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.
Shawn Meghan Burn
Bystander intervention is a form of helping that occurs when onlookers intercede to provide direct or indirect aid to a victim. When bystanders step in to prevent or reduce harm to others, they act as agents of primary and secondary health prevention. But theory and research suggest the bystander intervention process is complex and multiple social-psychological and situational barriers imperil bystander action. Bystanders are often ill-prepared to intervene when others are at risk for emotional or physical harm. They may not notice that someone needs help due to distraction from self-focus, engagement in social interaction, intoxication, or aspects of the situation like crowding or noise. Due to inadequate knowledge, bystanders may misdiagnose the situation and believe intervention is unnecessary. The negative consequences of nonintervention may be unknown to them such that the situation fails to increase their empathic arousal and motivate their action. Lacking knowledge, they may not recognize the seriousness of the situation and or the potential costs of inaction, and so are insufficiently alarmed. Pluralistic ignorance can arise when multiple uncertain bystanders conceal their concern and hesitate to act, assuming others’ inaction means intervention is inappropriate or unnecessary. When there are multiple witnesses, bystanders may assume their help is unneeded, place intervention responsibility on others, or feel less responsible for helping due to diffusion of responsibility. When the victim is not a member of their in-group, or is assumed at fault for their predicament, they may feel less empathy and a reduced responsibility to help. Or, bystanders may assign responsibility for intervention to the victim’s friends or fellow in-group members, or to those “in charge” of the setting. Even when bystanders realize help is needed and take responsibility for helping, they may not act if they do not know how or lack confidence in their ability to successfully carry out the actions required to help. When they have the skills, they may not help if they perceive the costs of action to outweigh the benefits of action. Audience inhibition arising from group norms supporting inaction and from bystander worry about what others will think about them if they act unnecessarily or ineptly can prevent bystander action by increasing bystanders’ perceived helping costs.
Recognition of bystanders as a potentially valuable public health asset has increased interest in promoting bystander intervention. Bystander intervention promotion and communications empower bystander action by combating intervention- and audience-specific barriers to bystander intervention using targeted information, communications, and skills training. Theory and research suggest that effective promotions and communications foster context-specific attitudes, beliefs, norms, and skills such that bystanders: (1) are able to quickly and accurately identify a situation as intervention-appropriate; (2) experience action-motivating arousal (including empathy) in the face of the event; (3) have positive attitudes towards intervention and perceive the benefits of action as outweighing the perceived costs; (4) are empowered to act and feel confident in their ability to effectively intervene (bystander efficacy); and (5) are resistant to evaluation apprehension and norms contraindicating action. Effective bystander intervention promotion draws on social psychology and communications studies, and best practices for health promotion and prevention programs. The application of social marketing and formative and summative program evaluation methods enhance the potential of bystander intervention promotions and communications to empower bystander action.
Behavioral journalism is a term used to describe a theory-based health communication messaging strategy that is based on conveying “role model stories” about real people and how they achieve healthy behavior changes. The aim is to stimulate imitation of these models by audiences of their peers. Theoretical foundations for the strategy itself are in Albert Bandura’s social cognitive theory and Everett Rogers’s model of diffusion of innovations, but it can be used flexibly to convey various kinds of theory-driven message content. Behavioral journalism emerged as an explicit health communication technique in the late 1970s and was developed as a distinct alternative to the social marketing approach and its focus on centrally generated messages devised by experts. It has been used subsequently to promote smoking cessation, improvements in nutrition and physical activity, avoidance of sexually transmitted diseases and unplanned pregnancy, reduced intergroup hostility, advocacy for healthy policy and environmental changes, and many other diverse health promotion objectives. Formats used for behavioral journalism include reality television programs, broadcast and print news media, printed newsletters for special audiences, documentary film and video, digital and mobile communication, and new social media. Behavioral journalism is intended for use in concert with community organization and actions to prompt and reinforce the imitation of role models and to facilitate and enable behavior change, and its use in that context has yielded many reports of significant impact on behavior. With citations of use growing steadily in the past two decades, behavioral journalism has proven to be readily adaptable to new and emerging communication technologies.
The Christian gospel message was intended to be public. The biblical basis for this is undisputable. Yet in recent times the visibility of the Christian perspective on issues affecting society that are often debated in the public sphere has declined in many Western societies. In “Sociology and Theology Reconsidered: Religious Sociology and the Sociology of Religion in Britain,” John Brewer states that “religion has tended to be restricted to the private sphere” in many modern nation-states over the 20th century, meaning public displays of religiosity have been frowned upon and strictly limited. The privatization of religion is a result of a decline in the importance of religion in modern societies, a process termed “secularization.” Yet the idea of increasing secularization in society is not accepted by all. Despite common-sense notions that such societies have become increasingly secular in nature, Christian values do still clearly underpin the nature and functioning of institutions of the state and government in many Western nation-states. Bryan Turner states in “Religion and Contemporary Sociological Theories” that since the late 20th century at least, there has actually been a “growing recognition of the importance of religion in public life”, something José Casanova termed “public religion.” The sociologist Peter Berger suggested that we began to witness the “desecularization” of the world in the late 20th century as there has been (and continues to be) a global resurgence in religious adherents. This situation was evident most considerably in the rapid growth of Christianity across the globe throughout the 20th century, a phenomenon that continues to gather momentum into the 21st century.
Sophie Christman Lavin and E. Ann Kaplan
Ecocinema involves the human gaze looking at cinema through the lens of the environment, in a manner analogous to the way feminists provided the cinematic lens of gender in the 1970s. However, as with feminism, enormous differences pertain in regard to how the ecocinema lens is mobilized.
In analyzing films from the late 1800s to the early 21st century, ecocinema studies has evolved to include critical lines of inquiry from perspectives of psychology, feminism, socioeconomics, science, and activism. Research frames used in these inquiries include: setting and landscape in films, ecological analyses of mainstream and independent fictional films, posthuman cinematic representations, transnational and regional, and more recently, trauma in speculative dystopian films. Ecocinema critics analyze films of various types, including Hollywood, independent, transnational, documentary, animated, art cinema, and especially climate fiction (“cli-fi”) films.
Ramachandra Guha’s transnational typology of environmental ideologies will provide a useful starting place for the mapping of different perspectives in ecocinema. Guha distinguished utopian wilderness environmentalism, pervasive in the United States, from the agrarian focus typical in India. Meanwhile, most developed nations utilize scientific industrial methods to exploit the environment. Oftentimes, these latter approaches are grounded in growth economies and are thus in conflict with the unrealistic ideals of so-called neo-primitivism (NP). Neo-primitivism involves returning to simple, sustainable lifestyles within or close to the natural world—lifestyles that do no environmental damage. NP is beloved by many, but the consensus is that it is idealistic to consider going back to this way of life. A film such as Avatar (produced and directed by James Cameron in 2009) addresses the complexity of diverse constructions of nature by providing examples of utopian wilderness ideology that compete with, and are opposed to, the destructive scientific industrialism that disregards and dominates nature without compunction. Other films, such as Amazon Sisters (Sweeny, 1992), Elemental (Koch, Roshan, & Vaughan-Lee, 2012), Into the Wild (Blocker, Hildebrand, Kelly, & Penn, 2007), or Grizzly Man (Beggs & Herzog, 2005), act as simultaneous celebrations and critiques of wilderness ideologies and deal with gender and racial identities, and thus they have been a central focus of ecocinema scholarship.
Although films from all genres have historically engaged environmental issues, it was rarely in a way that made a self-conscious or critical statement about the human impact on the natural world from the perspective of ecological concerns—this is the focus of ecocinema. See for example, Birt Acres’s Rough Sea at Dover (1895), the Lumiere Brothers’ Oil Wells of Baku (1896), Thomas Edison’s Sorting Refuse at Incinerating Plant, NYC (1903), and the British South Africa Company’s Rhodesia To-Day (1912). In the early 21st century, the genre that most often engages with the contemporary politics of climate change is the documentary. Documentaries, such as An Inconvenient Truth (Guggenheim, 2006), Manufactured Landscapes (Baichwal, 2006), Into Eternity (Eskilsson & Madsen, 2010), Chasing Ice (Ahrens & Orlowski, 2012), E-Waste Tragedy (Esteve, Popp, Úbeda, & Dannoritzer, 2014), This Changes Everything (Cuarón & Lewis, 2015), among others, critique human damage to the planet and thus position viewers as ethical witnesses. Such works hope to influence the outcome of our shared anthropocentric future.
The analyses of ecocinema are addressed using two distinct methods—the macro and the micro. The macro method studies how films represent the large-scale processes of earth-based climate systems, and its lens evaluates how films represent climate and environmental dilemmas facing humans as a species. The micro-lens provides enhanced analyses that explore how gender, race, and class figure into the cultural work climate fantasies perform. This lens indexes the ways in which various cultures are often disproportionately impacted by climate systems.1 Oftentimes the macro and micro levels are both incorporated in a single film and reveal the intersection between climate and culture, as seen in Taklub (Trap, Castillo & Mendoza, 2015), a film that portrays Super-typhoon Haiyan and its impact on residents in Tacloban, Philippines. As background to mapping the texts, evolving science discourses will be emphasized as evidence for global warming but with the understanding that this evidence relies on modeling. Although our main concern with this cultural work in ecocinema is how climate change impacts across gender, race, and class, the inequalities revealed also speak to the politics of climate change evident in cinematic treatments of the issue.
In understanding crowd psychology and its explanation of conflict and violence, there are different theoretical approaches that turn on different understandings of communication processes. There are three models of communication in the crowd worth reviewing: classic, normative, and dynamic. Classic models suggest that crowd members are influenced by an idea of emotion presented to them. Normative models suggest that influence is constrained by what is seen as consonant with group norms. And, finally, dynamic models examine how that which becomes normative in the group depends upon intergroup relations. The last of these approaches can explain the patterned, socially meaningful and yet changing nature of crowd action. Crowd action, itself, is a form of communication because it serves to shape the social understandings of participants as well as the social understandings of those beyond the crowd. It is argued that the nature and centrality of crowds contribute to the understanding and creating of social relations in society.
Religion encompasses many forms of communication: between groups, within groups, and with God (or other deities). Such communication can be especially powerful when group members highly identify with their religious group and the beliefs therein. Equally, it can be divisive, as evidenced by religion-based intergroup conflict and intolerance (which often overlaps along ethnic or political lines). However, not all religious communication is verbal or explicit. Religious individuals also commonly transmit their beliefs, values, and identities through symbols, physical spaces, and music. Likewise, communication with God is often pursued with silent prayer, meditation, or ritual, which also serve to reinforce one’s spirituality alongside religious group boundaries. Taken together, these varying forms of communication have implications not only for religious intergroup relations (e.g., intergroup contact or conflict), but also for intragroup relations (e.g., the strengthening of social ties) and individual health outcomes (e.g., effective communication with health care providers and coping practices). Given the importance of religious identity for many individuals, the benefits for individual well-being and intragroup relations, and yet the intergroup strife that religious group divisions can incite, the ways in which we communicate our religious group identities deserve closer attention.
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.
Srinivas Melkote and H. Leslie Steeves
The decades that immediately followed World War II witnessed the political independence of most of the so-called Third World from colonization and the birth of the United Nations, marking the formal beginning of development and directed social change to facilitate it. The role of communication in development (devcom) has evolved according to the overarching goals of the development programs and theories during each historical period since then. The process of modernization, in which devcom was initially nurtured, was influenced by quantitative and empirical social sciences theory, philosophy, and methodology; in particular, it had a strong economics orientation. It has been one of the most powerful paradigms in development study and practice to originate after World War II, with enormous economic, social, and cultural consequences. Concepts and theories that articulated the development of Western Europe and North America were used by sociologists, economists, political scientists, anthropologists, and others to generate development models for countries in Asia, Africa, Latin America, and the Caribbean. Mass media were accorded a central position in the modernization paradigm. The use of media for transmission of information and for persuasion, derived from World War II–related psychological warfare research in the United States, were transferred to areas such as extension education, instruction, agricultural, and health extension in development. By the 1970s, the concept of development and change expanded to include many more types of social change guided by different theories, disciplinary influences, geographical considerations, and methodologies. Change now included a widely participatory process of social change in a society and included social and cultural aspects besides the economic. While the participatory mode of communication for development programs and activities was a welcome addition to the devcom toolbox, the definitions of participation reflected a wide variety of approaches. In many contexts, the level of participation required by the people was low and perfunctory.
Toward the end of the 1980s, the concept and practice of empowerment expanded upon the earlier objective of participation in development communication models and practice. Broadly, empowerment is a process by which individuals, organizations, and communities gain control and mastery over their social and economic conditions. The concept and practice of empowerment posed a challenge to the identity and practice of development communication. It changed the way communication was conceptualized earlier and used in development and change work. At present, social justice within the processes of development and social change has gained traction and urgency. In the last 40 years, there has been a steep increase in income inequality and individual opportunity globally. Millions of people are still exposed to life-threatening diseases, malnutrition, hunger, and other debilitating conditions, and have very limited access to basic resources, such as education and healthcare. What are the progressive alternatives to the neoliberal model of directed change? What should be the place and role of devcom in alternative approaches? These concerns are addressed by anchoring ideas within a critical theory of social change for social justice.
Wayne A. Beach, Kyle Gutzmer, and Chelsea Chapman
Beginning with phone calls to an emergency psychiatric hospital and suicide prevention center, the roots of Conversation Analysis (CA) are embedded in systematic analyses of routine problems occurring between ordinary persons facing troubling health challenges, care providers, and the institutions they represent. After more than 50 years of research, CA is now a vibrant and robust mode of scientific investigation that includes close examination of a wide array of medical encounters between patients and their providers. Considerable efforts have been made to overview CA and medicine as a rapidly expanding mode of inquiry and field of research. Across a span of 18 years, we sample from 10 of these efforts to synthesize important priorities and findings emanating from CA investigations of diverse interactional practices and health care institutions. Key topics and issues are raised that provide a unique opportunity to identify and track the development and maturity of CA approaches to medical encounters. Attention is also given to promising new modes of research, and to the potential and challenges of improving medical practices by translating basic and rigorous empirical findings into innovative interventions for medical education. A case is made that increasing reliance on CA research can positively impact training and policies shaping the delivery of humane and quality medical care.