Creating Authentic and Lasting Community Relationships to Enhance Awareness and Understanding of Cancer Research
Linda Fleisher, Evelyn González, and Armenta Washington
Building and sustaining relationships fundamentally requires mutual trust based on authentic and reciprocal communication. Successful academic and community partnerships require a deep understanding of the needs of all stakeholders facilitated through dialogue and ongoing communication strategies. This dialogue is especially crucial to address health disparities and bridge the divide between academics and other professionals and the communities they serve. Innovative and sound health communications and community engagement approaches can help to address this divide. For those working with communities to improve health, Community Based Participatory Research (CBPR) principles can serve as a compass to guide those efforts of building on the strengths and resources within the community and ensuring co-learning to address social inequities. Moreover, using innovative and interactive health communication strategies, such as community forums, photovoice projects, and the development of culturally sensitive and relevant messaging, can empower and engage the community, facilitating long-lasting relationships between the academic institutions and communities that ultimately address the unique concerns and values of those most in need.
Walid A. Afifi
The turn of the 21st century has seen an explosion of frameworks that account for individuals’ decisions to seek or avoid information related to health risks. The four dominant frameworks are Risk Perception Attitude Framework, the Risk Information Seeking and Process model, the Planned Risk Information Seeking Model, and the Theory of Motivated Information Management. A comparison of the constructs within each and an examination of the related empirical tests reveal important insights into (a) factors that have consistently been shown to shape these decisions across these approaches and (b) constructs in need of additional theorizing and empirical testing. Specifically, the analysis suggests that uncertainty, efficacy, affect, risk perceptions, and subjective norms all play crucial roles in accounting for decisions to seek or avoid risk-related information. However, inconsistencies in the direction of influence for uncertainty or information discrepancy, risk perceptions, and negative affect argue for the need for considerably more theoretical clarity and empirical rigor in investigations of the ways in which these experiences shape decision making in these contexts.
Michael L. Hecht and Michelle Miller-Day
Adolescent substance use and abuse has long been the target of public health prevention messages. These messages have adopted a variety of communication strategies, including fear appeals, information campaigns, and social marketing/branding strategies. A case history of keepin’ it REAL, a narrative-based substance abuse prevention intervention that exemplifies a translational research approach, involves theory development testing, formative and evaluation research, dissemination, and assessment of how the intervention is being used in the field by practitioners. The project, which started as an attempt to test the notion that the performance of personal narratives was an effective intervention strategy, has since produced two theories, an approach to implementation science that focused on communication processes, and, of course, a school-based curriculum that is now the most widely disseminated drug prevention program in the world.
At the core of the keepin’ it REAL program are the narratives that tell the story of how young people manage their health successfully through core skills or competencies, such as decision-making, risk assessment, communication, and relationship skills. Narrative forms not only the content of curriculum (e.g., what is taught) but also the pedagogy (e.g., how it is taught). This has enabled the developers to step inside the social worlds of youth from early childhood through young adulthood to describe how young people manage problematic health situations, such as drug offers. This knowledge was motivated by the need to create curricula that recount stories rather than preaching or scaring, that re-story health decisions and behaviors by providing skills that enable people to live healthy, safe, and responsible lives. Spin-offs from the main study have led to investigations of other problematic health situations, such as vaccination decisions and sexual pressure, in order to address crucial public health issues, such as cancer prevention and sex education, through community partnerships with organizations like D.A.R.E. America, 4-H clubs, and Planned Parenthood.
V. Santiago Arias and Narissra Maria Punyanunt-Carter
Through the years, the concept of family has been studied by family therapists, psychology scholars, and sociologists with a diverse theoretical framework, such as family communication patterns (FCP) theory, dyadic power theory, conflict, and family systems theory. Among these theories, there are two main commonalities throughout its findings: the interparental relationship is the core interaction in the familial system because the quality of their communication or coparenting significantly affects the enactment of the caregiver role while managing conflicts, which are not the exception in the familial setting. Coparenting is understood in its broader sense to avoid an extensive discussion of all type of families in our society. Second, while including the main goal of parenting, which is the socialization of values, this process intrinsically suggests cultural assimilation as the main cultural approach rather than intergroup theory, because intercultural marriages need to decide which values are considered the best to be socialized. In order to do so, examples from the Thai culture and Hispanic and Latino cultures served to show cultural assimilation as an important mediator of coparenting communication patterns, which subsequently affect other subsystems that influence individuals’ identity and self-esteem development in the long run. Finally, future directions suggest that the need for incorporating a nonhegemonic one-way definition of cultural assimilation allows immigration status to be brought into the discussion of family communication issues in the context of one of the most diverse countries in the world.
Andrew M. Ledbetter
Owing to advances in communication technology, the human race now possesses more opportunities to interact with interpersonal partners than ever before. Particularly in recent decades, such technology has become increasingly faster, mobile, and powerful. Although tablets, smartphones, and social media are relatively new, the impetus behind their development is old, as throughout history humans have developed mechanisms for communicating ideas that transcend inherent temporal and spatial limitations of face-to-face communication. In the ancient past, humans developed writing and the alphabet to preserve knowledge across time, with the later development of the printing press further facilitating the mass distribution of written ideas. Later, the telegraph was arguably the first technology to separate communication from transportation, and the telephone enabled people at a distance to hear the warmth and intimacy of the human voice. The development of the Internet consolidates and advances these technologies by facilitating pictorial and video interactions, and the mobility provided by cell phones and other technologies makes the potential for communication with interpersonal partners nearly ubiquitous. As such, these technologies reconfigure perception of time and space, creating the sense of a smaller world where people can begin and manage interpersonal relationships across geographic distance.
These developments in communication technology influence interpersonal processes in at least four ways. First, they introduce media choice as a salient question in interpersonal relationships. As recently as the late 20th century, people faced relatively few options for communicating with interpersonal partners; by the early years of the 21st century, people possessed a sometimes bewildering array of channel choices. Moreover, these choices matter because of the relational messages they send; for example, choosing to end a romantic relationship over the phone may communicate more sensitivity than choosing to do so via text messaging, or publicly on social media. Second, communication technology affords new opportunities to begin relationships and, through structural features of the media, shape how those meetings occur. The online dating industry generates over $1 billion in profit, with most Americans agreeing it is a good way to meet romantic partners; friendships also form online around shared interests and through connections on social media. Third, communication technology alters the practices people use to maintain interpersonal relationships. In addition to placing traditional forms of relational maintenance in more public spaces, social media facilitates passive browsing as a strategy for keeping up with interpersonal partners. Moreover, mobile technology affords partners increased geographic and temporal flexibility when keeping contact with partners, yet simultaneously, it may produce feelings of over-connectedness that hamper the desire for personal autonomy. Fourth, communication technology makes interpersonal networks more visibly manifest and preserves their continuity over time. This may provide an ongoing convoy of social support and, through increased efficiency, augment the size and diversity of social networks.
Monique Mitchell Turner
In social marketing, the use of guilt appeals can be effective for influencing healthy behaviors. Guilt, being a moral, other-based emotion, can spur people to think of others, act honestly, and be empathetic. Likewise, collective guilt, the feeling that arises when people believe their in-group caused illegitimate harm to others, can lead people to feel positively toward the victimized others and desire policies that will help them. We can see then, that guilt, though often considered “negative” can lead to an array of prosocial, constructive, behaviors. In that vein, a number of researchers have assessed the possibility that guilt based persuasive appeals can induce such positive behaviors.
Clearly, guilt-appeals can be an effective tool for reducing risk (STI testing), increasing prevention practices (encouraging mammograms), and effecting altruistic health-related behaviors (donating blood). In the correct conditions, guilt appeals can induce guilty feelings, lead people to want to “right the wrong,” generate positive attitudes about the message’s advocacy, and intend to engage in a behavior.
Kaite Yang and Emily Pronin
Social psychological research on thinking has generally focused on the attitudes, emotions, motivations, and biases that affect thinking and consequent behavior. What has received less attention is the speed of thinking: how quickly thinking occurs and whether thoughts accelerate or slow down. Communication design and processing may take for granted that the structure and reception of messages occur at a certain speed. Recent findings from the psychological study of thought speed shed light on ways that this research may be applied to health communication. Fast and slow rates of thinking are correlated with distinct patterns of affective, cognitive, physiological, and behavioral events. Fast thinking is associated with positive mood, energy, approach motivation, arousal, creativity, and risk-taking. Slow thinking is associated with negative mood and depression, low energy, and cognitive impairment. Potential theories exist for why psychological and physiological experiences are associated with thought speed.
Recent experimental research demonstrates that thought speed can be successfully manipulated to elicit psychological effects, and it can be manipulated independent of thought content. Researchers, healthcare practitioners, and communicators should be aware of the psychological correlates and consequences of thought speed and consider harnessing the effects of thought speed to augment communication. Thought acceleration and deceleration can be integrated into the design and processing of health communication.
Kristin L. Farris and Maureen P. Keeley
Social support in the context of chronic illness management is important, as individuals diagnosed with these conditions and their loved ones often experience increased distress, reduced relational quality, and diminished physical health as a result of coping with these long-term symptoms. Therefore, diagnosed individuals and their close relational partners rely on others to provide support in their time of need. The communication of social support is characterized by “verbal and nonverbal behavior produced with the intention of providing assistance to others perceived of needing that aid” (MacGeorge, Feng, & Burleson, 2011, p. 317). Individuals living with these chronic illnesses and their loved ones often turn to a variety of interpersonal others, including friends, family, health care providers, and support groups to manage the difficulties that accompany their physical symptoms. Although some researchers suggest that diagnosed individuals seek support most frequently from close relational partners, other scholars assert that chronic care support groups (whether meeting face to face or via computer-mediated channels) offer support recipients an opportunity to discuss their challenges and receive help from experientially similar others.
On the one hand, regardless of the support provider, individuals who have been diagnosed with chronic conditions generally perceive effective supportive communication to be messages in which their support providers enact competent tangible assistance in managing the illness, provide an opportunity for them to vent their feelings, and express messages of empathy and affection, among others. Ineffective messages, on the other hand, are those in which diagnosed individuals feel their partners are overly involved in helping them make decisions about their care or portraying negative attitudes or discomfort around them. Overall, research in this area suggests that support recipients and their relational partners have improved emotional, relational, and physical outcomes when they perceive support to be available or receive effective support from these resources.
Andrea Kloss and Anne Bartsch
Emotions are an important part of how audiences connect with health and risk messages. Feelings such as fear, anger, joy, or empathy are not just byproducts of information processing, but they can interact with an individual’s perception and processing of the message. For example, emotions can attract attention to the message, they can motivate careful processing of the message, and they can foster changes in attitudes and behavior. Sometimes emotions can also have counterproductive effects, such as when message recipients feel pressured and react with anger, counterarguments, or defiance. Thus, emotion and cognition are closely intertwined in individuals’ responses to health messages. Recent research has begun to explore the flow and interaction of different types of emotions in health communication. In particular, positive feelings such as joy and hope have been found to counteract avoidant and defensive responses associated with negative emotions such as fear and anger. In this context, research on health communication has begun to explore complex emotions, such as a combination of fear and hope, which can highlight both the severity of the threat, and individuals’ self-efficacy in addressing it. Empathy, which is characterized by a combination of affection and sadness for the suffering of others, is another example of a complex emotion that can mitigate defensive responses, such as anger and reactance, and can encourage insight and prosocial responses.
Erin M. Hill
Narcissism is a personality trait characterized by perceptions of grandiosity, superiority, and the need for attention and admiration. There has been an increase in focus on examining the development of narcissism and how the trait influences a range of social and health behaviors. A key feature of narcissism is that it is characterized by high self-esteem with a simultaneously fragile ego that requires continual monitoring and manipulation. Therefore, much of the behaviors narcissists engage in are linked to the drive to maintain perceptions of superiority and grandiosity. In the area of health and well-being, narcissism has been positively correlated with psychological health, a relationship that may be accounted for by self-esteem. However, there has been less research on the relationship between narcissism and physical health and well-being. There is some evidence that narcissism is linked to a variety of physical appearance-oriented health behaviors (i.e., behaviors that could affect body weight or other aspects of physical appearance, including eating and exercise). Narcissism has also been positively linked to risk-taking behaviors, including use of substances, as well as risks that could significantly impact others, including sexual behaviors and risky driving. The relationship between narcissism and health is therefore complex, with some positive correlates (e.g., physical activity), but also various health risk behaviors.
In considering how narcissism might interact with health messages, communicators have to keep in mind that narcissists seem to have some deficits in judgment and decision-making, such as overconfidence and a narrow focus on rewards associated with behaviors. Their behaviors tend to be driven by managing their own ego and by drawing attention and admiration from others to maintain perceptions of superiority and grandiosity. In turn, health communicators may need to rely on creative strategies that tap into these domains of narcissism in order to effectively modify health behaviors among narcissistic individuals. Further research on the influence of narcissism in healthcare seeking and related preventive behaviors would also help to provide a more detailed understanding for how the trait influences health decisions, information that would be useful for both health researchers and practitioners.