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Janice L. Krieger and Jordan M. Neil

Strategic communication is an essential component in the science and practice of recruiting participants to clinical research studies. Unfortunately, many clinical research studies do not consider the role of communication in the recruitment process until efforts to enroll patients in a timely manner have failed. The field of communication is rich with theory and research that can inform the development of an effective recruitment plan from the inception of a clinical research study through informed consent. The recruitment context is distinct from many other health contexts in that there is often not a behavioral response that can be universally promoted to patients. The appropriateness of a clinical research study for an individual is based on a number of medical, psychological, and contextual factors, making it impossible to recommend that everyone who is eligible for a clinical research study enroll. Instead, clinical research study recruitment efforts must utilize strategic communication principles to ensure that messages promote awareness of clinical research, maximize personal relevance, minimize information overload, and facilitate informed choice. This can be accomplished through careful consideration of various aspects of the communication context described in this chapter, including audience segmentation, message content, message channels, and formative, process, and outcome evaluation, as well as the enrollment encounter.


Gary L. Kreps

Ehealth, also known as E-health, is a relatively new area of health communication inquiry that examines the development, implementation, and application of a broad range of evolving health information technologies (HITs) in modern society to disseminate health information, deliver health care, and promote public health. Ehealth applications include (a) the widespread development of specialized health information websites (often hosted by government agencies, health care systems, corporations, professional societies, health advocacy organizations, and other for-profit and nonprofit organizations); (b) the widespread use of electronic health record (EHR) systems designed to preserve and disseminate health information for health care providers, administrators, and consumers; (c) an array of mobile health education and support applications that have often been developed for use with smartphones; (d) mobile health behavior monitoring, tracking, and alerting equipment (such as wearable devices and systems imbedded in vehicles, clothing, and sporting equipment); (e) interactive telemedicine systems for collecting health data and delivering health care services remotely; (f) interactive adaptive tailored health information systems to support health education, motivate health behaviors, and to inform health decision making; (g) online social support groups for health care consumers, caregivers, and providers; (h) health promotion focused digital games to engage consumers in health education and train both providers and consumers about health promoting procedures; (i) dedicated computer portals that can deliver a variety of digital health information tools and functions to consumers, caregivers, and providers; and (j) interactive and adaptive virtual human agent systems that can gather and provide relevant health information, virtual reality programs that can simulate health environments for training and therapeutic purposes, and an ever-increasing number of digital applications (apps) for addressing a range of health conditions and activities. As information technology evolves, new ehealth applications and programs are being developed and introduced to provide a wide range of powerful ehealth systems to assist with health care and health promotion. Ehealth technologies have been found by many researchers, practitioners, and consumers to hold tremendous promise for enhancing the delivery of health care and promotion of health, ultimately improving health outcomes. Many popularly adopted ehealth applications (such as health websites, health care portals, decision support systems, and wearable health information devices) are transforming the modern health care system by supplementing and extending traditional channels for health communication. The use of new ehealth applications enables the broad dissemination of relevant health information that can be personalized to the unique communication orientations, backgrounds, and information needs of individuals. New ehealth communication channels can provide health care consumers and providers with the relevant health information that they need to make informed health care decisions. These ehealth communication channels can provide this information to people exactly when and where they need it, which is especially important for addressing fast-moving and dangerous health threats. Yet, with all the promise of ehealth communication, there is still a tremendous amount of work to be done to make the wide array of new ehealth applications as useful as possible for promoting health with different audiences. This article describes the current state of knowledge about the development and use of HITs, as well as about strategies for improving ehealth communication applications to enhance the delivery of health care and the promotion of public health.