Patrick J. Ewell and Rosanna E. Guadagno
According to Nisbett and Ross, “Information may be described as vivid, that is, as likely to attract and hold our attention and excite the imagination to the extent that it is (a) emotionally interesting, (b) concrete and imagery-provoking, and (c) proximate in a sensory, temporal, or spatial way.” Despite a widespread belief held by scholars and practitioners alike that vividness enhances persuasion, most early studies on this topic found weak or nonexistent vividness effects. To further understand this relationship, subsequent research focused on explaining these inconsistent findings. Taylor and Thompson explored the different ways that vividness has been operationalized across studies. Guadagno, Okdie, Sagarin, DeCoster, and Rhoads elucidated the conditions under which vividness enhances or detracts from persuasion. Generally, the extant literature suggests that vividness is an effective means of enhancing persuasion when the main point of a communication is the sole component made vivid. These findings caution against attempts to persuade by increasing overall message vividness, because off-thesis or incongruent vividness has the unintended and undercutting consequence of distracting influence targets from the point of the communication. This conclusion is based on the results of individual empirical studies as well as meta-analytic findings. Literature on shock advertising as a specialized case of vividness also exists. Future research on vividness might further delineate when, how, and why vividness sometimes enhances and sometimes detracts from persuasion.
Sarah C. Vos and Elisia Cohen
Using pictures (also called images) in health and risk messages increases attention to messages and facilitates increased retention of message content, especially in low-literate populations. In risk communication, researchers have found that pictorial warnings stimulate communication and that images without text can communicate risk information as effectively (or, in some cases, more effectively) than text. However, little empirically based guidance exists for designing images for health and risk messages because most studies use an absence-presence model and compare visual communication to textual communication, rather than compare different types of visual communication. In addition, visual communication theories focus on describing the “how” aspect of communication instead of offering proscriptive guidance for message design. Further complicating the design of visual messages is that the number of possibilities for a visual message is, like text-based messages, almost infinite. Choices include colors, shapes, arrangement, and the inclusion of text, logos, icons, and so on. As a result, best practices on visual messages often draw on design recommendations. Before the widespread advent of Internet use and the adoption of social networking sites like Facebook and Twitter, using images—especially color images—could be cost prohibitive. However, these online platforms facilitate the distribution of visual content, and many public health organizations use these platforms to distribute visual messages. The need for guidance and research on using pictures effectively is growing. Although there has been increasing focus on images in health messages, many questions still exist about how visual messages should be composed and what their effect is. The existing evidence suggests that visual information can improve persuasive and, on social networking sites, diffusion outcomes. However, visual information may be prone to misinterpretation. Researchers should also evaluate ethical considerations when choosing pictures. Message testing is highly recommended.
S. Anne Moorhead
Social media used for communication purposes within healthcare contexts is increasing and becoming more acceptable. The users of social media for healthcare communication include members of the general public, patients, health professionals, and health organizations. The uses of social media for healthcare communication are various and include providing health information on a range of conditions; providing answers to medical questions; facilitating dialogue between patients and between patients and health professionals; collecting data on patient experiences and opinions used for health intervention, health promotion, and health education; reducing stigma; and providing online consultations. With emerging advances over time, including new platforms and purposes, these uses will change and expand, increasing usability and thus providing more opportunities to use social media in connection to healthcare in the future. However, both patients and health professionals may require training to fully maximize the uses of using social media in healthcare.
Social media has numerous benefits for healthcare communication, including increased interactions with others; more available, shared, and tailored information; increased accessibility and widening access; and increased peer/social/emotional support. While there may be further benefits of using social media in healthcare, there are many limitations of social media for healthcare communication as well. The main reported limitations include a lack of reliability; quality concerns; and lack of confidentiality and privacy. From the available evidence, it is clear that maintaining patient privacy as well as the security and integrity of information shared are concerns when using social media.
As patients and members of the general public use social media widely, some may expect it in healthcare, thus it important for health professionals and organizations to manage expectations of social media in healthcare communication. This results in challenges ranging from encouraging staff to use social media to dealing with user problems and complaints. It is recommended that organizations embrace social media but have a specific purpose for each activity and platform while continually monitoring traffic. Regardless of the nature or size of the healthcare organization, it is time to adopt appropriate guidelines for the use of the social media in healthcare communication to address the challenges and the growing expectations of using social media, especially within healthcare contexts. The key message is that social media has the potential to supplement and complement but not replace other methods to improve communication and interaction among members of the general public, patients, health professionals, and healthcare organizations.
Sophie Christman Lavin and E. Ann Kaplan
Ecocinema involves the human gaze looking at cinema through the lens of the environment, in a manner analogous to the way feminists provided the cinematic lens of gender in the 1970s. However, as with feminism, enormous differences pertain in regard to how the ecocinema lens is mobilized.
In analyzing films from the late 1800s to the early 21st century, ecocinema studies has evolved to include critical lines of inquiry from perspectives of psychology, feminism, socioeconomics, science, and activism. Research frames used in these inquiries include: setting and landscape in films, ecological analyses of mainstream and independent fictional films, posthuman cinematic representations, transnational and regional, and more recently, trauma in speculative dystopian films. Ecocinema critics analyze films of various types, including Hollywood, independent, transnational, documentary, animated, art cinema, and especially climate fiction (“cli-fi”) films.
Ramachandra Guha’s transnational typology of environmental ideologies will provide a useful starting place for the mapping of different perspectives in ecocinema. Guha distinguished utopian wilderness environmentalism, pervasive in the United States, from the agrarian focus typical in India. Meanwhile, most developed nations utilize scientific industrial methods to exploit the environment. Oftentimes, these latter approaches are grounded in growth economies and are thus in conflict with the unrealistic ideals of so-called neo-primitivism (NP). Neo-primitivism involves returning to simple, sustainable lifestyles within or close to the natural world—lifestyles that do no environmental damage. NP is beloved by many, but the consensus is that it is idealistic to consider going back to this way of life. A film such as Avatar (produced and directed by James Cameron in 2009) addresses the complexity of diverse constructions of nature by providing examples of utopian wilderness ideology that compete with, and are opposed to, the destructive scientific industrialism that disregards and dominates nature without compunction. Other films, such as Amazon Sisters (Sweeny, 1992), Elemental (Koch, Roshan, & Vaughan-Lee, 2012), Into the Wild (Blocker, Hildebrand, Kelly, & Penn, 2007), or Grizzly Man (Beggs & Herzog, 2005), act as simultaneous celebrations and critiques of wilderness ideologies and deal with gender and racial identities, and thus they have been a central focus of ecocinema scholarship.
Although films from all genres have historically engaged environmental issues, it was rarely in a way that made a self-conscious or critical statement about the human impact on the natural world from the perspective of ecological concerns—this is the focus of ecocinema. See for example, Birt Acres’s Rough Sea at Dover (1895), the Lumiere Brothers’ Oil Wells of Baku (1896), Thomas Edison’s Sorting Refuse at Incinerating Plant, NYC (1903), and the British South Africa Company’s Rhodesia To-Day (1912). In the early 21st century, the genre that most often engages with the contemporary politics of climate change is the documentary. Documentaries, such as An Inconvenient Truth (Guggenheim, 2006), Manufactured Landscapes (Baichwal, 2006), Into Eternity (Eskilsson & Madsen, 2010), Chasing Ice (Ahrens & Orlowski, 2012), E-Waste Tragedy (Esteve, Popp, Úbeda, & Dannoritzer, 2014), This Changes Everything (Cuarón & Lewis, 2015), among others, critique human damage to the planet and thus position viewers as ethical witnesses. Such works hope to influence the outcome of our shared anthropocentric future.
The analyses of ecocinema are addressed using two distinct methods—the macro and the micro. The macro method studies how films represent the large-scale processes of earth-based climate systems, and its lens evaluates how films represent climate and environmental dilemmas facing humans as a species. The micro-lens provides enhanced analyses that explore how gender, race, and class figure into the cultural work climate fantasies perform. This lens indexes the ways in which various cultures are often disproportionately impacted by climate systems.1 Oftentimes the macro and micro levels are both incorporated in a single film and reveal the intersection between climate and culture, as seen in Taklub (Trap, Castillo & Mendoza, 2015), a film that portrays Super-typhoon Haiyan and its impact on residents in Tacloban, Philippines. As background to mapping the texts, evolving science discourses will be emphasized as evidence for global warming but with the understanding that this evidence relies on modeling. Although our main concern with this cultural work in ecocinema is how climate change impacts across gender, race, and class, the inequalities revealed also speak to the politics of climate change evident in cinematic treatments of the issue.
R. Craig Lefebvre and P. Christopher Palmedo
Many ideas about best practices for risk communication share common ground with social marketing theory and practice: for example, segmentation, formative research, and a focus on behavioral outcomes. Social marketing first developed as a methodology to increase the public health impact of programs and to increase the acceptability and practice of behaviors that improve personal and social well-being. The core concepts of this approach are to be people-centered and to aim for large-scale behavior change. An international consensus definition of social marketing describes it as an integration of theory, evidence, best practices, and insights from people to be served. This integrated approach is used to design programs that are tailored to priority groups’ needs, problems, and aspirations and are responsive to a competitive environment. Key outcomes for social marketing efforts are whether they are effective, efficient, equitable, and sustainable.
The 4P social marketing mix of Products, Prices, Places, and Promotion offers both strategic and practical value for risk-communication theory and practice. The addition of products, for example, to communication efforts in risk reduction has been shown to result in significantly greater increases in protective behaviors. The Cover CUNY case demonstrates how full attention to, and consideration of, all elements of the marketing mix can be used to design a comprehensive risk-communication campaign focused on encouraging college student enrollment for health insurance. The second case, from the drug safety communication arena, shows how a systems-level, marketplace approach is used to develop strategies that focus on key areas where marketplace failures undermine optimal information-dissemination efforts and how they might be addressed.
Scientific advances, technological development, and changes in risk consciousness have led to stronger demands on society to manage and control various kinds of risks. Risks should be assessed, prevented, controlled, and communicated in order to prevent negative impacts. Risks related to the environment and health are probably some of the most research-dependent examples. It is primarily scientific experts that provide knowledge to authorities, organizations, and citizens about environmental and health risks and thus exert considerable influence on the understanding and management of risk. At the same time, there are actors in society—especially citizen and interest organizations—that question whether risk regulation is reliable and relevant. There are also demands that citizens should have more transparency and control over risk regulation. The current situation is characterized thus by a paradox: Issues relating to environment and health are seen as increasingly expert dependent while citizens simultaneously demand increased influence over them. This development is especially noticeable in the European Union, with its strong emphasis on the rights of citizen and consumers to have access to information about risk and also opportunities to influence their regulation.
In response to this situation, risk governance has been put forward. It refers to a body of ideas for how to more responsibly and efficiently deal with complex risks issues, where there are different interests and standpoints about how to regulate them. Fundamental ideas of risk governance are openness, transparency, participation, inclusion, deliberation, and reflexivity; that experts involved should be open to questioning the situation; should not conceal issues of uncertainty and pluralism (that there exist different legitimate understandings, evaluations, and recommendations); and should be receptive to the input and participation of other stakeholders. This means that risk regulation should no longer be organized into three discrete activities: risk assessment, risk management, and risk communication (aiming at a one-way transfer of knowledge from the regulators to the public).
Jessica Fitts Willoughby
People who communicate health and risk information are often trying to determine new and innovative ways to reach members of their target audience. Because of the nearly ubiquitous use of mobile phones among individuals in the United States and the continued proliferation of such devices around the world, communicators have turned to mobile as a possible channel for disseminating health information. Mobile health, often referred to as mHealth, uses mobile and portable devices to communicate information about health and to monitor health issues. Cell phones are one primary form of mHealth, with the use of cell phone features such as text messaging and mobile applications (apps) often used as a way to provide health information and motivation to target audience members. Text messaging, or short message service (SMS), is a convenient form for conveying health information, as most cell phone owners regularly send and receive text messages. mHealth offers benefits over other channels for communicating health information, such as convenience, portability, interactivity, and the ability to personalize or tailor messages. Additionally, mHealth has been found to be effective at changing attitudes and behaviors related to health. Research has found mobile to be a tool useful for promoting healthy attitudes and behaviors related to a number of topic areas, from increased sexual health to decreased alcohol consumption. Literature from health communication and research into mHealth can provide guidance for health communicators looking to develop an effective mHealth intervention or program, but possible concerns related to the use of mobile need to be considered, such as concerns about data security and participant privacy.
Richard T. Craig
Who filters through information and determines what information is shared with media audiences? Who filters through information and determines what information will not be shared with media audiences? Ultimately, who controls the flow of information in the media? At times commentary pertaining to media content references media as an omnipotent individual entity selecting the content transmitted to the public, reminiscent of a Wizard of Oz manner of the all-powerful being behind the curtain. Overlooked in this perception is the reality that in mass media, there are various individuals in positions of power making decisions about the information accessed by audiences of various forms of media. These individuals are considered gatekeepers: wherein the media functions as a gate permitting some matters to be publicized and included into the public discourse while restricting other matters from making it to the public conscience.
Media gatekeepers (i.e., journalists, editors) possess the power to control the gate by determining the content delivered to audiences, opening and closing the gate of information. Gatekeepers wield power over those on the other side of the gate, those seeking to be informed (audiences), as well as those seeking to inform (politics, activists, academics, etc.). The earliest intellectual explanation of gatekeeping is traced to Kurt Lewin, describing gatekeeping as a means to analyze real-world problems and observing the effects of cultural values and subjective attitudes on those problems like the distribution of food in Lewins’s seminal study, and later modified by David Manning White to examine the dissemination of information via media. In an ideal situation, the gatekeepers would be taking on the challenge of weighing the evidence of importance in social problems when selecting among the options of content and information to exhibit. Yet, decisions concerning content selection are not void of subjective viewpoints and encompass values, beliefs, and ideals of gatekeepers. The subjective attitudes of gatekeepers influence their perspective of what qualifies as newsworthy information. Hence, those in the position to determine the content transmitted through media exercise the power to shape social reality for media audiences. In the evolution of media gatekeeping theory three models have resulted from the scholarship: (1) examination of the one-way flow of information passing through a series of gates before reaching audiences, (2) the process of newsroom personnel interacting with people outside of the newsroom, and (3) the direct communication of private citizens and public officials. In traditional media and newer forms of social media, gatekeeping examination revolves around analysis of these media organizations’ news routines and narratives. Gatekeeping analysis observes human behavior and motives in order to make conceptualizations about the social world.
Brenda L. Berkelaar and Millie A. Harrison
Information visibility refers to the degree to which information is available and accessible. Availability focuses on whether people could acquire particular information if they wanted. Accessibility focuses on the effort needed to acquire available information. In scholarly, industry, and popular press, people often conflate information visibility with transparency, yet transparency is generally a valued or ideological concept, whereas visibility is an empirical concept. Growing interest in studying and managing information visibility corresponds with the rapid growth in the use of digital, networked technologies. Yet, interest in information visibility existed prior to the introduction of networked information and communication technologies. Research has historically focused on information visibility as a form of social control and as a tool to increase individual, organizational, and social control and coordination. As a research area, information visibility ties to classic communication and interdisciplinary concerns, as well as core concerns of contemporary society including privacy, surveillance, transparency, accountability, democracy, secrecy, coordination, control, and efficiency. An emerging research area with deep historical roots, information visibility offers a promising avenue for future research.
Michael Mackert and Marie Guadagno
Advertising as a field and industry often has a contentious relationship with both health communication and public health due to legitimate concerns about how advertising for certain products, such as alcohol and tobacco, could contribute to less-healthy decisions and behaviors. While acknowledging such concerns, advertisers and their approach to solving communication problems could also provide valuable lessons to those working in health communication. Indeed, advertising agencies are designed to develop creative and effective messages that change consumer behavior—and health communication practitioners and scholars aim to change population-level behavior as well. The perspective and approach of the account planner in the advertising agency—a role whose chief responsibility is to bring the consumer perspective into every step of the advertising development process and inspire effective and creative campaigns—would be particularly valuable to those working in health communication. It was account planning work that shifted traditional milk advertising from promoting it as a healthy drink to the iconic “got milk?” campaign, which positioned milk as a complement that makes other food better—an approach that drove positive sales after years of declining milk consumption. Yet many who work in health communication and public health often know little of how advertising agencies work or their internal processes that might be productively adopted. This lack of understanding can also lead to misperceptions of advertisers’ work and intentions. As an example, one might assume dense medical language in prescription drug advertising is intended to add unnecessary complexity to the advertisements and obscure side effects; instead, advertising professionals who work on prescription drug advertising have often been trained on clear communication—but cannot fully utilize that training because of regulations that require medically accurate terminology that might not be comprehensible to most viewers. Improved understanding of how advertisers can act as agents of change, and increased dialogue between the fields of advertising and health communication, could contribute to improved health communication research, practice, and policy.