M. Jeffrey Farrar, Yao Guan, and Kaitlyn Erhardt
Humans live not only in a physical world but also in a mental world. Theory of mind reflects the understanding that the mind is comprised of different mental states, such as intentions, desires, and beliefs. This conception of the mind is a critical achievement in human development because it directly impacts effective communication and social interaction. It allows for the understanding of others’ behaviors by inferring their mental states. The formation of a theory of mind has been a central topic in psychology, neuroscience, cognitive science, and philosophy. It impacts related processes, such as communication skills, perspective-taking ability, and social cognition.
Across the life span, the understanding of the mind becomes increasingly complex. Early in development, infants and toddlers can discern the intentions of others. Later, more sophisticated reasoning about the mental states of others becomes possible. For instance, the ability to follow and understand the recursive thought that “Sam believes, that Mary said, that Jose wanted . . .” develops. Additionally, within distinctive developmental time periods, people differ in their ability to take into account mental states. Once people’s beliefs, including their misconceptions, are identified, it is possible to generate effective communication strategies designed to teach, learn, and even reduce risk-taking behaviors.
Nancy Grant Harrington
Sensation seeking is a biologically based personality trait that is characterized by the need to seek a variety of sensations and experiences and the willingness to take risks to achieve them. There is a large volume of literature on sensation seeking that delineates important conceptual and operational distinctions, including several prominent measures of sensation seeking. Issues related to research design and data analysis include whether researchers treat sensation seeking as an independent or dependent variable, use total scale versus subscale scores in analyses, treat scores as continuous or grouped variables, and consider demographic variables in their analyses. Research may relate sensation seeking to a range of behaviors, from maladaptive behaviors such as substance use and risky sex to more neutral or even adaptive behaviors such as preferences for music and art or preferences for certain careers. Research may establish a genetic basis for sensation seeking and/or associate sensation seeking with neurological and physiological responsiveness. Research also explores the associations of sensation seeking to perceptions of risk, as well as the sex and age of individuals and groups in an international context.
“Rehabilitation groups” refers to community-based organizations which substantially rely on the work of volunteers to assist people with disabilities towards functional independence. One may differentiate between rehabilitation groups and clinical healthcare services by categorizing clinical services as being predominantly concerned with treatments designed to lower symptoms and cure ill health. Alternatively, rehabilitation groups focus their attention on delivering programs designed to assist people in regaining “functional independence” with or without the ongoing presence of symptoms. Common programs rehabilitation groups deliver are described as including but not being limited to the following:
• Mental health rehabilitation: assisting people with lived experience of mental illness towards social and emotional wellbeing.
• Drug and alcohol rehabilitation: facilitating recovery from abuse of and dependency on psychoactive substances such as alcohol and other drugs.
• Physical health rehabilitation: improving physical and/or neurocognitive functions that have been diminished by ongoing effects of disease or injury.
Major themes of communication influence rehabilitation groups and there are connections between the daily work of rehabilitation groups and the theoretical paradigms that influence them. Theoretical paradigms include social disability theory, recovery-oriented care, person-centered care, and cultural materialism.
James E. Grunig and Jeong-Nam Kim
The concept of publics and related notions such as receivers, audiences, stakeholders, mass, markets, target groups, and the public sphere are central to any discussion of formal communication programs between organizations or other strategic communicators and the individuals or groups with which they strive to communicate. The concept explains why individuals and collectivities of individuals are motivated to communicate for themselves (to seek or otherwise acquire information), with similar individuals to form organized groups, and with formal organizations to make demands on those organizations or to shape the behavior of the organizations. Theories of publics originated in the 1920s as the result of debates over the nature of citizen participation in a democracy, the role of the mass media in forming public opinion, the role of public relations practitioners in the process, and the effects of communicated messages on publics, audiences, and other components of society. J. Grunig developed a situational theory of publics in the 1960s that has served as the most prominent theory of publics for 50 years, and J.-N. Kim and J. Grunig recently have expanded that theory into a situational theory of problem solving. These theories have been used to identify and segment types of publics, to explain the communication behaviors of those publics, to conceptualize the effects of formal communication programs, to understand the cognitive processes of members of publics, and to explain the development of activist groups. Other scholars have suggested additions to these theories or alternatives to more thoroughly explain how communication takes place between members of publics and to identify latent publics that are largely ignored in the situational theories.
Shirley S. Ho and Andrew Z. H. Yee
Health communication research has often focused on how features of persuasive health messages can directly influence the intended target audience of the messages. However, scholars examining presumed media influence on human behavior have underscored the need to think about how various audience’s health behavior can be unexpectedly influenced by their exposure to media messages. Two central theoretical frameworks have been used to guide research examining the unintended effects: the third-person effect and the influence of presumed media influence (IPMI). The theoretical explanations for presumed media influence is built on attribution bias, self-enhancement, perceived exposure, perceived relevance, and self-categorization. Even though both the third-person effect and the IPMI share some theoretical foundations, and are historically related, the IPMI has been argued to be better suited to explaining a broader variety of behavioral consequences. One major way that presumed media influence can affect an individual’s health behavior is through the shifting of various types of normative beliefs: descriptive, subjective, injunctive, and personal norms. These beliefs can manifest through normative pressure that is theoretically linked to behavioral intentions. In other words, media have the capability to create the perception that certain behaviors are prevalent, inculcating a normative belief that can lead to the uptake of, or restrain, health behaviors. Scholars examining presumed media influence have since provided empirical support in a number of specific media and behavioral health contexts. Existing findings provide a useful base for health communication practitioners to think about how presumed media influence can be integrated into health campaigns and message design. Despite the proliferation of research in this area, there remains a need for future research to examine these effects in a new media environment, to extend research into a greater number of health outcomes, to incorporate actual behavioral measures, and to ascertain the hypothesized causal chain of events in the model.
Mengfei Guan and Jennifer L. Monahan
Positive emotional appeals can be an important, if often underutilized, component in health campaigns. Research reviewed from advertising, marketing, health communication, and social influence demonstrated how campaigns can promote risk-reduction behaviors by focusing on positive incentives, highlighting positive outcomes, and evoking positive feelings toward the health-related behavior. People who feel good during and after exposure to a health message tend to have favorable attitudes toward the message, which in turn establishes more open, rather than resistant, attitudes toward the issue or risk-reduction behavior promoted in the message. Along with influencing behavior via attitudes, positive affect can have a direct impact on behavior or intention. As suggested by broaden-and-build theory, positive affect broadens attention and thinking processes, increases openness to information, and helps form beliefs that the behavioral change promoted in the message is possible. Relatedly, positive affect tends to activate approach-oriented behaviors through the function of the behavioral activation system.
Two primary strategies have demonstrated efficacy at promoting positive feelings: the use of gain-framed appeals and evoking the core relational theme of happiness. Gain-framed appeals emphasize the rewards obtained by following message recommendations and can boost behavioral adoption, particularly of proscriptive behaviors, by highlighting positive outcomes and goal congruency. Happiness occurs when people believe they are making progress toward realizing their goals, and messages can be created to induce positive feelings like happiness by focusing on self-efficacy, response efficacy, and perceived benefits. Positive message appeals are especially useful for counteracting the potential drawbacks of traditional negative appeals in that they can reduce message fatigue, gain attention, and attenuate psychological reactance. Challenges for future research include increasing efforts to systematically understand how and when to best utilize the power of positive messages in campaigns. Another related challenge is to examine how positive affect is aroused at a particular stage of exposure to health risk messages, and how emotions (both negative and positive), flow, evolve, and transit from one to another (e.g., fear to relief, anxiety to happiness) during and after message exposure.
William Mosley-Jensen and Edward Panetta
Health professionals and the public puzzle through new or controversial issues by deploying patterns of reasoning that are found in a variety of social contexts. While particular issues and vocabulary may require field specific training, the patterns of reasoning used by health advocates and authors reflect rhetorical forms found in society at large. The choices made by speakers often impact the types of evidence used in constructing an argument. For scholars interested in issues of policy, attending to the construction of arguments and the dominant cultural modes of reasoning can help expand the understanding of a persuasive argument in a health context. Argumentation scholars have been attentive to the patterns of reasoning for centuries. Deductive and inductive reasoning have been the most widely studied patterns in the disciplines of communication, philosophy, and psychology. The choice of reasoning, from generalization to specific case or from specific case to generalization, is often portrayed as an exclusive one. The classical pattern of deductive reasoning is the syllogism. Since its introduction to the field of communication in 1957, the Toulmin model has been the most impactful device used by critics to map inductive reasoning. Both deductive and inductive modes of argumentative reasoning draw upon implicit, explicit, and affective reasoning. While the traditional study of reasoning focused on the individual choice of a pattern of reasoning to represent a claim, in the last 40 years, there has been increasing attention to social deliberative reasoning in the field of communication. The study of social (public) deliberative reasoning allows argument scholars to trace patterns of argument that explain policy decisions that can, in some cases, exclude some rhetorical voices in public controversies, including matters of health and welfare.
Natoshia Askelson and Erica Spies
Parents can be the target of health and risk messages about their children and can be a channel by which children hear health messages. This dual role can make parents powerful agents for change in children’s health. Parents receive health messages from a variety of sources including health care providers, schools, the media, the government, and family. Parents tend to be a more frequent target for health messages when their children are infants or young. They receive many messages related to keeping their children safe. Most of these messages are not developed as part of a rigorous data-driven and theory-based intervention and often lack sophisticated message development and design. Furthermore, instead of segmenting parents and tailoring messages, parents are frequently treated as a monolith, with no diversity related to behavior or communication.
As children age, parents can become the channel by which children can hear a health message. Parents of school-age children and adolescents are continually communicating messages to their children and are often targeted to communicate messages related to health or risk behaviors. Intentional efforts to encourage parents to talk to their children are often related to risk behaviors among older children. Specifically, parents are asked to convey messages about sexual health, alcohol and drug use, and driving. Evidence points to parent–child communication in general and communication about specific risk behaviors as protective for children. Research has also suggested that adolescents want to hear health messages from their parents. Parents are a natural choice to communicate about health and risk throughout childhood and adolescence due to the parent–child relationship and the influence parents can have over children. However, this special relationship does not automatically translate into parents having good communication skills. Messages designed to encourage parents to communicate with their children about a health topic have often been developed with the assumption that parents know what to communicate and how to effectively communicate with their children. Deficits in communication skills among parents have been recognized by some campaign developers, and an emphasis on developing those skills has been a significant part of some messages targeting parents. Health communication campaigns have been developed to inform parents about when and how to talk to their children about health issues such as alcohol, drugs, and sex. Unfortunately, not all parent–child communication is positive or effective and this can have potential unintended consequences. Treating parents as an audience in a more nuanced manner, with greater emphasis on evidence-based message development, could result in more effective messages and better health outcomes.
Amanda J. Dillard and Erin M. Ellis
When individuals are asked whether they will someday own their own home, enjoy a productive career, or develop a myriad of diseases, many are optimistic. Generally, they think they will experience more good than bad outcomes in life and they view themselves as more likely than similar others to experience the good things and less likely than others to experience the bad things. In the area of health behavior and communication, there are three primary types of optimism that have been defined and operationalized: (1) Dispositional optimism is the generalized positive expectancy that one will experience good outcomes. (2) Comparative optimism refers to the belief that one is either more likely than others to experience positive events or less likely than others to experience negative events. (3) Unrealistic optimism refers to an underestimation of one’s actual risk of experiencing some negative event. Although the three types of optimism may be correlated, their associations may be modest. Also, unlike dispositional optimism, which is an individual difference, comparative and unrealistic optimism are often risk perceptions about specific events and therefore can be defined as accurate or inaccurate. For this reason, the latter two types of optimism have sometimes been labeled the optimistic bias. Research on all three varieties of optimism affords opportunities to understand how optimism influences information processing in a health message or one’s behavioral intentions following the message.
Responding to health messages about environmental risks and risky behaviors requires adjustments to what individuals do: how they organize and perform occupations, and their understanding of what occupations mean—for themselves and others. Encouraging people to make a change means influencing what they want to do, the possibilities open to them, and societal support and demand for healthful ways of life. Bringing an occupational perspective to the design of risk messages will generate new insights into the complexities of everyday occupations, revealing the dynamic territory into which health messages are targeted. Occupation, or everyday doing, is described as the means by which people experience their very nature, become what they have the potential to be, and sustain a sense of belonging in family, community and society. To influence what people do, designers of health messages are encouraged to consider what engages people in occupations and keeps them engaged; the identity and cultural meanings expressed through occupation; the exhilaration of challenge and risk; the satisfactions of competence and flow experiences that keep people engaged in what they are doing; whether or not people are fit and prepared for the occupations they embark on and what happens when they are not; and the pull of habits and routines, which hold existing patterns of occupation in place. Equally, health message designers need to engage with the occupational science literature, which recognizes how people are shaped toward particular occupations and occupational identities by social policy, institutional practices, and media messages. That means questioning the rhetoric that occupations are freely chosen, rather than shaped and patterned by the historical, sociocultural, political, and geographic context. Simultaneously, health message designers need to recognize that individuals incorporate specific occupations and occupational patterns into their lifestyle and sense of self, believing they have a measure of control over what they do while rationalizing failure to make health-supporting changes.