Effects of Mass and Interpersonal Communication on Breast Cancer Screening: Advancing Agenda-Setting Theory in Health Contexts

Drawing on components of agenda-setting theory and the two-step flow of information from mass media to news audiences, this study examines the effects of mass and interpersonal communication on breast cancer screening practices among college- and middle-aged women (n = 284). We theorized that screening behaviors among younger women would be influenced more by interpersonal sources of information while screening among middle-aged women would be more influenced by exposure to mass-mediated information. Findings supported anticipated patterns, revealing important and varying roles for both mass and interpersonal communication in the health behaviors of women. Implications for health practitioners and campaign planners, as well as recommendations for future research, are discussed.     

Using Communication Infrastructure Theory to Formulate a Strategy to Locate “Hard-to-Reach” Research Participants

In health-communication research, participants who are disproportionately affected by health disparities are often “hard-to-reach,” making them difficult to identify for formative research. This study used communication infrastructure theory (CIT) to create a strategy for locating a specific subset of residents—those who use 911 for healthcare—within a low-income Atlanta community. Findings suggest the need for strategies that involve employing both the communication channels that are part of the neighborhood storytelling network and the community's discursive spaces, more specifically the communication hot spots and community comfort zones located within the community's built environment.     

Examining the Bidirectional Nature of Topic Avoidance and Relationship Dissatisfaction: The Moderating Role of Communication Skills

This study examined the bidirectional nature of the association between one's own topic avoidance and relationship dissatisfaction. It also explored how perceptions of a dating partner's communication competence and one's own communication efficacy affect this association. Three hundred undergraduates tracked their topic avoidance with their dating partner over a two week period. The results provided modest support for the idea that the association between topic avoidance and dissatisfaction is bidirectional for women, but not men. In addition, for men and women, global dissatisfaction with their dating relationship was a stronger predictor of daily topic avoidance (than daily topic avoidance was of daily dissatisfaction). Initial global levels of relationship dissatisfaction predicted greater levels of topic avoidance and this effect was quite stable over time, particularly for women. The results also revealed that the perception of a partner's communication incompetence was indirectly associated with increases in topic avoidance over time only because it affected one's communication efficacy. Finally, the results indicated that women who were highly efficacious were particularly dissatisfied by their topic avoidance over time.     

Mothers,Sons and Testicular Cancer: An Exploratory Investigation of Health Communication

This study highlights the importance of parent-child communication of sensitive health-related issues, specifically the importance of cancer prevention discussions. For females, communication about breast cancer has been desensitized; yet, testicular cancer is not being discussed among males, even though it is highly curable when caught early. Testicular cancer primarily impacts males ages 15–40, so introducing the conversation early is important. In this exploratory study, mothers (N = 22) participated in three focus group discussions and described communication with their sons about general health issues and testicular cancer. While the mothers discussed a number of health issues with their sons, they did not mention testicular cancer and believed their sons knew very little about testicular cancer. Mothers' communication about testicular cancer with their sons was characterized by uncertainty and ambiguity. Findings from this study shed light on how little mothers know about testicular cancer as well as the need for comprehensive testicular cancer campaigns that target intervening publics.     

Merck's One Less Campaign: Using Risk Message Frames to Promote the Use of Gardasil® in HPV Prevention

In 2006, Merck introduced Gardasil® through its One Less campaign, highlighting how the vaccine protects against the transmission of human papillomavirus (HPV) and, potentially, cervical cancer. The purpose of this study was to determine how young women learned about Gardasil and if the One Less campaign influenced the patient's decision to receive/decline the vaccines. Participants primarily learned about Gardasil from television advertising, and felt the campaign addressed the psychometric paradigm hazard factors of control and dread associated with HPV. However, participants reported that physicians/physician's assistants and mothers remained the primary sources of influence when choosing to receive/decline the vaccine series.     

Emergency Communication Challenges in Response to Hurricane Katrina: Lessons from the Centers for Disease Control and Prevention

In response to Hurricane Katrina's extensive destruction and related public health threats, the Centers for Disease Control and Prevention (CDC) deployed more than 1,000 staff to its emergency operations center and to affected areas. Among them were members of CDC's Emergency Communication System. This paper describes the strategies and tactics used by health communication specialists during the pre-event, response, and post-event stages to address a range of emergency communication exigencies. It highlights three difficult challenges for CDC communication specialists during Hurricane Katrina: rapid dissemination of health messages; adaptation of health messages for diverse audiences, locations, and circumstances; and phasing of key risk messages during the emergency response.     

Communication Skills,Social Support,and Burnout among Advocates in a Domestic Violence Agency

Intimate partner violence affects millions of lives annually. Domestic violence advocates work to alleviate this problem; yet the nature of the work leaves them vulnerable to negative outcomes such as burnout. This study examined the relationships between communication anxiety, communication competence, perceived social support, and feelings of burnout among domestic violence advocates. Results from a survey of 69 individuals recruited from a US domestic violence agency show the combination of communication anxiety, communication competence, perceived emotional support, and perceived informational support accounted for approximately 13% of the variance in advocates' emotional exhaustion and 21% of the variance in advocates' experiences of reduced personal accomplishment. Responses also differ with the advocate's position in the agency. The following recommendations are offered: develop scenario-based communication skills training programs to reduce communication anxiety and increase communication competence, hold regular debriefing meetings to help advocates process their experiences and to receive peer support, and develop formalized mentoring programs that can provide social support for new workers.     

The Relationship Between Counseling Self-Efficacy and Communication Skills of Volunteer Rape Crisis Advocates

This research examines the relationships between communication competence, communication anxiety, and five subdimensions of counseling self-efficacy. The sample consists of volunteers trained at two rape crisis centers (n = 63) over a one-year period. As hypothesized, communication anxiety was negatively related and communication competence positively related to the subdimensions of counseling self-efficacy. Results suggest that training programs need to be aware of how personality characteristics may affect a volunteer's ability to become an efficacious counselor. Implications for how rape crisis centers can integrate these communication issues into their training programs and improve the self-efficacy of their advocates are discussed.     

Using communication to manage uncertainty about cervical cancer screening guideline adherence among Appalachian women

Changes to the United States Preventive Services Task Force (USPSTF) recommendations for cervical cancer preventive services have led to patient confusion, especially in medically underserved populations. We investigated how patient uncertainty concerning cervical cancer screening guidelines is appraised and managed through communication with healthcare providers by conducting in-depth, face-to-face interviews with 24 adult women between the ages of 24 and 65 (m?=?41, SD?=?14) living in Appalachia Kentucky. In general, participants expressed a high degree of uncertainty about the updated cervical cancer screening guidelines and appraised this uncertainty as both a danger and an opportunity. Communication with healthcare providers served both to exacerbate and to mitigate patient uncertainty. The study identifies how healthcare providers may use the change in USPSTF guidelines as a “teachable moment” to productively counsel patients on the importance of timely screening, the typical progression of certain types of high-risk HPV (human papillomavirus) infection to cervical cancer, and the importance of follow-up care.     

Staying abreast of breast cancer: examining how communication and motivation relate to Singaporean women's breast cancer knowledge

Numerous health communication studies have highlighted the importance of factual knowledge as an antecedent to health behavior, but few have explored other dimensions of health knowledge, such as structural knowledge. This study seeks to fill this gap by investigating conceptual differences between these two kinds of knowledge in the context of breast cancer in Singapore, and find out how communication and motivational factors are related to them. Using a nationally representative random-digit-dialing survey of women aged 30–70 (N = 802), results showed that interpersonal communication and elaboration were associated with both knowledge types. Attention to online health news and the level of risk perception were positively associated with structural knowledge but not factual knowledge. Theoretical and practical implications for health communication were discussed.     

Managing Patient-centered Communication across the Type 2 Diabetes Illness Trajectory: A Grounded Practical Theory of Interactional Sensitivity

This article uses the theoretical and methodological framework of Grounded Practical Theory (GPT) to provide a lens for analyzing and interpreting discourse as a situated form of social action in routine Type 2 diabetes visits. Drawing on a total data-set of 400 audio-recorded routine visits, we randomly selected 55 visits for qualitative analysis. In this article, we use Conversation Analysis to document communication techniques, which we in turn use as evidence to ground our claims within the GPT framework. We use two single cases of interaction to analyze communication techniques physicians use when recommending a change from oral medication to insulin. We argue treatment intensification is a key moment in health communication to reflect about patient centeredness because physicians can find themselves in an interactional dilemma: while insulin may effectively help control unstable disease, an insulin recommendation may simultaneously counter patient values and treatment preferences. Our analysis suggests that physicians use what we call interactional sensitivity to balance medical need and patient preferences when making medical decisions by tailoring their communication according to the local situation and the patient's larger illness trajectory. We propose that interactional sensitivity is a type of communication work and a quality of patient-centered communication characterized by the theoretical relationship between tailoring communication to the contingencies of the local interaction and the global illness trajectory. Overall, this article contributes to health communication scholarship by proposing a normative model for reflecting on how physicians negotiate challenging interactions with patients during routine chronic illness visits.     

Communication Efficacy and Couples' Cancer Management: Applying a Dyadic Appraisal Model

The purpose of the present study was to apply Berg and Upchurch's (2007) developmental-conceptual model to understand better how couples cope with cancer. Specifically, we hypothesized a dyadic appraisal model in which proximal factors (relational quality), dyadic appraisal (prognosis uncertainty), and dyadic coping (communication efficacy) predicted adjustment (cancer management). The study was cross-sectional and included 83 dyads in which one partner had been diagnosed with and/or treated for cancer. For both patients and partners, multilevel analyses using the actor-partner interdependence model (APIM) indicated that proximal contextual factors predicted dyadic appraisal and dyadic coping. Dyadic appraisal predicted dyadic coping, which then predicted dyadic adjustment. Patients' confidence in their ability to talk about the cancer predicted their own cancer management. Partners' confidence predicted their own and the patient's ability to cope with cancer, which then predicted patients' perceptions of their general health. Implications and future research are discussed.     

Cancer communications research and health outcomes: Review and challenge

This report presents a detailed review of current published research on cancer communications that provide strong positive outcome data on the effectiveness of strategic communications in cancer control. The research literature is examined in three categories based on the communications strategy used and behavior targeted: 1) strategic communications on adoption of prevention behaviors in diverse populations; and on promotion of cancer detection and screening behaviors; 2) tailored communications on promotion of cancer prevention and control; and on promotion of screening and detection behaviors; and 3) interpersonal communications on provision of social support to individuals living with cancer. The review of the literature suggests that communication interventions can influence important health outcomes in cancer prevention and control, and communication is a central process for disseminating cancer information to key populations. For example, the review illustrates the role of the NCI's Cancer Information Service as an important source of communication for providing consumers with relevant cancer information. Implications are drawn from this review for demonstrating the value of the expanded research programs proposed by the National Cancer Institute as part of their Extraordinary Opportunity in Cancer Communications Research initiative.     

"The policy exists but you can't really use it": communication and the structuration of work-family policies

Although work-family benefits are increasingly important organizational policies, limited research addresses the impact of communication on benefit utilization. However, communication is significant because the perceived appropriateness of work-family benefits emerges through interaction. For example, when coworkers complain about "picking up the slack" for those using family leave, their discourse may impact future decisions of other workers regarding whether they utilize the work-family benefits available to them. We apply Giddens' (1984) Structuration Theory to examine organizational members' discursive responses to conditions (and contradictions) present in utilizing work-family benefits in a governmental organization. We argue the daily discursive practices of individuals can either reinforce or undermine formally stated work-family initiatives, and in turn discuss the implications of this "structuration" of policy.     

Predicting Success: Revisiting Assumptions about Family Political Socialization

This study, guided by family communication patterns theory, examined the role of family communication in political socialization. We tested whether certain communication styles were associated with higher levels of political similarity within the family. Additionally, the independent influences of the mother and father, as well as the direction of these influences, were considered. Results suggest that different communication styles are associated with higher levels of political similarity. Additionally, it was found that children were more likely to share their mothers' political attitudes than their fathers'. Explanations for these findings are discussed and implications focusing on the role of communication in the socialization literature are considered.     

Profiling Younger Adults’ Communication About Aging

According to the Communicative Ecology Model of Successful Aging (CEMSA), how people talk about age can have implications for how they cope with aging later in life. However, most research on communication and successful aging has focused on older adults. In this study, we use latent class analysis to profile how younger adults (age 18–39) communicate about aging and examine how these profiles relate to their attitudes toward aging (affect, efficacy, anxiety, and perceptions of successful aging). Consistent with past research on older adults, we found three distinct profiles of communication behavior (disengaged, engaged, and bantering). An engaged profile was clearly associated with the most positive attitudes toward aging, while a disengaged profile was associated with the least positive attitudes. These findings suggest that patterns of talk about aging may start early in life, underscoring the importance of studying communication about aging across the lifespan.     

What makes local governments' online communications successful? Insights from a multi-method analysis of Facebook

Little is known about how public sector organisations capitalise on the potential of social networking sites (SNSs) as communication channels. Previous research is short on theoretical models and managerial insights into the success of local governments' online communication strategies. The purpose of this study is to explore how successfully local governments utilise SNSs for managing their external communication with citizens. Using a multi-method analysis of 15,941 posts and 19,290 comments on the Facebook pages of the 25 largest German cities, we make five contributions to research and practice. First, we analyse the properties and topics of government posts to draw a rich picture of how local governments use Facebook as a communications channel. Second, we conceptualise success in governments' online communications in terms of the frequency and polarity of citizens' reactions, which we use for third, evaluating government communication behaviour in SNSs. Fourth, we identify which benefits SNSs offer that traditional communication channels do not provide. Fifth, we offer guidelines for improving the online communication strategies of local governments using SNSs.     

Naming and Claiming Cancer among African American Women: An Application of Problematic Integration Theory

This study examines how a sample of African American women understands the uncertainties fundamental to cancer risk communication. Utilizing data from four focus groups, Problematic Integration (PI) theory is applied as an interpretive lens for illustrating their felt difficulties of talking openly about cancer and breast cancer in everyday life. The women describe worry about cancer and its prevalence among African American women; ambivalence and uncertainty; belief that what is not uncertain is certain and awful; fear and avoidance; contradictions in “claiming” and “rebuking” cancer; and hopefulness.     

Adult Child Perceptions of Communication and Humor When the Parent Is Diagnosed with Cancer: A Suggestive Perspective from Communication Theory

This study examines the function of communication and humor in the older adult parent-adult child dyad when the parent has been diagnosed with cancer. Qualitative data of open-ended data from 46 adult children of a parent recently diagnosed with cancer revealed that discussing diagnosis and treatment procedures was perceived to be a satisfying conversation, whereas withholding information had an adverse affect. The discussion of the parents' feelings during the cancer period was a difficult and complex communicative experience. The Meta-Humorous Interaction Theory (MetaHIT) was used as a conceptual framework to understand the function of appropriate and inappropriate uses of humor in terms of cognitive, affective, and behavioral elements of humor. Humor was often used as a coping or relief function for discussing side effects of cancer treatment. This investigation underscores the importance of understanding how adult children use humorous communication to cope with the unknown conversational territory of a parent's cancer diagnosis.     

Information Seeking and Workplace Safety: A Field Application of the Risk Perception Attitude Framework

Communication theory is ideally suited to advance systematic forms of knowledge about workplace safety. The focus of this research is to examine workplace safety using health communication theory and research. A field study using a random sample of production workers (n=645) in a manufacturing organization was conducted, to investigate individuals’ risk perception and efficacy beliefs and to validate the predictions of the risk perception attitude framework. Results were consistent with the theory, as risk and efficacy jointly predicted safety behavior, behavioral intentions, and safety information-seeking intentions. Given a particular level of risk, those with greater efficacy beliefs displayed more positive safety outcomes than those with lower efficacy beliefs. The responsive group (high risk, high efficacy) reported safer outcomes than the avoidant group (high risk, low efficacy) and the proactive group (low risk, high efficacy) reported safer outcomes than the indifferent group (low risk, low efficacy). This theoretical frame provides practical directions as to what shapes the safety behaviors and communication patterns of workers in dangerous jobs and offers insights for safety information-seeking and workplace safety.