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.
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.
Bradley A. Serber and Rosa A. Eberly
Mass public shootings in the United States have generated increasingly urgent efforts to understand and prevent active shooter scenarios. After the Columbine High School shooting in 1999, government officials tried to no avail to identify a demographic profile of those who might become active shooters. Confronted with the limitations of identifying potential shooters in advance, government officials, mental health professionals, criminologists, and others interested in preventing active shootings have shifted their focus to guns, mental health, and location security. However, the terrain of each of these topics is murky and exposes additional uncertainties. The sheer number of readily available guns, the prohibition of gun violence research by federal public health and justice institutions, and the variance in attitudes toward and laws about guns in the United States inhibit clear and consistent gun policy. Further, linking active shooters with mental illness risks stigmatizing the vast majority of mentally ill individuals who are more likely to be victims than perpetrators of violence. Because different locations vary in design, function, funding, resources, and vulnerabilities, no organization or institution can guarantee total security despite extensive and costly efforts. While political and social changes can lead to incremental and important improvements in each of these areas, the problem of active shootings is large, multifaceted, and evolving. Adding to the urgency is the increasing number of U.S. states voting to allow concealed and/or open carry of firearms on public college and university campuses.
In the absence of certainty and in recognition of contextual differences, government agencies and educational institutions recently have promoted variants of a “run, hide, fight” approach to active shooter situations, and many schools, workplaces, and other sites have subsequently adopted these tactics in their active shooter training messages. From a rhetorical perspective, pentadic analysis (Burke, 1969) of “run, hide, fight” and its variants reveals the complexities of trying to prevent active shootings. “Run” and “hide” demonstrate both the possibilities and challenges associated with the scene, or when and where an active shooting might occur. “Fight” implies the ambiguities of agent and agency, that is, who gets to fight and how, in debates about gun-free zones, concealed and open carry, and on-site and off-site law enforcement. Meanwhile, the multimodal nature and often disturbing content of active shooter training messages sensationalize the act of active shootings, making them seem more real and present despite the low probability of such an event occurring in any particular place at any particular time. Given these complexities, active shooter training messages as a whole illustrate a tension of purpose in that they presumably attempt to alleviate fear while simultaneously producing it. By looking at a variety of government documents and workplace active shooter training messages, this analysis will explore uncertainties, controversies, and lingering questions about the content and consequences of active shooter training messages and how the producers of these messages frame active shooter scenarios as well as efforts to prevent and respond to such occurrences. No previous studies of the rhetorical or communication dimensions of active shooter training have been conducted, and no archives yet exist that cull such training materials for purposes of comparison, contrast, and analysis in the aggregate.
Message Recipient Psychological Characteristics: Incurious and Curious Motives to Learn about Health Risks
Successfully conveying information about the risk of potential threats to an individual’s physical and mental health is a serious challenge for healthcare practitioners. Adding to the challenge is the role of individual differences in people’s tendencies to want to learn (or in their choice to passively avoid) new information. These characteristic motives can be both curious and incurious in nature and interact with the perceived locus of the relevant health threat, which must be taken into account first. Some health threats are relatively “external,” and involve addressing the potential risk of an undesired event (e.g., developing illness, encountering relationship troubles). Research indicates that individuals who view external threats as “controllable” are more likely to respond positively to relevant information, but perception of control alone does not determine whether health-relevant information is likely to be sought or acted on. Besides perceived controllability, individual differences in incurious worry reduction motives (IWRM) play an important role as well. Two different kinds of IWRM have been identified: focus on distress (IWRM-FD) and focus on relief (IWRM-FR). Dispositional tendencies toward IWRM-FD are associated with greater willingness to seek out information when risk is perceived as low (i.e., information about the potential external threat is expected to make one feel better), but a tendency to passively avoid any information when risk is considered high (i.e., information is expected to intensify distress). In contrast, tendencies toward IWRM-FR reflect wanting more information about potential threats when risk is believed to be high, while passively avoiding news when perceived risk is low. In regard to coping with perceived risk, IWRM-FD scores predict avoidant coping, whereas IWRM-FR levels are associated with proactive coping and seeking others’ advice.
Other risks are more “internal,” and involve threats to an individual’s certainty about his or her self-concept, purpose in life, or the wisdom of past behavior; in short, an “identity crisis.” Such threats underlie wondering things like “Who am I, really?” and are associated with less self-awareness, lower self-esteem, and greater overall distress. In response to internal threats, intrapersonal curiosity (InC) motivates individuals to engage in introspective self-exploration that may help them to clarify, to elaborate on, and to improve their understanding of their self-concept. Recent research has found that individual differences in InC are positively associated with IWRM, suggesting that dealing with identity crises involves the desire to better know oneself, as well as wishing to mitigate worries about experiencing self-doubt.
Bearing the above in mind, research on individual differences in tendencies to avail oneself of different coping strategies indicates that proactive coping (e.g., positive reframing, seeking advice) tends to result in beneficial outcomes, such as personal growth and improved health, but some proactive strategies are “double-edged” and may lead to some negative outcomes as well. In particular, proactive strategies like acceptance of one’s limitations or discussing them with others when seeking social support were helpful, but they also had the potential to leave individuals feeling less sure of themselves. These findings suggest that practitioners who wish to more effectively communicate information about risk of potential health threats should consider whether the nature of the threat is internal or external, the role of individual differences in IWRM and InC, and how to help their patients to focus on the positive benefits of acceptance (i.e., identify solvable problems) and seeking social support (i.e., acquiring useful advice) over the negative aspects (i.e., admitting limitations).
Maricel G. Santos, Holly E. Jacobson, and Suzanne Manneh
For many decades, the field of risk messaging design, situated within a broader sphere of public health communication efforts, has endeavored to improve its response to the needs of U.S. immigrant and refugee populations who are not proficient speakers of English, often referred to as limited English proficient (LEP) populations. Research and intervention work in this area has sought to align risk messaging design models and strategies with the needs of linguistically diverse patient populations, in an effort to improve patient comprehension of health messages, promote informed decision-making, and ensure patient safety. As the public health field has shifted from person-centered approaches to systems-centered thinking in public health outreach and communication, the focus in risk messaging design, in turn, has moved from a focus on the effects of individual patient misunderstanding and individual patient error on health outcomes, to structural and institutional barriers that contribute to breakdown in communication between patients and healthcare providers.
While the impact of limited proficiency in English has been widely documented in multiple spheres of risk messaging communication research, the processes by which members of immigrant and refugee communities actually come to understand sources of risk and act on risk messaging information remain poorly researched and understood. Advances in risk messaging efforts are constrained by outdated views of language and communication in healthcare contexts: well-established lines of thinking in sociolinguistics and language education provide the basis for critical reflection on enduring biases in public health about languages other than English and the people who speak them. By drawing on important findings about language ideologies and language learning, an alternative approach would be to cultivate a deeper appreciation for the linguistic diversity already shaping our everyday lives and the competing views on this diversity that constrain our risk messaging efforts.
The discourse surrounding the relationship between LEP and risk messaging often omits a critical examination of the deficit-based narrative that tends to infuse many risk messaging design efforts in the United States. Sociolinguists and language education specialists have documented the enduring struggle against a monolingual bias in U.S. education and healthcare policy that often privileges proficiency in English, and systematically impedes and discriminates against emerging bilingualism and multilingualism. The English-only bias tends to preclude the possibility that risk messaging comprehension for many immigrant and refugee communities may represent a multilingual capacity, as patients make use of multiple linguistic and cultural resources to make sense of healthcare messages. Research in sociolinguistics and immigration studies have established that movement across languages and cultures—a translingual, transcultural competence—is a normative component of the immigrant acculturation process, but these research findings have yet to be fully integrated into risk messaging theory and design efforts. Ultimately, critical examination of the role of language and linguistic identity (not merely a focus on proficiency in English) in risk messaging design should provide a richer, more nuanced picture of the ways that patients engage with health promotion initiatives, at diverse levels of English competence.
Metaphor equates two concepts or domains of concepts in an A is B form, such that a comparison is implied between the two parts leading to a transfer of features typically associated with B (called source) to A (called target). Metaphor is evident in written, spoken, gestural, and pictorial modalities. It is also present as latent patterns of thought in the form of conceptual mappings between domains of experience called conceptual metaphor. Metaphor is found commonly in a variety of health and risk communication contexts, including public discourse, public understanding and perceptions, medical encounters, and clinical assessment. Often metaphor use is beneficial to achieving desired message effects; however, sometimes its use in a message can lead to unintended undesirable effects. There is a general consensus, although not complete agreement, that metaphors in messages are processed through engagement with corresponding conceptual mappings. This matching process can be taken as a general principle for design of metaphor-based health and risk messages.
As the use of online technologies has grown in recent years, so has the study of computer-mediated communication.
Online communication began in universities through the use of e-mail. Soon, spaces such as multi-user dungeons (MUDs), Listserv, and bulletin boards were developed, which not only allowed people who knew each other offline to interact but also enabled individuals who were not previously acquainted to communicate via the Internet. The development of Web 2.0, which allowed for more user-generated content, led to new and innovative ways of interacting online, most notably thorough social media sites. Social media sites, such as Facebook and Twitter, allow not only for text-based interaction to occur but also for image- and video-based interaction.
Through all these developments, interactional norms and practices have developed. A key factor in these norms is what the medium enables, or affords, participants to do. Features such as whether an interactional platform is synchronous or asynchronous can impact the nature of the interaction. Similarly, the lack of visual or verbal contact when interacting may impact upon the interaction, through the potential for misunderstandings. Participants do, though, develop practices to suit the medium. If we examine these practices in detail, it is possible to also analyze the role which technology plays in the interaction. One method that has been used to do this is conversation analysis, which was developed for and using spoken interaction. Conversation analysis examines conversation in forensic detail to illuminate the norms and practices through which we conduct our everyday lives. In using this method for analyzing online interaction, we can not only understand the practices but also examine the affordances of particular interactional platforms.
Various interactional features of computer-mediated communication (CMC) have been examined from a conversation analytic perspective, including sequential organization, openings, turn-taking, and repair. A common focus of these studies it to explore the interactional patterns but also to understand how these might be impacted by the technology itself. The development of norms for a variety of forms of technologized interaction demonstrates how individuals are capable of adapting their interactional practices for new contexts.