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Given that individuals have (some) agency to influence their own experiences of aging via communication, it is important to better understand factors that may play a role in these processes. Specifically, this study examined whether and how themes of aging-related memorable messages (e.g. aging involves physical or mental health struggles; age is merely a subjective state) and the extent to which a message offered a sense of positivity and efficacy predicted individuals' efficacy assessments (coping, target, communication) and intention to seek additional information about aging processes. Analyses of responses from a sample of 232 older adults from the United States revealed that memorable message: (a) themes about aging predicted participants' reports of memorable message positivity and efficacy, (b) valence predicted memorable message positivity and efficacy, and (c) characteristics (positivity and efficacy) predicted individuals' efficacy assessments and, ultimately, intention to seek information about aging processes (both directly and indirectly). Results offer theoretical and practical implications. [ABSTRACT FROM AUTHOR]

Guided by theories of communicative disenfranchisement (TCD) and memorable messages (ToMM), this study analyzes 60 open-ended survey responses detailing experiences of grief following the onset of invisible, physical illness (e.g., chronic overlapping pain conditions, autoimmune rheumatic diseases). Employing reflexive thematic analysis, we identify (1) illness-related losses that are disenfranchised by discourses surrounding grief and (2) opportunities to enfranchise these losses via memorable messages. Situated at two points in time, before and after the onset of illness, we identify disenfranchised losses as what once was (e.g., physical [in]dependence, relational connection, images of self, and trust in institutions) and what will never be (e.g., family planning and career dreams). Next, we identify opportunities to disrupt this disenfranchisement through memorable messages of presence (e.g., nonverbal acknowledgment and verbal expressions of belief) and finding the fit (e.g., physical restructuring and community connection). In doing so, we extend theoretical understanding of both memorable messages, in the form that they can take (of experience) and as points of (dis)enfranchisement, and communicative (dis)enfranchisement. This study contributes to a growing body of health communication research on disenfranchising experiences in chronic illness by highlighting a resulting experience of illness not often talked about – illness-related loss and its grief process. Theoretical and practical implications, as well as limitations and future directions, are discussed. [ABSTRACT FROM AUTHOR]

It is estimated that there are 65 million people globally – 19 million U.S. adults alone – who have long COVID, or persistent symptoms and conditions that continue or develop after an initial SARS-CoV-2 infection. Amidst their suffering and the ambiguity surrounding their health, people with long COVID engage processes of reintegrating from disruptions brought upon by their COVID-19 infection and its fallout, as well as the pandemic writ large. This process is communicative resilience (Buzzanell, 2010, 2017, 2019), and the purpose of this study is to document the experiences of people with long COVID as they sensemake, adapt, and transform their lives through communication. We employed longitudinal interviewing during the middle stages of the pandemic (Summer 2021 to Summer 2022), talking to 19 people with long COVID over the course of one year (five interviews each; 89 total interviews). Grounded in the six processes of communicative resilience, findings center the temporal and dialectic nature of resilience, with throughlines of grief, patience, and hope set against a tumultuous sociopolitical backdrop. Findings of this study have implications for how resilience is studied across time; how people learn to live with chronic illnesses; and how to support people living with long COVID and those who provide them care. [ABSTRACT FROM AUTHOR]

Engaging the public and community organizations in local health actions greatly assists disease prevention and control. However, it remains unclear how organization-public relationships (OPR) and communication networks within communities contribute to community health actions. To fill this gap, a survey was conducted among community members in Shanghai, China, who were challenged by the Omicron wave of the COVID-19 pandemic. Results revealed that integrated connectedness to a storytelling network (ICSN) was a significant predictor of residents' community engagement. Trust, control mutuality, commitment, and ICSN were positively associated with community engagement intentions through the sense of community and organizational efficacy. This study is a step toward understanding how organizations and members collectively respond to health crises at the community level. [ABSTRACT FROM AUTHOR]

This study examines the effects of message framing (loss vs. gain) and format (narrative vs. expository) on intentions to discuss flu vaccination with a close social referent. We test the effects of video messages using a two-wave web-based randomized experiment among adults in Israel (baseline: N = 429, one-month follow-up: N = 241). Exposure to narrative messages was positively associated with intentions to discuss flu vaccination. Exposure to loss-framed messages was positively associated with increased likelihood of discussing vaccination with the referent at follow-up. Effects of message framing and format were moderated by concern for the referent's health. Findings support the use of persuasive messages to motivate interpersonal conversation to promote vaccination. Results contribute to theory on risk-framing by showing that audiences may evaluate loss-framed messages according to their risk perceptions, when greater concern for health risks motivate action, not only for one's own health but for another person's health. [ABSTRACT FROM AUTHOR]

Fertility problems, often called infertility, have been defined as the inability to conceive or maintain pregnancy throughout one year of trying (World Health Organization, 2020). Because fertility problems can present unique medical, emotional, relational, and identity challenges, they are often difficult to talk about, and even well-intentioned messages can be perceived negatively. This study uses Communicated Sense-Making (CSM; Kellas & Kranstuber Horstman, 2015), particularly its mechanism of memorable messages, to explore what types of support-related messages people experiencing infertility find memorable. Results from semi-structured interviews (N = 54) indicate five supra-themes of memorable messages: (a) communicating solidarity; (b) attempting to minimize participants' stress; (c) communicating investment or interest in the patient's experience; (d) sharing expertise; and (e) absolving the patient of responsibility; we identify several sub-themes within each. We also explore patterns between message types, senders, and message valence: message themes were perceived as either positive, negative, or neutral based on the combination of sender and perceived intention. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Although addressing cultural and religious practices is important in providing mental health care, little research exists on understanding mental health issues of minority groups such as Muslim immigrant women. We employed an intersectional approach to examine beliefs and attitudes toward mental health issues among Muslim immigrant women in Canada. Four focus groups (21 participants) were conducted, and 101 surveys were collected in Ottawa, Canada. Three core themes emerged from thematic content analysis of focus group data that relate to participants' communication about: 1) stressors, 2) mental health care seeking, and 3) utilizing coping strategies. The survey data were analyzed using independent samples t-test and One-Way ANOVA, the results of which supported the qualitative findings that social stigma was an important obstacle preventing those women from seeking professional mental health services. Muslim women with South and Southeast Asian cultural/ethnic backgrounds were more likely to get help from professionals than those with African cultural/ethnic backgrounds. No group differences were found in age, family income, and employment status. Broadly, the findings underscore the importance of developing knowledge about the intersections among gender, religion, cultural identity, immigration status, and social stigma that influence beliefs and attitudes toward mental health issues. Specifically, the findings point to the need for an intersectional approach that offers a more nuanced understanding for tailoring mental health care to Muslim immigrant women's needs. [ABSTRACT FROM AUTHOR]

Chronic illness affects millions worldwide, rendering the life of those affected complex to manage. Extant research points to the need for effective and supportive care for the successful treatment, yet health care encounters for this population are often filled with negative experiences, ranging from discontinuity of care to disenfranchisement from providers. One such group dedicated to sharing struggles is the NEISVoid (No End In Sight) community on Twitter. Through the use of the hashtag, #NEISVoid, they come together to share what experiences living with chronic illness look like, in vulnerable and potentially unfiltered ways. The present study analyzes the discourse surrounding the hashtag #NEISVoid in tweets published from January 1 2020, until September 1 2022 (N = 450,914 tweets) using the mixed-method analysis of topic model network (ANTMN) approach. We identify and discuss four broad discursive themes: community experiences, symptom management, efficacy solutions, and biomedical health. We analyze this discourse through the chronic care model (CCM) and in light of research on hashtag activism. We discuss practical and theoretical implications for health communicators. [ABSTRACT FROM AUTHOR]

Earning digital badges to showcase a person's expertise or knowledge are becoming increasingly popular. A healthcare provider's displaying of a Safe Zone badge within their online profile may offer prospective patients a cue as to the kind of care they might receive if they selected that particular provider. Prior research indicates LGBTQ+ individuals are looking for these types of cues within providers' biographies to make their selections. A between subjects, 2 (Safe Zone badge present/absent) x 2 (male/female doctor) online experiment was conducted (n = 658). Results revealed a main effect for the presence of the Safe Zone badge. Participants had greater anticipated satisfaction, liking, were more likely to view the provider as approachable, and were more willing to schedule an appointment with the provider displaying a Safe Zone badge. [ABSTRACT FROM AUTHOR]

The importance of physician-patient communication on patient health outcomes has been globally known. Poor communication in clinical settings, including in telemedicine visits, has been identified as a key barrier to successful medical consultation. This barrier is even more prevalent among people from linguistically and culturally diverse communities. This study investigated the influence of physician-patient communication on telemedicine patient health outcomes in Indonesia, a developing country with great linguistic and cultural diversity. This study utilized secondary data from a telemedicine utilization survey conducted during the coronavirus disease 2019 (COVID-19) pandemic. Socioeconomic factors and communication features were included as predictors of patients' health improvement. Logistic regressions were utilized to examine the significance of the communication features on patients' health. The analysis results indicated that five communication features including the adequacy of consultation length, a timely physician response, the provision of an explanation of the medication and possible side effects, the patient's ability to utter their physical condition and opinion regarding medication goals, and the patient's ability to comprehend physician explanations and instructions were significantly associated with the patient's health outcomes. Physicians and healthcare providers should focus on the provision of communication features revealed in this study to elevate the likelihood of improved health conditions in telemedicine patients. [ABSTRACT FROM AUTHOR]

Care provider communication with Black birthing families is impactful. This cross-sectional study asked 216 Black fathers to recall treatment by birthing care providers and tested variables contributing to birth satisfaction and fathering identity salience. Most fathers reported that care providers were respectful resulting in a positive birthing experience; however, 15% reported negative experiences with care providers. Perceived social support was shown to be a mediator between disrespect, mistreatment, inclusive communication, trust, and positive emotion with birth satisfaction and fathering identity salience. Care provider disrespect served as a "spoiler" of the birthing experience and subsequently diminished positive fathering identity salience. Analysis of open-ended comments showed that contrary to stereotypes about absent, disengaged Black fathers, fathers in this study were caring toward their newborns, present for them, and engaged in fathering. More work needs to be done with care provider communication to make every birth a positive and inclusive experience for Black fathers and their partners. [ABSTRACT FROM AUTHOR]

Miscarriage is a pervasive and socioemotionally complex pregnancy complication. Evidence suggests that poor clinical management can worsen these experiences. Yet, assessments of healthcare communication during a miscarriage are limited and a systematic review of the literature is needed. This review identified and synthesized original research on miscarriage and healthcare communication in the United States from the past 20 years to identify existing knowledge gaps for future miscarriage research. The following databases were searched: PubMed, PsychINFO, and ERIC Database. Data were charted according to Arksey and O'Malley's Scoping Review Framework. Eleven articles were included in the review and three primary themes emerged: (a) patients overwhelmingly prefer patient-centered care; (b) miscarriage is often overmedicalized, which leads to poor communication; and (c) informed decision-making related to one's miscarriage can improve patient experiences. Several gaps were also identified, including studies seeking physician perspectives on miscarriage communication, evaluation of standard care guidelines, and studies evaluating diverse patients' perspectives. This review highlights the need for patient-centered care that utilizes compassionate and accessible language and promotes informed decision-making. Future research should use quantitative methodologies and longitudinal designs to build upon these findings and improve patient experiences of miscarriage. [ABSTRACT FROM AUTHOR]

Millions of people around the world are affected by mental illness, yet a substantive portion of individuals with mental illness do not regularly seek help from medical professionals or utilize mental health services. Help-seeking involves an individual's communicative intention and behaviors to solicit advice and/or treatment and thus is essentially a communicative process. This manuscript reports a longitudinal study that examined predictors and outcomes of help-seeking in mental illness contexts. Three-wave data from 223 participants clinically diagnosed with one or more mental illness conditions were collected and analyzed. Results indicated that expected outcomes of help-seeking from counselors were significantly associated with participants' communication efficacy and target efficacy at Wave 1, which subsequently influenced motivation to seek help and actual help-seeking behaviors at Wave 2. Actual help-seeking behaviors predicted post-traumatic growth and cognitive reappraisal at Wave 3. Importantly, communication efficacy and target efficacy interacted in their effects on help-seeking motivation and behaviors. Theoretical implications for help-seeking communication processes and practical implications for mental health help-seeking are discussed. [ABSTRACT FROM AUTHOR]

Alcohol is a causal factor in about 10% of breast cancer (BCa) cases, but awareness of this link is low. This study explored how to raise awareness and inform the development of an intervention using the COM-B model (capability, opportunity, motivation, behavior) framework. Eight online focus groups were conducted with 36 participants (6 expert stakeholders,and 30 women aged 40–65). Participants reflected on a package of information about alcohol and BCa and discussed how to impart this information and encourage women to reduce drinking. Thematic analysis of focus group transcripts was undertaken. Three themes were identified: understanding ineffective messaging; transitions and challenges; and message acceptability. Current health information about alcohol was perceived as judgmental and BCa was put down to chance. Mid-life consisted of many challenges that could lead to increased consumption, but menopause transition may be a key moment for alcohol reduction. Barriers and enablers to communicating risk information and encouraging alcohol reduction were mapped onto the COM-B model. Psychological capability (relating to knowledge), social opportunity (in the form of social pressure) and automatic motivation (relating to drinking to cope) were barriers to behavior change. These will be targeted in an alcohol reduction intervention. It is important to tailor information to women's experiences, taking into account the social benefits of drinking, and encourage the development of healthy coping strategies. Acceptable intervention messages may include personal stories, clear statistics, and suggest healthy alternatives to drinking. It is vital that messaging does not appear judgmental or patronizing. [ABSTRACT FROM AUTHOR]

The creation of audio-visual content and the increase in the use of social networks by society have provided new opportunities for promoting health and the benefits of organ donation. This study analyzes the influence of audiovisual content produced by adolescents in the context of an educational program related to the promotion of organ donation with diffusion through social media. The program was implemented in the fourth year (mainly 15 and 16 year olds) in ten high schools in Spain. In the first phase, students learn about donation and create audio-visual messages about its benefits for society; in the second phase, they share this content on social networks. The influence of the content was measured using YouTube Analytics. In addition, a questionnaire was administered after the program to measure the way in which they shared the content on social networks. A total of 391 students participated in program, submitting 63 short films that obtained 104,912 views. The short films focused on appealing to society about the need for organs and the benefits of the organ donation and transplantation process. The social network that was used most frequently to share the content was WhatsApp (81.8%). Educating teenagers and turning them into prescribers of the health benefits of the organ donation and transplantation process through the use of social networks could be a good tool that can be exported to other fields of health. [ABSTRACT FROM AUTHOR]

Provider empathy is a crucial component in establishing therapeutic provider–patient relationships. The benefits of increased perceptions of empathy can support patient psychological adjustment to their cancer as well as patients' comfort and confidence in disclosing to providers, ultimately promoting patient engagement. Guided by the disclosure decision-making model, this manuscript explores how perceptions of empathy influence patient psychological adjustment and how those variables influence patient disclosure efficacy. The model ultimately predicts patient sharing and withholding of information during the medical interaction. This study tested a mediation model to investigate how current (n = 111) and former (n = 174) breast cancer patients' psychological adjustment mediates the relationship between patient perceptions of oncologist empathic communication and efficacy to disclose health information to their oncologist and their disclosure enactment in sharing and withholding. Overall, former patients compared to current patients had more positive perceptions of their oncologist's empathic communication, had better psychological adjustment, felt more self-efficacy to disclose to their oncologist, and shared more and withheld less information from their oncologist (p <.05 in all cases). Structural equation modeling revealed good fit to the data for both current and former patients such that more perceived empathic communication was associated with more efficacy for disclosure, which was associated with more sharing and less withholding. Additionally, there was an indirect relationship from perceptions of empathic communication to disclosure efficacy through patients' psychological adjustment to the diagnosis. Results reinforce the importance of providers' empathic communication for cancer patients' psychological adjustment because patient sharing and withholding of information remain crucially important to achieving holistic care across the cancer trajectory. [ABSTRACT FROM AUTHOR]

Physician-Patient communication (PPC) has been linked to patient adjustment outcomes. However, conflicting results have been reported and previous systematic reviews showed some methodological weaknesses. It has also been suggested that PPC is related to physicians' own adjustment outcomes. This systematic review aims to explore and synthesize the associations between PPC and both patient and physician adjustment outcomes. A systematic search was conducted primarily in five databases and 11.488 non-duplicated articles were identified. Forty-five studies met the eligibility criteria and data extraction was performed for sample characteristics, PPC measurement, adjustment outcomes under examination and main outcomes. The observed results showed that the majority of the included studies were cross-sectional, assessed PPC by proxy-report and reported an overall positive association with patients' adjustment outcomes. None of the studies examined the association between PPC and physicians' adjustment outcomes. Thirty-three studies were meta-analyzed and showed a positive and significant association between PPC and patients' adjustment outcomes (r =.16). Due to the small number of studies included in the meta-analysis, the heterogeneity was high. Subgroup analysis could not identify sources for heterogeneity. Research on the associations between PPC and physicians' own adjustment outcomes is warranted. Future studies should be rigorous in defining clear PPC definitions, directionality of communication processes, and study design. [ABSTRACT FROM AUTHOR]

The lack of daily conversation may lead to the deterioration of quality of life and cognitive function in older adults requiring long-term care. This study aimed to develop a scale to measure daily conversation among them, the Life-Worldly Communication Scale: LWCS, and to test its structural, convergent, and discriminant validity. The subjects were 539 older adults requiring long-term care in facilities and at home. A 24-item provisional scale was created, using a panel of experts. Structural validity of LWCS was examined from exploratory factor analysis to establish the factor structure, two confirmatory factor analyses for cross-validation, and measurement invariance between the institutional and home setting. Convergent validity was examined from the average variance extracted: AVE, composite reliability: CR, and simple regression analysis between LWCS and Interdependent Happiness Scale: IHS. Discriminant validity was examined using the heterotrait-monotrait ratio of correlations: HTMT. Multiple imputations were used to deal with missing data on these scales. The results showed that the goodness of fit of the three-factor, 11-item model obtained from the two-step CFA was SRMR =.043, RMSEA =.059, CFI =.978, and AGFI =.905. The model was confirmed for structural validity by measurement invariance tests: configural invariance (CFI=.973, RMSEA =.047), metric invariance (ΔCFI=.001, ΔRMSEA=−.004), scalar invariance (ΔCFI =-0.002, RMSEA = −0.003). Convergent validity was confirmed by AVE =.503~.772, CR =.801~.910, and simple regression analysis between LWCS and IHS (adjusted r2=.18, p <.001). Discriminant validity was also confirmed among the three factors (HTMT=.496~.644). LWCS can contribute to the assessment of daily conversation in geriatric settings and research regarding its promotion. [ABSTRACT FROM AUTHOR]

This study examined the efficacy of inoculation treatments in preventing anti-vaccination propaganda. Study predictions were tested in an independent-group experiment (N = 165), wherein participants were randomly assigned to a fact-based inoculation or a logic-based inoculation or a control message, with an excerpt from an anti-vaccination conspiracy film, Vaxxed, used as a counterattitudinal attack message. The results indicated that both inoculation treatments (fact-based and logic-based) were effective at instilling resistance to counter-persuasion, as compared to the control condition, and both types of inoculation messages were equal in their potential to facilitate resistance. In addition, we tested whether inoculating participants against an anti-vaccination conspiracy would help prevent the endorsement of other conspiracy theories. The data revealed that inoculating against one type of a conspiracy did not foster protection against other types of conspiratorial ideas, and, similar to previous research, endorsing one type of a conspiracy theory was positively associated with the endorsement of other conspiracies. These and other results are discussed along with their implications, limitations, and future research directions. [ABSTRACT FROM AUTHOR]

The United States faces troubling fertility trends that include high percentages of unintended pregnancies, as well as record-low fertility rates and individuals having fewer offspring than they desire. To address these problems, scholars and public health advocates have argued for the implementation of fertility information into existing sex-education curricula. In this study, we draw from 32 semi-structured interviews with secondary school sex educators to gain insight into their experiences on this front. They contended that one of the greatest barriers to their successfully teaching fertility related material was that students do not find fertility information relevant. Participants described three appeals that they employ to communicate fertility information as persistently relevant to the adolescents in their classes. Our interviews revealed that all three of these relevance appeals employ targeted invitations for students to tailor fertility information in ways that fit them personally. These findings suggest a need to re-conceptualize targeting and tailoring research in ways that connect with the goals of in situ, relevance-oriented communication, and they indicate how a focus on teaching health educators to establish fertility as relevant would help to situate future generations for better sexual and reproductive health over a lifetime. [ABSTRACT FROM AUTHOR]

This study examined how organizations may promote their employees' mental health in difficult times. Drawing from organizational crisis communication and organizational health promotion research, it proposed and tested a dual-process model that links leadership health support, an essential dimension of organizational health culture, with organizational leaders' crisis communication (i.e. use of ethical-base responses) and workers' self-care awareness and perceived stress in a crisis. Through a survey of 502 full-time U.S. employees conducted during COVID-19, we found that organizational leaders' use of ethical-base responses predicted employees' enhanced self-care awareness and decreased stress levels. Further, leadership health support provided a double-buffer effect to sustain employee mental health by directly bolstering employees' self-care awareness and organizational leaders' use of ethical-base responses. The findings of this study bridge the gaps in organizational health promotion and crisis communication literature and offer practical suggestions for organizations seeking to foster employees' mental health challenges during crises. [ABSTRACT FROM AUTHOR]

This paper explicates blame as a psychological construct in communication processes, with a focus on its underlying structure and its mediating role between message characteristics and the public's issue engagement. Data were collected from Amazon Mechanical Turk (N = 373) via a Web-based experiment, where we manipulated a news story about a child suffering an obesity-related health risk (asthma attack vs. heart attack) with different levels of preventability (high vs. low) and severity (high vs. low). Findings showed that blame should best be conceptualized and operationalized as a latent construct comprising both cognitive and affective components. Blame mediated message effects on social responses related to obesity prevention, including punitive attitudes, policy support, and intentions toward interpersonal communication and civic participatory behaviors. [ABSTRACT FROM AUTHOR]

This article presents a bibliometric analysis of research on COVID-19 health communication. We reviewed and analyzed 1,851 articles published in 170 peer-reviewed communication journals between January 2020 and November 2022, to identify key bibliometric information and major research topics in this rapidly expanding field of research. The distribution of countries indicates that the United States is the most productive country, and researchers from Spain, China and the United Kingdom also play an important role. Health Communication is the most influential journal in terms of research productivity and impact. The analysis of highly cited references demonstrates the interdisciplinary nature of this research field. The topics generated by structural topic modeling show that scholars have responded to a variety of issues in COVID-19 communication, encompassing different levels of health communication, the effects of information dissemination, the impact on the general public as well as vulnerable populations, health preventive behaviors and communication technologies. This study aims to enhance researchers' understanding of the current state of this research field and provide insights for future studies. [ABSTRACT FROM AUTHOR]

The COVID-19 emergency underlined the importance of an effective public health communication to limit the spread of the outbreak. Physicians as "public experts" can play a crucial part in health risk communication, even if their role is challenged by transformations into the information system. Therefore, the major objective of this study was to investigate public perception of medical experts' opinions regarding the COVID-19 emergency. The Italian public debate involving medical experts in the Twitter sphere during the SARS-CoV-2 pandemic has particularly been examined. A content analysis was performed on 2,040 randomly selected tweets. The results of content analysis show that the medical experts who tend to mitigate the risk received a higher number of tweets supporting their positions when compared to the experts whose statements were aimed at intensifying the risk. Since a public expert is a communicator, but also an advisor who can affect how laypersons perceive and react to risk events, this study can provide more knowledge about the public perception of different communication strategies incorporated by medical experts. [ABSTRACT FROM AUTHOR]

This survey study tested a two-level model of responses to conflicting advice about COVID-19 and examined the underlying emotional and cognitive mechanisms and the moderating role of advice source. Results showed that at the individual message level, advice evaluation was associated with advice outcomes. At the message group level, advice evaluation and outcomes were linked to perceived contradiction in content among the advice and the quantity of conflicting messages received, both directly and indirectly via recipients' emotions. Features of conflicting advice received primarily from impersonal sources had particularly strong associations with advice evaluation and outcomes. Implications for health communication were discussed. [ABSTRACT FROM AUTHOR]

Drawing upon construal level theory and regulatory fit literature, this research examined the effect of fit between humor and regulatory focus on audience engagement with health information on social media. The results of two studies showed that incongruity humor (vs. aggressive humor) induced greater social proximity between the source and the viewer, and humor type interacted with regulatory focus of a message to impact audience engagement. Specifically, incongruity humor paired with a prevention-focused message (vs. a promotion-focused message) resulted in greater content endorsement and health information engagement, whereas aggressive humor combined with a promotion-focused message (vs. a prevention-focused message) led to greater content endorsement. Results further identified processing fluency as a mediator of the fit effect on audience engagement. This research offers important theoretical and practical implications for public health interventions on social media. [ABSTRACT FROM AUTHOR]

This research investigated the predictors of satisfaction for parents of pediatric patients after a clinical consultation. Specifically, we assessed whether perceptions of their provider's communication quality influenced the degree to which their (dis)satisfaction with consultation length associated with their provider rating and intent to recommend the provider's office. Using patient satisfaction survey data collected after initial clinical visits to a pediatric hospital (N = 12,004), we found that communication quality was a stronger predictor for those who were dissatisfied with their consultation length, whereas communication quality made a relatively smaller difference for those who were satisfied with their consultation length. Put another way, parents' dissatisfaction with their child's consultation length mattered little when they perceived their provider to be high in communication quality, but it reduced their ratings and intentions to recommend when they perceived their provider to be low in communication quality. These results suggest that providers' communication behaviors have the capacity to buffer patients' negative evaluations otherwise incurred from shorter than desired consultations. [ABSTRACT FROM AUTHOR]

Healthcare providers (HP) work in high-stress situations, interacting with patients and families who are often in crisis. HPs who work in safety net clinics, which provide care to uninsured, Medicaid recipients and other vulnerable populations, interact with patients who are frequently frustrated by long wait times, extensive paperwork, short appointments, and have generally lower health literacy. Many patients have chronic conditions and substance use disorders which has been associated with higher likelihood to be perceived as verbally aggressive and/or perpetrate workplace violence (WPV). Using interviews with 26 HPs at safety net clinics, we investigated how HPs manage interactions with aggressive patients and avoid burnout. Findings are based on emotional labor constructs describing why and how workers use emotion management strategies to smooth communication and relationships with clients/patients. According to our participants, HPs perform emotional labor to de-escalate interactions, prevent WPV, and to develop relationships with patients who might become regular clinic patients. We found that HPs perceive an influence of the clinic context on patient aggression management, hold initial perceptions that shape engagement with aggressive patients, and report emotional labor and burnout that came from interacting with aggressive patients to prevent WPV. We offer implications that extend research on emotional labor and burnout, provide guidance to healthcare organizations, and offer directions for future theory and research. [ABSTRACT FROM AUTHOR]

The concept of race or ethnic concordance between health care provider and patient has emerged as a dimension of the patient-physician relationship that could influence health outcomes for patients from minoritized groups, particularly through differences in the way physicians communicate with patients based on race or ethnicity. However, two decades of study on concordance and physician-patient communication have produced contradictory results. Given the heightened societal awareness of racism and the persistence of health disparities, there is a need for a comprehensive review of the current state of knowledge. This review sets out to determine how communication patterns differ in race/ethnicity concordant versus discordant patient-physician medical encounters. Thirty-three studies employing a range of methodologies were identified. In most analyses, after accounting for covariates, no relationship was found between race/ethnicity concordance and communication variables. Race/ethnicity concordance with their physician does not appear to influence the quality of communication for most patients from minoritized groups. A number of methodological weaknesses were identified in existing research, among them: few studies investigated potential explanatory variables, the heterogeneity of ethnic and cultural experience was over-simplified, there was little consistency in operationalization of communication variables, and the physician-patient dynamic was inadequately conceptualized. [ABSTRACT FROM AUTHOR]

Little is known about how higher-weight patients experience patient-provider communication, particularly among those with chronic illness. This study uses quantitative analytical methods and nationally representative data to determine how patient-provider communication is affected when patients have one or more chronic illnesses, as well as if patient BMI has a moderating effect on this association. Pearson correlation and multivariate logistic regression were both used to determine the significance of these associations. A significant, negative, relationship was found between overall patient-provider communication and patient chronic illness status, but no significant relationship was found between respondent BMI and patient-provider communication. There was no observable moderation effect of respondent BMI on the relationship between their number of chronic illnesses and the perceived quality of the patient-provider communication they experienced. From this study there is evidence that patients with multiple chronic illness experience worse communication with their health care providers which could be due to numerous types of bias. More research is needed to better understand if and how weight and other bias affects outcomes for chronically ill patients. Research implications include improving the comprehensiveness of nation-wide surveys that measure health care quality to include improved measures of perceived bias, including weight bias, and patient-provider communication, as these are complex, multi-factorial concepts. [ABSTRACT FROM AUTHOR]

Companions (i.e., friends, family members, and other accompanying persons) play an important role in seizure clinic consultations, providing information that patients cannot. The COVID-19 pandemic has seen an increase in these consultations being conducted via telephone. Little is known, however, about how this shift might affect companion participation. Using conversation analysis applied to a set of recorded telephone neurologist-patient-companion consultations (n = 9) and comparable moments drawn from a set of face-to-face consultations (n = 37) (both collected in the UK), we aimed to explore this impact and to identify communication methods that clinicians can use to manage companion participation during telephone consultations. We identified four ways in which participation was observably affected by the telephone. Telephone consultations could make it unclear whether a companion was present and make it difficult for the companion to communicate directly with the neurologist. Passing the floor from one speaker to another was more complex remotely, which could also restrict the patient's own participation once the companion had the floor. These issues are rooted in the limitations of the telephone as a communication medium. Based on the issues identified, we conclude our analysis by highlighting some of the ways in which neurologists and other health professionals can manage companion participation in telephone consultations. These include encouraging the use of speakerphone, checking whether a companion is present throughout the call, keeping track of who can hear what throughout the call, and directing questions using given names to avoid ambiguity. [ABSTRACT FROM AUTHOR]

Based on previous work, we developed the comic "A healthy liver will always deliver!" to raise awareness about Non-Alcoholic Fatty Liver Disease (NAFLD) and promote healthy lifestyles. An online pre-post questionnaire design demonstrated an increase in health-threat beliefs regarding NAFLD among the general public, as well as response efficacy and self-efficacy beliefs, normative and control beliefs regarding the maintenance of preventive strategies involving healthy diets and active lifestyles, after interaction with the comic's narrative. This effect was more evident in women. Furthermore, although we could not perform all the ideal controls during the COVID-19 pandemic, and the online strategy attracted mostly university education-level subjects, the comic seemed relatable and engaging. However, more work will have to be performed to ensure its usefulness in terms of acquired knowledge and behavior changes, especially in at-risk segments of the population. [ABSTRACT FROM AUTHOR]

Social norms are common in persuasive messaging. For norms trending in a positive direction, it may be beneficial to emphasize change (i.e. dynamic norm) rather than the status quo (i.e. static norm). To test this proposition, we examined college students' responses to social norm messages encouraging moderate alcohol use. Undergraduates (N = 842) were randomly assigned to view a dynamic norm ("More college students drinking in moderation"), a static descriptive norm ("Most college students drink in moderation"), or a no message control. Four mechanisms were examined as potential mediators, three of which have been examined in previous work (preconformity, perceived importance, self-efficacy) and one of which was novel (psychological reactance). Results revealed that exposure to either social norm message (dynamic or static descriptive) was associated with more favorable attitude relative to a no message control. Attitude did not differ between the dynamic norm and static descriptive norm conditions. Only psychological reactance mediated the relationship between message condition (dynamic vs. static descriptive norm) and favorable attitude. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

This study employs the media system dependency theory to explore both macro- and micro-level dependencies between South Korean sojourners and Chinese media during the COVID-19 pandemic. Through semi-structured interviews with 25 South Korean sojourners in Beijing, we find that under the influence of Confucianism and collectivistic culture, South Korean sojourners are hard to identify with China's media environment and rely on Chinese media. Apart from Chinese television meeting South Korean sojourners' goal of play, other traditional media outlets, new media, and interpersonal communication with Chinese people fail to fulfill their goals of understanding, orientation, and play. These findings suggest that future research should take cultural factors into account to understand media dependency theory. [ABSTRACT FROM AUTHOR]

Guided by Brashers's uncertainty management theory, the purpose of this study was to better understand the experience of family caregivers utilizing Medicaid waivers to subsidize health care for children with disabilities. Specifically, the focus of this study was to explore caregivers' experience with Kentucky's Michelle P. Waiver (MPW), a Medicaid waiver that provides robust benefit offerings to children with disabilities. Little is known about how parents come to know about the waiver, and the communication challenges they experience when applying for and navigating their child's health care through Medicaid. Data were gathered by narratively interviewing 31 parents of children who are currently receiving services through the MPW. Data were analyzed using narrative thematic analysis. The analysis focused on the community-level communication that contributes to parent caregivers' uncertainty about the MPW system. Findings show that parents experience unique personal, social, and medical uncertainties related to the MPW when navigating care for their child in the community. This project contributes to the health communication literature theoretically by expanding the conceptualization of the uncertainty in illness framework to include the means of health care (i.e. Medicaid) as a consequential element of an individual's illness experience. [ABSTRACT FROM AUTHOR]

Recognizing the need for more evidence-based interventions and the potential of well-crafted messages in communicating the opioid epidemic, this study investigates the effectiveness of two messaging strategies (i.e., victim vividness and external attribution) that have the potential to mitigate stigmatization and influence a wide range of public policies concerning the opioid epidemic. Building upon the attribution theory of interpersonal behavior, an experiment with a 2 (victim vividness: high vs. low) × 2 (external attribution: present vs. absent) between-subjects factorial design was conducted among a national sample of U.S. adults (N = 995). The findings show that the messages with greater victim vividness reduced support for victim-oriented punitive policies, whereas the messages that mentioned external attribution increased support for perpetrator-oriented punitive policies. In addition, the two messaging strategies also worked indirectly through various emotions to influence policy support. Discussions on this study's contributions to both theory and practice are provided. [ABSTRACT FROM AUTHOR]

This manuscript focuses on the communication factors that affect the willingness of African Americans and Black Caribbean patients to participate in clinical trials and research studies. Low rates of research participation by members of communities of color have long been linked to health disparities. While there are many factors that contribute to low rates of accrual of African American and Black patients to clinical trials, a lack of attention to communication factors that enhance or inhibit the recruitment process is central to the problem. In this study, we describe results from the analysis of six focus groups (N = 31) consisting of African American (k = 3) and Black Caribbean (k = 3) participants. Our analyses focus on verbal and nonverbal communication behaviors and how they affect participants' willingness to participate in clinical trials. Specifically, when clinical research coordinators (CRCs) had a professional appearance, made the effort to explain a study in detail, made eye contact, took the time to listen and answer questions patiently, and gave the sense that the CRC was being truthful and transparent, patients felt respected and valued. Additionally, participants emphasized the importance of the process of developing and maintaining a trusting relationship between study participants and CRCs. The results of this study will be used to develop a clinical trial communication training program designed to enhance the communication skills of clinical research coordinators who discuss research participation with African American and Caribbean Black patients. [ABSTRACT FROM AUTHOR]

Research indicates that patients consider empathy as a key factor contributing to the quality-of-care. However, ambiguities in the definition of this multidimensional construct complicate definite conclusions to-date. Addressing the challenges in the literature, and using a hypothetical physician-patient interaction which explored patient-perceived differences between expressions of affective empathy, cognitive empathy, compassion and no empathy, this study aimed to test whether lay participants’ evaluations of the quality-of-care depend on the type of empathic physician behavior, and on the physician’s gender. We conducted a randomized web-based experiment using a 4 (type of empathy) by 2 (physician gender) between-subjects design. Empathy was subdivided into three concepts: first, affective empathy (i.e. feeling with someone); second, cognitive empathy (i.e. understanding); and third, compassion (i.e. feeling for someone and offering support). Perceived quality-of-care was the primary outcome. Compared with non-empathic interactions, quality-of-care was rated higher when physicians reacted cognitively empathic or compassionate (d = 0.71; 0.43 to 1.00 and d = 0.68; 0.38 to 0.98). No significant difference was found between affective empathy and no empathy (d = 0.13; −0.14 to 0.42). The physician’s gender was not related with quality-of-care. Aspects of participants’ personality but not their age, gender or the number of physician visits were associated with quality-of-care. No interactions were observed. In showing that patients rated quality-of-care higher when physician reactions were described as cognitively empathic and compassionate, as compared with affectively empathic or non-empathic, our findings refine views about the kinds of empathy that are important in patient care with implications for clinical practice, education and communication trainings. [ABSTRACT FROM AUTHOR]

Effective physician-patient communication builds robust physician-patient relationships and reduces medical disputes. However, much is unknown about the differences that exist in the communication behaviors of physicians in different departments. Using a mixed-methods research approach, the researchers used Roter Interaction Analysis System to uncover the communication behaviors of internists, surgeons, family physicians, and emergency physicians at a regional hospital in Taiwan. Semi-structured interviews were conducted to collect the communication experiences of 20 physicians from the internal medicine, surgery, family medicine, and emergency departments. The characteristics were presented through descriptive statistics, bar charts, and dendrograms. Physician-patient communications consisted of four dimensions, 10 factors, and 31 behaviors. The characteristics are as follows: (1) Internists need to improve their overall performance in terms of physician-patient communication behaviors; (2) Surgeons performed well in building relationships through non-verbal methods; (3) Family physicians excelled in facilitation and patient activation. (4) Emergency physicians performed well in patient education and counseling. The characteristics of the aforementioned communication behaviors among internists, surgeons, family physicians, and emergency physicians can be used to construct indicators of physicianpatient communication in each department and to develop patient-centered healthcare services in the future. [ABSTRACT FROM AUTHOR]

This study provides foundational data regarding instances of nonsupport (i.e. instances when support was expected from someone but not received) in the cancer context. In a sample of 205 young adult cancer patients from 22 countries, approximately three out of every five patients reported having experienced nonsupport at some point during their cancer journey. Men and women patients were approximately equally as likely to have experienced nonsupport and were approximately equally likely to be recalled by a cancer patient as a nonsupporter. Results showed that patients who had experienced nonsupport reported worse mental and physical health, greater depression, and greater loneliness than those who had not experienced an instance of nonsupport. Patients were also presented with a previously published list of 16 reasons why people choose to forgo communicating support to cancer patients, and patients rated each reason’s acceptability. Nonsupport reasons that assumed communicating support would create a burden for the patient (e.g. providing support would create a privacy issue; the supporter feared losing control of their own emotions) were rated as more acceptable. Reasons involving the nonsupporter making assumptions or decisions about the broader social support process were seen as less acceptable (e.g. communicating support does not help; assuming support is not desired). Together, these results demonstrate the prevalence and impact of nonsupport on cancer patients’ health outcomes and provide justification for nonsupport as an important avenue for future social support research. [ABSTRACT FROM AUTHOR]

To help solve the diabetes problem in Singapore, we developed humorous and fearful public service announcements (PSAs) based on popular Internet memes and investigated how the emotions derived from PSAs affect Singaporean millennials’ perceptions of PSAs’ effectiveness. In total, 416 people participated in the study through a Singaporean online survey company. Multivariable linear regression methods with SPSS were used to examine our hypotheses and research questions. According to the results, message manipulation significantly increased participants’ perceived emotion (i.e. perceived humor and fear). Moreover, the results showed that perceived humor and fear were positively associated with perceived PSA effectiveness in both models, testing the humor effect and fear effect separately. As per the moderation analysis, the association between the perceived emotion (i.e. humor and fear) and the perceived PSA effectiveness is likely to increase when attitudes toward the organization are less positive. Moreover, the association between perceived fear and perceived PSA effectiveness is likely to increase when participants’ involvement with memes is low. Our findings highlight important theoretical and practical implications for future studies investigating the effectiveness of Internet meme-based PSA messages regarding serious health issues. [ABSTRACT FROM AUTHOR]

Despite being high health care utilizers, many women Veterans perceive their pain condition to be poorly understood by their providers, which can be a strong demotivator for seeking care. We set out to understand the priorities rural-dwelling women Veterans have for using health care for their chronic pain, and interviewed participants about their experiences with (and priorities for seeking) health care for their chronic pain. Self-Determination Theory identifies three sources of motivation (autonomy, competence, relatedness), all of which were represented through two themes that reflect rural women Veterans’ rationale for decision-making to obtain health care for chronic pain: role of trust and competing priorities. Women described their priorities for chronic pain management in terms of their competing priorities for work, education, and supporting their family, but most expressed a desire to function in their daily life and relationships. Second, women discussed the role of trust in their provider as a source of motivation, and the role of patient-provider communication skills and gender played in establishing trust. Rural women Veterans often discussed core values that stemmed from facets of their identity (e.g. gender, military training, ethnicity) that also influenced their decision-making. Our findings provide insight for how providers may use Motivational Interviewing and discuss chronic pain treatment options so that rural-dwelling women Veterans feel autonomous, competent, and understood in their decision-making about their chronic pain. We also discuss importance of acknowledging the effects of disenfranchising talk and perpetuating gendered stereotypes related to chronic pain and theoretical implications of this work. [ABSTRACT FROM AUTHOR]

As excessive sugar intake can result in obesity, type 2 diabetes, cardiovascular disease, and even cancer, this study aims to help people reduce sugar-sweetened beverages (SSBs) intake by exploring how gender-differed body image concerns influence people’s attitude and intention of SSBs consumption. A 2 (Participants’ gender: Male vs. Female) × 2 (Image gender: Male vs. Female) × 2 (Body image concern: Gaining weight vs. Losing muscle mass) online experiment was conducted to examine how the genderdiffered body image concerns influence people’s perception of SSBs. The findings showed that genderdiffered body image concerns exerted a significant influence across genders. Muscle mass loss-related information is more effective in generating negative attitude toward SSBs from males. Female imagerelated physical appearance change is more effective in generating negative attitude toward SSBs from females. This study also contributes to targeted communication by revealing that the quality-oriented targeted information outperformed the traditional quantity-oriented targeted information. Furthermore, this study complements EPPM by discovering the underlying mechanisms of female-targeted body image concern, such as perceived severity and response efficacy. [ABSTRACT FROM AUTHOR]

Patronizing speech and dehumanization both have negative impacts on the health and wellbeing of the recipients of these behaviors. This experiment applied Fiske’s stereotype content model, Haslam’s dual model of dehumanization, and Hummert’s model of patronizing speech to assess the effects of warmthand competence-enhancing messages about a person with dementia on perceptions of humanness and patronizing speech toward people with dementia. Results supported our predictions that warmth- and competence-enhancing messages would translate into general tendencies to humanize people with dementia as a group. Predicted effects on patronizing communication did not materialize, but there were some unanticipated ways in which warmth- and competence-enhancing messages did influence intentions to use patronizing speech. [ABSTRACT FROM AUTHOR]

As the boundaries between our online and offline lives are increasingly blurred, it is important to attend to the ways in which online behaviors shape our offline perceptions and actions. While a great deal of health communication research has examined the effects of exposure to specific social media content, it is also important to investigate how broader patterns of everyday social media use may affect perceptions of health norms and behaviors in different ways. In this panel survey, we explored how using social media for informational, connection, and aspirational purposes affected perceptions of COVID-19 vaccination norms and changes in vaccine intentions between December 2020 and March 2021 in the US Using social media to seek information and to connect with others positively influenced vaccine intentions via strengthening perceptions of offline social norms supporting vaccination. These findings highlight how social media use is integrated with and informs our offline lives, as well as the important role apolitical social media use plays in shaping attitudes toward politicized science. [ABSTRACT FROM AUTHOR]

Most people in the United States do not engage in sufficient physical activity (PA). However, certain communication behaviors from romantic partners can motivate PA. Research indicates that confirming communication and communal coping (CC) in romantic relationships can increase PA efforts, but less research has examined the role of explicitly disconfirming communication or relationships between confirmation, disconfirmation, and CC on PA outcomes. We examined models in which shared PA appraisals mediate relationships between (a) confirmation and (b) disconfirmation and joint PA behavior in heterosexual, romantic dyads. Sex differences in actor and partner effects were also considered. Partners (N = 144) in 72 dyads completed assessments of key constructs. Results indicated that shared PA appraisals were critical in the confirmation model, mediating relationships between perceptions of confirmation and reports of joint PA. Unexpectedly, both partners’ reports of partner disconfirmation were positively associated with their partners’ reports of joint PA. Only one statistically significant sex difference emerged. Theoretical and pragmatic implications are discussed. [ABSTRACT FROM AUTHOR]

Public health campaigns have turned to the Health Belief Model (HBM) as a guiding framework for the past six decades. Carpenter’s 2010 HBM meta-analysis revealed important shortcomings as well as a path forward that has largely been ignored by recent COVID-19 research using this framework. Consistent with Carpenter’s recommendations, this study on the uptake of the first COVID-19 booster vaccine focused on the overlooked interactional processes of the original HBM founders. Our study used SEM and Hayes’s PROCESS 4.1 to explore the possibilities of the interdependent nature of the core three beliefs to form a model that is integrated. The study indicated that the core variables of the original HBM were significant predictors of the intent to take the first COVID-19 booster vaccine when considered in an interactional process framework. Our study results have implications for those designing public health advocacy campaigns regarding COVID-19 as it enters an endemic stage with future vaccines and medications. [ABSTRACT FROM AUTHOR]

One of the most detrimental side effects of the COVID-19 pandemic is the needed but not received care. Forgone health care affects the general public, but particularly children with special care needs. Previous research focused on non-modifiable factors, such as demographic background and insurance coverage. Based on Politi and Street's model of collaborative decision-making, we explored how two modifiable communication factors contributed to the prevention of forgone pediatric care during the COVID-19 pandemic. Using a nationally representative sample (n = 10845) from the 2020 National Survey of Children's Health (NSCH) survey, we found that health-care providers' family-centered communication and shared decision-making may reduce the possibility of forgone care through improved satisfaction with providers' communication. For children with mental health needs, providers' family-centered communication may also stimulate family's capacity to openly communicate, leading to better involvement in care and timely health care seeking. This helps to address COVID-related uncertainty, prevent higher health-care expenditures, and reduce negative health outcomes. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought telemedicine into mainstream medical practice (although questions remain over its role in a post-pandemic world). Research suggests that most patients and providers are satisfied with the flexibility and convenience of teleconsultations. However, there is continuing uncertainty about whether this shift has a clinically relevant impact on the quality of doctor-patient interaction. We conducted a systematic search of studies comparing communication in medical face-to-face consultations and teleconsultations. We included only studies which examined communication directly using recordings, excluding studies which used questionnaires or interviews. Studies were appraised using modified versions of the Critical Appraisal Skills Programme (CASP) checklists. Our search yielded 25,348 records, of which 22 were included in the final review. These studies were conducted in various medical specialties. Methodologies included approaches based on quantified communication behaviors using coding systems and qualitative studies using microanalytic methods. Except for duration (where there was evidence of face-to-face consultations being longer), no differences between the two modes of communication were consistently identified. In the aggregate, however, statistically significant differences were more prominent in primary care and more likely to favor face-to-face consultations. Qualitative studies also highlighted differences in how communication behaviors were manifested in each modality. Because much of the examined research was conducted in selected or non-routine settings, its applicability to the less selective use of telemedicine during and after the pandemic is limited. [ABSTRACT FROM AUTHOR]

Physician empathy is at the heart of doctor-patient communication and significantly influences patient outcomes. However, the research on how physicians express their empathy and how physician empathy affects patient outcomes and doctor-patient communication has not been well summarized in the latest literature. Thus, we conducted a systematic review to synthesize existing studies on physician empathy and its value to patient outcomes and doctor-patient communication. The systematic review consisted of studies published in English peer-reviewed journals between January 2017 and October 2021. Following the PRISMA procedure, a total of 3055 articles were retrieved, and 11 articles were retained. The thematic analysis revealed three emergent themes: physicians' empathic expressions; patient outcomes (patient functional status, patient safety, and patient satisfaction); and empathy enhancing doctor-patient communication. This study highlighted the different ways empathy may be expressed by physicians and its positive effects on patient outcomes and doctor- patient communication. This study also suggested the under-researched areas that can be expanded in the future. [ABSTRACT FROM AUTHOR]