Galina B. Bolden and Alexa Hepburn
The transcription system for Conversation Analysis (CA) was originally developed by Gail Jefferson, one of the founders of CA, in the 1960s. Jefferson’s transcription conventions aim to represent on paper what had been captured in field audio recordings in ways that would preserve and bring to light the interactionally relevant elements of the recorded talk. Conversation analytic research has demonstrated that various features of the delivery of talk and other bodily conduct are basic to how interlocutors carry out social actions in interaction with others. Without the CA transcription system it is impossible to identify these features, as it represents talk and other conduct in ways that capture the rich subtlety of their delivery. Jefferson’s system of conventions evolved side by side with, and was informed by the results of, interaction analysis, which has shown there are many significant aspects of talk that interactants treat as relevant but that are entirely missed in simple orthographic representation.
Conversation analysts’ insistence on capturing not only what is said but also details of how something is said, including interactants’ visible behaviors, is based on the assumption that “no order of detail in interaction can be dismissed a priori as disorderly, accidental, or irrelevant” (according to John Heritage in 1984). Conversation analytic transcripts need to be detailed enough to facilitate the analyst’s quest to discover and describe orderly practices of social action in interaction.
In understanding crowd psychology and its explanation of conflict and violence, there are different theoretical approaches that turn on different understandings of communication processes. There are three models of communication in the crowd worth reviewing: classic, normative, and dynamic. Classic models suggest that crowd members are influenced by an idea of emotion presented to them. Normative models suggest that influence is constrained by what is seen as consonant with group norms. And, finally, dynamic models examine how that which becomes normative in the group depends upon intergroup relations. The last of these approaches can explain the patterned, socially meaningful and yet changing nature of crowd action. Crowd action, itself, is a form of communication because it serves to shape the social understandings of participants as well as the social understandings of those beyond the crowd. It is argued that the nature and centrality of crowds contribute to the understanding and creating of social relations in society.
Mikaela L. Marlow
Discourse analysis is focused on the implicit meanings found in public discourse, text, and media. In the modern era, public discourse can be assessed in political or social debates, newspapers, magazines, television, film, radio, music, and web-mediated forums (Facebook, Twitter, and other public discussion). Research across a variety of disciplines has documented that dominant social groups tend to employ certain discursive strategies when discussing minority groups. Public discourse is often structured in ways that marginalize minority groups and legitimize beliefs, values, and ideologies of more dominant groups. These discursive strategies include appealing to authority, categorization, comparison, consensus, counterfactual, disclaimers, euphemism, evidence, examples, generalizations, rhetorical questions, metaphors, national glorification, and directive speech acts. Evoking such discourse often enables prevailing dominant groups to reify majority social status, reinforce negative assumptions about minorities, and maintain a positive public social image, despite deprecating and, sometimes, dehumanizing references.
Silvia Moscatelli and Monica Rubini
In everyday life, we are faced with disparate examples of intergroup bias, ranging from a mild tendency to ingroup favoritism to harsh episodes of discrimination, aggression, and even conflicts between groups. Where do they stem from? The origins of intergroup bias can be traced back to two main motivations, that is, attachment to one’s own group (“ingroup love”) and negative feelings toward outgroups (“outgroup hate”). Although lay people, but also some researchers, see the two motivations as intertwined, growing evidence from different fields (e.g., social psychology, evolutionary psychology, and neuroscience) has indicated that intergroup bias is more often driven by needs of ingroup protection and affiliation, which do not imply outgroup hostility or competitive attitudes. Outgroup hate is instead likely to arise in intergroup contexts characterized by a high degree of enmity. It is important that members of the groups involved, but also external observers, recognize ingroup love as the primary motor of intergroup conflict: the attribution of hate to the outgroup’s behavior renders negotiation and conflict resolution harder while at the same time justifying severe aggression or even annihilation of the opposing outgroup.
In the domain of intergroup communication, an intriguing way through which group members express their ingroup love and outgroup hate is represented by variations of linguistic abstraction and valence in depicting behaviors performed by ingroup or outgroup members. This unintended use of language reveals that group members are more prone to express ingroup love also at a linguistic level. However, specific changes in intergroup relations along variables such as group size, group status, or relative deprivation can give rise to linguistic patterns of outgroup hate.
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.
Wayne A. Beach, Kyle Gutzmer, and Chelsea Chapman
Beginning with phone calls to an emergency psychiatric hospital and suicide prevention center, the roots of Conversation Analysis (CA) are embedded in systematic analyses of routine problems occurring between ordinary persons facing troubling health challenges, care providers, and the institutions they represent. After more than 50 years of research, CA is now a vibrant and robust mode of scientific investigation that includes close examination of a wide array of medical encounters between patients and their providers. Considerable efforts have been made to overview CA and medicine as a rapidly expanding mode of inquiry and field of research. Across a span of 18 years, we sample from 10 of these efforts to synthesize important priorities and findings emanating from CA investigations of diverse interactional practices and health care institutions. Key topics and issues are raised that provide a unique opportunity to identify and track the development and maturity of CA approaches to medical encounters. Attention is also given to promising new modes of research, and to the potential and challenges of improving medical practices by translating basic and rigorous empirical findings into innovative interventions for medical education. A case is made that increasing reliance on CA research can positively impact training and policies shaping the delivery of humane and quality medical care.
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.
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.
Kevin A. Whitehead
In the wake of what has been called the “discursive turn” or “linguistic turn” in the social sciences, research at the intersection of language and communication and race and racism shifted from being largely dominated by quantitative and experimental methods to include qualitative and particularly discursive approaches. While the term “discursive” potentially encompasses a wide range of modes of discourse analysis, discursive approaches share a focus on language use as social action, and as a constitutive feature of actions, events, and situations, rather than as merely a passive means of describing or transmitting information about them. When applied to the study of race and racism, such approaches have examined ways in which language functions to construct, maintain, and legitimate as well as subvert or resist racial and/or racist ideologies and social structures.
Research in these areas has made use of a range of empirical materials, including “elite” texts and talk (media texts, parliamentary debates, academic texts, etc.), individual interviews, focus groups and group discussions, “naturally occurring” talk-in-interaction from conversational and institutional settings, and text-based online interactions. Although these different data types should not be seen as strictly mutually exclusive, each of them serves to foreground particular features of racial or racist discourse(s), thus facilitating or constraining particular sorts of discourse analytic findings. Thus, different data sources respectively tend to foreground ideological features of racial discourse(s) and their intersection with power and domination, including examination of “new” racisms and the production and management of accusations and denials of racism; discursive processes involved in the construction and uses of racial subjectivities and identities; interactional processes through which prejudice and racism are constructed and contested; and the everyday interactional reproduction of systems of racial categories, independently of whether the talk in which they occur can or should be considered “racist.”
Jessica Gasiorek and R. Kelly Aune
A majority of the extant literature in health and risk message processing focuses—for obvious reasons—on social influence and compliance-gaining. Interpersonal and relational issues with doctors and patients are a secondary focus. In contrast, research that specifically addresses comprehension of health and risk messaging is somewhat scant. However, other domains (e.g., cognitive psychology, reading studies) offer models and studies of comprehension that address message processing more generally. This material can usefully inform research in a health and risk context.
An important aspect of any communicative event is the degree to which that event allows interactivity. This can be described in terms of a continuum from static messaging to dynamic messaging. Message features may affect simple comprehension (in the former case) and active understanding (in the latter case) of messaging along this continuum. For static messaging, text features are the dominant focus; for dynamic messaging, how communicators cooperate, collaborate, and adjust their behavior relative to each other’s knowledge states is the focus. Moderators of these effects, which include sources’ dual goals informing and influencing targets, are also important to consider. Examples of this include direct-to-consumer-advertising (DTCA) of pharmaceutical medicines and pharmaceutical companies, which must meet the demands of the government regulatory bodies (e.g., fair and balanced presentation of benefits and risks) while simultaneously influencing the message processing experience of the target to minimize negative perceptions of their products. Impediments to creating understanding can arise in both the highly interactive setting of the face-to-face doctor-patient context as well as more static messaging situations such as PSAs, pamphlets, and pharmaceutical package inserts.
Making sense of message comprehension in health and risk communication is complex, and it is complex because it is broad in scope. Health and risk communication runs the gamut of static to dynamic messaging, employing everything from widely distributed patient information leaflets and public service announcements, to interactive web pages and massively connected social networking sites, to the highly interactive and personalized face-to-face meeting between doctor and patient. An equally comprehensive theoretical and methodological tool box must be employed to develop a thorough understanding of health and risk communication.