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.
Doug Ashwell and Stephen M. Croucher
The Global South–North divide has been conceptualized in political, cultural, economic, and developmental terms. When conceptualizing this divide, issues of economic growth/progress, technology, political and press freedom, and industrialization have all been used as indicators to delineate between the “North” and the “South.” The North has traditionally been seen as more economically, technologically, politically, and socially developed, as well as more industrialized and having more press freedom, for example; the South has been linked with poverty, disease, political tyranny, and overall lack of development. This conceptualization privileges development efforts in the Global South based on democratic government, capitalist economic structures with their attendant neoliberal agenda and processes of globalization. This negative view of the South is a site of contest with people of the South offering alternative and more positive views of the situation in the South and alternatives to globalization strategies. While there may be some identifiable difference between some of the countries in the identified Global South and Global North, globalization (economic, political, technological, etc.) is changing how the very Global South–North divide is understood. To best understand the implications of this divide, and the inequalities that it perpetuates, we scrutinize the Global South, detailing the background of the term “Global South,” and examine the effect of globalization upon subaltern groups in the Global South. We also discuss how academic research using frameworks of the Global North can exacerbate the problems faced by subaltern groups rather than offer them alternative development trajectories by empowering such groups to represent themselves and their own development needs. The culture-centred approach to such research is offered as alternative to overcome such problems. The terms usage in the communication discipline is also explained and the complexity of the term and its future is explored.
Chris R. Sawyer
Communication scholarship has profited greatly by the rise of social science during the mid-20th century. This scientific progress has been marked by increased outlets for peer-reviewed research, thriving sub-disciplines, and a rapidly accumulating corpus of findings. Social scientists have accomplished this feat largely by conducting tests of empirical models and their associated constructs. Over the same span of time, the discipline’s most prolific researcher, James C. McCroskey, pioneered the study of the construct with which he is most closely associated. Communication apprehension (CA) has impelled generations of scholars to investigate possibly the greatest impediment to successful communication, namely the fear of interacting with fellow humans. Tracing its development reveals that CA meets the standards for theory bridges: truth, abstraction, progress, and applicability. Consequently, describing CA as a bridge construct rests on four interrelated claims. First, the primary aim of CA research is to discover the truth about social anxiety. Studies of CA have outstripped competitor explanations for speaker anxiety by yielding an extensive literature of peer-reviewed articles, books, and doctoral dissertations. These writings are predicated on the presumption that CA taps into the true nature of social anxiety. Second, self-reported measures of CA, such as the PRCA-24, allow for enough abstraction to support scientific generalization. This makes it possible for CA researchers to connect concrete observations to abstract principles. Third, CA research contributes to scientific progress in communication. Explanations for CA have generally reflected theories and perspectives at the horizon of the field. Last, CA research impacts on the quality of everyday life. Ultimately, CA researchers seek to develop treatment and educational strategies for the one-fifth of the general population afflicted with this condition. Taken together, CA has served as a bridge construct that enables scholars to pursue truth, formulate testable generalizations, achieve scientific progress, and potentially improve the quality of human life.
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.