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The COVID-19 pandemic's effects on people's lives and society induced a need for rapid individual and collective sensemaking, including communication forums enabling stakeholders in the health ecosystem to share information, solve problems, and learn. This study specifically focused on the needs of the patients and family caregivers living with cystic fibrosis (CF) or primary ciliary dyskinesia (PCD), conditions that lead to chronic infections and inflammation in the airways. We explored how CF and PCD patients, family caregivers, and clinicians collectively received, processed, and used information about COVID-19 to facilitate self-care and health care decisions at the beginning of the pandemic. We applied macrocognitive theory to analyze qualitatively the questions and answers exchanged in a series of six webinars facilitated by a CF learning network at the beginning of the pandemic (March – April 2020). We identified three macrocognitive functions: sensemaking, decision-making, and replanning. We further generated nine themes: (a) understanding the nature of COVID-19, (b) exploring self-care needs and possibilities, (c) understanding health care possibilities, (d) making decisions about prevention and testing, (e) managing COVID-19 within families, (f) adjusting planned care, (g) replanning chronic care management, (h) defining COVID-19 health care strategies, and (i) refining health care policies. The exchange of questions and answers played a central role in facilitating important cognitive processes, which enabled a rapid anticipation of needs and adaptation of services to support patients, family caregivers, and clinicians during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Weight bias is prevalent for people in large bodies who are trying to conceive, pregnant, or postpartum. Using the theory of memorable messages as a framework, we explored the sources, valence, and content of messages that fat individuals (N = 237) recalled about their bodies before pregnancy through the postpartum stage. The most common source of memorable messages was healthcare providers, and most (77.2%) messages were negatively valenced. Thematic analysis revealed four overarching themes (fat mothers are bad mothers, denial of competent treatment, weight-normative commentary on fat bodies, and weight-inclusive counter-narratives). Our findings illuminate the significance of patient-practitioner communication across the pregnancy trajectory and highlight how counter-narratives can disrupt negative messages about fat pregnancy. [ABSTRACT FROM AUTHOR]

Type II diabetes is a chronic health condition and its successful management requires effective patient-provider communication. Responding to a call to model pathways between provider communication and patient health outcomes, this study tested four models of type II diabetic patient adherence with four mediators. Given the complex nature of type II diabetic care, patient adherence was conceptualized as wellness, screening, medication, and treatment adherence. Mediators included patient understanding, agreement, trust, and motivation. A sample of U.S. patients with type II diabetes patients who were both under the care of a medical provider and taking medication for their type II diabetes completed online surveys (n = 793). Findings indicated that the relationships between patient-centered communication and adherence outcomes were mediated by proximal outcomes. The results contribute to the understanding of patient-centered communication, adherence behaviors, and proximal outcomes of patient understanding, agreement, trust, and motivation. Findings indicate that relationships between patient-centered communication and wellness adherence is mediated by patient motivation, patient-centered communication and screening adherence is mediated by patient agreement, trust, and motivation, and patient-centered communication and treatment adherence is mediated by patient agreement, trust, and motivation. The discussion addresses theoretical and practical implications and directions for future research. [ABSTRACT FROM AUTHOR]

Understanding why sports and energy drinks remain increasingly popular among adolescents despite declines in other sugar sweetened beverages is critical. This study points to memory for advertising exposure and adolescent athletic identity as two aspects that together help to explain consumption. An online survey of U.S. adolescents aged 14–18 (n = 503) was combined with Nielsen data for television and social media advertising expenditures by sports and energy drink brands in participants' designated market areas (DMAs). Advertisement recall mediates the relationship between social media DMA expenditures and sports and energy drink consumption. Recall for television advertisements is related to consumption but is unrelated to television DMA expenditures. Athletic identity moderated the relationship between recall and consumption such that consumption increased as both recall and athletic identity increased, suggesting a role for motivated memory and motivated processing of ad messages based on athletic identity consistent with the limited capacity model of motivated media message processing. Based on these results, we conclude that effectiveness of expenditures in influencing behavior is dependent upon both ad recall and ad relevance, and that athletic identity is an important factor in ad effectiveness in the context of sports and energy drinks advertising. [ABSTRACT FROM AUTHOR]

The concept of trust has been extensively studied within the field of medicine. Yet, a list of factors that clearly influence patients' trust is still under debate. Moreover, the methodological approaches found in literature have been reported to be lacking in their assessments and measurements of trust relationships in the medical field although trust between a patient and medical provider has been proven to increase adherence and improve health outcomes. Hence, adding data to this debate and exploring a reliable method to explore the construct of trust is relevant. This study collects new evidence of the most salient indicators of patient trust by using a narrative approach and highlighting the potential of this method in collecting indicators that could be used to build training that aims to increase patients' trust. We used the Linguistic Inquiry and Word Count software for text analysis to examine the spontaneous narrations of episodes of trust and distrust within the doctor-patient relationship with a sample of 82 adult patients. Results demonstrate the role of the emotional aspects of the doctor-patient relationship. Data highlights the importance of doctors' benevolence toward patients, and positive emotions seem to be deeply connected with any experience of trust, which leads patients to feel more secure. Methods are presented to use these insights to construct mechanisms that establish medical trust and allow providers to implement effective interventions. [ABSTRACT FROM AUTHOR]

Despite the distress and disruption associated with eating disorder (ED), people struggling with EDs are often ambivalent about their eating issues and unmotivated for recovery. Rather than seek professional help, these people tend to turn to online ED groups for information and support. Using the stages of change model, this study investigates the characteristics of online peer communication around binging vis-à-vis participants' motivation and readiness for behavioral change. Our results illustrate how individuals with binging issues in different motivational stages discuss their problematic eating online and provides insights into their ambivalence toward treatment and relapses into binging. This study further clarifies how people with binging issues feel trapped in a cycle of dieting-binging, which is observed to be undergirded by unresolved weight-related issues, and how they cope with the stressful relationship between eating and body weight through their postings on social media. These findings suggest that healthcare providers should promote healthier methods of addressing the weight gain from binge eating and provide support tailored to individuals' motivational stage in breaking the dieting-binging cycle. [ABSTRACT FROM AUTHOR]

Hospitals represent complex organizations where a range of hospital workers, from physicians to administrators, encounter a deluge of information they must quickly process and act upon. New technologies implemented to streamline patient care, like electronic health records and wearable technologies, have both enhanced and complicated communicative exchanges between hospital workers and their organizations. Hospital workers feeling over saturated with workplace communication, and thus unable to effectively manage or interpret workplace messages, experience what has been labeled communication overload, which can negatively impact worker productivity and concentration. This study examines hospital workers (N = 303) in a Midwestern U.S. healthcare network, and uses structural equation modeling to offer a preliminary theoretical model that demonstrates the effects and outcomes of communication overload in high-risk organizations. The model offers theoretical implications through depicting communication overload as indirectly related to burnout, job satisfaction, and organizational identification through participation in decision-making and organizational safety climate. Results suggest that even if communication overload is an expected state in high-risk organizations, managers can prevent its negative effects on workers' job attitudes by providing workers opportunities to get involved in organizational decision-making and constructing a robust organizational safety climate. Finally, we suggest pairings of organizational safety communication channels and sources through which high quantities of safety information can be communicated without communicatively overloading workers. [ABSTRACT FROM AUTHOR]

Parents of children with Autism Spectrum Disorder (ASD) experience greater stress and caregiver burden than parents of children with other disabilities. To cope with the stress of long-term caregiving, they rely on professionals for support and guidance. However, parents continue to report unmet communication and support needs. To inform tailored communication for parents of a child with ASD, this study used the existing Family Caregiver Communication Typology framework which identifies four caregiver communication types (manager, carrier, partner, and lone) and their unique communication and support needs. In-depth, structured interviews were conducted with parents (n = 22) and ASD professionals (n = 28) to explore communication characteristics of ASD parent caregivers. A thematic analysis revealed communication behaviors among four ASD parent caregiver types, further validating the typology. Future research is needed to develop targeted interventions for improving family-centered care based on ASD parent caregiver types. [ABSTRACT FROM AUTHOR]

Family communication plays a key role in children's body image, disordered eating, and full-blown eating disorders;. However, much existing communication research on eating disorders has focused on general populations. As the LGBTQ+ community is disproportionately affected by eating disorders , more work is needed to better understand how family communication may be perceived as influencing eating disorders in the LGBTQ+ community. Thus, the current study aimed to further this understanding by examining familial memorable messages reported by LGBTQ+ individuals which they perceived to have influenced their eating disorders. In a Qualtrics survey, participants (n = 73) provided memorable messages received from family members and explained their significance. Results of a thematic analysis indicate five themes among the memorable messages: Problematic Body Size/Weight, Pathologized Eating, Emphasizing Appearance Ideals, Emotion Origins, and Other Focus. Findings support the theory of memorable messages and reveal the ways in which diet culture and LGBTQ+ identity stigma intersect within parent-child communication toward a perceived influence on LGBTQ+ eating disorders. Implications for future communication research on LGBTQ+ eating disorders, as well as practical applications, are discussed. [ABSTRACT FROM AUTHOR]

There has been a growing literature focusing on the persuasive effect of interactive narratives, but the findings are mixed. Furthermore, very few studies have examined how the impact of interactive narratives varies depending on story features and characteristics of the recipients. Informed by the research of interactive narratives and message framing, the current study empirically tests the indirect effect of an interactive narrative on attitude change using a digital anti-indoor tanning game, with transportation as a mediator and narrative ending and issue involvement as two second-stage moderators. Findings suggested a moderated moderated mediation relationship in which the indirect effect of the interactive narrative was the strongest for low-involvement participants when they experienced a loss-framed ending and was the weakest for high-involvement participants when they encountered the same type of ending. Theoretical and practical implications were discussed. [ABSTRACT FROM AUTHOR]

This vignette-based study examined in a sample of unvaccinated Belgian citizens (N = 1918; Mage = 45.99) how health care workers could foster reflection about and intentions to get vaccinated against COVID-19 by experimentally varying their communication style (i.e., autonomy-supportive vs. controlling) and the reference to external motivators (i.e., use of a monetary voucher or corona pass vs. the lack thereof). Each participant was randomly assigned to one of six conditions and rated a vignette in terms of anticipated autonomy satisfaction, perceived effectiveness, reflection, and vaccination intention. An autonomy-supportive, relative to a controlling, communication style predicted greater autonomy need satisfaction, which in turn related positively to perceived effectiveness, reflection, and vaccination intention. External motivators failed to generate positive effects compared to the control condition. The findings highlight the critical role of autonomy support in promoting a self-endorsed decision to get vaccinated. [ABSTRACT FROM AUTHOR]

Even before the widespread transition to telehealth as a result of COVID-19, there was a considerable amount of research exploring its value and impact. However, telehealth research with adolescent patients is somewhat limited, with most work focusing on access, feasibility, and acceptability but reporting far less frequently on relationship building and rapport. This study examines qualitative interviews with adolescent patients (n = 14) and parents (n = 20) from a larger convergent parallel mixed methods study to explore how they understand telehealth to have altered the sociophysical environment of primary care clinic encounters and whether they perceive these changes to influence adolescents' relationships with clinicians. We show that participants perceived the sociophysical environment of telehealth to be both less institutional (e.g. more relaxed and less rushed) and more instrumental (e.g. more focused on the chief complaint), which shaped interactions with clinicians in ways that were experienced as paradoxically less personal (e.g. lacking social connection) and more person-centered (e.g. more attentive to the individual patient). We discuss theoretical and practical implications of these findings and what they mean for defining person-centered communication for adolescent care. [ABSTRACT FROM AUTHOR]

Misinformation related to COVID-19 is a threat to public health. The present study examined the potential for deliberative cognitive styles such as actively open-minded thinking and need for evidence in deterring belief in misinformation and promoting belief in true information related to COVID-19. In addition, regarding how responses to the pandemic have been politicized, the role of political orientation and motivated reasoning were also examined. We conducted a survey in South Korea (N = 1466) during May 2020. Participants answered measures related to demographics, open-minded thinking, need for evidence, and accuracy perceptions of COVID-19 misinformation and true information items. Multi-level analyses of the survey data found that while motivated reasoning was present, deliberative cognitive styles (actively open-minded thinking and need for evidence) decreased belief in misinformation without intensifying motivated reasoning tendencies. Findings also showed a political asymmetry where conservatives detected COVID-19 misinformation at a lesser rate. Overall, results suggest that health communication related to COVID-19 misinformation should pay attention to conservative populations. Results also imply that interventions that activate deliberative cognitive styles hold promise in reducing belief in COVID-19 misinformation. [ABSTRACT FROM AUTHOR]

In early 2020, the first wave of the COVID-19 pandemic hit India, generating one of the highest rates of infection and death in the world. Meanwhile, healthcare workers experienced stigma and discrimination due to their association with COVID-19 patients. This study analyzed healthcare workers' experience of courtesy stigma in India, the communication strategies they used to manage stigma, and the impact on their mental health. A cross-sectional survey of 150 healthcare workers in India showed that almost 50% experienced discrimination due to their association with COVID-19 patients. Using Confirmatory Factor Analysis and Structural Equation Modeling, this study found that experience of discrimination was associated with perceived courtesy stigma. Two stigma management strategies (reducing offensiveness and passive acceptance) mediated the relationship between perceived courtesy stigma and perceived stress and depression. Participants also reported engaging in stigma management strategies of bonding with other healthcare professionals and passive acceptance of the stigma more than reducing stigma and displaying/disclosing stigma. We conclude that perhaps due to depletion of cognitive and emotional resources, healthcare workers engaged more in social support (bonding) and passive stigma acceptance strategies to alleviate the stress associated with providing COVID-19 patient care. Practical and theoretical implications are further discussed. [ABSTRACT FROM AUTHOR]

Using a stratified sample of German non-vaccinated residents (N = 1,328), we examined the effectiveness of the Theory of Motivated Information Management (TMIM) in explaining avoidant information management among family and friends, in the context of the COVID-19 vaccination. Our results generally supported the TMIM's utility as a theoretical framework for understanding avoidant information management, as the model fitted the data well. The study contributes to the theoretical development of the TMIM, by proving that anxiety and hope operate jointly and contribute to decisions for avoiding interpersonal discussions. Further, our findings indicate that avoidance efficacy is a valuable supplement to the considered types of efficacy assessments. As a practical implication, our findings indicate that interventions encouraging individuals to talk to their family and friends should focus on raising levels of communication and target efficacy, to overcome barriers to interpersonal discussions. This is significant in motivating individuals to get vaccinated. [ABSTRACT FROM AUTHOR]

School-based mental health literacy (MHL) programs can increase knowledge, reduce stigma, and encourage help-seeking behaviors in school-aged children. Yet, MHL intervention effects are inconsistent and unsustainable over time, and scholars have called for more theoretical work to address these limitations. The purpose of this theoretical review is to investigate how theory is utilized in MHL interventions, explore the interpersonal communication processes integrated in MHL interventions, and uncover the theoretical assumptions made in MHL interventions about interpersonal communication. We identified 27 articles for inclusion and utilized both content and interpretive analyses. Findings suggest that very few MHL interventions are based in theory; interpersonal communication is a central component within MHL programming; and numerous assumptions are made about interpersonal communication within MHL interventions that need to be addressed theoretically and empirically. Accordingly, we recommend that MHL intervention content and delivery practices are grounded in interpersonal communication theory related to disclosure and social support (seeking and provision). Additionally, teaching disclosure and social support skills may be a productive way for MHL interventions to help students build self-efficacy in communication about mental health for themselves and others. [ABSTRACT FROM AUTHOR]

This study explored how family communication patterns relate to parental knowledge about COVID-19, vaccine confidence, and intentions to vaccinate their children. Parents from 4 states (Ohio, New York, Georgia, and Texas; n = 702) completed an online survey in March 2021. Results revealed that conversation orientation was positively associated with both COVID-19 knowledge and overall vaccine confidence, which were both positively associated with intentions to vaccinate one's child. The relationships between the 4 subscales of conformity and the outcome variables were mixed. We discuss the potential benefits of applying family communication patterns theory to complicated situations where parents are making health decisions for both themselves and their children. [ABSTRACT FROM AUTHOR]

Based on the Risk Information Seeking and Processing Model, the present study examines whether COVID-19 message fatigue leads to greater information avoidance and heuristic processing, and consequently greater acceptance of misinformation. We conducted a survey of 821 Korean adults regarding their information seeking and processing regarding COVID-19 vaccination. Results of SEM analyses showed that COVID-19 message fatigue was (a) negatively related to information insufficiency and (b) positively related to information avoidance and heuristic processing. Information avoidance and heuristic processing were subsequently related to greater levels of misinformation acceptance. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

We describe racially discordant oncology encounters involving EOL decision-making. Fifty-eight provider interviews were content analyzed using the tenets of problematic integration theory. We found EOL discussions between non-Black providers and their Black patients were often complex and anxiety-inducing. That anxiety consisted of (1) ontological uncertainty in which providers characterized the nature of Black patients as distrustful, especially in the context of clinical trials; (2) ontological and epistemological uncertainty in which provider intercultural incompetency and perceived lack of patient health literacy were normalized and intertwined with provider assumptions about patients' religion and support systems; (3) epistemological uncertainty as ambivalence in which providers' feelings conflicted when deciding whether to speak with family members they perceived as lacking health literacy; (4) divergence in which the provider advised palliative care while the family desired surgery or cancer-directed medical treatment; and (5) impossibility when an ontological uncertainty stance of Black distrust was seen as natural by providers and therefore impossible to change. Some communication strategies used were indirect stereotyping, negotiating, asking a series of value questions, blame-guilt framing, and avoidance. We concluded that provider perceptions of Black distrust, religion, and social support influenced their ability to communicate effectively with patients. [ABSTRACT FROM AUTHOR]

Eliciting information from patients is fundamental to medical professionals' capacity to deliver good healthcare outcomes in Emergency Departments (EDs). There are different kinds of utterances that "do questioning", and health professionals can variously attend to the medical agenda and the interpersonal aspects of their interactions with those attending the ED in the way that they construct these utterances. We investigate a corpus of ED interactions to determine the prevalence and range of utterances produced by doctors and directed at patients that "do questioning." We developed a questioning utterance typology, informed by previous research on the formulation of such utterances and extended according to observations of our data. We subsequently manually coded 4,355 questioning utterances and report the variety of forms that such utterances can take, considering how these are distributed across doctors at different levels of seniority. We found that doctors at different seniority levels favored similar questioning utterance types and the most frequently used appeared to restrict the contributions of patients. We conclude that our extended typology of questioning utterances has value for understanding the ways in which doctors may encourage patients to provide more extensive responses. [ABSTRACT FROM AUTHOR]

How do consumers perceive risks associated with food contamination? How do they respond to foodborne illness outbreaks and food recalls resulting from food contamination? We report findings from an experiment (N = 1,010) in which participants were exposed to a simulated news report on a food contamination incident that had led to a foodborne illness outbreak and voluntary food recalls. Two characteristics of the food contamination incident were experimentally manipulated – severity (i.e., how serious the consequences of the incident were) and intentionality (i.e., whether the incident was caused by an accident or an intentional act to harm). We found that higher severity generally led to higher risk perceptions and risk-reduction intentions. A contamination incident attributed to an intentional act to harm, as opposed to an accident, caused greater intentions to temporarily reduce consumption of the contaminated food and to seek out more information, but only when incident severity was relatively low. Implications of these findings for effectively communicating food contamination risks are discussed. [ABSTRACT FROM AUTHOR]

Five years ago, we reviewed the state of memorable message scholarship in communication, with special attention to the utility of memorable message research in health communication. Since then, works advancing the theoretical and practical applicability of the construct have continued to emerge. In this article, we discuss the trends in published memorable message research over the last five years. Since 2017, thirty-four additional peer-reviewed articles focusing on memorable messages as a central concept have been published. Health communication as a subset of the field (as well as the journal Health Communication) see a higher concentration of these publications than other areas. In this review, we concentrate on the use of theory within recent memorable message work. Although much of the memorable message research continues to be atheoretical, more work utilizing control theory, the theory of memorable messages, and communicated narrative sense-making characterize the recent literature. Additionally, more research has emerged that highlights the theoretically driven investigations about the nature of memorable messages. We review the scholarship utilizing these and other theories and suggest avenues for future research. [ABSTRACT FROM AUTHOR]

Fertility problems, or the inability to conceive or carry a pregnancy to term for a period of over 12 months while engaging in unprotected sex, affects 12% of women and 9% of men of childbearing age. To answer calls for more research about individuals' fertility decision-making (DM) with their partners, we conducted in-depth, semi-structured interviews with 53 individuals who have experienced fertility decision-making with a romantic partner at some point in their lives. Our findings indicate at least three primary ways individuals and their partners navigated their decision-making communication in their infertility "journeys:" (1) the Driver-Navigator, (2) Driver-Passenger, and (3) Driver-Backseat Driver approaches. All decision-making communication approaches were viewed by individuals as collaborative (i.e. shared), but varied in degrees of "togetherness" (high, moderate, low) in how they communicated with each other about treatment decisions. Implications include helping couples and their clinicians to be aware of their DM approach(es) and offering alternative DM approaches based on understanding how and why certain approaches may (not) be effective in addressing goals, needs, and identities. [ABSTRACT FROM AUTHOR]

This article reports a scoping review of emerging research on COVID-19 health communication. We reviewed and analyzed 206 articles published in 40 peer-reviewed communication journals between January 2020 to April 2021. Our review identified key study characteristics and overall themes and trends in this rapidly expanding field of research. Our review of health communication scholarship during the early stages of the COVID-19 pandemic suggests that health communication scholars have risen to the challenges and interrogated important issues in COVID-19 communication at the individual, group, organizational, and societal levels. We identified important gaps that warrant future research attention including experimental research that seeks to test the causal effects of communication, studies that evaluate communication interventions in under-served populations, research on mental health challenges imposed by the pandemic, and investigations on the promise of emerging communication technologies for supporting pandemic mitigation efforts. [ABSTRACT FROM AUTHOR]

Integrating concepts from the communication theory of resilience (CTR) with theories of health information management and media-stimulated interpersonal conversation, this study investigates associations between worry about COVID-19, acquiring health information from government, news, and personal sources, and enactment of resilience processes. Findings from a representative sample (N = 600) of Floridians show that the extent to which people worried that they or their loves ones might contract COVID-19 during the first wave of the pandemic predicted the extent to which they reported getting health information from a range of news (e.g. national and local newspapers) and personal (e.g. family, friends/coworkers) sources. A serial multiple mediator model found that worry about COVID-19 was associated with acquiring information about COVID from news sources, which predicted getting information about COVID from personal sources, which in turn predicted enactment of resilience processes. Discussion centers on the role that emotions as well as information management at multiple levels (e.g. media, close relationships) play in people's attempts to enact resilience in the context of a public health emergency. [ABSTRACT FROM AUTHOR]

The impact of the Covid-19 pandemic has been widely documented. While deaths are now in the millions and many more have been impacted in other ways, the impact of Covid-19 has not been felt equally, with it exacerbating existing inequalities and disproportionately impacting a number of populations. With this Covid-19 has created unprecedented challenges in relation to health communication, with the need to reach disadvantaged populations. This systematic scoping review sought to 1) synthesize the existing research regarding communication inequalities in the response to the Covid-19 pandemic, and 2) analyze the recommendations that emerge from this body of evidence on how to best address these inequalities. This review includes 40 studies that fell into three broad groups (1) those revealing a disadvantage or inequality in studies of general population; (2) those focussing on communication with sub-groups disproportionately affected by the pandemic; and (3) those reporting and evaluating practical attempts to address inequalities. The results largely corroborate those found in past pandemics, highlighting the role of sociodemographic, cultural/religious, and economic factors in facilitating/jeopardizing the public's capacity to access and act upon public health messaging. In a number of studies it was encouraging to see recommendations from the literature – particularly, lessons learnt on the importance of community partnerships, trusted messengers and the co-creation of health and risk messages – being applied, however many challenges remain unmet. Covid-19 has also highlighted the need to actively tackle misinformation, something which was recognized, but largely unaddressed. [ABSTRACT FROM AUTHOR]

The concept of racial, ethnic, or cultural concordance between a healthcare provider and a patient has emerged as a dimension of the patient–physician relationship that could influence health outcomes for minoritized patients, particularly through differences in the way physicians communicate with patients of various races and ethnicities. However, two decades of study on concordance and physician–patient communication have produced contradictory results. Although existing systematic reviews have addressed race, ethnicity, and culture as influences on medical encounters, only one review, published in 2006, has examined the effects of this concordance across multiple ethnicities, specifically focusing on physician–patient communication. Given the heightened societal awareness of racism and health disparities in recent years, there is a need for a comprehensive review of the current state of knowledge. This review, therefore, will seek to determine how communication patterns differ in ethnically, racially, and culturally concordant versus discordant patient-provider medical encounters, in the process identifying explanatory and outcome variables associated with those differences. [ABSTRACT FROM AUTHOR]

Two experiments examined if persuasive effectiveness of health messages varies as a function of the communication channel (Facebook vs. news website), and if so, why. Specifically, we examined perceived ulterior motives of the communicator as an explanation for why public health campaigns may be less effective when conveyed via mass-directed (vs. interpersonal) channels, and further investigated if message recipients' health interest moderates such channel effects, if any. In Study 1 (N = 103), reading a medical news reporter's Facebook post on dental health (vs. a news article consisting of the identical content) lowered the participants' suspicion of ulterior motives of the source, which then promoted message-consistent attitudes and behavioral intention. Such effects, however, emerged only for those more interested in health. Using a different topic (a low-carb, high-fat diet), Study 2 (N = 338) replicated Study 1 findings, confirming the conditional persuasive advantages of social media over mass media as a health campaign channel. [ABSTRACT FROM AUTHOR]

Despite its prevalence, research on health information sharing via social network sites (SNSs) is mostly descriptive and often lacks a coherent theoretical framework. By integrating social support and socioemotional selectivity theory, the present study takes a uses and gratifications approach to examining what factors affected health information sharing via WeChat, the most widely used SNS in China. Results of an online survey (N = 519) show that emotional and informational support provisions both predicted health information sharing via WeChat. In addition, age moderated the effects of both support provision. While the relationship between emotional support provision and health information sharing was stronger among older adults, the effect of informational support provision was marginally significantly stronger among younger adults. These findings provide additional understanding of health information sharing via SNSs by revealing its emotional meaning and demonstrating different sharing motivations in different age groups, which offers implications on health information design, dissemination, and discussions in different groups. [ABSTRACT FROM AUTHOR]

Addressing patient-clinician communication barriers to improve multiple chronic disease care is a public health priority. While significant research exists about the patient-clinician encounter, less is known about how to support patient-clinician communication about lifestyle changes that includes the context of people's lives. Data come from a larger photo-based primary care study collected from 13 participants who were adults 60 or older with at least two chronic conditions, in English, Chinese (Cantonese or Mandarin), or Spanish. We use discourse analysis of three examples as anchor points demonstrating different interactional pathways for the photo-based communication. Patients and clinicians can move smoothly through a pathway in which photos are shared, clinicians acknowledge and align with the patient's explanation, and clinicians frame their medical evaluations of food choices, nutrition suggestions, and shared goal-setting by invoking the voice of lifeworld (VOL). On the other hand, when clinicians solely press the voice of medicine (VOM) in their evaluations of patients' pictures with little attention to patients' presentations, it can lead to patient resistance and difficulty moving to the next activity. Because photo-sharing is still relatively novel, it offers unique interactional spaces for both clinicians and patients. Photo-sharing offers a sanctioned moment for a primary care visit to operate in the VOL and promote goal-setting that both parties can agree upon, even if clinicians and patients framed the activity as one in which patients' lifeworld choices should be assessed as medically healthy or unhealthy based on the ultimate judgment of clinicians operating from the VOM. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought about an urgent need for public health departments to clearly communicate their prevention, testing, and treatment recommendations. Previous research supports that Twitter is an important platform that public health departments use to communicate crisis information to stakeholders. This study aimed to shed light on how international health departments shared relevant information about COVID-19 on Twitter in 2020. We conducted a quantitative content analysis of N = 1,200 tweets from twelve countries, across six continents. COVID-19 prevention behaviors were consistently referenced far more than testing or treatment recommendations across countries. Disease severity and susceptibility were referenced more than recommendation benefits, barriers, and efficacy. Results provide support for how public health departments can better communicate recommendations related to COVID-19 behaviors. Based on these results, implications for public health organizations and public relations practitioners worldwide are discussed, and hands-on action guidelines are provided. [ABSTRACT FROM AUTHOR]

Effective health communication requires various strategies. This study focused on two framing strategies closely relevant to health issues. Specifically, it examined how temporal framing moderates the effects of gain-loss framing on social distancing with particular attention to the underlying affective mechanisms of these interactions. A 2 (temporal framing: proximal vs. distal) X 2 (gain-loss framing: gain vs. loss) randomized experiment was conducted with 114 undergraduate students in Korea. The results showed that loss-framing was more effective than gain-framing when presented in temporally proximal frames, but such differences diminished when presented in temporally distal frames. The interaction effects of temporal framing and gain-loss framing had indirect effects on attitudes via fear and anger. They also had an indirect effect on intentions via fear. This study's results enhance our understanding of framing effects by testing the interaction effects between two types of framing in the context of social distancing and clarifying affective mediating processes through which framing exerts its effects. These findings have practical implications for designing effective health messages. [ABSTRACT FROM AUTHOR]

Effective emergency nurse-patient (EN) communication and ENs' communication with other healthcare workers have implications for patient outcomes. Effective EN-patient communication informs and empowers patients. This study sought to better understand ENs frontstage and backstage interactions in a metropolitan emergency department (ED). The researcher engaged in participant observation of 15 different ENs' healthcare interactions with patients and other healthcare workers in the ED for a total of 47 hours and 30 minutes. Iterative analysis of field notes builds reveal two key observations. First, frontstage and backstage spaces are fluid in nature, where healthcare workers simultaneously engage in backstage and frontstage communication regardless of physical space or audience. Second, frontstage communication processes can be categorized into three groups: information seeking and sharing, informally attending to patients and rapport building, and acting out of character. Further, a novel type of front stage interaction, "acting out of character" is conceptualized as when ENs act in ways that are inconsistent with their typical role when communicating with a patient. Implications for health communication practice and theorizing are discussed. [ABSTRACT FROM AUTHOR]

This study examined the effects of agency assignment on response to messages advocating threat preparedness, highlighting interactions between agency assignment and threat type. Participants were randomly assigned to one of four conditions crossing human agency vs. threat agency with human ascribed threats vs. threats not ascribed to humans. Two messages were shown in random order in each condition with responses measured after each message. In line with extant research, results showed a significant main effect for agency assignment on behavioral intentions such that, relative to human agency, threat agency increased intentions to follow message recommendations for threat preparedness. The main effect of agency assignment was qualified by an agency assignment by threat type interaction, indicating a partial matching effect on behavioral intentions wherein threat agency led to greater behavioral intentions than human agency for threats not ascribed to humans – but not for threats ascribed to humans. Results, limitations, and implications of the study are discussed. [ABSTRACT FROM AUTHOR]

Resistance to vaccines has hindered attempts to contain and prevent outbreaks of infectious diseases for centuries. More recently, however, the term "vaccine hesitancy" has been used to describe not necessarily outright resistance but also a delay in acceptance or uncertainty regarding vaccines. Given concerns about hesitancy and its impact on vaccine uptake rates, researchers increasingly shifted the focus from resistance to vaccines toward vaccine hesitancy. Acknowledging the urgency to accurately assess the phenomenon, it is critical to understand the state of the literature, focusing on issues of conceptualization and operationalization. To carry out this systematic review, we collected and analyzed all published empirical articles from 2000 to 2021 that explicitly included quantitative self-report measures of vaccine hesitancy (k = 86). Using a mixed-method approach, the review demonstrates and quantifies crucial inconsistencies in the measurement of the construct, lack of clarity in regard to the determination of who should or should not be defined as hesitant, and overreliance on unrepresentative samples. Crucially, our analysis points to a potential systematic bias toward exaggerating the level of hesitancy in the population. Modeling a vaccine hesitancy co-citation network, the analysis also points to the existence of insular academic silos that make it harder to achieve a unified measurement tool. Theoretical and practical implications for academics, practitioners, and policymakers are discussed. [ABSTRACT FROM AUTHOR]

Direct-to-consumer advertisements for healthcare services constitute a rare channel of public communication where consumers see and hear directly from their local providers and healthcare organizations. Although spending on these advertisements has increased drastically during the past decades, research on their content and effects remains rare. To fill this gap, we analyzed primetime television advertisements for healthcare services directly targeting consumers. The advertisements were collected from the two largest media markets in Nevada for one month. In total, 795 advertisements were identified, and 106 of them were non-duplicates. Analysis revealed that the advertisements focused on patients' good health outcomes by showing them smiling, going out and about, having fun with others, and enjoying rigorous physical activities. On the other hand, the advertisements focused less on the providers. Although the advertisements often showed providers in clinical settings, basic information about their professional degrees was often missing. Mentions of providers' other qualifications and professional experiences were even scarcer. Also, a substantial number of advertisements failed to show providers interacting with patients. Additional analysis of patient and provider characteristics revealed under-representation of racial or ethnic minority and older adult patients. Representation of women and minorities as providers was even more uncommon. We discussed the implications of these findings from the perspective of patient expectation and made suggestions to help providers improve their direct-to-consumer advertisements. [ABSTRACT FROM AUTHOR]

Pelvic floor disorders (PFDs), including fecal and urinary incontinence as well as pelvic organ prolapse, are common medical issues faced by one-third of all women across the lifespan. Despite this prevalence, many women are unaware of them, have highly stigmatized perceptions of them, and thus do not actively seek support or treatment for them. Given that PFDs can drastically impact quality of life to the point of social isolation and depression, this study examines chaos and desire as both lived and storied constructs that ultimately influence whether and how women with PFDs assert control over their social and corporeal disruption. Guided by narrative sensibilities and informed by semi-structured interviews with 22 women living with varying PFDs, our analysis highlights how chaos serves as a catalyst for continued chaos (i.e. barriers to seeking medical care), mitigation (i.e. resignation and/or public bodily containment), and/or change (i.e. motivations to seek medical care). These findings offer both theoretical and practical implications for helping individuals grappling with the dis-ease of PFDs (i.e. patients, providers, and practitioners) to envision and act otherwise. [ABSTRACT FROM AUTHOR]

There remains an urgent need for effective communication about the importance of widespread adherence to behavioral recommendations to control the COVID-19 pandemic that will also reduce resistance to such guidance. We examined two strategies for COVID-19 communication— (1) self-affirmation (reflecting on a personal value in order to boost self-integrity and reduce defensiveness to potentially threatening information); and (2) manipulating self/other message framing – and moderation of these strategies by COVID-19 risk. 600 participants (Mage = 32.55, 51% female) were recruited for an online study and, after assessment of risk factors for severe COVID-19 infection, were exposed to the experimental manipulations. Three classes of defensive responses were considered as outcomes of interest: reactance, attitudinal responses, and behavioral responses. We found that participants derogated the self-focused message more than the other-focused message. Further, other-focused messaging and/or self-affirmation were more likely to elicit positive responses among individuals at higher risk for COVID-19 complications. Our findings suggest having individuals affirm values prior to viewing COVID-19 messages, and framing messages in terms of the importance of protecting others, may be beneficial strategies for encouraging responsiveness – particularly if the targets of such messages are at risk of COVID-19 complications themselves. [ABSTRACT FROM AUTHOR]

Social media is a primary source of sexual health information for young adults. Increased exposure to sexual health education on social media is associated with safer sexual behavior. Given the diversity of social media accounts, condom brands may be a trusted source of sexual health information. We quantified user interactions on the social media posts of the three most frequently used social media sites of condom brands from January 2020 to June 2021. We analyzed the reach each account had in terms of sexual health information separated into three categories: sexual health education, sexual health resources and social issues relating to sexual health. On Instagram, 48% of posts provide sexual health education, 5% mention resources, and 23% mention social issues. On YouTube 68% of posts provide sexual health education, 35% mention resources, and 31% mention social issues. Providing sexual health education had a positive association with likes on Instagram (n = 923, t = 4.09, p <.001). In terms of sexual health education topics, posts pertaining to reproductive health and sexual self-acceptance were a positive predictor of likes on Instagram (n = 56, t = 7.00, p <.001, n = 77, t = 2.37, p =.015 respectively). Posts pertaining to sex were a positive predictor of likes both on Instagram (n = 74, t = 2.79, p =.005) and YouTube (n = 57, t = 2.21, p =.029). These findings suggest that the sexual health education and resources provided by condom brands have significant reach and positive reception. To promote sexual health to a larger and more receptive audience, future research and education campaigns should recognize and utilize the social media influence of condom brands. [ABSTRACT FROM AUTHOR]

This study examined the risk preventive responses of individuals, especially those who do not adhere to preventive measures (e.g. anti-maskers) for COVID-19, by integrating three dominant theories in risk and health communication. The complex causal relationship between motivational elements and individualsʻ preventive behavior adoption was studied using Fuzzy-Set Qualitative Comparative Analysis. With a survey (N = 372) of non-abiding populations, this study found generalizable and unique configurations of motivational elements. Different effects of key motivational variables from three theories were found with different demographic factors. Theoretical and practical implications were also discussed. [ABSTRACT FROM AUTHOR]

The notion of peace and the "doing of peace(building)" are integral components of individual and community/societal well-being. Yet although health (defined broadly to include well-being), organizing, and peace are interrelated, there is a lack of research that considers them together. In this manuscript, we argue that peace is constituted through the processes and acts of organizing for well-being. "Peacebuilding" constitutes organizing processes by multiple actors over time to prevent and mitigate violence. To highlight the intersections between health, organizing, and peace, in this article we draw upon our peacebuilding collaborations in Liberia, West Africa, as part of the Violence Prevention Initiative (VPI; pseudonym). We elaborate on three projects from the VPIʻs work as a means through which to then propose ways in which communication scholars can theorize intersections among health, organizing, and peace and contribute to empirical research at these intersections. [ABSTRACT FROM AUTHOR]

Guided by the fostering relationships function of patient-centered communication (PCC), the present study utilized a 2 (high/low nonverbal immediacy) x 2 (high/low verbal immediacy) between-subjects experimental design to determine whether physician verbal and nonverbal immediacy influenced participant liking for physician, motivation to process a health message, and recall of the health message. An actor physician delivered a 3–4 minute video-recorded message, diagnosing U.S. adult participants, serving as analogue patients, with a health issue. The results indicated main effects for physician verbal immediacy and nonverbal immediacy on participant liking for physician and motivation such that participants had greater liking for the physician and motivation to do what the physician requested when the physician demonstrated greater verbal and nonverbal immediacy. However, physician verbal and nonverbal immediacy did not influence participantsʻ recall. Physicians should consider displaying verbal and nonverbal immediacy to create a positive impression among patients, and to motivate patients to take steps to improve their health. [ABSTRACT FROM AUTHOR]

The purpose of this literature review was to identify interventions designed to improve healthcare team communication in the United States. We conducted a review of peer-reviewed, English-language articles describing interventions aimed at improving healthcare team communication. We analyzed articles that met pre-specified inclusion and exclusion criteria and characterized who is testing communication interventions, the rationale for testing, and ways of measuring effectiveness. We descriptively categorized the strength and types of study findings. Thirty articles were retained in our analysis. Most assessments were conducted by academic medical centers, the Veterans Health Administration, and teaching hospitals. Interventions sought to improve teamwork, patient safety, clinical outcomes, costs of care, and enhance provider job satisfaction and well-being. Intervention strategies included didactic lectures, simulation, Crew Resource Management, quality improvement, or a combination of these approaches. The vast majority employed a pre-post survey design and measured outcomes using participant feedback. Many assessments failed to utilize a social science theory or communication-specific measures. Interventions with the best training content were conducted at academic medical centers, used a pre-post design, and utilized statistical analysis to analyze results. While interventions for improving healthcare team communication are diverse and have uneven effectiveness, early markers of success merit continued development and assessment. [ABSTRACT FROM AUTHOR]

Social media platforms contribute to the dissemination of information and encourage communication between health agencies and the public, especially during health crises. Public health agencies must engage in carefully crafted educational, communicative, and interactive practices to be effective in their messaging to build relationships with the public. Using quantitative content, social network, and thematic analysis, this study examined 2,500 tweets from April to August 2020 that included the hashtag #YoMeInformoPMA. Panama's Public Health Ministry created the #YoMeInformoPMA hashtag to keep citizens informed and engaged during the COVID-19 pandemic. Research on social media use and implementation in Latin America during the COVID-19 pandemic, to inform and engage the public, is limited. Therefore, the aim of this investigation was to analyze strategies, themes, multimedia formats, key actors, and overall communications patterns of a Latin American health community hashtag. Our results determined that actors using the hashtag #YoMeInformoPMA mainly used an interactive strategy, a message that aims to promote casual conversations, advice, and problem-solving. Findings highlighted evidence of a communication strategy by specific actors in this network, supporting recent studies that indicate engagement between the public and health agencies can take place on social media. Practical implications and recommendations for communication preparation via social media for future health crises are discussed. [ABSTRACT FROM AUTHOR]

The paper explored the extent to which hospital appointed official root cause analysis (RCA) panels consider antecedent and proximal events when they investigate communication related sentinel events (CRSEs) in hospitals. It also explored which CRSEs are most common in the hospital setting in Hong Kong and the communication modes most commonly associated with CRSEs. The data consisted of Risk Alert and Annual Report on SEs issued by the Hong Kong Hospital Authority from October 2007 to September 2017. Over the period studied, there were 379 reported sentinel events (SEs). In 186 of these SEs we identified communication as a contributing factor. We examined the RCA panels' reports on contributing factors and subsequent recommendations in these 186 SEs and found that their recommendations only highlighted the proximal contributing factors and not antecedent factors that may be relevant. RCA panels most often recommended that communication should be enhanced or documentation improved. We propose that it is time to review the RCA process to recognize that many CRSEs may occur because of antecedent factors that result from the complex hospital organizational structure and its associated hierarchical culture. We suggest two ways forward, 1) applying a language and social psychology perspective to the investigations of CRSEs and, 2) the involvement of experts from different disciplines who can work with clinicians during RCA investigations. [ABSTRACT FROM AUTHOR]

Communication in healthcare represents the complex interplay between multiple individual and contextual factors unfolding over the course of the medical encounter. Despite significant improvements in patient-centered care delivery, studies of health communication typically focus exclusively on clinical interactions between adult patients and their clinicians. Much less is known about non-dyadic interactions, such as pediatric triads involving a child patient and accompanying parent. Understanding the dynamics of triadic pediatric healthcare communication is the first step toward evaluating and ultimately optimizing these healthcare interactions. Thus, we undertook a mixed-method analysis of 28 audio-recorded triadic medical interactions between healthcare providers, pediatric asthma and allergy patients, and their parents to explore the prevalence of various features of these interactions. Our findings point to mechanisms through which healthcare providers and parents may facilitate or hinder children's involvement in their own asthma and allergy care, including interruptions, unclarified technical medical language, the flow of information exchange, and the formation of dyadic conversational partnerships (coalitions) between providers and parents. Our analyses further reveal that children's participation during their medical visits was minimal (13% of the interaction). Providers in our sample elicited input directly from pediatric patients more often than from parents, though the difference was small. Taken together, these findings provide a foundation on which to develop training and communication interventions to ensure that children have a voice in their medical care. [ABSTRACT FROM AUTHOR]

Motivation-based message appeals and incidental emotions have the potential to encourage COVID-19 vaccination, especially when the motivation components of the two agree. Risk perception may also interact with self vs. other-oriented message appeals. Results from a 2 (message appeal) × 4 (incidental emotion) online experiment (N = 306) indicate that when exposed to an altruistic message, those who experienced self-transcendent emotions reported higher COVID vaccination intention than those amused or not induced with emotions. This effect, however, was not identified in the egoistic message condition. Risk perception was positively associated with self-vaccination intention but did not interact with message appeals. The main effect of risk perception and interaction effects between incidental emotions and message appeals provide important implications for addressing vaccine hesitancy and increasing vaccine uptake. [ABSTRACT FROM AUTHOR]

Vaping prevention messages are widely used to communicate the health harms and addiction risks of vaping and discourage vaping among adolescents and young adults. We conducted a meta-analysis of experimental studies to examine the effects of these messages and to understand their theoretical mechanisms. Systematic, comprehensive searches generated 4,451 references, among which 12 studies (cumulative N = 6,622) met inclusion criteria for the meta-analysis. Across these studies, a total of 35 different vaping-related outcomes were measured, and 14 outcomes assessed in two or more independent samples were meta-analyzed. Results showed that compared to control, exposure to vaping prevention messages led to higher vaping risk perceptions, including harm perceptions (d = 0.30, p <.001), perceived likelihood of harm (d = 0.23, p <.001), perceived relative harm (d = 0.14, p =.036), addiction perceptions (d = 0.39, p <.001), perceived likelihood of addiction (d = 0.22, p <.001), and perceived relative addiction (d = 0.33, p =.015). Also, compared to control, exposure to vaping prevention messages led to more vaping knowledge (d = 0.37, p <.001), lower intentions to vape (d = −0.09, p =.022), and higher perceived message effectiveness (message perceptions; d = 0.57, p <.001; effects perceptions; d = 0.55, p <.001). Findings suggest vaping prevention messages have an impact, yet may operate through different theoretical mechanisms than cigarette pack warnings. [ABSTRACT FROM AUTHOR]

Though experienced by more than 1 in 5 (50 million) American adults, chronic pain is invisible, subjective, difficult to communicate, and often stigmatized. When faced with a serious injury or ongoing illness, individuals create an "illness identity" by modifying their goals and expectations for the future, adapting to impairments, and understanding new emotional reactions. The current, two-phase study uses the communication theory of identity (CTI) to explore the process of illness identity adoption in the context of chronic pain, which may be different than for more understood, less stigmatized illnesses. A focus group was conducted (N = 6), from which interview protocol were created. Interview participants (N = 23) described specific differences between their pre- and post-pain selves within three identity frames: personal, relational, and enacted. Within each frame, several sub-themes of pain-related identity changes are identified, as well how they were communicated and how they subsequently influenced communication. Additionally, three pain-related identity gaps, or ways in which two identity frames contradict each other, were identified, all created explicitly because of the onset of chronic pain: personal-enacted, personal-relational, and personal-communal. Theoretical contributions include using CTI to outline the illness identity adoption process in the context of chronic pain, identifying unique identity gaps created by this relatively widespread condition. Practically, understanding pain-related identity outcomes can help pain patients make sense of and manage their situation, and de-stigmatize the chronic pain experience. [ABSTRACT FROM AUTHOR]

Preventing vaping by adolescents and young adults is unquestionably an important goal. Ma et al.'s meta-analysis invites the conclusion that vaping prevention messages are effective. This commentary discusses two concerns about that conclusion and the affiliated meta-analysis: (1) None of the analyzed effect sizes describes the effectiveness of vaping prevention messages; the effect sizes describe the difference in effectiveness (the difference on an outcome variable) between the two conditions being compared. (2) As the two conditions being compared vary, so do the relevant conclusions–—but the review combines different kinds of comparisons. [ABSTRACT FROM AUTHOR]