Michael Mackert, Sara Champlin, and Jisoo Ahn
Health literacy—defined as the ability of an individual to obtain, process, understand, and communicate about health information—contributes significantly to health outcomes and costs to the U.S. health-care system. Approximately one-quarter to one-half of U.S. adults struggle with health information, which includes understanding patient education materials, reading medication labels, and communicating with health-care providers. Low health literacy is more common among the elderly, those who speak English as a second language, and those of lower socioeconomic status. In addition to conceptualizing health literacy as an individual-level skill, it can also be considered an organizational or community-level ability.
Increased attention to the field of health literacy has resulted in debates about the definition and the best ways to assess health literacy; there is also a strong and growing movement within the field of health literacy research and practice to frame health literacy less as a deficit to overcome and more as an approach to empowering patients and improving outcomes. As health-care providers have recognized the importance of health literacy, workshops, and training programs have been developed and evaluated to improve the care of low-health-literate patients. Similarly, health promotion professionals have developed best practices for reaching low-health-literate audiences with traditional and new digital media, which can also increase access for patients with hearing or visual impairments. Additionally, recent policy changes in the United States, including those related to the Affordable Care Act, contribute to a greater focus and regulation of factors that impact health literacy. Researchers and practitioners together are advancing understanding of health literacy, its relationship to health outcomes and health-care costs, and improved strategies for improving the health of lower health literate patients. Development and review of health literacy pieces can aid in shared decision making and provide insights for patients on various health-care services.
Dennis Myers, Terry A. Wolfer, and Maria L. Hogan
A complex web of attitudinal, cultural, economic, and structural variables condition the decision to respond to communications promoting healthy behavior and participation in risk reduction initiatives. A wide array of governmental, corporate, and voluntary sector health-related organizations focus on effective messaging and health care options, increasing the likelihood of choices that generate and sustain wellness. Researchers also recognize the significant and multifaceted ways that religious congregations contribute to awareness and adoption of health-promoting behaviors. These religiously based organizations are credible disseminators of health education information and accessible providers of venues that facilitate wellness among congregants and community members. The religious beliefs, spirituality, and faith practices at the core of congregational cultural life explain the trustworthiness of their messaging, the health of their adherents, and the intention of their care provision.
Considerable inquiry into the impact of religion and spirituality on health reveals substantive correlations with positive psychological factors known to sustain physical and psychological health—optimism, meaning and purpose, hope, well-being, self-esteem, gratefulness, social support, and marital stability. However, the beliefs and practices that create receptivity to health-related communications, care practices, and service provision can also be a deterrent to message impact and participation in healthy behaviors. When a productive relationship between spirituality and health exists, congregational membership offers rituals (e.g., worship, education, mission) and relationships that promote spiritual well-being. Research demonstrates increased life satisfaction and meaning in life, with health risk reduction associated with a sense of belonging, enriched social interactions, and shared experiences.
Congregations communicate their commitment to wellness of congregants and community members alike through offering a variety of congregationally based and collaborative wellness and risk reduction programs. These expressions of investment in individual and community health range across all age, gender, and ethnic demographics and address most of the prominent diagnostic categories. These programs are ordered along three dimensions: primary prevention (health care messaging and education), secondary prevention (risk education), and tertiary prevention (treatment). Applying the dimensions of sponsorship, goal/mission, focus, services, staffing, and intended outcome highlights the similarities and differences among them. Several unique facets of congregational life energize the effectiveness of these programs. Inherent trust and credibility empower adherence, and participation decisions and financial investment provide service availability. These assets serve as attractive contributions in collaborations among congregations and between private and public health care providers.
Current research has not yet documented the best practices associated with program viability. However, practice wisdom in the planning, implementation, and evaluation of congregationally based and collaborative health-related programs suggests guidelines for future investigation. Congregational leaders and health care professionals emphasize well-designed needs assessment. Effective congregational health promotion and risk reduction may be linked to the availability and expertise of professionals and volunteers enacting the roles of planner/program developer, facilitator, convener/mediator, care manager/advocate, health educator, and direct health care service provider.
Lily A. Arasaratnam
The phrase “intercultural competence” typically describes one’s effective and appropriate engagement with cultural differences. Intercultural competence has been studied as residing within a person (i.e., encompassing cognitive, affective, and behavioral capabilities of a person) and as a product of a context (i.e., co-created by the people and contextual factors involved in a particular situation). Definitions of intercultural competence are as varied. There is, however, sufficient consensus amongst these variations to conclude that there is at least some collective understanding of what intercultural competence is. In “Conceptualizing Intercultural Competence,” Spitzberg and Chagnon define intercultural competence as, “the appropriate and effective management of interaction between people who, to some degree or another, represent different or divergent affective, cognitive, and behavioral orientations to the world” (p. 7). In the discipline of communication, intercultural communication competence (ICC) has been a subject of study for more than five decades. Over this time, many have identified a number of variables that contribute to ICC, theoretical models of ICC, and quantitative instruments to measure ICC. While research in the discipline of communication has made a significant contribution to our understanding of ICC, a well-rounded discussion of intercultural competence cannot ignore the contribution of other disciplines to this subject. Our present understanding of intercultural competence comes from a number of disciplines, such as communication, cross-cultural psychology, social psychology, linguistics, anthropology, and education, to name a few.
Conflict, as part of interpersonal interactions, occurs in specific cultural settings. Viewing conflict as cultural behavior helps explain why disputes over seemingly similar issues can be handled so dissimilarly in different cultures. There have been numerous cross-cultural comparison studies of different conflict management strategies, most of them utilizing a “national culture” approach. The findings reported in the cross-cultural conflict literature point to a picture that collectivists value harmonious interpersonal relationships with others, preferring indirect or avoiding styles of dealing with conflict and showing concern for face-saving. Understanding the range of behavior choices and strategies available to manage conflict as well as differences in preferred styles adds considerably to people’s skills as effective communicators.
Following the devastation of World War II, policymakers and scholars worked to advance international partnerships and mutual understanding. In the 1940s and 1950s, international student exchange programs were launched to foster international good will; training programs for diplomats were created that focused on intercultural communication competence; and researchers turned their attention on how to optimize intergroup relations. Most prominently, Gordon Allport outlined principles of effective intergroup contact in the contact hypothesis. Scholarship based on the contact hypothesis later determined that the potential for friendship is not only a facilitating but also an essential factor for prejudice reduction and optimal intergroup contact. Focusing largely on the friendship experiences of international students studying abroad, research also identified numerous other benefits of intercultural-friendship formation, including stronger language skills, greater life satisfaction, lower levels of stress, and enhanced perceptions of the host country. Despite these benefits, the lack of friendship between sojourners and host nationals is a common finding in intercultural-friendship research and a concern for the many educational institutions worldwide that are attempting to internationalize, in part by attracting international students. Current research, therefore, often focuses on factors that influence intercultural-friendship formation and, increasingly, on measures for promoting intercultural friendship.
First among the factors affecting the development of intercultural friendships is cultural difference. Cultural similarity provides attributional confidence and reduces uncertainty; that is, interactants can more easily predict and explain behaviors in people who are similar to them. Highly dissimilar cultures often exhibit differences in communication patterns, value dimensions, and friendship styles that can impede relationship development, especially in the orientation and exploratory stages of social penetration, during which cultural complexities are most critical. Another prominent factor is the interactants’ motivation to form relationships across cultural lines. In one of the prime arenas for intercultural contact, international student exchange, for example, sojourners seeking cultural knowledge and personal growth generally have more interest in interaction and friendships with host nationals than students who are task oriented and focus on education for better career prospects after returning home. Similarly, host environment factors, such as host receptivity (ranging from welcoming attitudes to discrimination) influence the likelihood with which intercultural friendships are formed. Other factors affecting intercultural-friendship formation include communicative competence, intercultural sensitivity, and aspects of identity and personality (e.g., cultural versus personal identification, empathy, and open-mindedness). Among measures for promoting intercultural-friendship formation are infrastructures that facilitate proximity and frequency of contact, provide foreign language training, support experience abroad, and offer intercultural education and training to further intercultural competence and the appreciation of difference.
Malgorzata Lahti and Maarit Valo
The workplace is a highly meaningful context for intercultural communication where persons who come from different countries, identify with different ethnic groups or speak different languages get to collaborate and develop relationships with one another. Needless to say, interpersonal communication in the workplace has always been a primary area of interest for intercultural communication research.
Early scholarship focused on the preparation of U.S. military personnel, diplomats, business people, and missionaries for overseas assignments. However, the increasing pluralization of the social landscape has bolstered research endeavors. These days, the scope of intercultural workplace communication inquiry comprises everyday face-to-face and technology-mediated interactions in encounters, relationships, groups, and teams in a variety of working arrangements, and across a range of public and private sector organizations worldwide. The scholarship also draws on the organizational approaches of antidiscrimination and diversity management that emerged in the United States and have subsequently been exported to and reinterpreted in workplaces around the world.
Researchers have looked into such workplace communication processes and phenomena as social categorization, stereotyping, prejudice and discrimination, conflict and its management, organizational satisfaction and identification, socialization, supportive communication, interpersonal relationship development and informal interaction, negotiation of shared workplace culture, knowledge sharing, decision-making, learning and innovation, or leadership and management. In recent years, there has been a growing interest in the ways languages are used in interactions at work.
Federica Pieragostini, Bruno Gabriel Salvador Casara, and Caterina Suitner
Globalization is making interethnic communication an increasingly widespread issue. The reduction of actual and psychological distances due to migratory flows and media communication increases contact opportunities between individuals from different ethnic groups. Communication between members belonging to different ethnic groups can also be considered a challenge as it brings in more general intergroup controversies. Ethnicity affects both verbal and nonverbal communication at different intensity levels. For example, using verbal communication, interethnic conflict may emerge through the use of hate speech, and—at a lower intensity level—may also emerge by the subtle use of pronouns (e.g., avoiding the use of “we” to exclude members of other groups). Similarly, in nonverbal communication, interethnic conflicts may strongly be evident in explicit exclusion behaviors, but also in subtler cues such as by enhancing spatial distance from persons belonging to other groups. Ethnic identities and their implications are also evident in and influenced by mass media narratives, which mirror, establish, and perpetuate inequalities and discrimination. Interethnic communication is therefore a challenge and an opportunity to understand and to improve relationships between ethnic groups.
The focus of intergroup communication research in the Baltic countries is on interethnic relations. All three countries have Russian-speaking urban minorities whose process of integration with Estonian, Latvian, and Lithuanian majorities has been extensively studied. During the Soviet era when the Russian-speaking communities in the Baltic countries were formed, they enjoyed majority status and privileges. After the collapse of the Soviet Union, there was a status reversal as Russian speakers become minorities in the newly emerged national states. The integration of once monolingual Russian-speaking communities has been the major social challenge for the Baltic states, particularly for Estonia and Latvia where they constitute about 30% of the population. Besides the Russian-speaking minorities, each of the Baltic countries has also one other significant minority. In Estonia it is Võro, a linguistically closely related group to Estonians; in Latvia it is Latgalians, closely related to Latvians; and in Lithuania, it is the Polish minority. Unlike the Russian-speaking urban minorities of fairly recent origin, the other minorities are largely rural and native in their territories.
The intergroup communication between the majorities and Russian-speaking minorities in the Baltic countries has often analyzed by a triadic nexus consisting of the minority, the nationalizing state, and the external homeland (Russia). In recent analyses, the European Union (through its institutions) has often been added as an additional player. The intergroup communication between the majorities and the Russian-speaking communities is strongly affected by conflicting collective memories over 20th-century history. While the titular nations see the Soviet time as occupation, the Russian speakers prefer to see the positive role of the Soviet Union in defeating Hitler and reconstructing the countries’ economy. These differences have resulted in some symbolic violence such as relocation of the Bronze Soldier monument in Estonia and the riots that it provoked. Recent annexation of Crimea by the Russian Federation and the role of the Ukrainian Russian speakers in the secessionist war in the Eastern Ukraine have raised fears that Russia is trying to use its influence over its compatriots in the Baltic countries for similar ends. At the same time, the native minorities of Võro and Latgalians are going through emancipation and have demanded more recognition. This movement is seen by some among the Estonian and Latvian majorities as attempts to weaken the national communities that are already in trouble with integrating the Russian speakers. In Lithuania, some historical disagreements exist also between the Lithuanians and Polish, since the area of their settlement around capital Vilnius used to be part of Poland before World War II. The Baltic setting is particularly interesting for intergroup communication purposes, since the three countries have several historical parallels: the Russian-speaking communities have fairly similar origin, but different size and prominence, as do the titular groups. These differences in the power balance between the majority and minority have been one of the major factors that have motivated different rhetoric by the nationalizing states, which has resulted in noticeably different outcomes in each setting.
Culture is a broad term that is often used in a wide variety of contexts. Its meanings can be anything from very narrow conceptualizations such as the notion of high culture to a much broader view of culture being all-encompassing. In addition, scholars identify different types of cultures, such as regional, national, or even global cultures, as well as sub-cultures or cultures of shared social practices. At the social systems level, culture is often defined as relating to shared social practices, meanings, beliefs, symbols and norms. The relationship between journalism, culture, and society is a symbiotic one. Journalism influences culture, but it is also influenced by it. In fact, as some argue, journalism is culture.
While journalism’s influence on culture has found extensive attention in the cultural studies literature, cultural and societal influences on journalism have been far less researched. When studies examine broader media system influences on journalism, the focus tends to be on political and economic determinants. However, cultural influences also provide substantial explanatory potential when trying to understand why journalism is practiced differently across the globe. Culture as the broader system of beliefs and practices in a given society, as in the case of cultural values, has an established research tradition in cross-cultural psychology. Three key works on cultural values provide guidance for examining cultural influences on journalism, and involving these in research improves understanding of journalism cultures on a variety of levels. Both normative calls for the preferred role of culture in journalism, as well as empirical studies of the influence of cultural values on journalism demonstrate the value such approaches bring to journalism studies.
Ee Lin Lee
Language is an arbitrary and conventional symbolic resource situated within a cultural system. While it marks speakers’ different assumptions and worldviews, it also creates much tension in communication. Therefore, scholars have long sought to understand the role of language in human communication. Communication researchers, as well as those from other disciplines (e.g., linguistics, anthropology, psychology, and sociology), draw on each other’s works to study language and culture. The interdisciplinary nature of the works results in the use of various research methods and theoretical frameworks. Therefore, the main goal of this essay is to sketch the history and evolution of the study of language and culture in the communication discipline in the United States.
Due to space constraints only select works, particularly those that are considered landmarks in the field, are highlighted here. The fundamentals of language and the development of the Sapir–Whorf hypothesis in leading to the formation of the language and social interaction (LSI) discipline are briefly described. The main areas of LSI study—namely language pragmatics, conversation analysis, discourse analysis, and the ethnography of communication—are summarized. Particular attention is paid to several influential theories and analytical frameworks: the speech act theory, Grice’s maxims of implicatures, politeness theory, discursive psychology, critical discourse analysis, the ethnography of speaking, speech codes theory, and cultural discourse analysis. Criticisms and debates about the trends and directions of the scholarship are also examined.