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Slide 1-

Health Communication in the 21st Century Kevin B. Wright Lisa Sparks H. Dan O’Hair
Slide 2-

Overview of Communication and Health Chapter One
Slide 3-

Overview of Communication and Health Arguments for the need to study health communication. U.S. spends over $1 trillion per year on healthcare. Over half of all U.S. deaths can be attributed to preventable behavioral and social factors (e.g. diet, exercise, etc.) Lack of health maintenance behaviors in U.S. linked to mortality rates.
Slide 4-

Overview of Communication and Health Arguments for the need to study health communication. The majority of health campaigns in the U.S. have only had limited success in terms of influencing health behaviors. The rise of global health issues, terrorism, and other concerns. The increased use of new technologies in health care.
Slide 5-

Overview of Communication and Health Defining health communication. World Health Organization defines health is a state of completed physical, mental, and social well-being. Communication is more difficult to define, but it possess characteristics such as a sender, receiver, message, channel. Health communication can be assessed at many levels (interpersonal, organizational, mass, etc.).
Slide 6-

A Brief History of Health Communication Research
Slide 7-

History of Health Communication Research Early research in the communication discipline began in the 1960’s Korsch & Negrete’s (1972) “Doctor-Patient Communication” is often cited as the founding article. ICA formed the health communication division in 1975.
Slide 8-

History of Health Communication Research The journal Health Communication was first published in 1989. The Journal of Health Communication was first published in 1996. Since the 1990’s health communication continues to grow and diversify. There are now many regional, national, and international health communication associations and conferences.
Slide 9-

Current Challenges to the U.S. Healthcare System Role of Health Communication Research
Slide 10-

Current Challenges/Role of Health Communication Research Aging population Cultural diversity and healthcare Tension between traditional and new approaches Biomedical model Biopsychosocial model
Slide 11-

Current Challenges/Role of Health Communication Research Funding for health research Changes to health insurance and managed care The impact of new technologies on healthcare
Slide 12-

Provider-Patient Interaction Chapter Two
Slide 13-

Provider and Patient Views of Health and Healthcare Provider perspective Provider training Provider communication skills training Challenges providers face in healthcare delivery Rising costs of healthcare and competition Impact of managed care on provider-patient communication
Slide 14-

Provider and Patient Views of Health and Healthcare Provider perceptions of patients and communication General perceptions Assessing patient cues
Slide 15-

Patient Perspective Patient socialization Everyday experiences Mass media Patient perceptions and expectations Patient uncertainty Problematic integration theory (Babrow, 2001) Patient needs and goals
Slide 16-

Provider-Patient Interaction Communication accommodation theory (Giles, Mulac, Bradac, & Johnson, 1987) Divergence Convergence Overaccommodation Underaccommodation
Slide 17-

Provider-Patient Interaction Characteristics of problematic provider-patient communication Provider workload/time constraints Questions, directives, blocking Relational control/provider dominance
Slide 18-

Improving Provider-Patient Communication Addressing patient concerns Recognizing provider perspectives and needs
Slide 19-

Outcomes of Provider-Patient Communication Satisfaction with healthcare Adherence to treatment Physical and psychological health outcomes
Slide 20-

Communication and Medical Malpractice Lawsuits Rise and cost of medical malpractice litigation Provider-patient communication and medical malpractice litigation
Slide 21-

Caregiving and Communication Chapter Three
Slide 22-

Caregiving Caregiver roles Caregiving and changes in relationships Communication issues surrounding symptom management Communication challenges associated with caregiving Willingness to communicate concerns Communication of emotional support
Slide 23-

Hospice and Palliative Care History of hospice and palliative care Dame Cicely Saunders—founder of hospice movement Hospice services and care Barriers to hospice care Palliative care Palliation refers to any treatment, care, or support that relieves symptoms and suffering Barriers to palliative care
Slide 24-

Attitudes Towards Death and Dying Communicating with others about death and dying Advanced care directives Coping with the death of a loved one Reactions to grief Organ donation
Slide 25-

Social Support and Health Chapter Four
Slide 26-

Types and Functions of Social Support Types of support Instrumental support Emotional support Esteem or appraisal support Informational support Proactive and reactive support Positive and negative functions of support
Slide 27-

Models of Social Support and Health Stress and health Physiological processes Stress and negative health outcomes Stress and social support Buffering model (Cohen & Wills, 1985) Direct effects model (Aneshensel & Stone, 1982)
Slide 28-

Models of Social Support and Health Coping strategies and health outcomes Problem-focused coping Emotional-focused coping Avoidance-focused coping
Slide 29-

Perceptions of Support Providers Social comparison theory (Festinger, 1954) and social support Lateral comparisons Upward comparisons Downward comparisons Reciprocity and social support Underbenefitted Overbenefitted
Slide 30-

Strong Tie Versus Weak Tie Support Networks Theory of weak ties (Granovetter, 1973) Communicating about illness in weak tie vs. strong tie networks
Slide 31-

The Role of Communication in the Social Support Process Cognitive complexity and support provision (Burleson, 1994) Cognitive complexity and comforting messages Interactive nature of support provision (Barbee, 1990) Solve person’s problem Support person emotionally Dismiss person’s problem Escape from dealing with issue
Slide 32-

Support Groups for People with Health Concerns Prevalence of support groups Reasons why people join support groups Difficulties communicating about illness within traditional social networks Other factors influencing support group participation
Slide 33-

Communication Processes within Support Groups Use of narrative Being helped by helping
Slide 34-

Culture and Diversity Issues in Healthcare Chapter Five
Slide 35-

Patient Diversity Increase in a variety of co-cultures in the U.S. due to immigration Cultural and language barriers to healthcare. Impact on healthcare system
Slide 36-

Cultural Differences in Concepts of Health and Medicine Cultural differences in attributions of illness/health Acculturation Informed consent Cultural differences of people born in the United States.
Slide 37-

Recognizing Cultural Diversity in Health Beliefs Effectively communicating with patients from diverse cultural backgrounds Barriers to providing culturally sensitive health care
Slide 38-

Alternative Medicine History of alternative medicine in the U.S. Types of alternative medicine Perceptions of alternative medicine Benefits/limitations of alternative medicine
Slide 39-

Spirituality, Culture, and Health Associations among spirituality, culture, and health Religion and psychological/physical health outcomes Religion and social support
Slide 40-

Social Implications of Illness Stigma and disease HIV/AIDS Cancer Alcoholism Mental illness
Slide 41-

Changing Social Perceptions of Health Issues through Comm. Language usage Use of narrative Advocacy
Slide 42-

Provider Diversity Specialization and unique provider cultures Socialization processes and provider diversity
Slide 43-

Communication and Health Organizations Chapter Six
Slide 44-

Health Organizations as Systems Characteristics of systems Interdependence Homeostasis Equifinality
Slide 45-

Types of Healthcare Organizations Organizations concerned with financing and regulating health services and products Centers for Medicare and Medicaid Insurance and managed care Organizations concerned with healthcare delivery Hospitals Nursing homes Pharmaceutical companies Professional organizations that influence other healthcare organizations Accreditation organizations
Slide 46-

Communication within Healthcare Organizations Organizational information theory (Weick, 1979) and healthcare organization Cycles Double interact loops Formal/informal communication networks Upward/downward communication
Slide 47-

Healthcare Organizational Culture Cultural belief systems of healthcare organizations Promoting new healthcare organizational environments
Slide 48-

Influences on Healthcare Organizational Communication Pharmaceutical and biotechnology companies Direct-to-consumer marketing Preceptorships HIPPA Patient Privacy HIPPA’s effect on medical research HIPPA’s effect on providers and patients
Slide 49-

Influences on Healthcare Organizational Communication Medicare and Medicaid Insurance and managed care Traditional health insurance Health maintenance organizations (HMO’s) Preferred provider organizations (PPO’s) Effects of managed care on provider-patient relationships
Slide 50-

Provider Stress, Conflict, and Support within Healthcare Organizations Stress and conflict Effects of job stress Social support and stress in the workplace
Slide 51-

New Technologies and Health Communication Chapter Seven
Slide 52-

Health Information on the Internet Health information access Credibility issues Literacy issues/underserved populations
Slide 53-

New Technologies and Patient-Patient Communication Health-related web communities and computer-mediated support groups Advantages and disadvantages of computer-mediated support groups Advantages/Disadvantages Social information processing theory (Walther, 1996)
Slide 54-

New Technologies and Provider-Patient Communication Email and wireless communication Satellite technology Wireless comm. devices Electronic records Disadvantages of new communication technologies
Slide 55-

Telemedicine and Providers Advantages of telemedicine for providers
Slide 56-

New Technologies and Provider-Patient Communication Potential for increased provider-patient interaction Telemedicine and patients Managed care organization efforts to reach patients via the Internet
Slide 57-

New Technologies and Health Campaigns Tailoring health messages Advantages of message tailoring Process of message tailoring
Slide 58-

Mass Communication and Health Chapter Eight
Slide 59-

Two Perspectives of Media Influence Cultivation Theory (Gerbner, Gross, Morgan, & Signorelli, 1982) Uses and gratifications theory (Katz, Blumler, & Gurevitz, 1974) Needs fulfilled by the mass media concerning health Information seeking Entertainment, diversion, and tension release Media use to fulfill social needs Convenience
Slide 60-

Media Usage, Health Portrayals, and Health Behaviors Unrealistic portrayals of health situations Unhealthy role models and the promotion of unhealthy behaviors in advertising The influence of media on eating habits Obesity Eating disorders Media content and cosmetic surgery Media content and acts of violence
Slide 61-

Media Usage, Health Portrayals, and Health Behaviors The relationship between media and substance abuse Alcohol Tobacco products Media and sexual behavior Direct-to-consumer advertising of prescription medication
Slide 62-

Health News Stories in the Media Problems in the reporting of health news stories Agenda-setting theory (Protess & McCombs, 1991) HIV/AIDS as an example Overreporting Underreporting
Slide 63-

Health News Stories in the Media Media bias and inaccuracies in reporting health issues Framing
Slide 64-

Risk and Crisis Communication Chapter Nine
Slide 65-

Defining Risk Communication Risk communication versus crisis communication
Slide 66-

Global and Large-Scale Health Threats Environmental threats/world hunger Environmental injustice Natural disasters Hunger Pandemics HIV/AIDS SARS/Avian flue Terrorism
Slide 67-

At-Risk Communities with the United States Risk factors Social status Social capital Human capital Communication strategies for dealing with health risks Dealing with the threat of HIV/AIDS Dealing with the threat of terrorism Coping with the psychological effects of terrorism
Slide 68-

Other Health Risk Issues Community-based health initiatives for at-risk or marginalized populations Risk communication strategies at the provider-patient level
Slide 69-

Health Campaigns and Community Health Initiatives Chapter Ten
Slide 70-

Campaign Goals Health awareness and behavioral change campaigns Public policy approaches
Slide 71-

Theoretical Approaches to Health Campagins Social cognitive theory (Bandura, 1977) Cognitive processes influencing health behavior Environmental influences on health behavior Theory of reasoned action (Ajzen & Fishbein, 1980) Health belief model (Becker, 1974) Extended parallel process model (Witte, 1992)
Slide 72-

Theoretical Approaches to Health Campagins Stages of change models Transtheoretical model (Prochaska & DiClemente, 1984) Multi-stage model of behavioral change (Lippke & Ziegelmann, 2006)
Slide 73-

The Process of Conducting a Health Campaign Audience analysis Conducting audience analysis research Available data Surveys Interviews/focus groups Audience segmentation
Slide 74-

The Process of Conducting a Health Campaign Creating message content Gaining audience members’ attention and motivating them to action Persuasive message appeals Other message considerations
Slide 75-

The Process of Conducting a Health Campaign Channel and message dissemination processes
Slide 76-

Formative Campaign Evaluation Pilot testing Launching the campaign, process evaluation, and outcome evaluation
Slide 77-

Interdisciplinary Health Teams Chapter Eleven
Slide 78-

Interdisciplinary Health Teams Diversity of healthcare professional Importance of interdisciplinary teams Continuum of health care teams Unidisciplinary Interdisciplinary Transdisciplinary
Slide 79-

Model of Synergistic Healthcare Teams Instilling a sense of ownership Building and maintaining trust Building commitment to team and mission (vision) Sense of accomplishment Becoming performance based Prioritizing and setting goals Measuring results Decision-making procedures
Slide 80-

Model of Synergistic Healthcare Teams Developing team synergy Role congruence Competent listening Participation and empowerment Conflict management Consensus building
Slide 81-

Emerging Health Communication Contexts and Challenges Chapter Twelve
Slide 82-

Health Literacy Importance of understanding health literacy issues Health literacy and health outcomes Health literacy and provider-patient communication
Slide 83-

Breaking Bad News Defining bad news Demographic effects on bad news delivery Current provider education in breaking bad news
Slide 84-

Health Communication and Older Adults Getting older and experiencing health problems Presbycusis Cognitive decline, Alzheimer’s disease, and dimentia Physical activity/mobility Polypharmacy
Slide 85-

Provider-older patient interaction Stereotypes of older patients Companions and provider-patient interaction Managed care influences on provider-older patient interaction
Slide 86-

Institutionalized Older Adults Nursing homes Communication issues