Patric R. Spence, David Westerman, and Robert G. Rice
Humans often prefer representations that are cognitively easier to store, and such representations are easier to retrieve later to make judgments about the social world. Exemplification theory draws on physiological memory mechanisms and argues that simple, iconic, concrete, and emotionally arousing depictions of events (exemplars) are favored and thus more likely to be stored and used than are abstract, inconsequential depictions or representations. Inconsequential information or representations are forgotten because they are not processed as being essential for survival. Exemplified events vary on a continuum of how accurately they represent a larger occurrence of events. Through specific uses of pictures, quotes and other depictive strategies, concrete, iconic, and emotionally arousing information is often added to a story. Research has documented the strength of specific exemplars in creating inaccurate estimations of events and perceptions of severity and susceptibility. Moreover, in the presence of a risk, portrayals with exemplars have been shown to motivate individuals to intend to change behavior. Exemplification is a strong theory that is understudied and underutilized. The theory has strong explanatory, predictive, and organizing power, and it has application to phenomena in contexts such as media effects, persuasion, crisis and risk communication, health communication and public relations.
Alice M. Kiger, Donna M. Fagan, and Edwin R. van Teijlingen
Faith communities play an important role in health promotion in some parts of the world, notably North America and sub-Saharan Africa. They appear to be less prominent in the United Kingdom, despite the fact that it is a high-income country with a well-developed national public health system. Faith communities can be instigators of health promotion (faith-based health promotion), or they can provide settings where other agencies can conduct health promotion (faith-placed health promotion). Key opportunities and barriers for faith-based and faith-placed health promotion can be found by drawing on examples from the United States and Africa.
Fatalism is a set of beliefs that encompasses such dimensions as predestination, pessimism, and attribution of one’s health (life events) to luck. Locus of control refers to the extent to which individuals believe they are in control of events that affect them. Individuals with an external locus of control perceive their life is controlled by environmental factors they can’t change, or by chance or fate. Fatalism and external locus of control are both negatively associated with health behaviors and health outcomes; and contribute to health disparities due to the link between culture and socio-economic factors.
Jessica Gall Myrick and Robin L. Nabi
Fear is a negatively valenced discrete emotional state that is an inherent part of the human experience. With strong evolutionary roots, fear serves important functions, including alerting people to present threats and motivating action to avoid future threats. As such, fear is an emotion that frequently attracts the attention of scholars and message designers who hope to persuade audiences to change their behavior in light of potential threats to well-being and public safety. Several theories have aimed to describe the effects of fear-based appeals on audiences, focusing largely on the cognitive correlates of fear (i.e., severity and susceptibility) and their subsequent impacts on persuasive outcomes. However, more recent theorizing has returned to a focus on the influence that the emotion of fear itself has on attitude and behavior change. Given that many health-oriented fear appeals have been shown to evoke multiple emotions, including anger, disgust, and sadness, current theorizing has taken a mixed-emotions or emotional flow perspective to provide a deeper understanding of fear appeal effects. Further, individual differences have been considered to determine who is most likely to experience fear during and after message consumption.
In addition to fear appeals that purposefully aim to scare audiences to motivate attitude and behavior change, recent work suggests that fear can be generated by other forms of messages (e.g., news accounts, social media posts, interpersonal conversations) that may influence receivers’ approaches to health issues. Moreover, research also suggests that fear may motivate social sharing of messages, which can in turn allow for more widespread influence of fear-based messages.
Douglas L. Kelley, Bianca M. Wolf, and Shelby E. Broberg
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.
E. Michele Ramsey
Given the impact of gender on health, healthcare decisions, and treatments for illness, as well as the increased inequities encountered by non-white men and women, messages about health and health risks are affected by purposeful assumptions about gender identity. While the term sex denotes the biological sex of an individual, gender identity is about the psychological, cultural, and social assumptions about a person associated with that person because of his or her sex. Gender and health are intimately connected in a number of ways, and such connections can differ based on race, ethnicity, age, class, religion, region, country, and even continent. Thus, understanding the myriad ways that notions of gender affect the health of females and males is fundamental to understanding how communicating about risks and prevention may be tailored to each group.
Gender role expectations and assumptions have serious impacts on men’s health and life expectancy rates, including self-destructive behaviors associated with mental health and tobacco use, self-neglecting behaviors linked to the reluctance of men to seek treatment for ailments, reluctance to follow a physician’s instructions after finally seeking help, and risk-taking behaviors linked to drug and alcohol use, fast driving, guns, physical aggression, and other dangerous endeavors. Because gender role expectations tend to disfavor females, it is not surprising that gender generally has an even greater impact on women’s health than on men’s. Even though biological factors allow women, on average, to live longer than men worldwide, various gendered practices (social, legal, criminal, and unethical) have serious impacts on the lives and health of women. From sex discrimination in research and treatment regarding issues linked to reproductive health, depression, sexual abuse, alcohol and drug abuse, the sex trade, and normalized violence against women (such as rape, female genital mutilation, forced prostitution/trafficking, and domestic violence), women’s lives across the globe are severely affected by gender role expectations that privilege males over females.
While some general consistencies in the relationships between gender, women, and health are experienced worldwide, intersections of race, ethnicity, class, age, country, region, and religion can make for very different experiences of women globally, and even within the same country.
The recent years have seen an increasing call to reconsider the binary means by which we have defined sex and gender. Advances in our understandings of lesbian, gay, bisexual, intersex, and transgendered individuals have challenged traditional notions and definitions of sex and gender in important and complex ways. Such an important shift warrants a stand-alone discussion, as well as the recognition that sexual orientation should not be automatically linked to discussions of sex and gender, given that such categorization reifies the problematic sex/gender binaries that ground sexist and homophobic attitudes in the first place.
Worldwide, key behavioral risk factors for ill-health and premature death include smoking, alcohol, too much or too little of several dietary factors, and low physical activity. At least three structural factors (biological attributes and functions, population size and structure, and wealth and income disparities) modify the global impact that the risk factors have on health; without accounting for these structural drivers, the effect of government-driven incentives to act on the behavioral risk factors for improved health will be suboptimal. The risk factors and their impact on health are further driven by malleable circumstantial drivers, including technological developments, exposure to products, social influences and attitudes, and potency of products. Government-driven incentives, which can be both positive and negative, can act on the circumstantial drivers and can impact on the behavioral risk factors to improve or worsen health. Government-driven incentives include a range of policies and measures: policies that reduce exposure; regulation of the private sector; research and development to reduce potency; resource allocation for advice and treatment; direct incentives on individual behavior; and, managing co-benefits and adverse side effects. Within a framework of government-driven whole-of-society approaches to improve health, an accountability system is needed to identify who or what causes what harm to health to whom. A health footprint, modeled on the carbon footprint is proposed as the accounting system.
Paul Sebastian Ruppel and Günter Mey
Grounded theory methodology is one of the most widely used approaches to collect and analyze data within qualitative research. It can be characterized as a framework for study design, data collection, and analysis, which aims at the development of middle-range theories. The final result of such a study is called a “grounded theory,” and it consists of categories that are related to each other.
Health and risk message design researchers working with grounded theory methodology are explicitly invited to use any kind of data they consider suitable for a particular project. Grounded theory methodology studies were originally based on intense fieldwork data, but in the meantime, interviews have become the most widely used type of data. In addition, there is a growing interest in using visual data such as pictures or film. Grounded theory methodology originated from sociology, but has since been applied in many different disciplines. This widened application went along with modifications, new developments, and innovations, and led to several current variants of grounded theory methodology.
Basic features of grounded theory methodology include theoretical sampling, specific coding procedures with a comparative approach to analysis, and memo writing. The strategy of theoretical sampling requires that theoretical insights gained from the analysis of initially collected data guide subsequent data collection. Hence, during the research process data collection and analysis alternate and interact. For data analysis, different ways of coding enable the researcher to develop increasingly abstract conceptual ideas and reflections, first embodied in codes, later in categories. This analytical process allows for a step-by-step development of categories that are grounded in data. Category development entails comparisons at all stages, for example, of different cases during sampling, of different data pieces, and of different codes and categories during analysis. As a result, grounded theory methodology is also known as the constant comparative method. Throughout the research process the researcher writes memos and keeps track of the development of conceptual ideas, methodological reflections, and practical to-dos. Today, many researchers use software specifically developed to assist the process of qualitative data analysis.
Roxanne L. Parrott
Health and risk policymaking focuses on decisions made and actions undertaken to set standards and pass laws to promote healthcare and public health quality, while achieving global health security. Policymakers in governments and institutions deliberate for the purposes of achieving effective and efficient policies, revealing both acceptance and rejection of evidence from health and risk, prevention, and economic sciences, as well as gaps in these domains. Health and risk communicators function implicitly within the boundaries of these decisions and actions, while contributing to prevention science related to strategic messaging and information dissemination. Policymakers face barriers to their efforts residing in the sheer volume of health and risk sciences research; the lack of evidence demonstrating that policies lead to intended outcomes (often, because a policy has not been trialed/implemented); and the absence of economic analyses associated with costs of interventions proposed and undertaken. The precautionary principle (PP) based on adopting caution when evidence is absent, uncertain, or ambiguous regarding possible harm to humans or the environment may function as a guide in some situations. Advocates may draw attention to particular issues in other cases. Policies may be stalled owing to the policy context, including election cycles, legislative and institutional bureaucracies, competing agendas, and fragmented systems of healthcare. Health and risk communicators may collaborate with policymakers and work to translate evidence into useful formats to facilitate the application of evidence to policymaking decisions and actions.
Kevin Real and Andy Pilny
Effective communication in health care teams is central to the delivery of high-quality, safe, dependable, and efficient patient care. Understanding how health care team communication operates within healthcare systems is important. Viewing health care teams in hospital settings as creators and channels for diffusions of health and risk messages is an important contribution to health communication scholarship. Health care teams are essential elements of healthcare systems. In many instances, they are components of multiteam systems embedded within larger network ecosystems. These teams are not identical, thus, considering how team type (e.g., unidisciplinary, multidisciplinary, interdisciplinary) shapes distinct communication processes offers a better understanding of how these teams facilitate health and risk message diffusion. TeamSTEPPS is an important framework for essential teamwork behaviors that facilitate team processes in healthcare systems. Significantly, we develop specific communication competencies drawn from observation work that facilitate health care team effectiveness. Ideas developed by Kurt Lewin are utilized to consider how different types of multiteam systems can be effective as channels and facilitators of health and risk messages. We end the chapter with examples from field research. A set of hospital nursing unidisciplinary teams comprise a network of teams that form a heterarchical structure with important messages flowing between teams. An innovative form of hospital interdisciplinary rounds relies on specific communication practices to create and exchange health and risk messages to patients, families, health care team members, and other healthcare stakeholders.