Health and Risk Communication

Within a range of health communication contexts, anger can be either a detriment to the receptivity of health promotion messages when poorly controlled, or a benefit to information processing when appropriately directed. In the former case, anger can disrupt cognitive processing, leading to a range of negative outcomes, including emotional turbulence and a preoccupation with anger-eliciting events that can severely limit the receptivity of health promotion and risk prevention messages. However, when properly directed and elicited in moderation, anger can motivate greater purpose and resolve in response to health threats, stimulate more active processing of health warnings, sharpen focus on argument quality, and direct greater attention to coping-relevant information concerning harmful health risks.

A premise in health promotion and disease prevention is that exposure to and consequences of illness and injury can be minimized through people’s actions. Health campaigns, broadly defined as communication strategies intentionally designed to encourage people to engage in the actions that prevent illness and injury and promote wellbeing, typically try to inspire more than one person to change. No two people are exactly alike with respect to their risk for illness and injury or their reactions to a campaign attempting to lower their risk. These variations between people are important for health messaging. Effective campaigns provide a target audience with the right persuasive strategy to inspire change based on their initial state and psychosocial predictors for change. It is often financially and logistically unreasonable to create campaigns for each individual within a population; it is even unnecessary to the extent to which people exist in similar states and share psychosocial predictors for change. A challenging problem for health campaigns is to define those who need to be reached, and then intelligently group people based on a complex set of variables in order to identify groups with similar needs who will respond similarly to a particular persuasive strategy. The premise of this chapter is that segmentation at its best is a systematic and explicit process of research to make informed decisions about how many audiences to consider, why the audience is doing what they are doing, and how to reach that audience effectively.

Affectionate communication comprises the verbal and nonverbal behaviors people use to express messages of love, appreciation, fondness, and commitment to others in close relationships. Like all interpersonal behaviors, affectionate communication has biological and physiological antecedents, consequences, and correlates, many of which have implications for physical health and wellness. Investigating these factors within a biological framework allows for the adjudication of influences beyond those attributable to the environment. In particular, there are observable genetic and neurological differences between individuals with a highly affectionate disposition and those less prone to communicating affection, suggesting that variance in the tendency to engage in affectionate behavior is not entirely the result of environmental influences such as enculturation, parenting, and media exposure. In addition, the expression of affection is associated with markers of immune system competence and appears to help the body to relax and remain calm. The biological effects of affectionate communication are perhaps most pronounced in situations involving either acute or chronic stress. Specifically, highly affectionate individuals are less likely than others to overreact physiologically to stress-inducing events. Whatever stress reaction they do mount is better regulated than among their less affectionate counterparts. Moreover, highly affectionate individuals—or simply those who receive expressions of affection prior to or immediately following a stressful situation—exhibit faster physiological recovery from their elevated stress. Perhaps unsurprisingly, therefore, being deprived of adequate affectionate communication is predictive of multiple physical and psychological detriments, including elevated stress and exacerbated depression, social and relational problems, insecure attachment, susceptibility to diagnosed anxiety and mood disorders, susceptibility to diagnosed secondary immune disorders, chronic pain, and sleep disturbances.

Research on forgiveness and its health-related effects has steadily increased since the late 20th century. Most of the forgiveness-health literature demonstrates that forgiveness indirectly influences health through a variety of psychosocial affective factors. Common distinctions in this research are reflected in studies focused on reduction of negative affect and, thus, negative health effects, and studies focused on preventative and health-promoting implications of forgiveness (e.g., increased positive affect). While a lack of clarity exists regarding health implications stemming from reductions in unforgiveness (as distinct from increases in forgiving responses), current research supports the notion that forgiveness, as opposed to unforgiveness, affects psychological, physical, and relational health in overridingly beneficial ways. More specifically, forgiveness, and/or the moderation of unforgiveness, is associated with the exhibition of positive affect (e.g., sympathy, empathy, and optimism), improved self-esteem, higher life satisfaction, and better mental health ratings. Physical health effects of forgiveness include enhanced bioregulation in response to transgression stressors, as well as better self-rated health status and the exhibition of positive health behaviors. Limitations in the current literature most commonly relate to disparate definitional, methodological, and interpretative issues typical of transdisciplinary forgiveness and health research. Current trends and future directions for forgiveness-health research include consideration of additional variables thought to be associated with forgiveness processes, including religiosity, empathy, and social support. Additionally, research that focuses on communicative and relational aspects of health and well-being is warranted. Suggestions for research opportunities in forgiveness-health research framed by a communicative lens are offered.

From birth to death, our interactions with others are what inform our identity and give meaning to life. Ultimately, it is interpersonal communication that is the bedrock of wellness. Much of the scholarship on interpersonal communication places communication in the background, characterized merely as a resource, symptom, or contributing factor to change. In the study of our interpersonal experiences, communication must be at the forefront. As a pragmatic lens concerned with real-world issues, a life-span perspective of interpersonal scholarship provides boundless opportunities for bridging science and practice in meaningful ways that improve social life on multiple levels, from families to schools to government to hospitals. Interpersonal communication research that is concerned with life-span issues tends to prioritize communicative phenomena and bring the communication dynamics of our relational lives to the surface. Typically, this scholarship is organized around the various stages or phases of life. In other words, researchers concerned with interpersonal communication often contextualize this behavior based on dimensions of human development and life changes we typically encounter across the life course, those major life experiences from birth to death. Much of that scholarship also centers on how we develop competence in communication across time or how communication competence is critical to our ability to attain relational satisfaction as well as a high psychological and physical quality of life. This research also highlights the influential role of age, human development, and generational differences, recognizing that our place in the life span impacts our goals and needs and that our sociocultural-historical experiences also inform our communication preferences. A life-span perspective of interpersonal communication also encompasses various theoretical paradigms that have been developed within and outside the communication discipline. Collectively, this scholarship helps illustrate the communicative nature of human life across the entire life trajectory.

In today’s media-saturated environment, individuals may be exposed to hundreds of media messages on a wide variety of topics each day. It is impossible for individuals to attend to every media message, and instead, they engage in the phenomenon of selective exposure, where certain messages are chosen and attended to more often than others. Health communication professionals face challenges in creating messages that can attract the attention of targeted audiences when health messages compete with more entertaining programming. In fact, one of the greatest obstacles for health campaigns is a lack of adequate exposure among targeted recipients. Individuals may avoid health messages completely or counterargue against persuasive attempts to change their health-related attitudes and behaviors. Once individuals have been exposed to a health message, their current mood plays an important role in the processing of health information and decision making. Early research indicated that a positive mood might actually be detrimental to information processing because individuals are more likely to process the information heuristically. However, recent studies countered these results and suggested that individuals in positive moods are more likely to attend to self-relevant health information, with increased recall and greater intent to change their behaviors.

Since mood has the ability to influence exposure to health messages and subsequent message processing, it is important for individuals to be able to manage their mood prior to health information exposure and possibly even during exposure. One way individuals can influence their moods is through media use including TV shows, movies, and music. Mood management theory predicts that individuals choose media content to improve and maintain positive moods and examines the mood-impacting characteristics of stimuli that influence individuals’ media selections. Therefore, an individual’s mood plays an important role in selection of any type of communication (e.g., news, documentaries, comedies, video games, or sports).

How can health message designers influence individuals’ selection and attention to health messages when negative moods may be blocking overtly persuasive attempts to change behaviors and a preference for entertaining media content? The narrative persuasion research paradigm suggests that embedding health information into entertainment messages may be a more effective method to overcome resistance or counterarguing than traditional forms of health messages (e.g., advertisements or articles). It is evident that mood plays a complex role in message selection and subsequent processing. Future research is necessary to examine the nuances between mood and health information processing including how narratives may maintain positive moods through narrative selection, processing, and subsequent attitude and/or behavior change.

The parent–child relationship is one of the most influential, important, and meaningful relationships in an individual’s life. The communication between parents and children fuels their bond and functions to socialize children (i.e., gender, career and work, relationship values and skills, and health behaviors), provide social support, show affection, make sense of their life experiences, engage in conflict, manage private information, and create a family communication environment. How parents and children manage these functions changes over time as their relationship adapts over the developmental periods of their lives. Mothers and fathers may also respond differently to the changing needs of their children, given the unique relational cultures that typically exist in mother–child versus father–child relationships.

Although research on parent–child communication is vast and thorough, the constant changes faced by families in the 21st century—including more diverse family structures—provides ample avenues for future research on this complex relationship. Parent–child communication in diverse families (e.g., divorced/stepfamilies, adoptive, multiracial, LGBTQ, and military families) must account for the complexity of identities and experiences in these families. Further, changes in society such as advances in technology, the aging population, and differing parenting practices are also transforming the parent–child relationship. Because this relationship is a vital social resource for both parents and children throughout their lives, researchers will undoubtedly continue to seek to understand the complexities of this important family dyad.

Parents can be the target of health and risk messages about their children and can be a channel by which children hear health messages. This dual role can make parents powerful agents for change in children’s health. Parents receive health messages from a variety of sources including health care providers, schools, the media, the government, and family. Parents tend to be a more frequent target for health messages when their children are infants or young. They receive many messages related to keeping their children safe. Most of these messages are not developed as part of a rigorous data-driven and theory-based intervention and often lack sophisticated message development and design. Furthermore, instead of segmenting parents and tailoring messages, parents are frequently treated as a monolith, with no diversity related to behavior or communication.

As children age, parents can become the channel by which children can hear a health message. Parents of school-age children and adolescents are continually communicating messages to their children and are often targeted to communicate messages related to health or risk behaviors. Intentional efforts to encourage parents to talk to their children are often related to risk behaviors among older children. Specifically, parents are asked to convey messages about sexual health, alcohol and drug use, and driving. Evidence points to parent–child communication in general and communication about specific risk behaviors as protective for children. Research has also suggested that adolescents want to hear health messages from their parents. Parents are a natural choice to communicate about health and risk throughout childhood and adolescence due to the parent–child relationship and the influence parents can have over children. However, this special relationship does not automatically translate into parents having good communication skills. Messages designed to encourage parents to communicate with their children about a health topic have often been developed with the assumption that parents know what to communicate and how to effectively communicate with their children. Deficits in communication skills among parents have been recognized by some campaign developers, and an emphasis on developing those skills has been a significant part of some messages targeting parents. Health communication campaigns have been developed to inform parents about when and how to talk to their children about health issues such as alcohol, drugs, and sex. Unfortunately, not all parent–child communication is positive or effective and this can have potential unintended consequences. Treating parents as an audience in a more nuanced manner, with greater emphasis on evidence-based message development, could result in more effective messages and better health outcomes.

“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.

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.