Health Communication Scholars Research Articles

Blurring the Paradigmatic Edges: Navigating the Boundaries Between Critical-Interpretive and Interpretive Approaches to Health Communication Research

Critical-interpretive health communication (CIHC) scholars take seriously the imperative to “take an ethical position” on communicative phenomenon, specifically identifying both issues of power as well as opportunities to catalyze social change (Zoller & Kline, 2008, p. 93) Yet, researchers are also likely to encounter competing impulses to understand or even appreciate others’ lived experiences in line with interpretive health communication (IHC) practices. My perspective essay traces the blurry edges between CIHC and IHC, and offers guidance to researchers who traverse these borders. Specifically, I articulate the key points of convergence and divergence between CIHC and IHC perspectives, and consider the questions and implications accompanying these approaches.

Doing Critical Health Communication: Negotiating the Terrain of Transdisciplinary Collaboration

In this article, we think about how critical health communication scholars can speak to audiences outside the discipline in order to make an impact on public health and policy, health promotion, and health care delivery. We take into consideration how are we situated in our relationship with transdisciplinary research as well as the challenges and opportunities involved in collaborating with transdisciplinary teams including the ways we can navigate the inherent method/ological tensions in such collaborations. We focus on how the methodological considerations of “critical” health scholarship are situated vis-a-vis the epistemic status quo commitments in the disciplines of our potential allies.

Does Discrimination Breed Mistrust? Examining the Role of Mediated and Non-Mediated Discrimination Experiences in Medical Mistrust

Medical mistrust is associated with a decreased likelihood of engaging in various health behaviors, including health utilization and preventive screening. Despite calls for research to address medical mistrust, few studies have explicitly delved into antecedents to medical mistrust. The current study a) examines the relationship between discrimination experiences and medical mistrust and b) experimentally tests the influence of mediated vicarious discrimination on reported levels of medical mistrust. Participants (N = 198) were randomly assigned to view news stories in one of four experimental conditions: no exposure, no discrimination control, implicit racial discrimination, and explicit racial discrimination. Results indicated prior personal and vicarious discrimination experiences were related to medical mistrust. Furthermore, exposure to mediated discrimination influenced medical mistrust in different ways for Black and White participants. Among Black participants, medical mistrust was significantly higher for those exposed to the implicit racial discrimination condition than the control condition. Marginal differences were found for White participants such that those exposed to both explicit and implicit racial discrimination conditions reported higher medical mistrust than those exposed to the control condition. Our findings are discussed in terms of the theoretical and practical implications for health communication scholars seeking to examine and influence health behaviors.

Critical Health Communication Methods: Challenges in Researching Transformative Social Change

This reflexive essay describes how methodological choices involved with critical commitments to understanding the economic and political roots of health status lead to challenges in the field that intersect with the politics of academic training, visibility, and publishing. Through the lens of my own research experiences, I discuss lessons learned as well as ways that I continue to struggle. I consider issues that are primarily personal and those that we should address as a field. In the essay, I describe six observations from my experiences researching transformative social change that have implications for critical health communication scholars and the discipline of health communication.

Examining Assumptions in Science-Based Policy: Critical Health Communication, Stasis Theory, and Public Health Nutrition Guidance

Recent work in rhetoric of science, technology, health, and medicine argues for a shift away from critique, even as some health communication scholars call for critical engagement with the situated, ideological nature of scientific claims supporting public health messages. We suggest that critique of scientific claims remains important to rhetoricians of health and medicine, but that such critique must go further in examining interactions between science, values, and public health policy. We offer an adapted version of stasis theory as a framework for pursuing this end. Using the U.S. public health nutrition policy Dietary Guidelines for Americans as a case study, we engage this framework to explore how science-based nutrition policy provides a discursive lens that influences how subsequent scientific evidence is produced, interpreted, and employed.

Insider/Outsiders, Reproductive (In)justice, and the U.S.-Mexico Border

ABSTRACT In this article, we combine narrative and visual elements – our experiences as scholars in reproductive justice, health communication, and border studies coupled with photos from reproductive justice activist marches we attended in El Paso and Houston – to advocate for a stronger coalition between health communication scholars and Latina/o communication scholars in responding to and resisting reproductive injustices and gendered violence currently occurring at the U.S.-Mexico border.

Responding to depression-related Imgur posts: A content analysis of social support and non-bona fide features in user-generated comments.

ObjectivesA growing body of health communication scholarship has explored the utility of social media platforms for eliciting social support, although much of this scholarship has focused on Facebook and Twitter. This study contributes to this body of research by identifying support in comments submitted to depression-related Imgur posts. Furthermore, the use of non-bona fide linguistic features (e.g. humor, sarcasm, and irony) is documented for comparison with supportive elements.MethodsA content analysis was performed of 1530 comments submitted in response to 20 popular Imgur posts about depression, including the emergence of four social support types outlined by the Multi-Dimensional Support Scale—reassuring, empathic, informational, and tangible support—as well as non-bona fide features.ResultsFindings suggest a supportive discourse, with nearly 60% of comments containing some supportive element. Reassuring and informational support emerged most prominently (26.3% and 26.2% of comments, respectively), followed by empathic (22.9%) and tangible (0.3%) support types. Non-bona fide features manifested in 28.8% of comments. Results indicate significant covariation between non-bona fide features and support, as these infrequently co-occurred.ConclusionsThis study’s findings suggest that depression-related messages frequently receive support from Imgur commenters, especially reassuring and informational support. Additionally, this study provides a conceptual framework for future analyses of online social support by integrating non-bona fide communication with established support types. The results of this study could have implications for health professionals and scholars interested in the use of social media platforms such as Imgur, which serves a predominantly young male demographic, for support provision.

Defining Moments…Telling Stories to Foster Well-being, Humanize Healthcare, and Advocate for Change

ABSTRACTHealth Communication launched the “Defining Moments” forum in 2009 to showcase the social and material power of storytelling. On its 10-year anniversary, we take stock of how authors have enacted “Defining Moments” including what was narrated, by whom, and why. In eight loosely coupled thematic clusters, we revisit the more than 75 published essays to date, finding value in ways that speak to the emerging and enduring issues of concern for health communication scholars. Across the essays, the maturation of health narrative theorizing is revealed by the sheer scope of topics addressed, coupled with the expanded voices and ways of voicing experience. Collectively, these essays have enlarged academic conventions and offered diverse entry points for refiguring the experience of illness and well-being.

Big Data, Computational Social Science, and Health Communication: A Review and Agenda for Advancing Theory

ABSTRACTContemporary research on health communication has been marked by the presence of big data and computational social science (CSS) techniques. The relative novelty of these approaches makes it worthwhile to consider their status and potential for advancing health communication scholarship. This essay offers an introduction focusing on how big data and CSS techniques are being employed to study health communication and their utility for theory development. Key trends in this body of research are summarized, including the use of big data and CSS for examining public perceptions of health conditions or events, investigating network-related dimensions of health phenomena, and illness monitoring. The implications of big data and CSS for health communication theory are also evaluated. Opportunities presented by big data and CSS to help extend existing theories and build new communication theories are discussed.

Storytelling in Acoustic Spaces: Podcasting as Embodied and Engaged Scholarship

ABSTRACT Health Communication launched the “Defining Moments” feature of the journal in 2009, including essays that showcase the social and material power of storytelling. Over the past 10 years, essays have enlarged academic conventions and offered diverse entry points for refiguring the experience of living well in the midst of inescapable illness, trauma, and disability. Health Communication builds on this legacy by introducing a podcast by the same name. In this essay, I position podcasting as embodied and engaged scholarship that connects health communication scholars, physicians and other care providers, patients and families, and general publics interested in illness and healthcare, vulnerability and well-being.

Old‐age language variation and change: Confronting variationist ageism

AbstractThe speech of older adults (65+ years old) is a rich resource for a wide range of researchers, including oral historians, developmental psychologists, health communication scholars, speech and hearing specialists, and discourse analysts. Yet in variationist sociolinguistics—the study of language variation, language change, and their social motivations—older adults have fallen afoul of a kind of scholarly ageism. Often consigned to the status of a historical benchmark against which the speech of younger people is compared, and with only rare acknowledgment of their biological, psychological and social diversity, old‐age speakers deserve greater attention. This article provides linguists with an overview of relevant conceptualizations of age and ageing in gerontology, explains why a focus on older speakers is critical to the advancement of the study of language variation and change, and offers practical suggestions for overcoming some of the challenges associated with old‐age research.

A Cardiology Exhibit at a Science Museum, Viewed as Speech Acts in Sequence

ABSTRACTAn exhibit about cardiology at a science museum is an elaborate form of health communication, with messaging happening across text, pictures, models, and videos. This qualitative case study uses concepts of speech act sequencing and interpellation to explain a series of multimodal exhibits about cardiovascular health. Health exhibits are described as verbal and audiovisual arguments combining assertions of information; directives to change behavior, and designations of risk candidacy—or sequences of assertive, directive, and declarative speech acts. Visitors are targeted as heart disease candidates according to their risk factors, such as hypertension, overweight, and inactivity. Communication research focused on health exhibits is rare, and this article presents a new way of looking at them that contributes to the current discussions about controlling language. Implications for health communication scholars and multimedia message designers are explored.

TV, Social Media, and College Students’ Binge Drinking Intentions: Moderated Mediation Models

Many studies to date have examined how media influence health-related behavior through social norms. However, most studies focused on traditional media. In the era of traditional and social media integration, our study advances health and mass communication scholarship by examining the influence of both traditional and social media mediated through social norms. Also, we examined a boundary condition for the norms-mediated media influence process. Namely, in the context of college binge drinking, we predict that exposure to TV and social media prodrinking messages can influence college students’ binge drinking intentions through perceived peer descriptive and injunctive norms. We also predict that group identification will moderate this indirect effect. Our moderated mediation models were tested via structural equation modeling (N = 609). We found that college students’ exposure to social media prodrinking messages indirectly influenced their binge drinking intentions via perceived injunctive norms, and students’ identification with their peers moderated this indirect effect. However, neither descriptive nor injunctive norms mediated the influence of students’ exposure to TV prodrinking messages on their binge drinking intentions. Theoretical and practical implications of the findings are discussed.

Anticipating Loss: Learning to Live with My Father’s Cancer

ABSTRACTIn this article, I explore my experience living with my father’s cancer diagnosis and treatment, as well as how it has affected our family. I discuss how this 12-year journey of living with cancer as a chronic illness has impacted my experience and how living with the anticipation of loss has shaped me. I reflect on the dialectical tension faced by families dealing with chronic cancer and the implications for how health communication scholars explore the impact of cancer on family members.

A narrative framework for forgiveness at the end of life: suggestions for future research in health communication

ABSTRACTForgiveness is a topic that is relevant and prominent in end of life conversations. However, while the process of forgiveness has become increasingly studied in health contexts by communication scholars, through various methodologies and across multiple contexts, research on forgiveness in the end of life context, particularly in the field of health communication, is lacking. Moreover, there is a need for qualitative inquiry, and I argue that as this research gap is addressed, the projects of the medical humanities and hospice can—and should—inform how health communication scholars situate and understand forgiveness at the end of life. This essay proposes an interpretive narrative approach, which grounds forgiveness within the narratives of the living and the dying, of persons and not patients.

IRB Problems and Solutions in Health Communication Research

ABSTRACTIn this article, we contribute to the current literature on the difficulties that social scientists encounter with IRBs, but with a focus on the distinct challenges that health communication scholars face in dealing with IRBs at their own institutions and elsewhere. Although health communication researchers, like other communication researchers, can expect to face many of the same challenges that their social science colleagues face during the IRB process, the researcher narratives we present in this article suggest that health communication research presents some distinct challenges because the communication interactions that we investigate occur in highly protected, private spaces, including the medical exam room, online patient forums, and electronic health records. To that end, we present a series of examples in which health communication researchers were able to find solutions or workarounds to the challenges they faced in gaining IRB approval for their research. In every case that we present, the researcher had to revise her initial study design to get around the constraints imposed by IRB requirements, and in every case, the researcher reports having experienced points of incommensurability similar to those reported by many other social scientists. In some situations, investigators even express frustration that the IRB’s needs and demands superseded those of healthcare professionals and the patients whom they serve. Additionally, in some situations, investigators’ understandings of human subjects’ protection actually go further to protect patients’ privacy and confidentiality than the IRB required. But, in all four cases that we present, the health communication research was ultimately successful.

Perceived Stress in Online Prostate Cancer Community Participants: Examining Relationships with Stigmatization, Social Support Network Preference, and Social Support Seeking

Men with prostate cancer often need social support to help them cope with illness-related physiological and psychosocial challenges. Whether those needs are met depends on receiving support optimally matched to their needs. This study examined relationships between perceived stress, prostate cancer-related stigma, weak-tie support preference, and online community use for social support in a survey of online prostate cancer community participants (n = 149). Findings revealed a positive relationship between stigma and perceived stress. This relationship, however, was moderated by weak-tie support preference and online community use for social support. Specifically, stigma was positively related to perceived stress when weak-tie support was preferred. Analyses also showed a positive relationship between stigma and perceived stress in those who used their online community for advice or emotional support. Health communication scholars should work collaboratively with diagnosed men, clinicians, and online community administrators to develop online interventions that optimally match social support needs.

A Content Analysis of Publication Trends in Internet-Focused Healthcare Communication Research: A Look at the Past and Potential Future of the Field

Both healthcare professionals and scholars are recognizing the potential of the Internet as a valuable channel for health communication. Compared with traditional media channels, the Internet has expanded the range of an individual’s health information seeking behavior. Although some research has shed light on the trends, patterns, and directions in general health communication scholarship, research addressing Internet-focused topics has not yet been undertaken. This study explored the trends in discipline, topic, theory, and methodology of Internet-focused research in nine top-ranked journals over sixteen years. The findings identified some notable trends and potential future directions of the field. The authors found that Internet-focused research in health communication is highly interdisciplinary. For example, researchers from both communication- and medical-related fields have contributed to this field of research. Published research about the Internet and new communication technologies in the nine journals have increased greatly over sixteen years. For instance, the number of published studies about Internet-focused research increased from 0 in 1997 to 36 in 2012. A wide range of diverse topics have been investigated, such as health information seeking, online social support, and advancements in health care. In addition, a limited number of theories and methodologies have been employed across studies. The results showed only a small amount of Internet-focused health communication articles used explicit theoretical frameworks. Interdisciplinary research efforts, specifically between scholars from communication and health-related fields are strongly encouraged to investigate Internet health communication phenomena. In addition, health communication scholars are encouraged to develop and test theories that specifically deal with new media topics.

The Role of the Built Environment: How Decentralized Nurse Stations Shape Communication, Patient Care Processes, and Patient Outcomes

ABSTRACTIncreasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians (“techs”) and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.

“We’re a Culture, Not a Costume:” Ethical Analysis of a College Student-Led Organization’s Anti-Racism Campaign

Students Teaching against Racism in Society (STARS) attracted both national and international headlines in October 2011 with their anti-racism campaign entitled “We’re a culture, not a costume.” At the time of the campaign, STARS was composed of ten undergraduate student members at Ohio University (OU). Situated in Athens, Ohio, OU has a history of hosting block parties for Halloween. In order to combat “racist” costumes, STARS initiated a campaign, funded by the Dean of Students in order to foster conversation and to bring awareness to racist, discriminatory, stereotypical, and prejudiced Halloween costumes. This campaign raises many ethical dilemmas. Therefore, this analysis seeks to explore implicit and explicit values and ethical dilemmas inherent within the campaign. Since racial inequalities often lead health disparities, this ethical analysis of STARS’ campaign has implications for both intercultural and health communication scholars. Additionally, future implications and directions of research as well as future considerations for similar campaigns are discussed.