Communication Outcomes Research Articles

The framing of Sikh Americans: White Christonormativity, discursive hyper(in)visibilities, and racialization of religion

ABSTRACT We use discourse tracing analysis to examine Sikh media representations across four U.S. newspapers in the last two decades. Guided by the theory of hyper(in)visibility, our study focuses on how representations are othered and erased through various types of discursive hyperinvisibilities, such as myopic, faulty, hazy, and selective visibilities deployed within White Christonormative structures of interpretation. Such othering and erasure then result in the looping of media reports emphasizing stereotypes, misidentification, homogenization, and simplification over 18 years, reinforcing the racialization of religious minorities in a unidimensional way that perpetuates minoritization through discursive tactics of hyper(in)visibility of multiple marginalized groups. These representations have implications that trickle down into real-world intercultural interactions across various spheres of life, including multicultural community settings and workplace interactions, and extend to policy implications such as surveillance architectures. The practical consequences result in intercultural communication outcomes involving hate speech, violence, stereotyping, and microaggressions.

The role of previous experience in the analysis of the psychological contract and its outcomes during the socialization process: a signalling theory perspective

Psychological contract theory has largely neglected the role of previous experience. In this study, we examine how previous work experience influences outcomes of communication with organizational insiders during organizational socialization among healthcare staff. We develop a model based on signalling theory, within which information acquisition during socialization is associated with psychological contract fulfilment, which is in turn is related to better health, happiness, and social relationships. Moderated mediation analysis based on data collected at entry and three months later confirms indirect effects between three types of information acquisition and three employee outcomes via the mediating role of psychological contract fulfilment. Importantly, these indirect effects are present only for inexperienced newcomers. Our findings build on signalling theory and add to knowledge about how the psychological contract forms during early socialization. They also suggest that organizations should pay particular attention to inducting inexperienced newcomers.

Fractional whale driving training-based optimization enabled transfer learning for detecting autism spectrum disorder

Autism Spectrum Disorder (ASD) is a neurological illness that degrades communication and interaction among others. Autism can be detected at any stage. Early detection of ASD is important in preventing the communication, interaction and behavioral outcomes of individuals. Hence, this research introduced the Fractional Whale-driving Driving Training-based Based Optimization with Convolutional Neural Network-based Transfer learning (FWDTBO-CNN_TL) for identifying ASD. Here, the FWDTBO is modelled by the incorporation of Fractional calculus (FC), Whale optimization algorithm (WOA) and Driving Training-based Optimization (DTBO) that trains the hyperparameters of CNN-TL. Moreover, the Convolutional Neural Networks (CNN) utilize the hyperparameters from trained models, like Alex Net and Shuffle Net in such a way that the CNN-TL is designed. To improve the detection efficiency, the nub region was extracted and carried out with the functional connectivity-based Whale Driving Training Optimization (WDTBO) algorithm. Moreover, the TL is tuned by the FWDTBO algorithm. The result reveals that the ASD detection technique, FWDTBO-CNN-TL acquired 90.7 % accuracy, 95.4 % sensitivity, 93.7 % specificity and 93 % f-measure with the ABIDE-II dataset.

Intercultural Communication of Chinese Opera: A Review of Current Research, Challenges, and Future Directions

Chinese opera, an essential component of Chinese culture, is gaining global recognition for its cross-cultural communication. This study delves into its historical context, notable international cases, influences of media and technology, communication challenges, and strategic approaches, aiming to provide a coherent overview, identify challenges, and propose future research directions in the field. Challenges include narrow research scopes, insufficient empirical studies on communication outcomes in diverse cultural settings, and deficiencies in digital and innovative practices. Future research can propel digital communication advancements and delve into local community psychological dynamics, cultural identities, and cross-cultural educational initiatives concerning Chinese opera.

Factors of Language Dominance Chosen by Young Self-Learning Bilinguals on X Platform

This study aims to explore the patterns of English language dominance among young self-learning bilinguals on platform X, while also uncovering the factors that affect their ability to communicate with others in English. Additionally, it examines how the use of English as the dominant language impacts these young bilingual learners. The research employs a qualitative approach, gathering data through in-depth interviews with participants and focusing on the social media accounts of bilingual youth engaged in independent learning on platform X. The collected data is analyzed through a data condensation process leading to conclusions. The findings indicate that specific languages play a significant role in fostering emotional connections and enhancing language proficiency, which in turn influences the dominant language usage among young self-learning bilinguals on X by creating meaningful connections through language. Furthermore, the study discusses how a language can develop linguistic skills through patterns of communicative interaction, which can affect each individual's language preferences and proficiencies. It highlights the positive correlation between proficiency in one language and proficiency in another, emphasizing the various interaction dynamics among factors such as language skills, personal backgrounds, language delivery, and the ability to interpret and understand communication outcomes.

Researcher-Reported Variables Needed for Translation of Social Communication Evidence-Based Practices for Elementary-Aged Students with Autism.

Organizations such as the National Clearinghouse on Autism Evidence and Practice have disseminated reports on evidence-based practices (EBPs) for individuals with autism to inform practice. However, some practitioners routinely employ unvalidated interventions more frequently than EBPs, signaling the presence of a research-to-practice gap. The current review investigated the degree to which single-case research studies with social communication outcomes for elementary-aged students with autism included details on variables that may impact the adoption and implementation of EBPs in practice. The results suggest limited reporting of variables that aid decision-making in the adoption and implementation of EBPs. Limited reporting can negatively impact uptake and fidelity and, therefore, student outcomes. Suggestions are made to improve researchers' reporting of the critical components of EBPs that will facilitate adoption and implementation by practitioners.

Streamlining Communication: "Resident Huddle" on General Medicine Wards at a Veterans Affairs Hospital.

Background Orienting medical trainees to new practice environments is essential. Huddles have been shown to improve communication and safety outcomes. However, their use in orienting trainees to systems processes and changes on inpatient general medicine (GM) wards remains unexplored. Objective Implement a weekly inpatient huddle between residents and hospital leaders to improve dissemination of information around health system operations. Methods In 2019, we established "Resident Huddle," a weekly 20-minute huddle for senior internal medicine residents rotating on GM wards at a US Department of Veterans Affairs Hospital led by the site leads. Resident Huddle content included system updates, rotation updates, process reminders, performance feedback, and systems and patient safety concerns raised by trainees. Reactions to the huddle were assessed via survey. Behavioral change was assessed by rates of complete trainee admission medication reconciliation documentation before and after huddle implementation. Results Resident Huddle started in October 2019 and continues to this day. Between October 2019 and June 2022, 136 of 205 participants completed surveys (66% response rate). Respondents agreed or strongly agreed that the huddle provided useful information for care delivery (94%, 128 of 136), improved work engagement (73%, 99 of 136), provided feedback on practice patterns (90%, 121 of 135), and that issues they experienced were acknowledged and acted upon (86%, 114 of 133). Retrospective medical record analysis demonstrated improvement in admission medication reconciliation completion rate by trainees from pre-intervention (32%, 19 of 60) to post-intervention (73%, 44 of 60). Conclusions A weekly huddle between hospital leaders and residents strengthened communication and equipped trainees with operational health systems knowledge to enhance patient care outcomes while fostering a greater sense of engagement with their work environment.

Effect of standardized EHR-integrated handoff report on intraoperative communication outcomes.

We evaluated the effectiveness and implementability of a standardized EHR-integrated handoff report to support intraoperative handoffs. A pre-post intervention study was used to compare the quality of intraoperative handoffs supported by unstructured notes (pre) to structured, standardized EHR-integrated handoff reports (post). Participants included anesthesia clinicians involved in intraoperative handoffs. A mixed-method approach was followed, supported by general observations, shadowing, surveys, and interviews. One hundred and fifty-one intraoperative permanent handoffs (78 pre, 73 post) were included. One hundred percent of participants in the post-intervention cohort utilized the report. Compared to unstructured, structured handoffs using the EHR-integrated handoff report led to: (1) significant increase in the transfer of information about airway management (55%-78%, P < .001), intraoperative course (63%-86%, P < .001), and potential concerns (64%-88%, P < .001); (2) significant improvement in clinician satisfaction scores, with regards to information clarity and succinctness (4.5-4.7, P = .002), information transfer (3.8-4.2, P = .011), and opportunities for fewer errors reported by senders (3.3-2.5, P < .001) and receivers (3.2-2.4, P < .001); and (3) significant decrease in handoff duration (326.2-262.3 s, P = .016). Clinicians found the report implementation highly acceptable, appropriate, and feasible but noted a few areas for improvement to enhance its usability and integration within the intraoperative workflow. A standardized EHR-integrated handoff report ensures the effectiveness and efficiency of intraoperative handoffs with its structured, consistent format that-promotes up-to-date and pertinent intraoperative information transfer; reduces opportunities for errors; and streamlines verbal communication. Handoff standardization can promote safe and high-quality intraoperative care.

360° Journalism and Empathy: Psychological Processes and Communication Outcomes

360° Journalism and Empathy: Psychological Processes and Communication Outcomes

Conversational Implicatures in Medical Discourse: An Analysis of Doctor-Patient Dialogues in Amman, Jordan

Effective communication is crucial in medical practice, and adherence to Grice's conversational maxims (quantity, quality, relevance, and manner) can improve communication between doctors and patients. In medical practice, doctors must provide clear and concise information while being honest about medical conditions and treatment options. It is also essential for doctors to communicate using simple language to ensure that the patients understand. This study analyses conversational implicature considering medical discourse in Amman. Twenty-six observations (tape-recorded doctor-patient dialogues) were randomly selected from private and government clinics in Amman, Jordan. The data was sorted and analyzed using the qualitative method of a six-phase framework. This study identifies the cooperative principles, their functions, and conversational implicature in doctor-patient discourse. Our results indicate the significance of all four conversational maxims in medical discourse, with manner being the most prominent aspect, followed by quality, relevance, and quantity. The function of cooperative principles observed in presenting the concepts of expression, direction, assertion, and declaration enhances the quality of medical discourse and promotes clarification in conversation. We observed that non-cooperative conversational implicatures are more frequently used in the doctor-patient dialogue, flouting Grice’s maxims. This flaw could lead to ineffective communication and negative health outcomes. In medical discourse, 66.7% of instances violated the Grice maxim, indicating non-cooperative conversation, while 33.3% involved cooperative implicature. The effective observance of the conversational maxims can positively impact doctors' communication with patients and promote better understanding of medical condition and treatment options that may lead to improved health outcomes.

The coproduction of a multilevel personal narrative intervention for people with aphasia in a community communication support group—A pilot study

IntroductionPeople with aphasia (PWA) face challenges in sharing personal stories due to communication difficulties. Discourse treatment in aphasia focusing on personal narrative macrostructure has yet to receive the attention this warrants of researchers and clinicians. Emerging person-centered approaches involve coproduction and codesign with PWA for meaningful discourse treatments. Few studies explore discourse treatment's impact on functional communication. This pilot study aims to explore whether the use of the coproduction approach in the development of a multilevel personal narrative intervention at the group level increased the production of macrostructure elements in trained and untrained narrative discourse contexts, improved aphasia severity and functional communication skills, and advanced quality of life of the participants with aphasia.MethodsAn ABA design was followed featuring a pre-treatment baseline assessment phase, a treatment phase, and a post-treatment assessment phase immediately after treatment was completed. Three people with chronic stroke-induced aphasia, three communication partners, and a moderator took part in the study. All participants were members of a university-led community aphasia communication group. The research protocol consisted of eleven, two-hour, weekly sessions over an 11-week block. Nine treatment sessions were carried out following codesign and coproduction methods that focused on participants with aphasia producing words, sentences, and total communication strategies to express macrostructure elements in their personal stories. Assessment measures were collected at baseline and post-treatment to evaluate improvements in trained and untrained narrative abilities, aphasia severity, functional communication, and the impact of aphasia on quality of life.ResultsMultilevel personal narrative therapy improved the narrative skills of the participants with aphasia at the macrostructural level of narrative discourse. Improvements were also observed in functional communication and quality of life post-treatment.DiscussionThe involvement of participants with aphasia in the codesign and coproduction of the treatment content for the group intervention facilitated improvement in narrative skills, functional communication, and overall quality of life with aphasia. It is recommended that researchers and clinicians consider using content from the personal narratives of clients with aphasia to build discourse treatment and adopt codesign and coproduction approaches, when designing interventions for people with chronic aphasia, to improve communication outcomes in everyday life.

Pushing hands and buttons: The effects of corporate social issue stance communication and online comment (in)civility on publics’ responses

Despite increasing interest and involvement in corporate social advocacy (CSA) among companies, there are growing concerns among public relations scholars and practitioners regarding the undesired outcomes of CSA communication. To advance the knowledge of whether and how CSA communication might contribute to enhancing publics’ support for an organization, a 3 (organizational issue stance: pro-refugee immigration vs. against-refugee immigration vs. open dialogue) x 2 (social media comment civility: civil vs. uncivil) between-subjects online experiment was conducted with a U.S. adult sample (N = 1388). We found when the organization expressed its pro-refugee immigration stance (in contrast to advocating against refugee immigration or calling for open dialogue), greater support toward the organization was intended by participants. Advocating for open dialogue about refugee immigration resulted in undesired effects only when social media user comments following the CSA communication were uncivil, as it led to higher level of conflicted and cynical feelings sequentially, which in turn lowered participants’ intended support for the organization. Political ideology and pre-existing issue stance were key moderators influencing participants’ responses to the organization’s CSA statement. Theoretical and practical implications for public relations scholars and practitioners are further discussed.

Caregiver-Youth Communication Patterns and Sexual and Reproductive Health Among American Indian Youth.

Improving communication between American Indian caregivers and their youth has been suggested as an Indigenous-forward strategy to help alleviate the sexual and reproductive health (SRH) disparities faced by American Indian youth as a result of the legacy of colonial violence against American Indian communities. Studies with non-American Indian and American Indian populations suggest that effective communication about SRH between parents and youth plays a role in reducing sexual risk behaviors among youth. There is limited research that examines youth sexual risk behaviors in relation to communication patterns separately assessed in caregivers and youth. The current study aimed to examine the association between caregiver-youth communication patterns and engagement in sex, age at sexual debut, and condom use among American Indian youth in the United States. The study draws on baseline caregiver and youth data collected fromNen ŨnkUmbi/EdaHiYedo, astepped wedge design trial with American Indian youth living on the Fort Peck Reservation in Montana. 113 caregiver responses were matched to 145 youth for the current study. Caregiver-youth communication patterns were examined in relation to youth engagement in sex, age at sexual debut, and number of protected acts of vaginal and/oranal sex. Multivariable models were used to adjust for confounders and to examine relationships between caregiver-youth communication and youth sexual risk outcomes. An increase in overall level of self-reported youthcommunication with caregivers about sexual and reproductive health topics was significantly associated with a greater likelihood of youth ever having engaged in sex. A significant interaction effect between youth communication and convergence with caregiver response was observed for the number of protected acts of vaginal and/or anal sex, where caregiver communication (regardless of self-reportedyouth communication with caregivers) was associated with a greater number of protected sex acts. This study fills a gap in the extant literature by reporting on relationships between communication about SRH, assessed separately in caregivers and youth, and youth sexual risk behaviors. Findings emphasize the importance of involving American Indian caregivers in SRH interventions to improve SRH outcomes among American Indian youth, and inform future experimental research that will evaluate how changes in caregiver communication potentially impact youth SRH.

Augmentative and alternative communication for individuals with post-stroke aphasia: perspectives of South African speech-language pathologists

This qualitative study aimed to describe speech-language pathologists’ (SLPs’) perspectives on augmentative and alternative communication (AAC) use for people with post-stroke aphasia focusing on: (a) current AAC practice, (b) factors that influence the use of AAC, and (c) the success and relevance of AAC interventions. Semi-structured interviews took place with ten South African SLPs with experience in aphasia intervention. The transcribed interviews were thematically analyzed using a six-phase process of inductive and deductive analysis within a phenomenological framework. All the participants use AAC with their clients, employing a variety of approaches that reflect their diverse settings, experiences, and perspectives on AAC. AAC use is complex, and SLPs make conscious choices considering multiple factors. Barriers to use were often associated with limited resources in the low- and middle-income country (LMIC) context, but most participants retained a positive view of AAC, actively working to circumvent barriers to use. Participants consistently emphasized the vital role of partners in communication interactions, linked to the importance of defining AAC broadly. It is necessary to advance the integration of AAC into rehabilitation plans to improve communication and social participation outcomes for people with post-stroke aphasia, especially in LMICs such as South Africa.

Adherence and Opportunity Frequency as Predictors of Communication Outcomes from Pivotal Response Parent Training.

Access to intervention is a barrier for children with autism. As parent-mediated interventions have emerged to address this need, understanding implementation components contributing to child gains is critically important. Existing literature documents relationships between parent treatment adherence and child progress; however, less is understood about components, such as frequency of learning opportunities, which could also affect child outcomes. This study is a secondary analysis of data from a randomized controlled trial evaluating Pivotal Response Treatment group parent training (PRTG) compared to psychoeducation. Linear regression and mediational models were employed to identify potential predictors and mediators of outcome. PRTG produced large increases in adherence and learning opportunities. In general, greater frequency of learning opportunities and adherence predicted better child outcomes. The best-fitting cross-sectional mediational models indicated at least partial mediational effects, whereby increased learning opportunities mediated the relationship between greater adherence and improved child outcomes. This study provides preliminary evidence of how early gains in adherence may support parents to provide more frequent learning opportunities, which, in turn, yield positive effects on child social communication. Future large-scale research, with greater granularity of measurement, is needed to further understand the temporal relationships between these variables.

Improving young patient- practitioner communication about sexual health during medical visits.

Young people face barriers that lead to gaps in sexual and reproductive health care communications. Issues such as discomfort discussing sexual health lead to inadequate delivery of services resulting in unintended pregnancies and STIs. Closing this communication gap between patients and health care practitioners would improve communication and health outcomes. The objective of this study was to gain feedback from focus groups about: (a)barriers and facilitators to communication surrounding sexual health and (b)the feasibility and acceptability of a question prompt list (QPL) and informational video emphasizing asking questions about sexual health during medical visits as tools young people could use to be more involved during visits. Three focus groups were conducted: two with young adults (n=14) and one with practitioners (n=5) of sexual/reproductive health care services. Practitioners were recruited from healthcare clinics. Young adults were aged 18-22 years old. Participants identified barriers to communication such as embarrassment over sexual health topics and practitioner assumptions about patients' base of knowledge. A facilitator to communication was patient-friendly language. Focus group participants offered suggestions on how to improve the QPL as well as themes that should be covered in an educational video. Participants viewed the QPL and educational video as useful for encouraging conversations between patient and practitioner. Many barriers obstruct communication between young adults and practitioners on topics relating to sexual health. Both the QPL and an educational videocould be used to enhance patient-practitioner communication.

Examining the role of pre-visit anxiety on patient uncertainty and breast cancer patient-provider communication.

Effective communication between cancer patients and providers is critical for addressing psychological distress, reducing uncertainty, and promoting patient well-being. This is particularly relevant during medical appointments that may elicit uncertainty, such as surgical consultations for newly diagnosed women with breast cancer. This study aimed to evaluate how pre-appointment anxiety and illness uncertainty affect patient-provider communication in breast cancer surgical consultations and subsequent post-appointment well-being. Breast cancer patient anxiety has been studied as an outcome of provider communication, though less is known about the extent to which preexisting anxiety or uncertainty act as antecedents to effective patient-provider communication. This study analyzed videorecorded breast cancer surgical consultations (N = 51) and corresponding patient surveys to understand how pre-appointment anxiety influences pre-appointment patient uncertainty, patient-provider communication during the appointment, and subsequent post-appointment uncertainty. The proposed model achieved good fit to the data such that more pre-appointment anxiety was associated with more pre-appointment uncertainty, more pre-appointment anxiety was associated with more empathic opportunities per minute, and more empathic opportunities were associated with less post-appointment uncertainty. Results indicate breast cancer patients with anxiety pre-appointment are at-risk for more illness uncertainty and are more likely to explicitly provide empathic opportunities. This supports the need for added attention to empathic opportunities to not only address patients emotionally but to also assess whether a patient may be at higher risk of having preexisting anxiety.

Contextualized, Multicomponent Language Instruction: From Theory to Randomized Controlled Trial.

Clinicians address a wide range of oral language skills when working with school-age students with language and literacy difficulties (LLDs). Therefore, there is a critical need for carefully designed, rigorously tested, multicomponent contextualized language interventions (CLIs) that have a high likelihood of successful implementation and measurable academic impacts. This clinical focus article summarizes the development and testing of a CLI entitled Supporting Knowledge in Language and Literacy (SKILL), which is a supplementary narrative intervention program for elementary school-age children. Our aims are to (a) to review the foundational theoretical models that are the foundation of SKILL; (b) describe the iterative process used to develop the phases, lessons, procedures, materials, and progress monitoring tool; (c) summarize recent findings of the randomized controlled trial that was conducted to test its efficacy; and (d) discuss factors that may contribute to successful implementation of multicomponent language interventions. A total of 357 students in Grades 1-4 with LLDs were randomized to a treatment group or to a business-as-usual control group. The treatment group received the SKILL curriculum in small groups during 30-min lessons by trained speech-language pathologists, teachers, and special educators. Students who received SKILL significantly outperformed those who did not on oral and written measures of storytelling and comprehension immediately after treatment and after 5-months at follow-up. Gains were similar among students with different levels of language ability (at-risk, language impaired) and language status (monolingual, bilingual) at pretest. There is growing support for the use of multicomponent CLIs to bring about educationally relevant outcomes for students with LLDs. The authors present this review of how SKILL was designed, manualized, and rigorously tested by a team of researchers and practitioners with the hope that this approach will serve as a springboard for the development of future multicomponent CLIs that may meaningfully improve communicative and educational outcomes for students with LLDs.

The dimensions of uncertainty and ambiguity in adolescents and young adults' romantic relationships: A systematic review

Contemporary romantic relationships in adolescence and young adulthood no longer follow a linear trajectory but come to be increasingly characterized by high heterogeneity. Social networks have also constituted a new context for interaction, which has given rise to the tendency to enact behaviors characterized by uncertainty and ambiguity. This study aims at providing a framework of the existing literature contributions on the dimensions of relational uncertainty and relational ambiguity in adolescents and young adults' romantic relationships. A state-of-art systematic review was performed on PsycInfo, Google Scholar, Scopus, and Science Direct, adopting the PRISMA statement. Through a qualitative analysis, four themes emerged from the 23 included articles: (a) the definitions of relational uncertainty and relational ambiguity, (b) the impact on the quality of the romantic relationship, (c) communicative and individual outcomes, and (d) coping strategies.

Implementing a Uniform Outcome Measurement Approach for Early Interventions of Autism Spectrum Disorders

Naturalistic developmental behavioral interventions for children with autism spectrum disorder show evidence for effectiveness for specific social communication targets such as joint attention or engagement. However, combining evidence from different studies and comparing intervention effects across those studies have not been feasible due to lack of a standardized outcome measure of broader social communication skills that can be applied uniformly across trials. This investigation examined the usefulness of the Brief Observation of Social Communication Change (BOSCC) as a common outcome measure of general social communication skills based on secondary analyses of data obtained from previously conducted randomized controlled trials of 3 intervention models, Early Social Intervention (ESI), Early Start Denver Model (ESDM) and Joint Attention Symbolic Play Engagement and Regulation (JASPER). The subset of datasets from the 3 randomized controlled trials was created to examine differences in the BOSCC scores between intervention and control groups over the course of the interventions. Based on 582 videos from 207 caregiver-child dyads, the BOSCC noted significant differences between intervention vs control groups in broad social communication skills within 2 of the 3 intervention models, which were longer in duration and focused on a broad range of developmental skills. The BOSCC offers the potential to take a uniform measurement approach across different intervention models to capture the effect of intervention on general social communication skills but may not pick up the effects of some brief interventions targeting proximal outcomes. Comparing Parent-Implemented Interventions for Toddlers With Autism Spectrum Disorders; https://www. gov/; NCT00760812. Intensive Intervention for Toddlers With Autism (EARLY STEPS); https://www. gov/; NCT00698997. Social and Communication Outcomes for Young Children With Autism; https://www. gov/; NCT00953095.