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In Western healthcare systems, increasing numbers of nurse practitioners are practicing in primary care organizations, and their integration onto interprofessional teams can be somewhat bumpy. In this article, we rely on the institutional theory of organizational communication to investigate the situated communication challenges faced by NPs as they integrate onto primary health care teams (RQ1), and how these local challenges manifested institutional features (RQ2). We analyze interview data from NPs, their physician partners, clinical nurses, and a network administrator for NPs at five family medicine clinics in Quebec, Canada. We found three main challenges to IP communication between NPs and physicians, namely a lack of time, the professional necessity of bothering, and talking to – and like – a doctor. We present the solutions that participants found to overcome or workaround these challenges. We also interpreted the institutional features that inflected – or "moored" – the situated communication practices and challenges reported by our participants to better understand how the local experience of IP communication is shaped by broader institutional forces. [ABSTRACT FROM AUTHOR]

It is well-known that communication with patients can be challenging for residents. Although some studies have focused on residents' experiences of communication challenges, few, if any, have investigated the language residents use when describing such challenges. In this study, we explore the metaphors residents use when asked to share stories about challenging communication situations. Metaphor has been the focus of research in a variety of health-related disciplines; here, we use it to gain an understanding of why these situations are seen as challenging. Methodologically, we draw on metaphor-led discourse analysis, which facilitates a systematic approach to the identification and analysis of metaphors. The empirical material consists of 138 Danish residents' 259 narratives about communication challenges. We identified more than 700 metaphors used in connection with accounting for communication challenges with patients. The metaphors are primarily driven by vehicles belonging to four groups, namely: "Location," "Movement," "Games and play," and "Battle and warfare." We discuss the implications of these metaphors in relation to residents' conceptualizations of communication and challenges. [ABSTRACT FROM AUTHOR]

Drawing on normative rhetorical theory (NRT), we examined communication dilemmas that internal medicine residents (IMRs) experience when interacting with patients and responses they adopt to manage these dilemmas. We conducted semi-structured, intensive interviews with 15 IMRs and analyzed the data using the phronetic iterative approach. Findings suggested that IMRs experienced two interpersonal dilemmas: (a) asserting expertise while respecting patients and (b) discussing patient behaviors without indicating deviance. The two dilemmas were more salient for international IMRs who were less familiar with the local culture and embraced a different perspective of the IMR-patient relationship. The two interpersonal dilemmas were connected to a supra-level dilemma of practicing tasks required by evidence-based medicine while being patient-centered. IMRs reported engaging in an interpretive lens to view patients as "people" and communicative responses to manage the dilemmas. By applying NRT to a novel context, our findings demonstrate the impact of macro-level paradigms on IMRs' conflicting purposes in medical encounters and offer practical implications for communication interventions for IMRs. [ABSTRACT FROM AUTHOR]

Advanced Web 2.0 communication technologies have facilitated health-related information (HRI) sharing on the Internet. Especially, the COVID-19 pandemic and lockdowns around the world have forced more people to turn to the Internet for HRI. A better understanding of users' sharing content and sharing behavior can help communicators improve health literacy, raise community awareness, and facilitate social support exchanges. This paper reports the results of a systematic review of online HRI sharing literature, including key research topics, theories and methods used in past studies, and key factors of sharing behavior across online platforms. Following the PRISMA procedure for a systematic review, 58 articles were identified and analyzed using keyword matching, thematic analysis, and expert review. Guided by the platform theory, our findings differentiated five types of online platforms that differently influenced online users' sharing content and sharing purposes, including micro-blogs, social network sites, online health communities, social question and answer sites, and Wikis. The findings also clarify five main research topics and applicable theories used in each topic, including personal health sharing, health-related knowledge sharing, general health message diffusion, outcomes of HRI sharing, and exploratory research. Key factors of sharing behavior and potential sharing outcomes are also reviewed and summarized in the research framework developed from the motivation theory. Our study contributes to the understanding of online sharing behavior and provides implications for health communicators to develop effective health campaigns. Potential research directions are also identified and discussed. [ABSTRACT FROM AUTHOR]

Managing the information needs of diverse populations through accessible, high-quality, and evidence-based health communication is critical to controlling the COVID-19 pandemic. Access to comprehensive information is especially important for the >25 million limited English proficient (LEP) individuals in the U.S. who prefer to communicate in languages other than English. We assessed the alignment of COVID-19 communication with LEP constituents' needs by examining multilingual content availability on the health department websites of the largest U.S. cities by population. To guide content analysis, we designed a codebook to evaluate six content types, six delivery modes, and three score measures for each website; for each, we measured Holsti's percent of agreement. We then compared the amount of information provided in all combined content types across cities and languages by delivery mode. We thematically analyzed open-ended responses about users' experiences with each city's webpages. We found that COVID-19 information was not presented consistently across languages: many cities provided less information among several delivery modes in other languages compared to English. We found a discrepancy in the amount of information, presentation quality, and ease of navigability of the information among languages and between cities. Users described having negative experiences with most cities' COVID-19 websites in languages other than English. Our findings indicate a gap in the application of the cultural sensitivity approach by local health departments to address issues related to equitable multilingual, multimodal emergency communication, and underscore the need to improve guidelines for communicating public health information as a component of advancing health equity. [ABSTRACT FROM AUTHOR]

This study investigated how normative information on Facebook (i.e., the number of Likes on a Facebook post and a refuting comment) influences one's intention to share a rumor post regarding genetically modified foods. The results of an online experiment with 630 Facebook users showed that a high number of Likes increased the intention to share the post through perceived descriptive and injunctive norms of sharing behavior. The number of Likes on the post and a refuting comment interacted to influence perceived injunctive norms about rumor sharing. A comment stating that the post is a rumor increased injunctive norm perceptions about rumor sharing when the number of Likes on the post is low. [ABSTRACT FROM AUTHOR]

Despite the prevalence of uncertainty in medicine, many physicians experience anxiety as a result of medical uncertainty and are reluctant to discuss uncertainty with others. When pediatricians do disclose uncertainty to parents, they are managing both the parents' and their own feelings of uncertainty. The current study applies uncertainty management theory and multiple goals theory to explore pediatricians' communication about uncertainty. We collected data using in-depth semi-structured interviews with 18 pediatricians. The results suggest that pediatricians prioritize task and relational goals with parents and task and identity goals with fellow physicians. Though, their appraisal of uncertainty influences their goal-oriented communication. The results highlight the relationship between uncertainty management theory and a multiple goals framework. These frameworks provide a valuable approach for gaining a more thorough understanding of pediatrician communication in the context of uncertainty. [ABSTRACT FROM AUTHOR]

Most adults in the United States (U.S.) fail to meet guidelines for physical activity (PA) and nutrition outlined by the Centers for Disease Control. One important predictor of engagement in healthy behavior is support from one's romantic partner. However, messages from partners may fail to motivate healthy behavior if they threaten recipients' face and cause reactance. The present study examines face-threatening acts (FTAs) and face management strategies (FMSs) in conversations between romantic couples and their associations with reactance, healthy eating, and PA behaviors. Cohabitating couples (N = 70) were recruited, and one member of the couple completed a 10-day diary survey in which they reported on daily memorable conversations they had with their partner about PA and/or healthy eating. Participants completed measures of positive and negative face threat, as well as the extent to which they engaged in healthy eating and PA that day. Trained raters assessed reported conversations for positive and negative face threat as well as positive and negative FMSs. Results indicate that both participant and trained raters' reports of positive face threat were associated with increased reactance, whereas only participants' reports of negative face threat were associated with increased reactance. Both positive and negative FMSs were associated with reduced reactance. Reactance was negatively associated with healthy eating and PA. Results are discussed in terms of implications for reactance and politeness theories, as well as pragmatic implications for the millions of partnered individuals in the U.S. seeking to improve their health. [ABSTRACT FROM AUTHOR]

Parent-child sexual communication is associated with myriad positive sex-related outcomes for young people, but these conversations tend to be infrequent and limited in scope. Using the Social Norms Approach, we hypothesized that learning that other parents talk with their children about sex-related topics would motivate parents to talk about more sex-related topics with their son. In an online experiment, parents in the United States (N = 378) with a son aged 13–16 were asked how many of 30 sex-related topics they had discussed with their son after exposure to one of the two SNA messages or a control. A 30-day follow-up study repeated these questions. The experiment revealed no significant differences between the three conditions, but all three conditions resulted in greater intentions to discuss more topics with their son in the future. Regardless of condition, parents who identify their sons as gay or bisexual talked about more sex-related topics than parents of sons who identify their sons as straight. The results from this study suggest that social norms messages are not more effective at increasing parents' communication intentions. Parents in all conditions planned to discuss more sex-related topics with their son, suggesting that simply bringing these topics to parents' attention may be enough to increase intentions to have these conversations. Findings are discussed in light of motivating and equipping parents to handle these conversations and tailoring educational materials for parents based on their child's sexual and romantic orientation. [ABSTRACT FROM AUTHOR]

Studies have shown that healthcare professionals (HP) play a significant role in parents' experience when informed of the birth of a child with Down Syndrome (DS). Past studies have focused on faith dilemmas of religious mothers that were informed that their child was born with DS and on understanding how faith was a source of emotional support for them. Studies that focus on religious activist mothers are scarce. We utilized a qualitative methodology to explore the experiences of Jewish mothers who are religious and activists. Semistructured interviews and focus groups were conducted with 17 religious Jewish mothers of children with DS, who participated in an activist, self-support group. The data were analyzed using interpretative phenomenological analysis (IPA). Most mothers felt unsupported by the HP although a few mentioned being congratulated on the birth and empowered by a physician who focused on their child's potential to develop. The mothers appreciated when HPs considered their opinions and values. They shared the common goal of changing the existing pathological, statistics-based discourse concerning children with DS. The study reinforces the important role of HP and policymakers' in collaborating with parents and their support groups early in the diagnostic stage. [ABSTRACT FROM AUTHOR]

Health literacy is an important social determinant of health. Achieving health literacy of immigrants can be critical to empower this disadvantaged population in healthcare communication. However, to achieve this goal, it is a prerequisite to examine the relationship between health literacy and patient engagement in healthcare communication. This systematic review conceptualizes behavioral, emotional, and cognitive dimensions of patient engagement in healthcare communication and examines how health literacy and patient engagement among immigrants shape each other. A systematic review was conducted to identify relevant articles from five databases between 2010 and 2020. The reviewers synthesized findings from 15 articles that met the inclusion criteria. The results indicate that communication researchers should be more attentive to the emotional dimension of patient engagement in healthcare communication and that more empirical studies are needed to evaluate the relationship between health literacy and patient engagement among immigrants. Practical implications and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

During times of a pandemic, government emergency response webpages are an important communication channel and if properly managed, will mitigate pandemic impacts. Guided by the Crisis and Emergency Risk Communication (CERC) framework and web interactivity literature, this study examined the information content and interactivity of U.S. state governments' COVID-19 homepages when many states declared stay-at-home orders in March or April of 2020. Using a web archive service, we retrieved 48 state governments' COVID-19 homepages. Three coders coded these pages for the presence or absence of information content on five dimensions (timely updates, sensemaking information, efficacy information, targeted guidance, and anti-stigma communication) and interactivity on four dimensions (accessibility, navigability, media richness, and engagement). Results revealed that a large proportion of state governments' COVID-19 homepages provided timely information facilitating people's understanding of the pandemic. Yet, there were some information gaps regarding how to cope with the pandemic or its related problems, such as mental stress and social discrimination. While many COVID-19 homepages allowed easy navigation, page engagement and accessibility seemed inadequate. U.S. state governments' COVID-19 homepages could be a good source for sensemaking. Practitioners and researchers should explore how to better harness interactive Internet technologies and present information that fosters people's efficacy to manage through the pandemic. [ABSTRACT FROM AUTHOR]

Undetectable = Untransmittable (U = U) is the scientific fact that HIV cannot be transmitted when an individual is virally suppressed. This breakthrough discovery has the potential to greatly reduce HIV stigma and its negative effects. However, U = U is not widely known. Given that Twitter has the potential to raise awareness of health issues, the purpose of this study was to analyze the content of the #UequalsU on Twitter. The results showed that mentioning sex and mentioning love were strong predictors that a tweet would be liked and retweeted. This information could help to spread the message of U = U more widely and potentially lessen HIV stigma. [ABSTRACT FROM AUTHOR]

Through an online, nationally representative survey (N = 1,164), this study examines how individuals perceive and cope with infectious disease outbreaks. Findings inform risk and crisis communication strategies for health organizations. This study explored how individuals' threat appraisals (perceived controllability, perceived predictability, and perceived responsibility) and their cognitive (i.e., information seeking) and conative coping (i.e., protective actions) differ by infectious disease threat (IDT) type (i.e. airborne, bloodborne, foodborne, sexually-transmitted, waterborne, or zoonotic/vectorborne) in epidemic situations. Findings revealed that IDT types varied significantly based on individuals' appraisals of predictability, controllability, and responsibility for different disease types. Across all disease types, predictability was the most impactful factor related to participants' information seeking and planned protective action taking. [ABSTRACT FROM AUTHOR]

It is important to examine gaps in online health-related activities (OHAs) between socially advantaged and disadvantaged groups, considering that emerging information and communication technologies may bring about social disparities in their adoption and possibly expand preexisting health disparities. We thus examined whether digital divide occurs in the area of OHAs, including engagement with a very recent technology. To be more specific, we explored the effects of education, income, and race/ethnicity on OHAs, such as online health information seeking, social media use for health, and health information technologies (HITs) utilization. Moreover, given the importance of socio-contextual factors in digital divide, we examined how social support interacts with education, income, and race/ethnicity, and jointly influences OHAs. Using data from the 2017 Health Information National Trends Survey, we found the effects of education on several OHAs. Income only affected HITs utilization that had just started to diffuse across the U.S. society. We also identified reinforcing effects of social support and education on HITs utilization, and reinforcing effects of social support and income on online health information seeking. The implications of these findings for health communication and public health research were discussed. [ABSTRACT FROM AUTHOR]

Guided by communication infrastructure theory and social support theory, this study scrutinizes how the storytelling networks of marginalized communities, particularly migrant domestic workers (MDWs), provided social support amid the COVID-19 pandemic. Data obtained from in-depth interviews with 32 Indonesian MDWs in Hong Kong revealed that the community storytelling networks, comprising interpersonal relationships, community organizations, and media outlets, played an essential role in assisting the coping efforts of MDWs during the pandemic. These storytelling networks offered various types of social support, including informational, emotional, and instrumental or tangible assistance. However, these connections to the storytelling networks were also sources of the spread of misinformation. Theoretical and practical implications are further discussed. [ABSTRACT FROM AUTHOR]

An experimental study exposed participants (N = 299) to different message frames to investigate whether Family Communication Patterns (FCP) and message characteristics influenced willingness to communicate about Family Health History (FHH). Message frames were either collective (our), individual (mine), or control (no pronouns). Afterward, participants were asked about their perceived collective psychological ownership of health information, attitudes, subjective norms, and FHH communication intentions. Although the message frames had no impact on perceived collective psychological ownership of health information, conversation orientation and conformity orientation (respecting parental authority) were positively associated with perceived collective psychological ownership of health information. Additionally, perceived collective psychological ownership, attitudes, and subjective norms were found to have indirect effects between FCP and FHH communication intentions. These findings provide further support that FCP influences how health message appeals are processed and suggest interventions could be tailored to FCP orientations for effective FHH behaviors. [ABSTRACT FROM AUTHOR]

The manner in which scientific information related to the COVID-19 pandemic has been shared and discussed in similar venues has, to date, been largely neglected. Considering the role that such discourse plays in knowledge sharing and knowledge production, it is essential to understand such communication processes as they relate to global health crises like the COVID-19 pandemic. The current study examines communication expressed by participants in the r/COVID19 subreddit, a community that facilitates scientific discussion of the ongoing coronavirus pandemic. A computational content analysis was performed to identify the primary themes of users' communication on r/COVID19, while stepwise segmented regression was used to assess identify longitudinal changes in the volume of user contributions. Findings showed that while conversations were centered on scientific conversations, they were catalyzed by sociological and political developments rather than scientific breakthroughs. Future studies should examine the effects of pandemic-related communities on lurkers, the effects of visibility on scientific and medical contributions, and the implications of pseudonymity and ambiguous credentials in a community addressing a volatile health and scientific topic. [ABSTRACT FROM AUTHOR]

Many adolescents and young adults hold erroneous beliefs that cigarillos and waterpipe tobacco (WT) are safer than cigarettes, contributing to use. Communication campaigns can correct misperceptions and increase risk beliefs. We tested point-of-sale (POS) communication campaigns focused on chemical exposure for cigarillos and WT. We conducted two cluster randomized trials at 20 gas stations with convenience stores (10 stores for cigarillos, 10 for WT) in North Carolina between June and November 2017. Within each trial, stores were randomly assigned to either the intervention (campaign messages displayed) or a no message control condition. We conducted intercept surveys with repeated cross-sectional samples of 50 adolescents and young adults (ages 16–25) per store, at baseline and follow-up. There were 978 participants (mean age = 20.9 years) in the cigarillo trial, and 998 participants (mean age = 21.0 years) in the WT trial. Rates of campaign exposure were low (26% for cigarillos; 24.3% for WT). The cigarillo campaign increased knowledge that ammonia is in cigarillo smoke (p <.01). There were also significant increases in knowledge about ammonia and cyanide in cigarillo smoke and arsenic in WT smoke (p <.05) in the sub-sample who reported exposure to the campaign. No differences were found in outcome expectancies, product attitudes, worry about chemical exposure, or behavioral intentions in either campaign. Garnering attention for communication campaigns in saturated POS environments, often dominated by tobacco advertising, is challenging. Our study demonstrates the feasibility of anti-tobacco campaigns at the POS and points to several lessons learned for future POS campaigns. [ABSTRACT FROM AUTHOR]

Memorable messages oftentimes are associated with hope, can foster anticipatory resilience prior to the experience of disruptive events, and can buffer the negative impact of adverse experiences on mental health. However, associations among memorable messages, engagement in resilience processes, and mental health have not been examined. Drawing from the communication theory of resilience (CTR), analyses of data from 262 Chinese adults suggested that memorable messages provided a sense of agency and pathways – two interrelated but distinct components of dispositional hope – and functioned as a form of anticipatory resilience that was positively associated with outcomes of coping with disruptive life events including mental health, posttraumatic growth, and meaning in life. These associations were mediated by the extent to which individuals engaged in change- and continuity-related resilience processes as outlined in CTR. Findings offer theoretical implications for memorable message and resilience research as well as practical implications for communicative strategies that can cultivate anticipatory resilience, promote positive adaptation, learning, and reflection, and mitigate the negative effects that disruptive events can have on mental health. [ABSTRACT FROM AUTHOR]

Several distinct terms are used to identify descendants of the African diaspora (DADs) as fellow members of a racialized population. However, "Black" and "African American" are the two labels most commonly used. Given the recent calls for examining institutionalized racism in the United States, health scholars must contemplate the problems that may arise when these two terms are used interchangeably, namely the extent to which mislabeling may reify already significant health disparities. This essay examines the histories and meanings of "Black" and "African American" as identity labels and explores their importance in relationship to the effective recruitment of DADs to health research and clinical trials. In this paper, we employ the communication theory of identity and critical race theory as lenses to call attention to the discursive challenges associated with recruitment of DADs in health research. We also encourage health communication scholars to explore and extend the scope of this research. We do this by first describing the unintended consequences in health research through disregard of DADs' chosen identity labels. We then use the various terms to describe DADs to illuminate existing tensions between "Black" and "African American." We describe how each moniker is used and perceived, broadly and in health contexts. Finally, we call for more research into the effects of mislabeling and propose a plan for researchers' next steps. [ABSTRACT FROM AUTHOR]

The aggressive conduct of patients is a perennial problem that nurses face in health care. Studies have shown that such aggressiveness can be detrimental to the work and emotional wellbeing of nurses. Yet, the literature has had inconsistent findings; in some cases nurses are negatively affected by aggression, while in other cases nurses are not affected. Street and colleagues contended that such inconsistencies in research exist because social mechanisms embedded in communication are often not taken into consideration. This study adopts Street et al.'s pathways model and links patients' aggressive communication to nurses' emotional health outcomes, via the proximal outcome of communication satisfaction and the intermediate outcome of organizational identity. Results support Street et al.'s postulation and demonstrates that patients' aggressive communication does not have a direct effect on nurses' emotional health. Instead, the effect is indirect, mediated by communication satisfaction and organizational identity. [ABSTRACT FROM AUTHOR]

Patient-centered communication promotes positive patient outcomes. This study examines the linguistic markers of two key dimensions of patient-centered communication (i.e., provider compassionate care and shared decision-making) and their mediating effects on patient perceived quality of and affective responses to the provider's treatment recommendations. Transcripts (N = 343) of provider talk from provider-patient interactions in medical visits for upper respiratory infection symptoms where patients were not prescribed with antibiotics were analyzed with the Linguistic Inquiry and Word Count (LIWC) dictionary. Results showed that providers' use of affiliation words positively predicted patients' perceptions of their providers' compassionate care. Providers' use of insight words negatively predicted patients' perceptions of provider shared decision-making. Meanwhile, providers' use of first-person singular pronouns, causation and differentiation words, and clout words were positively related to perceived provider shared decision-making. Patient perceived compassionate care and shared decision-making further increased patients' positive affect toward and perceived quality of non-antibiotic treatment recommendations. These perceptions also reduced their negative affect toward the recommendations. Implications of the findings are discussed with regard to patient-centered communication in relation to the promotion of antibiotic stewardship. [ABSTRACT FROM AUTHOR]

In this defining moments essay, I take up feminist new materialist and reproductive justice theories to explore communication, autonomy, consent, and in/justice in the context of pelvic exams. I use feminist new materialism and reproductive justice to illustrate the ways in which traditional medical education practices, histories of misogynoir, speculums, patient gowns, and more communicate and matter in pelvic exam teaching and practice. In so doing, I move between academic prose and short narratives drawn from my lived experiences as both a patient and a Gynecological Teaching Associate (a role in which I instruct medical students learning to perform pelvic exams). Ultimately, I argue that attending to influence of other-than-humans and adopting relational conceptions of agency can help health communication scholars and practitioners advance equity and justice in pelvic exams. [ABSTRACT FROM AUTHOR]

The study presented in this article examined individuals' interpersonal communication about media coverage during the COVID-19 pandemic. In times of a severe public health crisis, people rely heavily on media coverage to stay informed. Communicating with others about this coverage can help them gain deeper insights and evaluate pandemic-related information. According to the two-step flow of communication, opinion leaders, such as health experts, play an important role in interpersonal communication by disseminating information, influencing others, and providing orientation. To examine the nature of interpersonal communication about pandemic-related media coverage, we conducted 22 semi-structured interviews. We explored: a) the communicative roles within the informal social network, b) the functions of the communication for the individual, and c) the potential transformations in the trajectory of the pandemic. Findings show that communication with close and more distant social contacts occurred largely on an equal basis, while the rare opinion leaders mainly emerged as information brokers. Communication about media coverage serves the functions of information sharing and retrieving, information validation, and coping with negative emotions. Finally, communication partners, roles, and conversational topics partly changed over time. Our study extends existing research on interpersonal communication about health topics, as well as on the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Online communities are increasingly important discursive spaces in which individuals obtain health information and engage in sensemaking, and they play an especially essential role during viral outbreaks in which social distancing requirements may preclude engagement with other communities and information sources. However, the manner in which those communities evolve in response to a rapidly developing public health crisis, as well as in reaction to one another, is not well-understood. This longitudinal study uses latent Dirichlet allocation to assess the co-evolution of three subreddits focused on COVID-19 during the earliest, most volatile stages of the outbreak. The results demonstrate the power of being the first online community addressing an emerging health crisis as well as the manner in which latecomers to the conversation gravitate toward distinct niches to differentiate themselves with respect to both topical foci and associated communication styles. The results also highlight individuals' detachment toward developments in even an unprecedented crisis such as a global pandemic, which represents a critical barrier that health communication professionals must overcome to persuade audiences to take health crises seriously. Future studies should examine the potential role of coordination among community administrators as well as the extent to which users are aware of and exert agency over the co-evolutionary processes spanning multiple communities. [ABSTRACT FROM AUTHOR]

While health communication campaigns seek to encourage and promote healthy behaviors, they are not always successful. Health communication efforts may fail for several reasons, such as viewers experiencing excessive freedom threats and reactance. This study (n = 201) proposes and demonstrates that descriptive norm appeals in health PSAs can indirectly lead to enhanced behavioral intentions toward the message advocacy via reducing perceived freedom threats, inhibiting psychological reactance, and improving message credibility. However, this serial mediation was only found for message viewers with relatively low media literacy skills – precisely, who did not show considerable critical thinking toward media content. For participants who reported a high level of critical thinking toward media content, the use of descriptive norm appeals did not decrease freedom threats, nor did it indirectly affect behavioral intentions. The findings of this study contribute to the theory of psychological reactance and norms-based research. Both theoretical and practical implications are provided for health communication scholars and practitioners. [ABSTRACT FROM AUTHOR]

The growing popularity of vaping devices is of major concern for public health practitioners, and personal relationships have the potential to either increase or decrease the use of vaping devices. The escalation of romantic relationships, in particular, can have implications for the use of vaping devices. The current study seeks to understand how emerging adults negotiate communication about the use of vaping devices while initiating and escalating romantic relationships. Five focus groups were conducted with groups of participants who either did or did not use vaping devices. Results reveal the various reasons participants were reluctant to date individuals who vaped and illustrated the role of vaping norms in the stages of relational escalation. Practical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

Drawing on a multiplicity of mass media and health behavior theories, we propose an integrated health communication (IHC) framework to understand and leverage the ways in which mass mediated and interpersonal sources of health information influence the public's health behavior in the context of their prescription drug decisions. Building on the agenda setting theory, two-step flow theory, and the Health Belief Model, we dig into the interrelationships between mass media and interpersonal information sources and information seeking engagement. Employing survey methodology, our framework was tested using a sample of U.S. adults (N = 628). The major results include (a) information gained through interpersonal sources and perceived benefits of the prescription drugs positively and sequentially mediate the association between mass media exposure and intent to seek prescription drug information, (b) interpersonal health information positively moderate the mediation of mass media exposure – perceived benefits – intent to seek prescription drug information, and (c) the inexpert interpersonal information's positive interaction effect with mass media exposure on intent to seek prescription drug information mediated through perceived benefits was greater with high expert interpersonal communication. These results impart valuable theoretical contributions and have the potential to guide integrated health communication (IHC) campaigns. [ABSTRACT FROM AUTHOR]

The human papillomavirus (HPV) vaccine is relatively novel to people in China. Social media is becoming an important channel for learning new health information. However, limited is known about what HPV vaccine information has been disseminated on social media, and how such online information is associated with health-related behaviors in China. Based on Longo et al.'s model of patient use of healthcare information for healthcare decision, and Longo's model of health information seeking behaviors, this study examined HPV vaccine-related information type and information acquisition pattern. Following the mixed-methods approach, we first crawled 67,773 postings about HPV vaccine on Weibo, the largest microblogging website in China, and performed topic modeling to identify HPV vaccine-related topics that are prevalent on Weibo. The results showed six major topics about HPV vaccine, namely policy, guidance information, advertising, scandals, personal experience sharing, and HPV risks. Second, we conducted an online survey (n = 1,982) to investigate how scanning, seeking, and discussing the six HPV vaccine topics identified from big data analytics can affect HPV vaccine knowledge, safety concern, and vaccination intention. We documented significant impacts of social media health communication on users' health knowledge, attitude and behavioral intention. [ABSTRACT FROM AUTHOR]

Sexual health is critical to overall well-being, yet it is challenging and uncomfortable to discuss. Individuals frequently encounter uncertainty about their sexual health as they experience bodily changes, navigate romantic or sexual relationships, and explore their identities. In this study, we called on uncertainty management theory to guide an investigation of sexual health uncertainty. Specifically, we asked how people use social support to manage their sexual health uncertainty in online forums. Grounded theory analyses revealed that negative emotions, avoidance, and pursuing medical care prompted people to seek emotional and informational support online, and support served three functions: integrating information, assessing risk, and strategizing communication. The results point to stigma as a driving force in sexual health discussions online and imply practical recommendations for sexual education, communication about sexual topics, and patient-provider relationships. [ABSTRACT FROM AUTHOR]

Often health communication campaigns addressing misusing prescription opioids and opioid use disorder (OUD) do not pay enough attention to the associated stigma. This study investigated the effectiveness of a well-designed opioid awareness campaign on reducing stigma and provided evidence for future health communication design. CDC's Rx Awareness videos were used as the experiment material. 137 college students participated in this online experiment, and audience characteristics and video features were considered and tested. The results showed that Rx Awareness videos significantly reduced participants' stigmatizing attitudes and perceived public stigma and increased their empathy toward people with OUD. Empathy is a promising strategy to reduce opioid stigma. People with an opioid prescription history expressed more empathy. Recovery information, prescription history, and narrators' race influenced the audience's perceived public stigma. Implications for health communications and limitations of the study are discussed. [ABSTRACT FROM AUTHOR]

In this study, we extended and tested the privacy calculus framework in the context of a hypothetical AI-based contact-tracing technology for application during the COVID-19 pandemic that is based on the communication privacy management and contextual integrity theories. Specifically, we investigated how the perceived privacy risks and benefits of information disclosure affect the public's willingness to opt in and adopt contact-tracing technologies and how social and contextual factors influence their decision-making process. Four hundred eighteen adults in the United States participated in the study via Amazon Mechanical Turk in August 2020. A percentile bootstrap method with 5,000 resamples and bias-corrected 95% confidence intervals in structural equation modeling was used for data analysis. The participants' privacy concerns and perceived benefits significantly influenced their opt-in and adoption intentions, which suggests that the privacy calculus framework applies to the context of COVID-19 contact-tracing technologies. Perceived social, personal, and reciprocal benefits were identified as crucial mediators that link contextual variables to both opt-in and adoption intentions. Although this study was based on a hypothetical AI-based contact-tracing app, our findings provide meaningful theoretical and practical implications for future research investigating the public's technology adoption in contexts where tradeoffs between privacy risks and public health coexist. [ABSTRACT FROM AUTHOR]

In recent decades, women's use of contraception has evolved. Women not only utilize contraceptives to prevent pregnancy, but also to manage menstruation and other factors related to their personal agency. Despite an abundance of available contraceptive options, many women struggle to navigate and address their contraceptive needs. A hundred and thirty-four female participants responded to an open-ended questionnaire about contraceptive messages and decision making in an online survey. Using Uncertainty Management Theory as a framework, we illustrate how the women make sense of and manage uncertainty from multiple contraceptive messages. Results highlighted the absence of desired information, and identified messages that women wish they had received from healthcare providers and others. Our findings suggest that women's understanding of contraceptives' side effects is a communicative process in which anecdotal evidence is often treated as medical fact and healthcare providers are viewed as ineffective and dismissive in relaying and addressing information about contraception. In the absence of satisfying healthcare interactions, women seek information elsewhere to make their contraceptive choices. [ABSTRACT FROM AUTHOR]

Miscarriage occurs in roughly one in five pregnancies in the United States. Although it is largely considered a "women's issue," non-miscarrying spouses also endure the mental and relational health effects of the loss. Drawing on communicated narrative sense-making (CNSM) theory, we interviewed heterosexual, cisgender, mostly white, married men (n = 45) to solicit their stories of their spouse's miscarriage. Six types of memorable messages (i.e., messages that affect the values, behaviors and/or beliefs of the receiver) from social network members emerged – have faith, brush it off, this (pain) is your fault, silence, I'm so sorry, and this happens a lot. These messages illuminate the importance of context in memorable message meaning-making; highlight the complexity of "message gaps" in narratively processing difficulty; and uncover ethical issues with attending to men's experiences with miscarriage. We explore how these findings inform memorable messages theorizing and research. [ABSTRACT FROM AUTHOR]

The purpose of this study is to seek an effective strategy to promote COVID-19 vaccination among young adults. Given that COVID-19 is less deadly for young adults, this study explores whether highlighting potential benefits or disadvantages that others may experience as a result of one's vaccination increases young adults' intention to get vaccinated, particularly for those who have low perceived risk of COVID-19. To test this idea, we conducted an experiment and analyzed the effect of interaction between message frame (gain vs. loss) and reference point (self vs. others) on intention for vaccination by one's perceived risk (low vs. high). The results show that for those with low perceived risk of COVID-19, messages about potential negative consequences to others (e.g., family, friends, community members) from one's failure to get vaccinated led to message elaboration and favorable attitude toward vaccination, which in turn promoted one's intention to get vaccinated. We discuss practical implications of the findings for message strategies that target populations experiencing COVID-19 disparities. [ABSTRACT FROM AUTHOR]

The success of health protection measures depends on public compliance. This paper aims to understand the influence of three different types of communication (i.e., news media, social media, and interpersonal communication) on people's engagement in health protective behavior during a public health crisis. Our C-ENT model of health protective behavior proposes that communication raises perceptions of efficacy, norms, and threat, which in turn influence health protective behavior (communication → efficacy, norms, threat: C-ENT). We test the model for the case of social distancing during the COVID-19 pandemic, based on a representative online survey during the first week of the lockdown in Switzerland (N = 1005). The results support the C-ENT model and illustrate the important role of communication engagement during a public health crisis. News media use was associated with perceptions of behavior-related efficacy and norms and disease-related threat, and these perceptions were positively associated with compliance with social distancing. Social media use and interpersonal communication were related with perceived norms. Social media use was negatively and interpersonal communication positively associated with health behavior-supporting normative perceptions. Our findings suggest taking the distinct pattern among communication types (i.e., news media, social media, and interpersonal communication), perceptions, and behavior into account in order to understand existing dependencies and design respective communication strategies. [ABSTRACT FROM AUTHOR]

The current study was designed to examine effective message strategies that can be employed in designing mediated communication messages to improve clinical trial research participation. In the study, a total of 300 participants completed an online experiment in which they responded to five different clinical trial recruitment advertisements whose information sources varied in their credentials and race. Overall, peer-featured ads in which previous clinical trial participants communicated their prior experience in clinical trial participation, compared to expert-featured ads in which medical doctors communicated information about clinical trials, led to higher message and topic relevance, higher message credibility, more favorable attitudes toward clinical trials, and higher intentions to participate in future clinical trials. Further, there was a statistically significant interaction among source credentials, racial match (between source and participant), and participant's race on message and topic relevance such that both White and Black participants rated ads from racially mismatched peers highly effective (greater message and topic relevance); however, for doctor featured ads, White participants reported higher message and topic relevance for racially matched (White doctor) ads, and Black participants reported higher message and topic relevance for racially mismatched (White doctor) ads. We discuss theoretical and practical implications. [ABSTRACT FROM AUTHOR]

Language discordance poses a barrier to effective physician-patient communication, and health care outcomes, such as patient satisfaction, can be associated with language barriers experienced by Spanish-speaking patients. This exploratory study assessed specific aspects of communication between 128 Spanish-speaking primary care patients and their physicians (primary English speakers without an interpreter present). The rating scale developed for this study was used by five raters, who listened to audiotapes of each of these medical visits. Patients and physicians completed measures of visit satisfaction. Results indicated physicians with better Spanish-language skills were less frustrated with medical visit communication and more connected to their patients; patients whose physicians were rated as having better Spanish-speaking ability reported having greater choice in their medical care. Patients whose physicians spoke more Spanish were more satisfied with the information given by their physicians. Physicians rated as having better Spanish-speaking ability were more likely to say they could not understand all the patients wanted to tell them. These data support the importance of language concordance in physician-patient communication and awareness of potential communication barriers between physicians and patients. [ABSTRACT FROM AUTHOR]

Given the importance of local organizing to environmental health advocacy and activism, we need more understanding of how neighbors communicate about health risks. Individual residents in a neighborhood can be agents of social change, communicating about common health concerns and ways to cope with them, potentially leading to health activism. In this study, we used a grounded theory approach to analyze Pennsylvania residents' (N = 407) responses to open-ended questions that asked their thoughts on engaging in conversations with neighbors about the risk of lead exposure. Our findings describe (a) what respondents would want to share with neighbors about health risks and how they would communicate with their neighbors, (b) what actions they would like to promote to neighbors, and (c) what additional factors would facilitate conversations with neighbors. Based on the critical examination of the findings, we discuss communication strategies that can motivate health activism to bring about social structural changes. [ABSTRACT FROM AUTHOR]

Numerous studies have highlighted the relation between drinking behavior and alcohol references on social media. However, most studies on substance-use-related social media effects rely on self-report data, and it remains unclear whether individuals can accurately report their online alcohol-related communication. This study contributes to this line of research by examining whether individuals accurately report their alcohol-related self-sharing behavior on social media and what factors contribute to a misestimation of this behavior. A sample of 149 Belgian college students (64.3% females, Mage = 21.33, SD = 1.49) participated in this study, who were asked survey questions on their general and alcohol-related social media use. In addition, all posts they shared on their Instagram profiles between April 1st, 2019, and March 31st, 2020, were captured and coded. The results indicated a positive association between the counted and self-reported frequencies of sharing alcohol posts on Instagram. However, most participants overestimated how often they shared this content. The perceived injunctive norms and sharing alcohol posts for entertainment motives were the only significant predictors of this overestimation. We conclude that this overestimation may be a result of subtle social desirability processes and a misremembrance of what has been shared. [ABSTRACT FROM AUTHOR]

Communication about menstrual health continues to be influenced by institutional and social practices which deem it to be unclean and impure. In a country such as India, several customs and traditions reinforce secrecy and shame about menstruation. As such, scholars advocate the need to generate knowledge that can open opportunities to converse on the topic of menstruation and understand issues related to bodily changes. Using a culture-centered approach, this study examined how college-going adult women from two cities in Northern India made sense of menstrual health. Data collection included 20 focus groups with 180 college-going women and interviews with 16 female family members. Participants discussed communication patterns surrounding menstrual health and how they uphold, challenge, and change social practices. Specifically, participants reflected on how they were communicated to about their menstrual health with underpinnings of secrecy and shame and how the influence of current opportunities for openness encourage them to anticipate positive change. Theoretical and practical implications for studying communication around menstruation in diverse cultural contexts are discussed. [ABSTRACT FROM AUTHOR]

A multi-method approach was used to explore correlates of technical and complex language use within 145 audio-recorded physician-patient interactions. When discussing the prospect of surgery, physicians used more technical and complex language (more jargon, larger words, longer sentences) than patients on average. Patients' demographic characteristics (education, health literacy, English fluency) and markers of health (condition severity) inconsistently predicted physicians' and patients' use of complex and technical language. Interactions with happier and more hopeful patients involved less technical and complex language, but physicians' language use was unrelated to patients' emotions following the consultation. Finally, physicians' use of more technical language predicted greater patient satisfaction following the consultation, and physicians' use of more complex language at the initial consultation predicted better adherence by patients following surgery. Our results highlight the nuanced role of language use within healthcare interactions and identifies language complexity as a novel target for health communication research.

The present study tests and extends the RISP model (a) by applying the model in the context of COVID-19 in South Korea and (b) by examining the impacts of information seeking and processing on misinformation exposure and acceptance. Based on a survey of 346 Korean adults, this study showed that information avoidance, but not information seeking, was a positive predictor of misinformation exposure. In addition, heuristic processing, but not systematic processing, moderated the relationship between misinformation exposure and misinformation acceptance, such that the relationship between misinformation exposure and misinformation acceptance was stronger among those who showed greater tendency for heuristic processing. In addition, information insufficiency was a negative predictor of both information avoidance and heuristic processing. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

The integration of art therapy in medicine is expanding as are calls to strengthen its evidence base of clinical outcomes. In this essay, we elevate the voices of non-clinically based artists who work in community and home settings. Although we do not discount the value of art therapy, we add nuance and complexity to clinical and society narratives about art and health by bringing into focus experiential intent and outcome as well as context to explore the meaning-making capacity of the arts. We argue: (1) aesthetic experiences can foster self-expression, relational development, and employment beyond medically identified goals and treatment plans; and, (2) Equating community-based art programming with art therapy oversimplifies our understanding of art and health and does a disservice to both. [ABSTRACT FROM AUTHOR]

Reflecting on 30 years of living with Crohn's Disease, I engage Managed Meaning of Embodied Experience (MMEE) theory, considering whether and how it can help me articulate new possibilities for working as an academic with chronic illness. I come to see that MMEE does enable restorying of possibility, but the stories that can be told are constricted by the assumption that illness is undesirable and in need of a fix. That is, MMEE rests on existing discourses founded on a hierarchical binary between illness and health. Applying Simone de Beauvoir's analysis of the political and practical binds arising when we accept binaries as natural, I call for a leveling of the ill/healthy hierarchy. This move facilitates chronically ill people existing as whole subjects rather than as lacking and in need of a fix to repair them to the healthy ideal. Using Beauvoir's idea of reciprocity, which calls for an intersubjective, situational construction of subjectivity, I offer a path toward wholeness for all people. [ABSTRACT FROM AUTHOR]

A growing body of research on medical communication indicates that nonverbal rapport (e.g., smiling, eye contact, closer proximity) is central to productive health care delivery. However, mechanisms integral to the process by which nonverbal rapport influences health improvement remain under-researched. This study breaks new grounds in proposing and testing mediation pathways that take into account organizational factors. We conducted a cross-sectional survey in a private hospital in Singapore among 417 patients to examine their communication with physicians and nurses. Results indicated that nonverbal rapport did not have a significant direct relationship with perceived health outcome in both the patient-physician dyad and the patient-nurse dyad. Instead, communication satisfaction and organizational identity completely mediated this relationship. In addition, respect positively moderated the relationship between nonverbal rapport and communication satisfaction in both dyads, while health literacy was not a significant moderator. The findings suggest that the organizational context should be considered in pathways research. [ABSTRACT FROM AUTHOR]

The question of how patient-provider communication affects health outcomes has been a longstanding concern for health communication scholarship and practice. As patient-provider communication becomes increasingly mediated by digital technologies, much research has sought to compare online patient-provider communication (OPPC) with that conducted in-person, weighing its relative merits against its costs and barriers. This line of inquiry has mostly focused on the comparative benefits of OPPC for service delivery with little attempt to link these benefits to the wider health implications of OPPC. Consequently, the mechanisms that explain the impacts of OPPC on patients' overall wellbeing have been underexamined. Through a survey of 681 participants in China, this study examined the direct and indirect pathways between OPPC and quality of life (i.e., sleep, exercise, social activities, and psychological wellbeing). Our results demonstrate statistically significant direct relationships between OPPC and the four quality-of-life constructs examined as well as the mediation effects of patient-centered care and health competence in these relationships. The findings call for greater attention to the longer-term contributions of OPPC in empowering patients, especially those who are underserved by the healthcare system. [ABSTRACT FROM AUTHOR]

Various conspiracy theories have accompanied COVID-19 since its initial outbreak. Based on a nationwide survey in China, this study probes the health consequences of beliefs in different COVID-19 conspiracy theories in China. The research found that believing the coronavirus has a foreign natural origin was associated with increased rather than decreased intention to adopt protective behaviors. Nonetheless, believing that the source of the pandemic was a Chinese lab or that it is a foreign biological weapon was related to reduced intentions to protect one's health. In addition, measured as national pride and satisfaction with China's pandemic control effort, people's level of nationalism was strongly associated with their intention to adopt protective behaviors, which moderates the health consequences of believing in false conspiracy theories. Scientific literacy was also associated with an increased likelihood of adopting preventive measures. Despite revealing the diversified health consequences of conspiracy beliefs, this study demonstrates the importance of examining collectivist sociopolitical constructs in health communication. [ABSTRACT FROM AUTHOR]

This exploratory study aimed to identify communication trends typical of pharmacists' clinical communication in the context of hospital consultations. A cross-sectional design was used to investigate the pharmacist-patient exchange, applying the Roter Interaction Analysis System (RIAS). Communication variables and RIAS composites were assessed, including therapeutic information complexity, estimated through the ad-hoc score CTICS (Cancer Therapy Information Complexity Score). The study comprised 13 consultations of cancer patients with one female pharmacist, of which 6 included a patient family member, lasting on average 22.74 minutes and presenting repeated or overlapping consultation phases. The pharmacist's talk dominance reached 53.49%, slightly higher in dyadic consultations (U = 6.0, p =.032), and with an overall predominance of closed-ended questioning (W = 81.0, p =.013). Patients' questioning on biomedical issues was higher in dyadic consultations. The level of the pharmacist's rapport-building with the relative was higher when the patient's age was ≥80 years. Several strong correlations, both positive and negative, were found between composites, including between patient positive rapport-building and relative lifestyle/psychosocial information giving (Rho = −0.971, p =.001). Pharmaceutical consultations seem to be lengthier than other hospital practitioners' interviews, indicating a lack of clear organization and flow, thus challenging their efficiency regarding therapy management. Still, several positive communication features were found regarding the pharmaceutical care of older cancer patients. Further studies are needed, involving larger samples and other hospital consultation settings. [ABSTRACT FROM AUTHOR]