Jari Lyytimäki and Timo Assmuth
Communication is typically understood in terms of what is communicated. However, the importance of what is intentionally or unintentionally left out from the communication process is high in many fields, notably in communication about environmental and health risks. The question is not only about the absolute lack of information. The rapidly increasing amount and variability of available data require actors to identify, collect, and interpret relevant information and screen out irrelevant or misleading messages that may lead to unjustified scares or hopes and other unwanted consequences. The ideal of balanced, integrative, and careful risk communication can only rarely be seen in real-life risk communication, shaped by competition and interaction between actors emphasizing some risks, downplaying others, and leaving many kinds of information aside, as well as by personal factors such as emotions and values, prompting different types of responses. Consequently, risk communication is strongly influenced by the characteristics of the risks themselves, the kinds of knowledge on them and related uncertainties, and the psychological and sociocultural factors shaping the cognitive and emotive responses of those engaged in communication. The physical, economic, and cultural contexts also play a large role. The various roles and factors of absent information in integrative environmental and health risk communication are illustrated by two examples. First, health and environmental risks from chemicals represent an intensively studied and widely debated field that involves many types of absent information, ranging from purposeful nondisclosure aimed to guarantee public safety or commercial interests to genuinely unknown risks caused by long-term and cumulative effects of multiple chemicals. Second, light pollution represents an emerging environmental and health issue that has gained only limited public attention even though it is associated with a radical global environmental change that is very easy to observe. In both cases, integrative communication essentially involves a multidimensional comparison of risks, including the uncertainties and benefits associated with them, and the options available to reduce or avoid them. Public debate and reflection on the adequacy of risk information and on the needs and opportunities to gain and apply relevant information is a key issue of risk management. The notion of absent information underlines that even the most widely debated risk issues may fall into oblivion and re-emerge in an altered form or under different framings. A typology of types of absent information based on frameworks of risk communication can help one recognize its reasons, implications, and remediation.
Kathryn Greene, Smita C. Banerjee, Anne E. Ray, and Michael L. Hecht
Results of national epidemiologic surveys indicate that substance use rates among adolescents remain relatively steady or even show slight declines; however, some substance use rates, such as electronic cigarettes, are actually rising. Thus, the need for efficacious drug prevention efforts in the United States remains high. Active Involvement (AI) interventions are a promising avenue for preventing and reducing adolescent substance use, and they create opportunities for adolescents to experience a core feature of engagement that is common to these interventions, such as producing videos, posters, or radio ads; or generating themes and images for messages such as posters.
Existing interventions grounded in theories of Active Involvement include programs delivered face-to-face and via e-learning platforms. Narrative Engagement Theory and the Theory of Active Involvement guide the components of change in AI interventions. Youth develop message content during participation in Active Involvement interventions. Advanced analytic models can be applied to address new research questions related to the measure of components of AI interventions.
Claude H. Miller and Reinaldo Cortes Quantip
Within a range of health communication contexts, anger can be either a detriment to the receptivity of health promotion messages when poorly controlled, or a benefit to information processing when appropriately directed. In the former case, anger can disrupt cognitive processing, leading to a range of negative outcomes, including emotional turbulence and a preoccupation with anger-eliciting events that can severely limit the receptivity of health promotion and risk prevention messages. However, when properly directed and elicited in moderation, anger can motivate greater purpose and resolve in response to health threats, stimulate more active processing of health warnings, sharpen focus on argument quality, and direct greater attention to coping-relevant information concerning harmful health risks.
Rachel A. Smith
A premise in health promotion and disease prevention is that exposure to and consequences of illness and injury can be minimized through people’s actions. Health campaigns, broadly defined as communication strategies intentionally designed to encourage people to engage in the actions that prevent illness and injury and promote wellbeing, typically try to inspire more than one person to change. No two people are exactly alike with respect to their risk for illness and injury or their reactions to a campaign attempting to lower their risk. These variations between people are important for health messaging. Effective campaigns provide a target audience with the right persuasive strategy to inspire change based on their initial state and psychosocial predictors for change. It is often financially and logistically unreasonable to create campaigns for each individual within a population; it is even unnecessary to the extent to which people exist in similar states and share psychosocial predictors for change. A challenging problem for health campaigns is to define those who need to be reached, and then intelligently group people based on a complex set of variables in order to identify groups with similar needs who will respond similarly to a particular persuasive strategy. The premise of this chapter is that segmentation at its best is a systematic and explicit process of research to make informed decisions about how many audiences to consider, why the audience is doing what they are doing, and how to reach that audience effectively.
Roxanne L. Parrott, Amber K. Worthington, Rachel A. Smith, and Amy E. Chadwick
The public, including lay members who have no personal or familial experience with genetic testing or diagnosis, as well as individuals who have had such experiences, face many intrinsic decisions relating to understanding genetics. With the sequencing of the human genome and genetic science discoveries relating genes to cancer, heart disease, and diabetes, the scope of such decisions broadened from prenatal genetic testing related to reproductive choices to genetic testing for contributors to common causes of morbidity and mortality. The decision about whether to seek genetic testing encompasses concerns about stigma and discrimination. These issues lead some who can afford the cost to seek screening through online direct-to-consumer sites rather than in clinical settings. Many who may benefit from genetic testing lack awareness of family health history that could guide physicians to recommend these diagnostic tests. Families may not discuss health history due to genetic illiteracy, with the public’s genetic illiteracy increasing their illness uncertainty and decreasing the likelihood that physicians will engage in conversations about personalized medicine with their patients. Physicians may nonetheless order genetic tests based on patients’ symptoms, during preoperative workups, or as part of opportunistic screening and assessment associated with a specific genetic workup. Family members who receive positive genetic test results may not disclose them to life partners, other family members, or insurance companies based on worries and anxiety related to their own identity, as well as a lack of understanding about their family members’ risk probability. For many, misguided beliefs that genes absolutely determine health and disease status arise from media translations of genetic science. These essentialist beliefs negatively relate to personal actions to limit genetic expression, including failure to seek medical care, while contributing to stereotypes and stigma communication. As medical science continues to reveal roles for genes in health across a broad spectrum, communicating about the relationships that genes have for health will be increasingly complex. Policy associated with registering, monitoring, and controlling the activities of those with genetic mutations may be coercive and target individuals unable to access health care or technology. Communicating about genes, health, and risk will thus challenge health communicators throughout the 21st century.
Lisbeth A. Lipari
Communication ethics concerns the creation and evaluation of goodness in all aspects and manifestations of communicative interaction. Because both communication and ethics are tacitly or explicitly inherent in all human interactions, everyday life is fraught with intentional and unintentional ethical questions—from reaching for a cup of coffee to speaking critically in a public meeting. Thus ethical questions infuse all areas of the discipline, including rhetoric, media studies, intercultural/international communication, relational and organization communication, as well as other iterations of the field.
Sandra Petronio and Maria K. Venetis
Communication privacy management theory (CPM) argues that disclosure is the process by which we give or receive private information. Private information is what people reveal. Generally, CPM theory argues that individuals believe they own their private information and have the right to control said information. Management of private information is not necessary until others are involved. CPM does not limit an understanding of disclosure by framing it as only about the self. Instead, CPM theory points out that when management is needed, others are given co-ownership status, thereby expanding the notion of disclosing information; the theory uses the metaphor of privacy boundary to illustrate where private information is located and how the boundary expands to accommodate multiple owners of private information. Thus, individuals can disclose not only their own information but also information that belongs to others or is owned by collectives such as families.
Making decisions to disclose or protect private information often creates a tension in which individuals vacillate between sharing and concealing their private information. Within the purview of health issues, these decisions have a potential to increase or decrease risk. The choice of disclosing health matters to a friend, for example, can garner social support to cope with health problems. At the same time, the individual may have concerns that his or her friend might tell someone else about the health problem, thus causing more difficulties.
Understanding the tension between disclosing and protecting private health information by the owner is only one side of the coin. Because disclosure creates authorized co-owners, these co-owners (e.g., families, friends, and partners) often feel they have right to know about the owner’s health conditions. The privacy boundaries are used metaphorically to indicate where private information is located. Individuals have both personal privacy boundaries around health information that expands to include others referred to as “authorized co-owners.” Once given this status, withholding to protect some part of the private information can risk relationships and interfere with health needs. Within the scheme of health, disclosure risks and privacy predicaments are not experienced exclusively by the individual with an illness. Rather, these risks prevail for a number of individuals connected to a patient such as providers, the patient’s family, and supportive friends. Everyone involved has a dual role. For example, the clinician is both the co-owner of a patient’s private health information and holds information within his or her own privacy boundary, such as worrying whether he or she diagnosed the symptoms correctly. Thus, there are a number of circumstances that can lead to health risks where privacy management and decisions to reveal or conceal health information are concerned.
CPM theory has been applied in eleven countries and in numerous contexts where privacy management occurs, such as health, families, organizations, interpersonal relationships, and social media. This theory is unique in offering a comprehensive way to understand the relationship between the notion of disclosure and that of privacy. The landscape of health-related risks where privacy management plays a significant role is both large and complex. The situations of HIV/AIDS, cancer care, and managing patient and provider disclosure of private information help to elucidate the ways decisions of privacy potentially lead to health risks.
Irina A. Iles and Xiaoli Nan
Counterfactual thinking is the process of mentally undoing the outcome of an event by imagining alternate antecedent states. For example, one might think that if they had given up smoking earlier, their health would be better. Counterfactuals are more frequent following negative events than positive events. Counterfactuals have both aversive and beneficial consequences for the individual. On the one hand, individuals who engage in counterfactual thinking experience negative affect and are prone to biased judgment and decision making. On the other hand, counterfactuals serve a preparative function, and they help people reach their goals in the future by suggesting effective behavioral alternatives.
Counterfactual thoughts have been found to influence an array of cognitive processes. Engaging in counterfactual thinking motivates careful, in-depth information processing, increases perceptions of self-efficacy and control, influences attitudes toward social matters, with consequences for behavioral intentions and subsequent behaviors. Although it is a heavily studied matter in some domains of the social sciences (e.g., psychology, political sciences, decision making), counterfactual thinking has received less attention in the communication discipline. Findings from the few studies conducted in communication suggest that counterfactual thinking is a promising message design strategy in risk and health contexts. Still, research in this area is critically needed, and it represents an opportunity to expand our knowledge.
Marouf Hasian Jr.
Critical studies of humanitarian discourses involve the study of the arguments, claims, and evidence that are used to justify intervention or non-intervention in key local, regional, national, or international contexts. These discourses can take the form of arguing over whether we should practice isolationism and not intervene in the sovereign affairs of other countries, or they can take the form of deliberations over the transcend needs of populations that cope with myriad disasters. In some cases these discourses are produced by foreigners who believe that the less fortunate need to be rescued from their misery, while at other times humanitarian discourses can be used in discussions about the human rights of the disempowered. Nongovernmental organizations (NGOs), nation-states, celebrities, medical communications, and militaries are just a few of the rhetors that produce all of these humanitarian discourses.
Central to many definitions of the term “cultural imperialism” is the idea of the culture of one powerful civilization, country, or institution having great unreciprocated influence on that of another, less powerful, entity to a degree that one may speak of a measure of cultural “domination.” Cultural imperialism has sometimes been described as a theory, especially where scholars build a case that the cultural influence of the stronger entity has had a pervasive, pernicious impact on the weaker.
The term evolved from 1960s neo-Marxist discourses within cultural, media, and postcolonial studies that contextualized the post–World War II “independence” wave of new nations emerging from colonial servitude. It was propelled by the writings of nationalist revolutionaries, revolutionary theorists, and their sympathizers of the 1950s and 1960s, but it has sweeping relevance across human history. The foremost western theorist of cultural imperialism in the West was Herbert Schiller. The concept was adopted and endorsed in the 1970s by both UNESCO and the Non-Aligned Movement.
Following Oliver Boyd-Barrett, the concept may denote a field of study embracing all relationships between phenomena defined as “cultural” and as “imperialism.” These encompass cultural changes that are (1) enforced on a weaker entity and (2) occur within both stronger and weaker entities through contact, contest, and resistance, including (3) assimilation of social practices encountered by the stronger in the weaker entity, and (4) original hybrids manifesting cultural traces of both stronger and weaker entities.
The concepts of cultural and media imperialism were much critiqued during the 1980s and 1990s, and many scholars preferred alternative concepts such as globalization and cultural globalization to analyze issues of intercultural contact, whether asymmetrical or otherwise. John Tomlinson critiqued the concept, identified four different discourses of cultural imperialism, and argued in favor of its substitution with the term “globalization.” Mirrlees has placed Tomlinson’s work in context by describing the dialectical—parallel but mutually aware—development of both a cultural imperialism and a cultural globalization paradigm. Both are influential in the 21st century.
“Imperialism” commonly references relations of conquest, dominance, and hegemony between civilizations, nations, and communities. “Cultural imperialism” relates primarily to the cultural manifestations of such relations. Culture and empire relate in many different ways, fueling different theories that often play on dichotomous discourses, including territorial/non-territorial, totalistic/partial, benign/malign, ephemeral/perpetual, superficial/essential, voluntary/involuntary, intended/unintended, welcome/unwelcome, forceful/peaceful, noticed/unnoticed, linear/interactive, homogeneous/heterogeneous, and acceded/resisted.
The concept has affinities with hegemony, the idea that stability in conditions of social inequality is achieved not mainly by force but by securing the consent of the masses (starting with co-option of their indigenous leaders)—through persuasion and propaganda—to the elite’s view of the world. This process is commensurate with forms of democracy that provide the appearance but not the reality of choice and control. Fissures within the ranks of the elites and within the masses create spaces for resistance and change.
Culture encompasses the totality of social practices of a given community. Social practices are manifest within social institutions such as family, education, healthcare, worship, labor, recreation, language, communication, and decision-making, as well as their corresponding domains. Any of these can undergo change following a society’s encounter with exogenous influences—most dramatically so when stronger powers impose changes through top-down strategies of command and influence.
Analysis of cultural imperialism often incorporates notions of media imperialism with reference to (1) print, electronic, and digital media—their industrialization, production, distribution, content, and capital accumulation; (2) cultural meanings that media evoke among receivers and audience cultures; (3) audience and media interactions in representations of topics, people, and ideas; and (4) relationships between media corporations and other centers of power in the reproduction and shaping of social systems.
Media are logically subsumed as important components of cultural imperialism. Yet the significance of media can be understated. The concept of mediatization denotes that “knowledge” of social practices draws heavily on media representations. Social practices that are experienced as direct may themselves be formed through exposure to media representations or performed for media.
Discourses of cultural imperialism speak to major current controversies, including: cultural suppression and genocide; ideas of “globalization”; influential economic models of “capitalism” and “neoliberalism”; ideologies that are embedded in the global spread of concepts such as “modern,” “progressive,” “growth,” “development,” “consumerism,” “free market,” “freedom,” “democracy,” “social Darwinism” and “soft power”; cultural specificity of criteria and procedures for establishing “truth”; instrumentalization for the purposes of cultural conquest of academic disciplines such as psychoanalysis, economics, social anthropology, or marketing, or environmental crises, especially as linked to western ideologies that underwrite humanity’s “right” to dominate nature.