behaviors narcissists engage in are linked to the drive to maintain perceptions of superiority and grandiosity. In the area of health and well-being, narcissism has been positively correlated with psychological health, a relationship that may be accounted for by self-esteem. However, there has been less research on the relationship between narcissism and physical health and well-being. There is some evidence that narcissism is linked to a variety of physical appearance-oriented health behaviors (i.e., behaviors that could affect body weight or other aspects of physical appearance, including eating and exercise). Narcissism has also been positively linked to risk-taking behaviors, including use of substances, as well as risks that could significantly impact others, including sexual behaviors and risky driving. The relationship between narcissism and health is therefore complex, with some positive correlates (e.g., physical activity), but also various health risk behaviors. In considering how narcissism might interact with health messages, communicators have to keep in mind that narcissists seem to have some deficits in judgment and decision-making, such as overconfidence and a narrow focus on rewards associated with behaviors. Their behaviors tend to be driven by managing their own ego and by drawing attention and admiration from others to maintain perceptions of superiority and grandiosity. In turn, health communicators may need to rely on creative strategies that tap into these domains of narcissism in order to effectively modify health behaviors among narcissistic individuals. Further research on the influence of narcissism in healthcare seeking and related preventive behaviors would also help to provide a more detailed understanding for how the trait influences health decisions, information that would be useful for both health researchers and practitioners.

Article

Whether viewed as a domain-specific behavior or as an enduring tendency, procrastination is a common form of self-regulation failure that is increasingly recognized as having implications for health-related outcomes. Central to procrastination is the prioritization of reducing immediate negative mood at the cost of decisions and actions that provide long-term rewards, such as engaging in health behaviors. Because people tend to procrastinate on tasks they find difficult, unpleasant, or challenging, many health-promoting behaviors are possible candidates for procrastination. As modifiable risk factors for the prevention of disease and disability, health behaviors are often the target of health risk communications aimed at health behavior change and reducing health procrastination. Research has consistently demonstrated the deleterious effects of chronic procrastination on health outcomes, including poor physical health, fewer health promoting behaviors, and higher stress in healthy adults and those already living with a chronic health condition. Examining the factors and psychological characteristics associated with chronic procrastination can provide insights into the processes involved in procrastination more generally, as well as the qualities of the health messages that can promote or prevent procrastination of the targeted behaviors. Low future orientation, avoidant coping, low tolerance for negative emotions, and low self-efficacy need to be considered when designing effective health risk communications to reduce procrastination of health behaviors. Yet, health risk communications aimed at reducing procrastination of important health behaviors such as healthy eating, regular physical activity, screening behaviors, and cessation of risky health behaviors often use fear appeals to motivate taking protective actions to reduce health risks. Such approaches may not be effective because they amplify the negative feelings towards the health behaviors, which can engender maladaptive coping responses and motivate procrastination rather than adaptive responding. This is especially likely among individuals prone to procrastination more generally, or specifically with respect to health. Health risk communication approaches that minimize the negative emotions associated with risk messages and instead highlight short-term benefits of engaging in health behaviors may be necessary to reduce further health behavior procrastination among individuals prone to this form of self-regulation failure.

Article

Toby Raeburn

“Rehabilitation groups” refers to community-based organizations which substantially rely on the work of volunteers to assist people with disabilities towards functional independence. One may differentiate between rehabilitation groups and clinical healthcare services by categorizing clinical services as being predominantly concerned with treatments designed to lower symptoms and cure ill health. Alternatively, rehabilitation groups focus their attention on delivering programs designed to assist people in regaining “functional independence” with or without the ongoing presence of symptoms. Common programs rehabilitation groups deliver are described as including but not being limited to the following: • Mental health rehabilitation: assisting people with lived experience of mental illness towards social and emotional wellbeing. • Drug and alcohol rehabilitation: facilitating recovery from abuse of and dependency on psychoactive substances such as alcohol and other drugs. • Physical health rehabilitation: improving physical and/or neurocognitive functions that have been diminished by ongoing effects of disease or injury. Major themes of communication influence rehabilitation groups and there are connections between the daily work of rehabilitation groups and the theoretical paradigms that influence them. Theoretical paradigms include social disability theory, recovery-oriented care, person-centered care, and cultural materialism.

Article

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.