Michael Mackert and Marie Guadagno
Advertising as a field and industry often has a contentious relationship with both health communication and public health due to legitimate concerns about how advertising for certain products, such as alcohol and tobacco, could contribute to less-healthy decisions and behaviors. While acknowledging such concerns, advertisers and their approach to solving communication problems could also provide valuable lessons to those working in health communication. Indeed, advertising agencies are designed to develop creative and effective messages that change consumer behavior—and health communication practitioners and scholars aim to change population-level behavior as well. The perspective and approach of the account planner in the advertising agency—a role whose chief responsibility is to bring the consumer perspective into every step of the advertising development process and inspire effective and creative campaigns—would be particularly valuable to those working in health communication. It was account planning work that shifted traditional milk advertising from promoting it as a healthy drink to the iconic “got milk?” campaign, which positioned milk as a complement that makes other food better—an approach that drove positive sales after years of declining milk consumption. Yet many who work in health communication and public health often know little of how advertising agencies work or their internal processes that might be productively adopted. This lack of understanding can also lead to misperceptions of advertisers’ work and intentions. As an example, one might assume dense medical language in prescription drug advertising is intended to add unnecessary complexity to the advertisements and obscure side effects; instead, advertising professionals who work on prescription drug advertising have often been trained on clear communication—but cannot fully utilize that training because of regulations that require medically accurate terminology that might not be comprehensible to most viewers. Improved understanding of how advertisers can act as agents of change, and increased dialogue between the fields of advertising and health communication, could contribute to improved health communication research, practice, and policy.
Mohan Jyoti Dutta, Satveer Kaur-Gill, and Naomi Tan
Cultivation theory examines the effects of the media, mainly television on viewer perception over an extended period of time. Television is seen by people throughout the globe, with many spending considerable amounts of time watching the medium. The act of watching television has been described as the first leisure activity to cut across social and ethnic divisions in society. This made it a unique mass media tool because mass message dissemination to diverse groups in a population was made possible. Cultivation scholars have studied the effects of the medium, trying to understand how television content can alter one’s social reality. Heavy viewers are considered to be most susceptible to the effects of cultivation. The reality of these effects poses important questions for health communication scholars considering the role television plays in disseminating health messages. Health communication scholars became interested in studying cultivation to understand the health-related effects the medium could have on viewers. Understanding the health effects of television is pivotal, considering that television and the structures that constitute television content set the agendas for many health topics, often disseminating negative and positive messages that can impact society, especially the young and impressionable. With television content addressing health issues such as nutrition, diet, body image, tobacco, cancer, drugs, obesity, and women’s health, cultivation theory can offer health communication scholars a framework to understand how health behaviors are shaped by the mass media and the roles these media play in reinforcing unhealthy behaviors. By establishing a basis for studying how such portrayals have direct health-related effects on viewers, cultivation theory creates openings for questioning the structures of the media that put out unhealthy content and for interrogating the roles and responsibilities of media agenda in inculcating positive health messages. Directions for future research include looking at contextually contrasting populations that share different cultural and community values, and different ways of consuming television. Research questions exploring the roles of community structures with different sets of subjective norms, or with different roles of community norms, in the realm of cultivation effects offer new areas for exploration.
Suruchi Sood, Amy Henderson Riley, and Kristine Cecile Alarcon
Entertainment-education (EE) began as a communication approach that uses both entertainment and education to engender individual and social change, but is emerging as a distinct theoretical, practice, and evidence-based communication subdiscipline. EE has roots in oral and performing arts traditions spanning thousands of years, such as morality tales, religious storytelling, and the spoken word. Modern-day EE, meanwhile, is produced in both fiction and nonfiction designs that include many formats: local street theater, music, puppetry, games, radio, television, and social media. A classic successful example of EE is the children’s television program Sesame Street, which is broadcast in over 120 countries. EE, however, is a strategy that has been successfully planned, implemented, and evaluated in countries around the world for children and adults alike. EE scholarship has traditionally focused on asking, “Does it work?” but more recent theorizing and research is moving toward understanding how EE works, drawing from multidisciplinary theories. From a research standpoint, such scholarship has increasingly showcased a wide range of methodologies. The result of these transformations is that EE is becoming an area of study, or subdiscipline, backed by an entire body of theory, practice, and evidence. The theoretical underpinnings, practice components, and evidence base from EE may be surveyed via the peer-reviewed literature published over the past 10 years. However, extensive work in social change from EE projects around the world has not all made it into the published literature. EE historically began as a communication approach, one tool in the communication toolbox. Over time, the nascent approach became its own full-fledged strategy focused on individual change. Backed by emerging technologies, innovative examples from around the globe, and new variations in implementation, it becomes clear that the field of EE is emerging into a discrete theoretical, practice, and evidence-based subdiscipline within communication that increasingly recognizes the inherent role of individuals, families, communities, organizations, and policies on improving the conditions needed for lasting social change.
Understanding the role of gender in the newsroom involves tracing a shift from an initial consensus that women’s only journalistic role was to write with “a woman’s touch” about women, for women readers, to a claim that women should be allowed to produce the same “unmarked” news as men. The claim became that women’s forms—women’s sections or other materials intended for women audiences—represented professional ghettos, and that women were needed to produce better, more ethical journalism. That is, within the newsroom, gender was first dichotomized, rendering the interests of women and men as opposites, and then it claimed to be irrelevant. Feminist scholars point out that, over time, men have consistently tried to protect their status, jobs, and salaries, and have failed to acknowledge how journalism was set up as a male enclave with “macho” values and a culture that disadvantaged women, especially mothers, with its tradition of long and irregular hours and lack of childcare.
Research on gender and journalism can be divided into two categories: (a) gender “at work” in newsrooms (including opportunities or inequities in jobs, promotions, and salaries, as well as sexism), and (b) representations of women. Scholars often assume that the first issue over-determines the second. On both issues, research shows improvement, but also continuing problems. Now women journalists appear to be well established; the news includes issues associated with women’s quotidian concerns, and it takes women seriously. Yet a variety of gender divides continue to characterize journalism. Researchers find gendered patterns in coverage, especially in politics and sports. Women television journalists are routinely sexualized, and their high visibility in television broadcasting—through explicit scrutiny of their bodies, hairstyles, clothing, and voices—is countered by their invisibility in management. Gendered double standards and a glass ceiling continue to stymie the promotion of women to key decision-making and governance positions in print and broadcast news organizations. Moreover, women are far from enjoying equity in the online context.
Women continue to be concentrated in low-status media outlets and beats: they dominate community, small-town, and regional news organizations, and they produce “soft news,” human-interest stories and features. Men still dominate, although they do not monopolize, most of the high status areas of news production, particularly politics and business, as well as the lucrative and popular area of sports, a highly gendered and sexist domain. The most overtly gendered arena is war correspondence. Women who report on war and conflict are judged by very different standards than men. In particular, mothers are condemned when they go off to dangerous conflict areas, although fathers who cover war continue to be largely immune from public criticism. Women war reporters run a high risk of sexual violence and harassment, although women who have been sexually attacked rarely tell their supervisors—probably for fear of being pulled off an assignment.
Countless platforms are now available to citizens to disseminate their views as citizen journalists, including blogs and Twitter; these provide opportunities for challenging gender roles and democratizing relations between men and women. On the other hand, social media threaten the business model of professional journalism; the resulting trend to part-time, freelance, and even unpaid work creates a precarious and potentially highly feminized labor force.
Amy E. Chadwick
Hope has been defined in primarily two ways, and both have implications for message design within health and risk communication. First, hope has been defined as a way of thinking, or disposition, that affects how people pursue goals. Dispositional hope manifests in beliefs about one’s capacity to initiate and sustain action toward goals (agency) and one’s ability to generate ways to reach those goals. Dispositional hope has been associated with positive physical and mental health outcomes. For example, high-hope women have greater intentions to engage in cancer prevention behaviors than do low-hope women. Numerous studies have associated higher hope with better pain management, and people who are higher in hope have a greater pain tolerance than people lower in hope. Hope is also related to better psychological adjustment.
Much of the research on dispositional hope focuses on correlating hope with a variety of positive health and non-health outcomes; however, psychotherapeutic interventions have also been designed to increase dispositional hope. These interventions have shown improvements in health-related outcomes. Although their potential is not yet realized, interventions for developing dispositional hope could improve compliance with medical recommendations, increase adoption of health behaviors, and decrease risk behaviors.
The second way that hope has been defined is as a discrete emotion. Discrete emotions are brief, intense, psychological, and evaluative reactions directed at external stimuli (e.g., people, events, or objects). In response to these external stimuli, emotions help individuals adapt to their environment by activating a unique pattern of thoughts (cognitions), physiological changes, subjective feelings, motor expressions, and action (or behavioral) tendencies.
Lazarus’s cognitive-mediational theory has been one of the most influential theories of discrete emotions that includes a definition of hope. Lazarus identifies the core relational theme of hope as “fearing the worst but yearning for better.” Lazarus deems hope to be a problematic emotion because he believes hope contains both positive and negative elements. Despite uncertainty about the exact nature of hope, Lazarus believes that hope is vital to coping with stress. Hope enables people to believe in the possibility of better circumstances and therefore is critical as a coping mechanism against despair. Lazarus does not provide guidance for what a message might need to include to evoke hope.
Drawing on Lazarus and appraisal theories in general, MacInnis and de Mello suggest tactics that consumer marketing advertisements could use to induce hope. Specifically, the authors focus on turning “impossibility into possibility” and enhancing “yearning.” De Mello and MacInnis also theorize that hope can lead to motivated processing of information resulting in both positive (e.g., coping, well-being, and goal achievement) and negative (e.g., risky behavior, self-deception) outcomes. Unfortunately, the theorizing of de Mello and MacInnis was never empirically tested.
To further explore how feelings of hope are created, Prestin examined underdog narratives in entertainment media. Underdog narratives show characters who are attempting to meet a goal despite unfavorable circumstances and odds. These narratives evoke hope and make people more motivated to meet their own personal goals. Although their potential has not been fully explored, underdog narratives may assist individuals in overcoming challenging circumstances, such as battling addiction or developing new health habits. There are numerous mechanisms still to be examined that may explain the effects of underdog narratives beyond their ability to evoke hope.
Recently, Chadwick defined hope as a future-oriented, discrete emotion that focuses on an opportunity to achieve a desired future outcome. Her definition builds on the work of Lazarus and Roseman and has implications for the design of messages that evoke hope. According to Chadwick, hope is evoked by appraisals of a future outcome as (a) consistent with goals (goal congruence), (b) possible but not certain (possibility), (c) important (importance), and (d) leading to a better future (future expectation). All four of these appraisals combine to create a perception of opportunity and the discrete emotion hope. Hope motivates behavior by focusing one’s thoughts on capitalizing on an opportunity. Chadwick states that hope also involves (a) an approach action tendency that motivates individuals to take, or continue, action to achieve the desired outcome, (b) increased heart rate and skin conductance, (c) an open facial expression, heightened focus, and alert body posture, and (d) a feeling of eager attention.
Chadwick’s definition has clear implications for developing messages that evoke hope. Messages designed to create appraisals of the importance, goal congruence, positive future expectation, and possibility of a future event evoke hope and are called hope appeals. Like other theoretical explications of emotional appeals, a hope appeal has two components: (a) the inducement of hope through the presentation of an opportunity and (b) the presentation of recommended actions to achieve the desired outcome. The recommended actions component includes information designed to (a) increase the receiver’s perception of his or her ability to perform the recommended action (i.e., self-efficacy) and (b) demonstrate the ability of the recommended actions to achieve the desired outcome (i.e., response efficacy).
Empirically, scholars have tested the effects of hope and messages that evoke hope. Hope appeals increase attention to messages about climate change and increase mitigation behavioral intention and mitigation behavior. In addition, feelings of hope increase interest in climate change protection and are positively correlated with pro-environmental behaviors and support for climate change policies. Feelings of hope significantly predict interest in climate protection, self-efficacy, interpersonal communication intention, information seeking intention, and behavioral intention. Hope and hopeful narratives have also been associated with greater perceived message effectiveness and more agreement with the message content. After a stressful experience that accelerates heart rate, evoking hope decelerates heart rate and decreases state anxiety. This research provides evidence that messages that evoke hope can counter the psychological and physiological effects of stressful events. In addition, researchers have examined the effects of hope on a variety of health, persuasion, political communication, and marketing outcomes. Preliminary evidence indicates that hope appeals are equally as or more effective than guilt and fear appeals at increasing interpersonal communication intention, self-efficacy, information seeking intention, and behavioral intention. In addition, hope appeals create less reactance (anger) than fear appeals. Together these results indicate that hope and hope appeals have substantial potential to influence health and risk behavior.
Robert Busching, Johnie J. Allen, and Craig A. Anderson
In our modern age, electronic media usage is prevalent in almost every part of the world. People are more connected than ever before with easy access to highly portable devices (e.g., laptops, smartphones, and tablets) that allow for media consumption at any time of day. Unfortunately, the presence of violence in electronic media content is almost as prevalent as the media itself. Violence can be found in music, television shows, video games, and even YouTube videos. Content analyses have shown that nearly all media contain violence, irrespective of age rating (Linder & Gentile, 2009; Thompson & Haninger, 2001; Thompson, Tepichin, & Haninger, 2006; Yokota & Thompson, 2000). It is therefore important to ask: What are the consequences of pervasive exposure to screen violence? One consequence of media violence exposure, hotly debated by some in the general public, is increased aggressive behavior. This relationship was investigated in many studies using experimental, longitudinal, or cross-sectional design. These studies are summarized in meta-analyses, which support the notion that media violence increase the likelihood of acting aggressively. This link can be explained by an increase in aggressive thoughts, a more hostile perception of the environment, and less empathic reaction to victims of aggressive behavior. However, the often debated notion that media violence allows one to vent off steam, leading to a reduced likelihood of aggressive behavior, has failed to receive empirical support. The effect of media violence is not limited to aggressive behavior; as a consequence of violent media usage attentional problems arise and prosocial behavior decreases.