Soyoon Kim and Brian G. Southwell
Typical discussion about the success of mediated health communication campaigns focuses on the direct and indirect links between remembered campaign exposure and outcomes; yet, what constitutes information exposure and how it is remembered remain unclearly defined in much health communication research. This problem mainly stems from the complexity of understanding the concept of memory. Prolific discussions about memory have occurred in cognitive psychology in recent decades, particularly owing to advances in neuroimaging technologies. The evolution of memory research—from unitary or dichotomous perspectives to multisystem perspectives—has produced substantial implications for the topics and methods of studying memory. Among the various conceptualizations and types of memory studied, what has been of particular interest to health-communication researchers and practitioners is the notion of “encoded exposure.” Encoded exposure is a form of memory at least retrievable by a potential audience member through a conscious effort to recollect his or her past engagement with any particular unit of campaign content. While other aspects of memory (e.g., non-declarative or implicit memory) are certainly important for communication research, the encoded exposure assessed under a retrieval condition offers a critical point at which to establish the exposure-outcome link for the purpose of campaign design and evaluation. The typical methods to assess encoded exposure include recall and recognition tasks, which can be exercised in various ways depending on retrieval cues provided by a researcher to assess different types and levels of cognitive engagement with exposed information. Given that encoded exposure theoretically relies on minimal memory trace, communication scholars have suggested that recognition-based tasks are more appropriate and efficient indicators of encoded exposure compared to recall-based tasks that require a relatively high degree of current-information salience and accessibility. Understanding the complex nature of memory also has direct implications for the prediction of memory as one of the initial stages of communication effects. Some prominent message-level characteristics (e.g., variability in the structural and content features of a health message) or message recipient-level characteristics (e.g., individual differences in cognitive abilities) might be more or less predictive of different memory systems or information-processing mechanisms. In addition, the environments (e.g., bodily and social contexts) in which people are exposed to and interact with campaign messages affect individual memory. While the effort has already begun, directions for future memory research in health communication call for more attention to sharpening the concept of memory and understanding memory as a unique or combined function of multilevel factors.
Message Recipient Psychological Characteristics: Incurious and Curious Motives to Learn about Health Risks
Successfully conveying information about the risk of potential threats to an individual’s physical and mental health is a serious challenge for healthcare practitioners. Adding to the challenge is the role of individual differences in people’s tendencies to want to learn (or in their choice to passively avoid) new information. These characteristic motives can be both curious and incurious in nature and interact with the perceived locus of the relevant health threat, which must be taken into account first. Some health threats are relatively “external,” and involve addressing the potential risk of an undesired event (e.g., developing illness, encountering relationship troubles). Research indicates that individuals who view external threats as “controllable” are more likely to respond positively to relevant information, but perception of control alone does not determine whether health-relevant information is likely to be sought or acted on. Besides perceived controllability, individual differences in incurious worry reduction motives (IWRM) play an important role as well. Two different kinds of IWRM have been identified: focus on distress (IWRM-FD) and focus on relief (IWRM-FR). Dispositional tendencies toward IWRM-FD are associated with greater willingness to seek out information when risk is perceived as low (i.e., information about the potential external threat is expected to make one feel better), but a tendency to passively avoid any information when risk is considered high (i.e., information is expected to intensify distress). In contrast, tendencies toward IWRM-FR reflect wanting more information about potential threats when risk is believed to be high, while passively avoiding news when perceived risk is low. In regard to coping with perceived risk, IWRM-FD scores predict avoidant coping, whereas IWRM-FR levels are associated with proactive coping and seeking others’ advice.
Other risks are more “internal,” and involve threats to an individual’s certainty about his or her self-concept, purpose in life, or the wisdom of past behavior; in short, an “identity crisis.” Such threats underlie wondering things like “Who am I, really?” and are associated with less self-awareness, lower self-esteem, and greater overall distress. In response to internal threats, intrapersonal curiosity (InC) motivates individuals to engage in introspective self-exploration that may help them to clarify, to elaborate on, and to improve their understanding of their self-concept. Recent research has found that individual differences in InC are positively associated with IWRM, suggesting that dealing with identity crises involves the desire to better know oneself, as well as wishing to mitigate worries about experiencing self-doubt.
Bearing the above in mind, research on individual differences in tendencies to avail oneself of different coping strategies indicates that proactive coping (e.g., positive reframing, seeking advice) tends to result in beneficial outcomes, such as personal growth and improved health, but some proactive strategies are “double-edged” and may lead to some negative outcomes as well. In particular, proactive strategies like acceptance of one’s limitations or discussing them with others when seeking social support were helpful, but they also had the potential to leave individuals feeling less sure of themselves. These findings suggest that practitioners who wish to more effectively communicate information about risk of potential health threats should consider whether the nature of the threat is internal or external, the role of individual differences in IWRM and InC, and how to help their patients to focus on the positive benefits of acceptance (i.e., identify solvable problems) and seeking social support (i.e., acquiring useful advice) over the negative aspects (i.e., admitting limitations).
Metaphor equates two concepts or domains of concepts in an A is B form, such that a comparison is implied between the two parts leading to a transfer of features typically associated with B (called source) to A (called target). Metaphor is evident in written, spoken, gestural, and pictorial modalities. It is also present as latent patterns of thought in the form of conceptual mappings between domains of experience called conceptual metaphor. Metaphor is found commonly in a variety of health and risk communication contexts, including public discourse, public understanding and perceptions, medical encounters, and clinical assessment. Often metaphor use is beneficial to achieving desired message effects; however, sometimes its use in a message can lead to unintended undesirable effects. There is a general consensus, although not complete agreement, that metaphors in messages are processed through engagement with corresponding conceptual mappings. This matching process can be taken as a general principle for design of metaphor-based health and risk messages.
Melissa J. Robinson and Silvia Knobloch-Westerwick
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.
Julie E. Volkman
In health and risk communication, evidence is a message feature that can add credibility, realism, and legitimacy to health and risk messages. Evidence is usually defined into two types: statistical or narrative. Statistical evidence employs quantifications of events, places, phenomena, or other facts, while narrative evidence involves stories, anecdotes, cases, or testimonials. While many health and risk messages employ statistical or factual information, narrative evidence holds appeal for health and risk communication for its utility in helping individuals learn their risks and illnesses through stories and personal experiences. In particular, narratives employed as evidence in a health or risk message especially hold value for their ability to communicate experiences and share knowledge, attitudes, beliefs, and ideas about complex health issues, propose behavior change, and assist individuals coping with disease. As a result, the personal experiences shared, whether they are from first-hand knowledge, or recounting another’s experience, can focus attention, enhance comprehension for risks, and recall of health and risk information. Furthermore, readers engage with the story and develop their own emotional responses which may align with the purpose of the health and risk message. Narratives, or stories, can occur in many ways or through various points of view, but the stories that “ring true” to readers often have a sense of temporality, coherence, and fidelity. As a result, formative research and pre-testing of health and risk messages with narratives becomes important to understand individual perceptions related to the health issue and the characters (or points of view). Constructs of perceived similarity, interest, identification, transportation, and engagement are helpful to assess in order to maximize the usefulness and persuasiveness of narratives as evidence within a health and risk message. Additionally, understanding the emotional responses to narratives can also contribute to perceptions of imagery and vividness that can make the narrative appealing to readers. Examining what is a narrative as evidence in health and risk messages, how they are conceptualized and operationalized and used in health and risk messages is needed to understand their effectiveness.
Norms are regularized patterns of attitudes and behavior that characterize a group of individuals, separate the group from other groups of individuals, and prescribe and describe attitudes and behaviors for group members. Relying on social identity theory and self-categorization theory, the role played by group norms within groups and the processes by which such norms are promulgated within groups are discussed. Norm talk or the communication of normative information within groups is explored, as a major proportion of communication within groups is dedicated to clarifying ingroup identities and group attributes such as attitudes and behaviors that characterize the group. Group members can glean normative information by attending to norm talk for instance, by listening to the content of fellow group members’ communications, from their behavior, and from influential or prototypical sources within the group.
According to self-categorization theory, once individuals categorize themselves as members of a salient group or category, they represent normative information cognitively as ingroup prototypes. Prototypes are a fuzzy set of group attributes (such as attitudes and behaviors that characterize the group) and simultaneously minimize differences within groups while maximizing differences between groups. Thus, clear group prototypes help create distinct identities that are clearly demarcated from other groups. Group members should be especially attentive to information that flows from prototypical sources within groups—such as leaders and ingroup media sources—while efforts should be made to differentiate from marginal or deviant members who deviate from the prototype and reduce clarity of ingroup prototypes. The processes through which attending to information communicated by different sources within groups—both prototypical and non-prototypical—help group members seek normative information and clarification of ingroup prototypes are discussed.
Nathan A. Crick
Poststructuralism represents a set of attitudes and a style of critique that developed in critical response to the growth and identification of the logic of structural relations that underlie social institutions—whether they exist in terms of politics, economics, education, medicine, literature, or the sciences. Poststructuralism should therefore not be thought of as a distinct philosophy that exists separately as its own “structure”—a proposition that would undermine its most fundamental attitudes. Rather, poststructuralism should be thought of as developing or arising only in response to pre-existing structures and, as a set of attitudes, helping us better understand, interpret, and alter our social environment by calling established meanings into question, revealing the points of ambiguity and indeterminacy inherent in any system, rejecting the rationalistic piety that all systems are internally coherent and circle around an unchanging center, showing how discourses are carriers of power capable of turning us into subjects, and placing upon us the burden of ethical responsibility that accompanies the acceptance of freedom.
Although poststructuralism by its very nature as a set of attitudes denies any attempt at comprehensive definition, this essay examines three of the major postructuralist thinkers in order to relate their thought to the study of communication. First, following Derrida, poststructuralist thought invites a critical deconstruction of any discourse that presents itself as completely coherent, centered, and rational. Poststructuralist approaches thus do not argue against a position by harnessing counterarguments drawing on a different set of principles. Rather, it deconstructs a discourse by occupying it and exposing the gaps, contradictions, paradoxes, and deferments, thus revealing its established hierarchies, binaries, logical conclusions, and principles to be far more loosely structured and poly-vocal than its advocates wish to present them. Second, following Barthes, poststructuralism refuses to locate any single point of origin of any text that can ground its meaning—particularly by pointing to some ground of the author. Although not denying that writers exist, Barthes refuses to identify the meaning of a text with the author’s biography and intentions, instead inviting multiple interpretations from the perspective of individual readers who encounter the text as a unique event. Therefore, just as discourses do not have a unified structure, neither do individual texts or the authors that produce them. Lastly, following Fouacult, poststructuralism invites an inquiry into how discourses, texts, and acts of communication are always implicated in relations of power that act upon possible actions. Following the first two propositions, poststructuralism does not analyze these relations of power as completely structured and determinate, however. Power relations are always within a dynamic relationship with acts of resistance, thereby constantly leaving space for freedom and possibility.
Nathan A. Crick
When John Dewey announced that communication was the most wonderful of all affairs, he recognized the centrality of communication within the tradition of American pragmatism. In other traditions of philosophy, such as idealism or empiricism, communication certainly played a role, but usually it was a secondary function of transmitting ideas from one mind to another. In idealism, ideas were discovered through intuitive revelation of the whole and only later expressed through transcendent eloquence, whereas in empiricism, particular data was attained purely by the senses and communication served a kind of documentary function of fact gathering. Pragmatism, however, inverted this traditional hierarchy. By arguing that the meaning of our ideas was only found in their effects and consequences in experience, particularly those consequences brought about through shared experience, pragmatists made communication both the origin and consummation of knowledge—regardless if that knowledge was practical, scientific, aesthetic, or social. Consequently, pragmatists believed that improving the quality of communication practices was central to improving not only the state of knowledge but the quality of our experience living together in a common world.
Conversation analytic research on “preference organization” investigates recorded episodes of naturally occurring social interaction to elucidate how people systematically design their actions to either promote or undermine social solidarity. This line of work examines public forms of conduct that are highly generalized and institutionalized, not the private desires or preferences of individuals.
For each action a person does in interaction—be it sequence-initiating or sequence-responding—there are alternative ways of doing it. These alternatives are not, however, symmetrical or equally valued. Rather, each alternative has different implications for “face,” “affiliation,” and the relationship of the participants involved.
As an example of a sequence-initiating action, in accomplishing the transfer of something of value (e.g., a loan of money, a ride, information about fellow participants) from one person to another, a participant may do the action of offering, or requesting, that valued item. But the interactants do not treat these offering or requesting alternatives as equivalent. Several studies demonstrate that the social action of offering is “preferred” over the action of requesting. Participants display their orientation to actions as “preferred” by producing them straightforwardly—without delay, qualification, or account. Correlatively, participants treat actions as “dispreferred” by withholding, delaying, qualifying, and/or accounting for them. More specifically, when opening face-to-face encounters, participants treat offers of information as valued and thus “preferred” over requests for that information, because such offers engender solidarity by enabling people to feel included (rather than excluded): Offers of information identifying unfamiliar persons are preferred during introduction sequences; and when a newcomer arrives to an already-in-progress interaction, an already-present speaker’s offer of information about the previous activity/topic of that interaction is preferred.
As an example of a sequence-responding action, after a participant issues a request, the addressed-recipient can grant, or refuse, that request. Again, participants do not treat these alternative response types as equally valued. Whereas participants recurrently do the action of granting in the preferred format—as this response is usually affiliative and supportive of social solidarity, they tend to do the action of refusing in the dispreferred format, as this response is most often disaffiliative and destructive of social solidarity.
Preference organization research illuminates how interaction works in both casual and institutional settings. For an example of the latter, during parent-teacher conferences, there is a marked contrast between how parents and teachers do the actions of praising and criticizing students: Whereas teachers design their student-praising utterances in the preferred format, parents treat their articulation of student praise as dispreferred. Correspondingly, whereas teachers treat their student-criticizing utterances as dispreferred, parents routinely produce their student criticisms as preferred. This regular pattern of parent-teacher interaction constitutes an endogenous method for circumventing conflict. Research on preference organization thus empirically demonstrates that human interaction is organized to promote social affiliation at the expense of conflict.
Janet B. Ruscher
Prejudiced attitudes and stereotypic beliefs about outgroups can be reflected in language and everyday conversations. Explicit attitudes and beliefs may be expressed through use of group labels, dehumanizing metaphors, or prejudiced humor. More implicit attitudes and beliefs may be leaked through variations in sentence structure and subtle word choices. Empirical work shows that such prejudiced attitudes and stereotypic beliefs can spread within ingroup communities through one-on-one conversation as well as more broadly through vehicles such as news, the entertainment industry, and social media. Individuals also convey their prejudiced beliefs when communicating to outgroup members as message recipients. Outgroups who are members of historically disadvantaged groups, in particular, are targets of controlling or patronizing speech, biased feedback, and nonverbal behavior that leaks bias.