The terrorist attacks of 9/11 were traumatic even for Americans who were not directly victimized or in the geographic vicinity. This study examined whether emotional support received through interaction with others buffered the association between terrorism-related stress and psychological health (depression, anxiety, and physical symptoms) for individuals with lower exposure to the attacks. Five hundred eleven college students from an eastern university completed measures of goal disruption (stress) from terrorism, received emotional support, and psychological health in the first 2 weeks of December 2001. The results indicate that received emotional support moderated the relationship between goal disruption and depression and somatic symptoms. These findings suggest that the provision of emotional support should be understood as a fundamental communication skill relevant to recovery from disaster events.
Influenced by Cooke and Kothari's (2001)5.
Cooke , B. and
Kothari , U. 2001. Participation: The new tyranny?, London: Zed Books, Ltd. View all references suggestion that participation “remains a way of talking about rather than doing things” (p. 32), we question to what extent this is true in the public health funding process. Thus, the aim of this article was to investigate the ways in which recent National Institutes of Health (NIH)-funded community-based participatory research (CBPR) projects discursively positioned CBPR in their grant applications. We collected 17 NIH-funded CBPR proposals, analyzed them using a grounded theory approach, and subjected the findings to critical analysis focusing on the definition of community, the type of community “participation” promoted, and the nature of the research proposed. We conclude that certain types of CBPR projects are privileged in the funding review process and discuss the implications of these findings for future CBPR praxis.
Twilight Sleep (TS) describes the delivery, via an injection, of an amnestic drug cocktail to a parturient woman throughout labor. In order to understand the development of modern-day rhetoric surrounding childbirth methods and procedures, this article explores the debate over TS between the public and technical sphere in New York City between 1914 and 1916 and examines the ways in which this debate altered obstetric health care for middle- and upper-class White women. The public response to this campaign posed a direct challenge to male obstetricians in New York City, many of whom were ill-equipped, both literally and figuratively, to use this procedure. Using a feminist rhetorical criticism, we examined the pro-TS rhetoric of women writers in New York City, the methods they borrowed from the women's movement, and the ensuing dialogue between the public and technical spheres. For this study, we analyzed journal and newspaper articles, a pamphlet, a collection of pro-TS organizational documents, letters to the editor, and books published about TS and the history of birth. Lastly, we analyzed theoretical notions of childbirth in women's health and communication studies. After examining the TS debate, we found that birth practices for middle- and upper-class women in New York City shifted and the obstetric community gained ascendancy over female midwifery. We also found that in certain instances, the rhetoric of pro-TS activists was more technically accurate than the rhetoric of some physicians. Hence the TS debate emerged from an argument over the right to use technical language in the technical and/or the public sphere. Conclusions and implications offered by this historical, feminist analysis question our current understanding of women's health and birthing practices, doctor-patient communication, and patient empowerment and access to technical knowledge.
The meanings associated with prostate cancer were studied in contemporary mass print media. The study includes both manifest and latent content analysis of a period of approximately 2 decades, from 1974 to 1995. The manifest analysis revealed a primary emphasis on the importance of early detection. The latent analysis found that prostate cancer's presentation is gendered. Its description is embedded in themes related to masculinity, sexuality, competition, brotherhood, and machismo. This small, qualitative, and inductive study raises questions about the socially significant portrayal of the meanings of disease in the media, about the men who have been diagnosed with prostate cancer, have symptoms of prostate cancer, or about all men, because any man might at some time be diagnosed with prostate cancer. Stereotypical imaging could alienate men who either do not or do not want to fit into the stereotypical ideal as it is protrayed in the media. Such a portrayal also may have inplications for the potential willingness of men to engage in early detection, avail themselves of treatment, act preventatively, or become involved in lobbying for monies for research into the early prevention, detection, and treatment of prostate cancer.
Content analysis is a research method that was traditionally utilized by communication scholars, but as the study of media messages has grown, scholars in other fields have increasingly relied on the methodology. This paper reports on a systematic review of studies using quantitative content analysis methods to examine health messages in the mass media, excluding the Internet, from 1985 to 2005. We searched for health-related content analysis studies published in peer-reviewed journals, identifying 441 articles meeting inclusion criteria. We examined article attributes including theories used, topics, media type, and intercoder reliability measures, and looked at differences over time. Our findings show that studies focusing on health-related messages increased from 1985 to 2005. During this time, studies primarily examined magazines, television, and newspapers, with an emphasis on topics related to substance use, violence, sex, and obesity and body image. Results suggest that studies published in communication journals are significantly more likely to include intercoder reliability data and theory discussion. We recommend that all publications, regardless of discipline or impact factor, request the inclusion of intercoder reliability data reported for individual variables, and suggest that authors address theoretical concepts when appropriate. We also encourage authors to include the term "content analysis," as well as media type and health topic studied, as keywords to make it easier to locate articles of interest when conducting literature searches.
The investigation described here examined ABC, CBS, and NBC news coverage of steroids in sports between March 1990 and May 2008. Employing a framing analysis guided by the health belief model (HBM), coverage of the barriers and benefits of using steroids is reported. Overall, the trend by these three news affiliates was to emphasize the illegality of using steroids, whereas considerably less coverage was devoted to the health costs, in terms of both severity and susceptibility, of using steroids. Furthermore, of the health costs reported, the specific consequences of steroid use varied considerably. The results are reported across four timeframes: 1990-2008, 1990-1996, 1997-2002, and 2003-2008.
In this article we discuss the portrayal of heart disease based on a content analysis of the highest circulating English-language magazines available in Canada and published in Canada or the United States in 1991, 1996, and 2001. It includes both manifest and latent content analysis. In terms of the manifest analysis, the findings indicate the dominance of the medical frame followed by lifestyle and social structural frames. The latent analysis reveals the following frames: (a) optimism about medicine; (b) medicine as "good" and, by contrast, the body as "bad"; (c) heart disease as an "attack"; (d) heart disease as an individual responsibility; (e) contradictory information; (f) male celebrity patients and doctors; and (g) prestigious medical doctors, journals, and institutions. The medicalized portrayal of heart disease as fear generating is considered. In addition, the lack of attention to social structural causation in contrast to current epidemiological findings is discussed.
Alzheimer's disease is growing in incidence and prevalence in the developed world. Rates have been increasing as populations have been aging. There are still many unknowns regarding prevention, causes, and treatments. The purpose of this article is to analyze the portrayal of Alzheimer's in the highest-circulation mass print English-language magazines published in the United States and Canada over a period of a decade, specifically those for 1991, 1996, and 2001. This research investigates the portrayal of persons with Alzheimer's, the disease itself, caregivers and experts, and the dominant frames or discourses within which Alzheimer's is described. Twenty-five articles from the highest-circulation mass print magazines available in Canada were studied through qualitative and inductive research of both manifest and latent content. One of the most notable findings is the absence of the person with the disease as a person with a voice, with needs and desires. When the disease itself is described it is characterized as fearsome, relentless, and aggressive. Both the unquestioned duty of the individual caregiver and his or her (usually the caregiver is a woman) suffering are emphasized. The disease, its diagnosis, and potential treatments are framed almost exclusively within a medical rather than a political-economy or lifestyle frame. Minimal attention is paid to prevention, early stages of the disease, social support, options for care, or other alternative understandings of issues related to Alzheimer's. The theoretical and practical significance of these findings is considered.
Since its first issue in 1992, few periodicals have enjoyed the rapid growth and international popularity of Cigar Aficionado. Although the magazine professes to simply celebrate "the good life and the joys of cigar smoking," we argue that it serves a more insidious function; specifically, the periodical supplies readers with 7 persuasive strategies aimed at rebuking dominant anti-smoking health assertions: (a) the cigars-are-not-cigarettes argument, (b) the life-is-dangerous argument, (c) the health-benefits argument, (d) the moderation argument, (e) the old-smokers argument, (f) the bad-science argument, and (g) the good-science argument. These pro-smoking arguments ultimately serve to relieve the cognitive dissonance associated with the consumption of a potentially deadly product and to maintain a loyal readership, free from guilt or anxiety.
Health disparities exist in the United States based on race, gender, and socioeconomic status. One way to alleviate some of the disparities regarding certain diseases or conditions is to increase awareness among populations most affected. Physicians have suggested that direct-to-consumer advertising (DTCA) of prescription drugs could play a role in awareness. Social identity theory suggests that individuals are likely to attend messages if they can identify, often based on race or gender, with people portrayed in the messages. This study analyzed DTCA in 11 years of Black, women's, news, and entertainment magazines to determine whether models in the ads targeted specific populations. Black magazines were more likely to contain ads featuring Black models only than were other genres, which had more DTCA picturing White models only. Health conditions the drugs were intended for varied by genre and over time, with STD drugs appearing primarily in Black magazines, and DTCA for heart disease not published in Black magazines, despite cardiovascular diseases being the No. 1 cause of death for Blacks (and Whites). Women's magazines featured DTCA for a wide variety of drugs, reinforcing their roles as caretakers, with proportionally few ads for women's health. Implications for targeted use of magazine genres as a means of providing health information to specific populations are discussed.
The majority of tanning bed users in the U.S. are women. Previous health communication research frequently focused on the risk of skin cancer, but few studies assessed the mediated communication environment that may surround women's beliefs and behaviors relevant to tanning. A content analysis of articles in eight magazines targeting girls, young women, older women, and women who are interested in fitness during the ten-year period of 1997-2006 was conducted. The amount of coverage of tanning bed use consequences was less than 50% of the coverage of tanning benefits. About 40% of the tanning benefits coverage touted looking healthy. The coverage of prevention methods focused on sunscreen use (55%), while the more important methods (e.g., protective clothing use) were rarely featured. Longitudinally, the coverage of the risk and prevention relevant issues increased between 1997 and 2006. The data indicate that the coverage of tanning benefits also increased during the same period.
Both global obesity prevalence rates and media attention to obesity have increased significantly in recent years. The current study examined the representation of obesity in The Irish Times, from 1997 to 2009. A quantitative content analysis was conducted on 479 articles to examine how the causes, consequences, and solutions to obesity have been portrayed and how obesity has been described. A frame analysis was also conducted to examine the dominant frames over time. It was found that attention to obesity was positively correlated with time, indicating coverage has increased significantly over the period examined. Regarding reported causes and solutions, the behavioral frame has been dominant, though environmental and mixed-frame stories have become more frequent. The presence of the genetic frame was consistently low. The study provides an overview of how the issue is being represented in Ireland's paper of record and informs health communicators of the dominant and trending messages and the implications for individuals' formation of illness representations.
This study examines the content of and audience response to organ donation videos on YouTube, a Web 2.0 platform, with framing theory. Positive frames were identified in both video content and audience comments. Analysis revealed a reciprocity relationship between media frames and audience frames. Videos covered content categories such as kidney, liver, organ donation registration process, and youth. Videos were favorably rated. No significant differences were found between videos produced by organizations and individuals in the United States and those produced in other countries. The findings provide insight into how new communication technologies are shaping health communication in ways that differ from traditional media. The implications of Web 2.0, characterized by user-generated content and interactivity, for health communication and health campaign practice are discussed.
Diabetes is a growing yet misunderstood health concern in the United States. This study examined the ways in which diabetes has been framed by the New York Times over the past decade. The public's perception of the causes and solutions to complex problems such as diabetes has significant implications for the way public policy interventions are viewed; therefore, understanding how diabetes is being framed in the media can be an important first step in shifting public opinion about ways to combat the disease. A content analysis of 239 articles published in the New York Times between 2000 and 2010 revealed that nearly one-third of articles failed to differentiate between type 1, type 2, and gestational diabetes, which may cause confusion given substantial differences in the root cause and treatment of each. An examination of frames used within each type of diabetes showed that the overall dominant frame across types was either a medical frame or a behavioral frame, with deficient use of a societal frame. The limited use of societal-level framing may make it difficult for the public to see the wider consequences of diabetes and decreases the likelihood of public support for policy solutions to combat the disease.
Successful global health initiatives are executed on the recognition that globalization involves simultaneous pulls between global unification and fragmentation. This article responds to the need for more understanding of the role of fragmentation in global health initiatives through analyses of 52 northern Nigerian newspaper reports of the 2003-2004 northern Nigerian stoppage of the Global Polio Eradication Initiative. By 2009 the stoppage had resulted in an epidemic in Nigeria and polio importations in 20 previously polio-free countries. Findings pointed to beliefs in contemporary forms of Western control and abuse through global organizations (nongovernmental organizations and for-profits), understandings of the "philanthropy" of the West and global organizations as self-serving and malevolent, and doubts about the polio vaccine product.
This study examined the unique effects of numeracy on self-efficacy in managing health and on information-seeking experience, and explored the mediating role of information-seeking experience. The proposed model was tested using a national random-digit-dial sample (n = 4,092) of adults participating in the 2007 Health Information National Trends Survey. Findings from multiple regression analyses revealed that higher numeracy was associated with higher self-efficacy in managing health and better (i.e., more positive) health information-seeking experience, and that better information-seeking experience partially mediated the association between higher numeracy and higher self-efficacy. Findings indicated that communication factors (e.g., information seeking) partially mediated the relationship between cognitive abilities (e.g., numeracy) and self-efficacy. Theoretical implications are discussed, along with practical implications for individuals, health care providers, and public health professionals.
Pandemics challenge conventional assumptions about health promotion, message development, community engagement, and the role of news media. To understand the use of press releases in news coverage of pandemics, this study traces the development of framing devices from a government public health agency's press releases to news stories about the 2009 H1N1 A influenza pandemic. The communication management of the H1N1 pandemic, an international news event with local implications, by the Singapore government is a rich locus for understanding the dynamics of public relations, health communication, and journalism. A content analysis shows that the evolution of information from press release to news is marked by significant changes in media frames, including the expansion and diversification in dominant frames and emotion appeals, stronger thematic framing, more sources of information, conversion of loss frames into gain frames, and amplification of positive tone favoring the public health agency's position. Contrary to previous research that suggests that government information subsidies passed almost unchanged through media gatekeepers, the news coverage of the pandemic reflects journalists' selectivity in disseminating the government press releases and in mediating the information flow and frames from the press releases.
Building on channel complementarity theory and media-system dependency theory, this study explores the impact of conflict-oriented news coverage of health issues on information seeking online. Using Google search data as a measure of behavior, we demonstrate that controversial news coverage of the U.S. Preventive Services Task Force's November 2009 recommendations for changes in breast cancer screening guidelines strongly predicted the volume of same-day online searches for information about mammograms. We also found that this relationship did not exist 1 year prior to the coverage, during which mammography news coverage did not focus on the guideline controversy, suggesting that the controversy frame may have driven search behavior. We discuss the implications of these results for health communication scholars and practitioners.
About 90% of all influenza-related deaths occur among people aged 65 years and older. Vaccination remains the primary option for preventing influenza infection. This study examined the efficacy of messages designed to increase the uptake of influenza vaccination. Two messages, narrative and didactic, were created based on the Extended Parallel Process Model (EPPM). The study employed a one-factor between-subjects experimental design with participants assigned randomly to three conditions: no message, didactic communication, and narrative communication. Participants were 311 Italian people aged 65 years or older. The results showed that, compared to no message and didactic communication, narrative communication was related to higher risk perception of influenza, to higher perception of the efficacy of the vaccine, and to self-efficacy related to vaccination, controlling for social trust, previous flu shot, and demographic variables. There were no differences among the three conditions with respect to the intention to receive the influenza vaccine. Findings suggest that narrative communication based on EPPM may have a persuasive effect on people aged 65 years or older.
This content analysis represents news coverage of organ donation from January 1990 to December 2005. Specifically, ABC, CBS, and NBC news broadcasts were examined to gain a greater understanding of organ donation coverage on TV. Overall this investigation revealed that organ donation received modest coverage (N = 1,507). Although the majority of coverage was positive, attention to the need for organs and the process of becoming a potential organ donor received modest exposure. In addition, non-living donor and living-donor donations received approximately equal coverage. Results are discussed with a focus on message design for practitioners and advocates of organ donation.
This study explores one elderly author's accounts of life within a fictionalized retirement home to understand how meanings of age are storied within a collective community and offered as alternative narratives to the dominant discourse of aging in our society. An examination of the five novels in content and form reveals how older individuals, acting as embodied and social beings, can reclaim meanings of age through the stories they share. Rather than perpetuate a one-dimensional view of later life, octogenarian Effie Leland Wilder deliberately stories her novels with multifaceted accounts that acknowledge the positive and negative experiences of growing older. Narrative medicine and narrative gerontology position imagination as essential for recognizing, understanding, and empathizing with the lived realities of disparate individuals. This study offers an important understanding of the ways in which storytellers and story-listeners can make sense of aging through fictive stories and literary ways of knowing. Implications for future research and practice are also discussed.
Internet-based discussion forums provide access to health information and social support, and serve as a resource for others. This investigation analyzed health-oriented Aboriginal Internet discussion forum (Forum A; Forum B) conversations. The findings were framed with Nutbeam's model of health literacy. Discussions within Forum B were centralized around issues of political activism and advocacy regarding Aboriginal health care. Activity in Forum A encouraged the development of "virtual" social capital, with health care discussions providing a "just-in-time" model for health education. Members of Forum A functioned as a smoking cessation self-help group and as health educators. The Internet provided a venue for the dissemination of health information and also served as a virtual voice for lifestyle coaching, political action, community building, and advocacy.
Consumption of alcohol is widespread in U.S. culture, particularly among college students. Using a communication privacy management framework (Petronio, 200229.
Petronio , S. 2002. Boundaries of privacy: Dialectics of disclosure, Albany: State University of New York Press. View all references), this study examined how college students who abstain from alcohol negotiate communication of their nondrinking status and establish meaning in a culture in which drinking is the norm. Through 25 face-to-face interviews, this article explores the experiences of “healthy deviants”—individuals who engage in healthy behavior that violates traditional norms. Interviews identified that participants relied on privacy rules when determining whether and how to disclose their nondrinking status. If participants perceived more costs from the disclosure than rewards, they did not disclose. Participants enacted specific strategies to manage (non)disclosure of their abstinence from alcohol, providing practical ways for people who engage in healthy deviance to avoid or manage stigma.
Abstinence for most adolescent-aged college students relates to several factors, including strong religious beliefs, an aversion to taking risks, high career expectations, or limited attractiveness. Young adults receive hundreds of messages from various sources; therefore, understanding their memorable sexual messages is essential. This exploratory research uses an interpretive method to unravel the memorable sexual narratives of 65 virgin respondents. Findings yield two primary themes: involuntary abstinence, and conscious abstinence, which demonstrate that messages of abstinence are important yet often imbue punitive internal attitudes and beliefs derived from mainstream media and peer relationships. The article concludes with a recommendation for health practitioners and communication scholars to create positive open spaces where young adults can discuss sexuality, sexual relationships, and sexual behaviors. Additionally, understanding stigmas related to abstinence helps reframe normative sex communication messages and promote constructive short- and long-term sexual health behaviors.
Although it ran on multiple mass media for the better part of a year, end line evaluation of the Nimechill youth abstinence campaign in Kenya indicated that exposure to the campaign had no relationship to youth decisions to defer sexual debut. One possible explanation of this lack of association could be that target audience members derived inconsistent and confusing meanings from visuals as opposed to text in the campaign. Employing Hall's concept of high- and low-context communication, we assessed target population interpretation of four campaign posters via 12 focus-group discussions and four individual in-depth interviews with Nairobi youth. We found that although participants endorsed and recognized campaign objectives, contextual cues in some campaign visuals were interpreted by participants as being contradictory to the abstinence message in the poster texts. In addition noticeable differences arose between the low-income and middle-/high-income groups in interpretation of one of the posters. We conclude with recommendations regarding use of visuals in high-context cultures and involvement of youth from various socioeconomic strata in campaign planning.
HIV/AIDS-related stigma is believed to result in negative social consequences for people with the disease and to be a deterrent to HIV serostatus testing. The ability of communicators to change people's stigma perceptions and subsequently impact decisions to test, however, is not well understood. Based on the entertainment-education approach, this article presents the results of a field experiment conducted in Abuja, Nigeria, testing a mediated intervention designed to reduce HIV-related stigma and risk perceptions. The results indicate that the intervention was effective relative to a control in impacting perceptions of the severity of HIV and some stigma-related attitudes, particularly for male participants; and that for this sample, risk and stigma perceptions significantly impact intentions to test for HIV. It also showed that severity perceptions mediated the relationship between viewing the film and testing intent.
This study tests the processes through which child abuse public service announcements (PSAs) are effective. The proposed model builds upon the persuasion mediation model of Dillard and Peck (2000 ), which integrates emotional response and perceived effectiveness as antecedents of issue attitudes and behavioral intention. The model tested the mediating role of perceived effectiveness in the persuasion process. Multigroup structural equation modeling was performed for three different types of child abuse prevention PSAs shown on YouTube to 486 college students. The model was well fitted across all three child abuse PSAs. Emotional response seems to exert the largest influence on behavioral intention directly and indirectly through perceived effectiveness and issue attitudes. In addition, perceived effectiveness has both a direct and an indirect impact on behavioral intention.
Scholars continue to identify the conditions under which exposure to alcohol-related messages predict related behaviors and outcomes. To examine this issue further, researchers used an experiment (n = 452) to investigate the role of participants' perceptions of prevention message realism, similarity, identification, and desirability in their expectancies regarding alcohol use and impaired driving. Results of the experiment indicated that exposure to the messages reduced participants' expectancies for drinking and driving and increased their efficacy for avoiding potentially dangerous situations only when the messages activated mediating variables. No overall difference existed between the treatment groups and the control group without accounting for participants' cognitive and affective reactions to the messages. These results indicate that campaign planners must consider individual differences in audience members' interpretation of messages in order to increase message effectiveness even within seemingly homogeneous target groups.
The successful use of drama as a vehicle to influence health-related attitudes and behaviors is credited to its ability to elicit an emotional experience and identification among audience members. This study investigated the views of adolescents regarding an entertainment-education (EE) component of their school's anti-drug program - a live performance of a professionally produced anti-drug abuse drama. The analysis draws mainly on data collected from 64 focus groups, conducted in 24 schools across Israel, and open-ended responses to questionnaires administered to more than 1,700 adolescents. The adolescents were generally entertained by the anti-drug abuse drama and moved by its "authenticity," which emerged as a central construct in this study. Yet only a fraction identified with the characters and many remained unwilling to "tell" on a friend who uses drugs. Drawing on these findings, implications to EE theory and practice are discussed, particularly as they relate to the drama's perceived realism or "authenticity," and its unintended effects.
This study examined the effect of self-efficacy statements in humorous anti-alcohol abuse television advertisements on college students. A posttest only group design experiment was conducted with 124 college students. It was found that highly rebellious individuals who watched ads with a self-efficacy statement (i.e., "You Are in Control of the Situation") indicated lower alcohol expectancies, higher risk perceptions, and higher intentions to change their drinking behaviors than those in the non-self-efficacy condition. The findings suggest that health promotional messages should be tailored to rebellious college students, particularly those who are at risk, in a manner that not only gains their attention but also minimizes possible defensive reactions to the given messages. Humorous messages with self-efficacy statements could offer ways to communicate with rebellious college students regarding their drinking problems.
Purdue University's Center for Healthcare Engineering developed a computer-assisted technology hub (CATHUB) designed to aid individuals with disabilities. Upon realizing the lack of input from the very individuals they were trying to help, Marifran approached the developers of CATHUB and offered to engage a group of amputees to aid in the design and implementation of the hub. In this essay, Courtney and Marifran recount, each from their own perspective, their experiences working with Amputees in Action as participants in their research project. Ultimately the researchers discovered their research agenda was not compatible with the amputees' needs, resulting in enlightened self-reflection by the researchers and abandonment of the research project.
Contemporary theory in interpersonal communication and health psychology supports the prediction that engaging in affectionate behavior within established relationships has a direct effect on the alleviation of stress symptoms following exposure to an acute stressor. Participants in this study were exposed to a series of standard laboratory stressors and were subsequently assigned either to an experimental group or to 1 of 2 control groups. Those in the experimental group were instructed to write a letter to a loved one in which they expressed their feelings of affection for that person. Those in 1 control group thought about a loved one but did not engage in any communicative behavior, and those in the other control group simply sat quietly. All 3 conditions were compared with respect to their levels of salivary free cortisol, an adrenal steroid hormone that is instrumental in the body's neuroendocrine stress response. Results indicated that, compared to the control groups, those in the experimental group experienced accelerated cortisol recovery following exposure to the acute stressors.
This study examines the relative effectiveness of using gain- versus loss-framed messages to promote H1N1 vaccination among older adults, focusing on the moderating roles of perceived vaccine safety and efficacy. An experiment was conducted with older adults recruited from senior centers in the state of Maryland. Results show that older adults who perceived low vaccine efficacy developed greater intentions to receive the vaccine when presented with a loss-framed message (versus a gain-framed message). For those who perceived high vaccine efficacy, message framing did not make a difference in postexposure intentions. Evidence regarding the interaction between message framing and perceived vaccine safety is limited. Theoretical and practical implications of the findings are discussed.
The purpose of this study is to examine the role of health consciousness in processing TV news that contains potential health threats and preventive recommendations. Based on the extended parallel process model (Witte, 1992), relationships among health consciousness, perceived severity, perceived susceptibility, perceived response efficacy, perceived self-efficacy, and message acceptance/rejection were hypothesized. Responses collected from 175 participants after viewing four TV health news stories were analyzed using the bootstrapping analysis (Preacher & Hayes, 2008). Results confirmed three mediators (i.e., perceived severity, response efficacy, self-efficacy) in the influence of health consciousness on message acceptance. A negative association found between health consciousness and perceived susceptibility is discussed in relation to characteristics of health conscious individuals and optimistic bias of health risks.
Novel smokeless tobacco products (such as snus) are aggressively promoted to smokers by the tobacco companies. The Extended Parallel Process Model (EPPM; Witte, 1992 )was used to evaluate the current perceptions of threat, efficacy, attitudes, and behavioral intentions regarding snus in a nationally representative sample of 1,836 smokers. Participants were then exposed to messages designed to discourage smokers from trying snus. On average, smokers perceived health threat of snus as somewhat serious, but believed they can effectively avert this threat. Support was found for the EPPM's proposition that when efficacy is high, greater perceived threat is associated with greater desired outcomes (less favorable attitudes toward snus and lower behavioral intentions to try snus in the future). No support was found for the proposition that when perceived efficacy is low, greater threat is associated with greater message rejection. Instead, message rejection was explained by fear felt while exposed to the anti-smokeless ads. This finding indicates the need to more clearly distinguish between cognitive (danger control) and affective (fear control) responses posited by the EPPM.
This study examined the ways in which health care providers (general practitioners and specialists) and patients communicate with each other about managing musculoskeletal (MSK) disorders, a major cause of long-term pain and physical disability. In managing their illness, patients must interact closely with health care providers, who play a large role in transferring knowledge to them. In-depth interviews with patients, general practitioners, and specialist rheumatologists in Australia and Canada were analyzed using Leximancer (a text-mining tool). Results indicated that, in their communication, doctors subtly emphasized accepting and adjusting to the illness ("new normal"), whereas patients emphasized pain relief and getting "back to normal." These results suggest that doctors and patients should accommodate in their communication across subtle and often unexpressed differences in the priorities of provider and patient, or they are likely to be at cross purposes and thus less effective.
This exploratory study examined patterns of nonverbal accommodation within health care interactions and investigated the impact of communication skills training and gender concordance on nonverbal accommodation behavior. The Nonverbal Accommodation Analysis System (NAAS) was used to code the nonverbal behavior of physicians and patients within 45 oncology consultations. Cases were then placed in one of seven categories based on patterns of accommodation observed across the interaction. Results indicated that across all NAAS behavior categories, physician-patient interactions were most frequently categorized as joint convergence, followed closely by asymmetrical-patient convergence. Among paraverbal behaviors, talk time, interruption, and pausing were most frequently characterized by joint convergence. Among nonverbal behaviors, eye contact, laughing, and gesturing were most frequently categorized as asymmetrical-physician convergence. Differences were predominantly nonsignificant in terms of accommodation behavior between pre- and post-communication skills training interactions. Only gesturing proved significant, with post-communication skills training interactions more likely to be categorized as joint convergence or asymmetrical-physician convergence. No differences in accommodation were noted between gender-concordant and nonconcordant interactions. The importance of accommodation behavior in health care communication is considered from a patient-centered care perspective.
This study explores the role of nurturing communication in distinguishing interpersonal and intergroup interactions between health professionals and patients, from the perspective of communication accommodation theory (CAT). Participants (47 men and 87 women) rated videotapes of actual hospital consultations on 12 goal and 16 strategy items derived from CAT. Health professionals in interpersonal interactions were perceived to pay more attention to relationship and emotional needs and to use more nurturant discourse management and emotional expression. These results point the way toward elucidating the perceived optimal balance in accommodative behavior, both group based and interpersonal, in these contexts, and they highlight the importance of nurturant communication to this process.
This study examines the practical side of communicating about patients' thoughts, feelings, and physical health. A study of 53 medical visits suggests that biopsychosocial communication need not be as difficult or as time consuming as many practitioners believe. Biopsychosocial medical visits can be conducted in roughly the same amount of time as biomedical visits with many important advantages. This report describes 6 communication techniques used by 1 doctor to encourage talk about lifeworld issues. The techniques include self-disclosing, expressing empathy, involving patients in decision-making, talking openly about patients' fears, asking open-ended questions, and listening attentively. The doctor studied was able to use these techniques without exceeding the average length of a biomedical visit.
This study sought to investigate the impact of person-centered comfort on cardiovascular reactivity and to test a recently developed dual-process theory of supportive message outcomes proposing that the impact of supportive communication is moderated by the motivation and ability to attend to message content. Participants (n = 179) completed a public speaking task that served to experimentally manipulate stress. During the preparation period, instant messages containing either low or high person-centered messages or containing no imbedded supportive message were sent. Results indicated that, in line with theoretical predictions, message content did influence mean arterial pressure and heart rate for participants exposed to moderate but not to low or high stress. Results are discussed in terms of the dual-process theory of supportive message outcomes, and the discussion offers both theoretical and practical implications of the research.