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.
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Exemplification Theory in Health and Risk Messaging
Patric R. Spence, David Westerman, and Robert G. Rice
Article
Mental Models of Risk
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.
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Absent Information in Integrative Environmental and Health Risk Communication
Jari Lyytimäki and Timo Assmuth
Communication is typically understood in terms of what is communicated. However, the importance of what is intentionally or unintentionally left out from the communication process is high in many fields, notably in communication about environmental and health risks. The question is not only about the absolute lack of information. The rapidly increasing amount and variability of available data require actors to identify, collect, and interpret relevant information and screen out irrelevant or misleading messages that may lead to unjustified scares or hopes and other unwanted consequences. The ideal of balanced, integrative, and careful risk communication can only rarely be seen in real-life risk communication, shaped by competition and interaction between actors emphasizing some risks, downplaying others, and leaving many kinds of information aside, as well as by personal factors such as emotions and values, prompting different types of responses. Consequently, risk communication is strongly influenced by the characteristics of the risks themselves, the kinds of knowledge on them and related uncertainties, and the psychological and sociocultural factors shaping the cognitive and emotive responses of those engaged in communication. The physical, economic, and cultural contexts also play a large role. The various roles and factors of absent information in integrative environmental and health risk communication are illustrated by two examples. First, health and environmental risks from chemicals represent an intensively studied and widely debated field that involves many types of absent information, ranging from purposeful nondisclosure aimed to guarantee public safety or commercial interests to genuinely unknown risks caused by long-term and cumulative effects of multiple chemicals. Second, light pollution represents an emerging environmental and health issue that has gained only limited public attention even though it is associated with a radical global environmental change that is very easy to observe. In both cases, integrative communication essentially involves a multidimensional comparison of risks, including the uncertainties and benefits associated with them, and the options available to reduce or avoid them. Public debate and reflection on the adequacy of risk information and on the needs and opportunities to gain and apply relevant information is a key issue of risk management. The notion of absent information underlines that even the most widely debated risk issues may fall into oblivion and re-emerge in an altered form or under different framings. A typology of types of absent information based on frameworks of risk communication can help one recognize its reasons, implications, and remediation.
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Scientific Uncertainty in Health and Risk Messaging
Stephen Zehr
Expressions of scientific uncertainty are normal features of scientific articles and professional presentations. Journal articles typically include research questions at the beginning, probabilistic accounts of findings in the middle, and new research questions at the end. These uncertainty claims are used to construct clear boundaries between uncertain and certain scientific knowledge. Interesting questions emerge, however, when scientific uncertainty is communicated in occasions for public science (e.g., newspaper accounts of science, scientific expertise in political deliberations, science in stakeholder claims directed to the public, and so forth). Scientific uncertainty is especially important in the communication of environmental and health risks where public action is expected despite uncertain knowledge. Public science contexts are made more complex by the presence of multiple actors such as citizen-scientists, journalists, stakeholders, social movement actors, politicians, and so on who perform important functions in the communication and interpretation of scientific information and bring in diverse norms and values.
A past assumption among researchers was that scientists would deemphasize or ignore uncertainties in these situations to better match their claims with a public perception of science as an objective, truth-building institution. However, more recent research indicates variability in the likelihood that scientists communicate uncertainties and in the public reception and use of uncertainty claims. Many scientists still believe that scientific uncertainty will be misunderstood by the public and misused by interest groups involved with an issue, while others recognize a need to clearly translate what is known and not known.
Much social science analysis of scientific uncertainty in public science views it as a socially constructed phenomenon, where it depends less upon a particular state of scientific research (what scientists are certain and uncertain of) and more upon contextual factors, the actors involved, and the meanings attached to scientific claims. Scientific uncertainty is often emergent in public science, both in the sense that the boundary between what is certain and uncertain can be managed and manipulated by powerful actors and in the sense that as scientific knowledge confronts diverse public norms, values, local knowledges, and interests new areas of uncertainty emerge. Scientific uncertainty may emerge as a consequence of social conflict rather than being its cause. In public science scientific uncertainty can be interpreted as a normal state of affairs and, in the long run, may not be that detrimental to solving societal problems if it opens up new avenues and pathways for thinking about solutions. Of course, the presence of scientific uncertainty can also be used to legitimate inaction.
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Social Amplification of Risk in Health and Risk Messaging
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.
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Agenda Setting in Health and Risk Messaging
Karyn Ogata Jones
Since McCombs and Shaw first introduced the theory in 1972, agenda setting has emerged as one of the most influential perspectives in the study of the effects of mass media. Broadly defined, “agenda setting” refers to the ability of mass media sources to identify the most salient topics, thereby “setting the agendas” for audiences. In telling us what to think about, then, mass media sources are perceived to play an influential role in determining priorities related to policies, values, and knowledge on a given topic or issue.
Scholars have studied this phenomenon according to both object (issue) salience and attribute salience and along aggregate and individual audience responses. The audience characteristics of need for orientation, uncertainty, relevance, and involvement are advanced as moderating and predicting agenda-setting effects. When agenda-setting theory is applied to the study of messaging related to health and risk communication, scholars have reviewed and identified common themes and topics that generally include media’s role in educating and informing the public about specific health conditions as well as public health priorities and administrative policies.
Agenda setting is often examined in terms of measuring mass media effects on audiences. Looking at interpersonal communication, such as that coming from medical providers, opinion leaders, or peer networks, in studies will allow research to examine the combined effects of interpersonal and mass communication. Testing possible interactions among differing sources of information along with assessment of issue and attribute salience among audiences according to an agenda-setting framework serves to document audience trends and lived experiences with regard to mass media, health, and risk communication.
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Direct-to-Consumer Advertising and Health and Risk Messaging
Kimberly A. Kaphingst
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
Numeracy in Health and Risk Messaging
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.
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Structuration Theory and Health and Risk Messaging
Joel Iverson, Tomeka Robinson, and Steven J. Venette
Risk can be defined using a mathematical formula—probability multiplied by consequences. An essential element of risk communication is a focus on messages within organizations. However, many health-related risks such as Ebola extend beyond an individual organization and risk is better understood as a social construction cogenerated within and between systems. Therefore, the process is influenced by systemic and supra-systemic values and predilections. Risk from a structurational perspective allows an understanding of the public as well as organizational responses to risk. Structuration theory provides a useful lens to move beyond seeing organizations as something that flows within an organization to understanding how organizations are enacted through communication. Structuration theory articulates the connections between systems and structures through the action of agents, whose practices produce and reproduce the rules and resources of social life. Within the structuration tradition, organizational communication scholars have shifted to an understanding of the communicative constitution of organizations (CCO). Specifically, one of the theories of CCO is the Four Flows Model. The four flows highlight the ways people enact organizations and provide a means to analyze the various ways communication constitutes organizations. The four flows are membership negotiation, activity coordination, reflexive self-structuring, and institutional positioning. Membership negotiation enacts the inner members and outsiders at a basic level including socialization, identity, and assimilation. Activity coordination produces collective action around a specific goal. Reflexive self-structuring is the decentralized enactment of structures for the organization through the communication of policies. Institutional positioning covers the macro-level actions where people in the organization act as an entity within the environment.
When considering the public reaction to Ebola, a simple way to evaluate risk perception is the intersection of dread and control. The U.S. public considered Ebola a serious risk. From a structuration perspective, the viral nature of twitter, media coverage, and public discussion generated resources for fear to be exacerbated. Structuration theory allows us to position the risk beliefs as rules and resources that are reproduced through discourse. The organizational implications fall primarily into the two flows of institutional positioning and reflexive self-structuring. For institutional positioning, U.S. healthcare organizations faced general public dread and perceived lack of control. Within the United States multiple policies and procedures were changed, thus fulfilling the second flow of organizational self-structuring. The Ebola risk had a significant impact on the communicative constitution of health-care organizations in the United States and beyond. Overall, risk is communicatively constituted, as are organizations. The interplay between risk and health-care organizations is evident through the analysis of American cases of Ebola. Structuration theory provides a means for exploring and understanding the communicative nature of risk and situates that risk within the larger systems of organizations.
Article
Climate Change Communication
Amy E. Chadwick
Climate change, which includes global warming, is a serious and pervasive challenge for local and global communities. Communication theorists, researchers, and practitioners are well positioned to describe, predict, and affect how we communicate about climate change. Our theories, research methods, and practices have many potential roles in reducing climate change and its effects. Climate change communication is a growing field that examines a range of factors that affect and are affected by how we communicate about climate change. Climate change communication covers a broad range of philosophical and research traditions, including humanistic-rhetorical analyses, interpretive qualitative studies, and social-scientific quantitative surveys and experiments. Climate change communication examines a range of factors that affect and are affected by how we communicate about climate change. Much of the research in climate change communication focuses on public understanding of climate change, factors that affect public understanding, media coverage and framing, media effects, and risk perceptions. Less prevalent, growing areas of research include civic engagement and public participation, organizational communication, and persuasive strategies to affect attitudes, beliefs, and behaviors related to the climate. In all of these areas, most of the research on climate change communication has been conducted in the United States, United Kingdom, Australia, Canada, and Western European countries. There is a need to expand the climate change communication research into other regions, particularly developing countries. In addition, climate change communication has natural links to environmental and health communication; therefore, communication scholars should also examine research from these areas to develop insights into climate change communication.
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Social Marketing Applied to Health and Risk Messaging
R. Craig Lefebvre and P. Christopher Palmedo
Many ideas about best practices for risk communication share common ground with social marketing theory and practice: for example, segmentation, formative research, and a focus on behavioral outcomes. Social marketing first developed as a methodology to increase the public health impact of programs and to increase the acceptability and practice of behaviors that improve personal and social well-being. The core concepts of this approach are to be people-centered and to aim for large-scale behavior change. An international consensus definition of social marketing describes it as an integration of theory, evidence, best practices, and insights from people to be served. This integrated approach is used to design programs that are tailored to priority groups’ needs, problems, and aspirations and are responsive to a competitive environment. Key outcomes for social marketing efforts are whether they are effective, efficient, equitable, and sustainable.
The 4P social marketing mix of Products, Prices, Places, and Promotion offers both strategic and practical value for risk-communication theory and practice. The addition of products, for example, to communication efforts in risk reduction has been shown to result in significantly greater increases in protective behaviors. The Cover CUNY case demonstrates how full attention to, and consideration of, all elements of the marketing mix can be used to design a comprehensive risk-communication campaign focused on encouraging college student enrollment for health insurance. The second case, from the drug safety communication arena, shows how a systems-level, marketplace approach is used to develop strategies that focus on key areas where marketplace failures undermine optimal information-dissemination efforts and how they might be addressed.
Article
Using Maps to Display Geographic Risk, Personal Health Data, and Ownership
Suellen Hopfer and Genesis Gutierrez
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.
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Blogging, Microblogging, and Exposure to Health and Risk Messages
Stephen A. Rains
The widespread diffusion of social media in recent years has created a number of opportunities and challenges for health and risk communication. Blogs and microblogs are specific forms of social media that appear to be particularly important. Blogs are webpages authored by an individual or group in which entries are published in reverse chronological order; microblogs are largely similar, but limited in the total number of characters that may be published per entry. Researchers have begun exploring the use and consequences of blogs and microblogs among individuals coping with illness as well as for health promotion. Much of this work has focused on better understanding people’s motivations for blogging about illness and the content of illness blogs. Coping with the challenges of illness and connecting with others are two primary motivations for authoring an illness blog, and blogs typically address medical issues (e.g., treatment options) and the author’s thoughts and feelings about experiencing illness. Although less prevalent, there is also evidence that illness blogging can be a resource for social support and facilitate coping efforts. Researchers studying the implications of blogs and microblogs for health promotion and risk communication have tended to focus on the use of these technologies by health professionals and for medical surveillance. Medical professionals appear to compose a noteworthy proportion of all health bloggers. Moreover, blogs and microblogs have been shown to serve a range of surveillance functions. In addition to being used to follow illness outbreaks in real-time, blogs and microblogs have offered a means for understanding public perceptions of health and risk-related issues including medical controversies. Taken as whole, contemporary research on health blogs and microblogs underscores the varied and important functions of these forms of social media for health and risk communication.
Article
Limited English Proficiency as a Consideration When Designing Health and Risk Messages
Maricel G. Santos, Holly E. Jacobson, and Suzanne Manneh
For many decades, the field of risk messaging design, situated within a broader sphere of public health communication efforts, has endeavored to improve its response to the needs of U.S. immigrant and refugee populations who are not proficient speakers of English, often referred to as limited English proficient (LEP) populations. Research and intervention work in this area has sought to align risk messaging design models and strategies with the needs of linguistically diverse patient populations, in an effort to improve patient comprehension of health messages, promote informed decision-making, and ensure patient safety. As the public health field has shifted from person-centered approaches to systems-centered thinking in public health outreach and communication, the focus in risk messaging design, in turn, has moved from a focus on the effects of individual patient misunderstanding and individual patient error on health outcomes, to structural and institutional barriers that contribute to breakdown in communication between patients and healthcare providers.
While the impact of limited proficiency in English has been widely documented in multiple spheres of risk messaging communication research, the processes by which members of immigrant and refugee communities actually come to understand sources of risk and act on risk messaging information remain poorly researched and understood. Advances in risk messaging efforts are constrained by outdated views of language and communication in healthcare contexts: well-established lines of thinking in sociolinguistics and language education provide the basis for critical reflection on enduring biases in public health about languages other than English and the people who speak them. By drawing on important findings about language ideologies and language learning, an alternative approach would be to cultivate a deeper appreciation for the linguistic diversity already shaping our everyday lives and the competing views on this diversity that constrain our risk messaging efforts.
The discourse surrounding the relationship between LEP and risk messaging often omits a critical examination of the deficit-based narrative that tends to infuse many risk messaging design efforts in the United States. Sociolinguists and language education specialists have documented the enduring struggle against a monolingual bias in U.S. education and healthcare policy that often privileges proficiency in English, and systematically impedes and discriminates against emerging bilingualism and multilingualism. The English-only bias tends to preclude the possibility that risk messaging comprehension for many immigrant and refugee communities may represent a multilingual capacity, as patients make use of multiple linguistic and cultural resources to make sense of healthcare messages. Research in sociolinguistics and immigration studies have established that movement across languages and cultures—a translingual, transcultural competence—is a normative component of the immigrant acculturation process, but these research findings have yet to be fully integrated into risk messaging theory and design efforts. Ultimately, critical examination of the role of language and linguistic identity (not merely a focus on proficiency in English) in risk messaging design should provide a richer, more nuanced picture of the ways that patients engage with health promotion initiatives, at diverse levels of English competence.
Article
A Culture-Centered Approach to Health and Risk Communication
Mohan Jyoti Dutta
The culture-centered approach (CCA) to health and risk communication conceptualizes the communicative processes of marginalization that constitute the everyday meanings of health and risks at the margins. Attending to the interplays of communicative and material disenfranchisement, the CCA situates health inequalities amidst structures. Structures, as the rules, roles, processes, and frameworks that shape the distribution of resources, constitute and constrain the access of individuals, households, and communities to the resources of health and well-being. Through voice infrastructures cocreated with communities at the classed, raced, gendered, colonial margins of capitalist extraction, the CCA foregrounds community agency, the capacity of communities to make sense of their everyday struggles with health and well-being. Community voices articulate the interplays of colonial and capitalist processes that produce and circulate the risks to human health and well-being, serving as the basis for community organizing to secure health and well-being. Culture, as an interpretive resource passed down intergenerationally, offers the basis for organizing, and is simultaneously transformed through individual and community participation. Culture-centered health communication, rooted in community agency, drawing upon cultural stories, resources, and practices in subaltern contexts, takes the form of organizing for health, mobilizing agentic expressions toward structural transformations.
Article
Types of Explanations in Health and Risk Messaging
Katherine E. Rowan
Explanations designed to teach, rather than to support scientific claims in scholarly works, are essential in health and risk communication. Patients explain why they think their symptoms warrant medical attention. Clinicians elicit information from patients and explain diagnoses and treatments. Families and friends explain health and risk concerns to one another. In addition, there are websites, brochures, fact sheets, museum exhibits, health fairs, and news stories explaining health and risk to lay audiences. Unfortunately, research on this important discursive goal is less extensive than is research on persuasion, that is, efforts to gain agreement. One problem is that explanation-as-teaching has not been carefully conceptualized. Some confuse this communication goal and discursive type with its frequent verbal and visual features, such as simple wording or diagrams. Others believe explanation-as-teaching does not exist as a distinctive communication goal, maintaining that all communication is solely persuasive: that is, designed to gain agreement.
Explanation-as-teaching is a distinct and important health communication goal. Patient involvement in decision making requires that both clinicians and patients understand options underlying health-care choices. To explore types of explanation-as-teaching, research provides (a) several ways of categorizing health and risk explanations for lay audiences; (b) evidence that certain textual and graphic features overcome predictable confusions, and (c) illustrations of each explanation type. Additionally, explanation types succeed or fail in part because of the social or emotional conditions in which they are presented so it is important to note research on conditions that support patients, families, and clinicians in benefiting from explanations of health and risk complexities and curricula designed to enhance clinicians’ explanatory skill.
Article
Health-Related Warning Message Processing
Christopher B. Mayhorn and Michael S. Wogalter
Warnings are risk communication messages that can appear in a variety of situations within the healthcare context. Potential target audiences for warnings can be very diverse and may include health professionals such as physicians or nurses as well as members of the public. In general, warnings serve three distinct purposes. First, warnings are used to improve health and safety by reducing the likelihood of events that might result in personal injury, disease, death, or property damage. Second, they are used to communicate important safety-related information. In general, warnings likely to be effective should include a description of the hazard, instructions on how to avoid the hazard, and an indication of the severity of consequences that might occur as a result of not complying with the warning. Third, warnings are used to promote safe behavior and reduce unsafe behavior. Various regulatory agencies within the United States and around the globe may take an active role in determining the content and formatting of warnings.
The Communication-Human Information Processing (C-HIP) model was developed to describe the processes involved in how people interact with warnings and other information. This framework employs the basic stages of a simple communication model such that a warning message is sent from one entity (source) through some channel(s) to another (receiver). Once warning information is delivered to the receiver, processing may be initiated, and if not impeded, will continue through several stages including attention switch, attention maintenance, comprehension and memory, beliefs and attitudes, and motivation, possibly ending in compliance behavior. Examples of health-related warnings are presented to illustrate concepts. Methods for developing and evaluating warnings such as heuristic evaluation, iterative design and testing, comprehension, and response times are described.
