Communicating About Health Current Issues and Perspectives

Now in its fifth edition, Communicating About Health: Current Issues and Perspectives continues to live up to its long-standing reputation as the most dynamic and current exploration of health communication on the market. The book offers rich, current research and in-depth analysis of the cultural, social, and organizational issues that influence health communication and health advocacy.

Communicating About Health is an indispensable resource for readers seeking to improve their communication abilities in fields related to health. This text explores health communication through the eyes of patients, care providers, health care leaders, campaign designers, and more. Readers will learn how culture, media, personal identity, technology, social networks, and other factors contribute to health and healing.

Athena du Pré is a Distinguished University Professor at the University of West Florida, where she directs graduate programs in Strategic Communication & Leadership and Health Communication Leadership. She is the author or coauthor of numerous books, including Communicating About Health: Current Issues and Perspectives (5th ed.), Understanding Human Communication (12th edition, coauthored by Ron Alder and George Rodman), and Essential Communication (coauthored by Adler and Rodman). Since joining the UWF faculty, she has twice been honored by the student body with an annual Distinguished Teaching Award.

Preface

Part I. Establishing a Context for Health Communication
Chapter 1 Introduction
Box 1.1: Career Opportunities: Profiles of More Than 125 Health-Related Jobs
The Philosophy Behind This Book
Box 1.2: Learn While You Make a Difference
What Is Health?
What Is Health Communication?
Box 1.3: Perspectives: True Stories About Health Communication Experiences
Defining Communication
Collaborative Sense- Making
Multiple Levels of Meaning
Context and Culture
Defining Health Communication
Box 1.4: Theoretical Foundations: The Basis for Health Communication
The History of Health Communication
Box 1.5: Resources: Health Communication Organizations and Resources
Health Care Models
Biomedical
Biopsychosocial
Box 1.6: Perspectives: A Memorable Hospital Experience
Sociocultural
The Importance of Health Communication
Box 1.7: Ethical Considerations: An Essential Component of Health Communication
Box 1.8: Perspectives: Down, But Not Out
Summary
Key Terms and Theories
Discussion Questions

Chapter 2 The Landscape for Health Communication
Current Issues in Health Care
Preventive Care
Cost Efficiency
Treatment Approaches
Mind-Body Dualism
Holistic Approach
Patient Empowerment
Impact of Social Changes
Global Health
Changing Populations
Technology Use
Managed Care
Conventional Insurance
Health Maintenance Organization
Preferred Provider Organization
High-Deductible Health Plan
Box 2.1 Managed Care at a Glance
Pros and Cons of Managed Care
Advantages
Disadvantages
Box 2.2 Resources: Before You Select a Managed Care Plan
Health Care Reform
Universal Coverage
Rationale
Single- and Multi-Payer Systems
Funding
The Affordable Care Act
Provisions
Potential and Advantages
Challenges and Disadvantages
Box 2.3 Ethical Considerations: Classroom Debate on Health Care Reform
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Part II. The Roles of Patients and Professional Caregivers
Chapter 3 Patient-Caregiver Communication
Box 3.1 Resources: Journals That Feature Health Communication Research
Medical Talk and Power Differentials
Knowledge and Power
Box 3.2 Ethical Considerations: Therapeutic Privilege
Who Talks and Who Listens
Box 3.3 Doorknob Disclosures
Questions and Directives
Blocking
Patronizing Behavior
Box 3.4 Stepping Over the Line
Why Do We Do It?
Box 3.5 Perspectives: Tyranny of the Urgent
Collaborative Communication Model
Reasons for a Shift
Theoretical Foundations
The Emerging Model
Communication Skill Builders
Motivational Interviewing
Box 3.6 Ouch!
Dialogue
Nonverbal Encouragement
Verbal Encouragement
Box 3.7 Perspectives: A Mother's Experience at the Dentist
Narrative Medicine
Box 3.8 Theoretical Foundations: Integrative Health Model
Box 3.9 Communication Tips for Patients
Healing Environments
Soothing Surroundings
Box 3.10 Career Opportunities: Health Communication Research
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Chapter 4 Patient Perspectives
Box 4.1 Perspectives: The Agony of Uncertainty
Patient Socialization
Voice of Lifeworld
Feelings Versus Evidence
Specific Versus Diffuse
Bridging the Gap
Patient Characteristics
Nature of the Illness
Box 4.2 Health and Communication Technology: Computer in the Room
Patient Disposition
Box 4.3 Career Opportunities: Patient Advocacy
Communication Skills
Satisfaction
Attentiveness and Respect
Box 4.4 Is Satisfaction Overrated?
Convenience
A Sense of Control
Cooperation and Consent
Reasons for Noncooperation
Care Providers' Investment
Box 4.5 Cash for Cooperation?
Informed Consent
Box 4.6 Ethical Considerations: Patients' Right to Informed Consent
Illness and Personal Identity
Reactions to Illness
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Chapter 5 Caregiver Perspectives
Box 5.1 Career Opportunities
Caregiver Preparation
Emphasis on Science
Campaign of Orthodox Medicine
The Flexner Report
Decline of Holistic and Folk Medicine
Science-Based Curricula
Evolving Models
Communication Training
Socialization
Hidden Curriculum
Isolation
Identity in Limbo
Privileges
Resentment
Box 5.2 Medical School Reform
Implications
Compassion Rebound
Systems-Level Influences on Caregivers
Organizational Culture
Time
Box 5.3 Ethical Considerations: Privacy Regulations Incite Controversy
Psychological Influences on Caregivers
Emotional Preparedness
Mindfulness
Confidence
Satisfaction
Stress and Burnout
Box 5.4 Perspectives: Blowing the Whistle on an Impaired Physician
Causes
Conflict
Box 5.5 Communication Skill Builder: Dealing with Difficult Patients
Emotions
Workload
Healthy Strategies
Medical Mistakes
Why Mistakes Happen
What Happens After a Mistake?
Communication Skill Builder: Managing Medical Mistakes
From the Beginning
Box 5.6 Health and Communication Technology: Mobile App Helps Save Time and Prevent Errors
If an Error Does Occur
Multidisciplinary Teamwork
Advantages
Difficulties and Drawbacks
Communication Skill Builder: Working in Teams
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Part III. Sociocultural Issues
Chapter 6 Diversity and Health Care
Intersectional Theory
Socioeconomic Status
Health Literacy
Communication Skill Builder: Surmounting Status and Literacy Barriers
Suggestions for Public Health Care Professionals
Suggestions for Health Care Providers
Suggestions for Patients
Gender Identities
Box 6.1 Nuanced gender identities
Assumptions
Risks of Silence
Communication Skill Builder: Talking About Gender
Race and Ethnicity
Different Care and Outcomes
Explanations
Distrust
High Risk, Low Knowledge
Limited Access
Patient-Caregiver Communication
Box 6.2 Ethical Considerations: Who Gets What Care?
Box 6.3. Ethical Considerations: Is Affirmative Action Justified or Not?
Box 6.4 Genetic Profiling: A View into Your Health Future
Language Differences
Box 6.5 Perspectives: Language Barriers in a Health Care Emergency
Box 6.6 Career Opportunities: Diversity Awareness
Disabilities
Box 6.7 Perspectives: "My Disability Doesn't Show"
Communication Skill Builder: Interacting with Persons Who Have Disabilities
Age
Children
Communication Skill Builder: Talking with Children About Illness
Older Adults
Communication Accommodation Theory
Implications of Ageism and Overaccommodation
Communication Patterns
Promising Options
Communication Technology and Older Adults
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?


Chapter 7 Cultural Conceptions of Health and Illness
Box 7.1. Resources: More About Culture and Health
Culture and Cultural Competence
The Challenge of Multiculturalism
Cultural Competence in Health Care
Cultural Conceptions of Health
Health as Organic
Health as Harmonic Balance
Physical, Emotional, and Spiritual
Harmony With Nature
Hot and Cold
Energy
Making Sense of Health Experiences
Box 7.2. Theoretical Foundations: Theory of Health as Expanded Consciousness
Health Condition as Social Asset
Health Condition as Social Liability
Disease as Curse
Stigma
The Morality of Prevention
Victim Role
Social Roles and Health
Sex, Gender, and Health
Female Identity and Health
Male Identity and Health
Family Roles and Health Communication
Box 7.3. Perspectives: Thai Customs and a Son's Duty
Illness and Coping Metaphors
"Fight for Your Life"
"Strive for Peace and Flexibility"
Sick Roles and Healer Roles
Mechanics and Machines
Parents and Children
Box 7.4. Ethical Considerations: Physician as Parent or Partner?
Spiritualists and Believers
Providers and Consumers
Box 7.5. Perspectives: Partners in Care
Partners
Holistic Care
Terminology
Box 7.6. Holistic Medicine at a Glance
Popularity
Advantages
Drawbacks
Box 7.7. Career Opportunities: Holistic Medicine
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Part IV. Coping and Health Resources
Chapter 8 Social Support, Family Caregiving, and End of Life
Conceptual Overview
Theoretical Perspectives
Box 8.1 When Communication Ability Is Compromised
Coping
Sense of Control
Dialetics
Crisis
Normalcy
Coping and Communication
Action-Facilitating Support
Box 8.2 Theory of Problematic Integration
Nurturing Support
Communication Skill Builder: Supportive Listening
Communication Skill Builder: Allowing Emotional Expression
Social Networks
When Support Goes Wrong
Friends Disappear
Hurtful Jests
Too Much Support
A Note of Encouragement
Animals as Companions
Transformative Experiences
Box 8.3 Organ Donations: The Nicholas Effect
Friends and Family as Caregivers
Profile of the Family Caregiver
Stress and Burnout
Box 8.4 Perspectives: A Long Goodbye to Grandmother
Caring for Caregivers
End-of-Life Experiences
Life at All Costs
Death with Dignity
Advance-Care Directives
Box 8.5 Ethical Considerations: Do People Have a Right to Die?
Box 8.6 Career Opportunities: Social Services and Mental Health
Communication Skill Builder: Delivering Bad News
Communication Skill Builder: Coping with Death
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Chapter 9 eHealth, mHealth, and Telehealth
Box 9.1 Ethical Considerations: The Pros and Cons of Telemedicine
eHealth
Theoretical Foundations
The Three Spheres
Weak and Strong Ties
Box 9.2 Profile of an ePatient
Why and When Do We Seek eHealth Information?
Is Online Health Information Useful?
Advantages
Rich Array of Information
Practical Advice
Social Support
Disadvantages
Unreliable Information
Conflicting Information
Overwhelming Amounts of Information
Digital Divide
Communication Skill Builder: Using the Internet Effectively
How Has Technology Influenced Health Communication?
mHealth
Telehealth
Telemedicine
Patient Portals
Telemonitoring
Telehealth at Point of Sale
Potential Advantages of Telehealth for Consumers
Patient-Centered Communication
Access to Services
Cost Savings
Patient Education
Potential Advantages of Telehealth for Health Professionals
Efficiency
Improved Care
Teamwork
Accessible Information
Potential Disadvantages of Telehealth
Scheduling Challenges
Liability
Threats to Privacy
Unorganized Information
Compensation Questions
Restricted Communication
Box 9.3 Career Opportunities: Health Information Technology
Summary
Key Terms and Theories
Discussion Questions
Answers To Can You Guess?

Part V. Communication in Health Organizations
Chapter 10 Health Care Administration, Human Resources, Marketing, and PR
Health Care Administration
Reimagining Health Care
Enhancing Health Care Experiences
Improving Community Health
Controlling Costs
Mergers, Alliances, and Buy-Outs
Efficiency and Six Sigma
Communication Skill Builder: Shared Vision and Dispersed Leadership
Invert the Pyramid
Box 10.1 Perspectives: "We Hate the Rules"
Build Relationships by Listening
Push Decision Making to the Lowest Level Possible
Hold People Accountable
Celebrate Successes
Box 10.2 Career Opportunities
Human Resources
Box 10.3 Staffing Shortages in Health Care
Theoretical Foundations
Communication Skill Builder: Building Great Teams
Hire Carefully
Teach the Culture and Values
Continually Recruit Internal Talent
Box 10.4 A Model for Innovative Leadership
Marketing and Public Relations
Box 10.5 Resources: Journals in the Field
Foundations for Theory and Practice
Focus on Relationships
Integrate
Develop Reputation, Not Only Image
Communication Skill Builder: Two-Way Communication and Social Media
Crisis Management
Service Excellence Is Everyone's Job
Blow Their Minds
Recognize and Create Moments of Truth
Use Service Failures as a Springboard
Tell Stories and Honor Heroes
Summary
Key Terms and Theories
Discussion Questions
Answers To Can You Guess?

Part VI. Media, Public Policy, and Health Promotion
Chapter 11 Health Images in the Media
Theoretical Foundations
Advertising
Box 11.1 Perspectives. Viagra Ads Promise Male Transformation
Pharmaceutical Advertisements
Advantages of DCT Advertising
Disadvantages of DCT Advertising
Communication Skill Builder: Evaluating Medical Claims
Nutrition
Obesity
Effects on Children
Activity Levels
Tobacco
Alcohol
Box 11.2 Perspectives. Barbie: Feminist Icon or Woman as Sex Object?
Body Image
Box 11.3 Perspectives: Boys' Toys on Steroids
Health Effects
Beauty Sells . . . Sometimes
News Coverage
Accuracy and Fairness
Sensationalism
Advantages of Health News
Communication Skill Builder: Presenting Health News
Box 11.4 Career Opportunities: Health Journalism
Entertainment
Portrayals of Health-Related Conditions
Mental Illness
Disabilities
Portrayals of Health-Related Behaviors
Sex
Violence
Portrayals of Health Care Situations
Entertainment and Commercialism
Entertainomercials
Product Placement
Box 11.5 Ethical Considerations: Is the Entertainment Industry Responsible for Health Images?
Entertainment-Education and Programming
Impact of Persuasive Entertainment
Media Literacy
Teaching Media Literacy
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Chapter 12 Public Health and Crisis Communication
Ebola
Communication with the Worried Well
Communication in the Midst of Trauma
What Is Public Health?
Box 12.1 Career Opportunities: Public Health
Risk and Crisis Communication
Box 12.2 Parents Grapple with Vaccine Information
Managing Perceptions
How Scared Is Scared Enough?
In the Heat of the Moment
Box 12.3 Theoretical Perspectives: Risk Management/Communication Framework
Case Studies: A Global Perspective
Box 12.4 Typhoid Mary and TB Andy
AIDS
SARS
Anthrax
Avian Flu
Box 12.5 Ethical Considerations: Who Should Be Protected?
Box 12.6 Lessons for Public Health and Crisis Communication
Summary
Key Terms and Theories
Discussion Questions

Chapter 13 Planning Health Promotion Campaigns
Box 13.1 Career Opportunities: Health Promotion and Education
Background on Health Campaigns
Motivating Factors
Exemplary Campaigns
Get to Know the Audience
Invest in Communication Infrastructures
Box 13.2 Storytelling Connects Underserved Women and Care Providers
Make Healthy Options Accessible
Take a Multimedia Approach
Set Clear Goals and Measure Success
Step 1: Defining the Situation and Potential Benefits
Benefits
Current Situation
Diverse Motivations
Step 2: Analyzing and Segmenting the Audience
Data Collection
Ethical Commitments
Data-Gathering Options
Choosing a Target Audience
Theoretical Foundations
Reaching Under-Informed Audiences
Segmenting the Audience
Audience as a Person
Young Audiences
Sensation-Seekers
Box 13.3 Ethical Considerations: The Politics of Prevention
Step 3: Establishing Campaign Goals and Objectives
Step 4: Selecting Channels of Communication
Channel Characteristics
Message Impact
Arousal
Involvement
Multichannel Campaigns
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

Chapter 14 Designing and Implementing Health Campaigns
Theories of Behaviors Change
Health Belief Model
Social Cognitive Theory
Theory of Reasoned Action
Transtheoretical Model
Wrapping It Up
Box 14.1. Theoretical Foundations: Synopsis of Campaign-Related Theories
Critical-Cultural Perspective
Box 14.2. Ethical Considerations: Three Issues for Health Promoters to Keep in Mind
Box 14.3. Resources: Designing Campaign Materials
Step 5: Designing Campaign Messages
Choosing a Voice
Box 14.4. Career Opportunities: Health Campaign Design and Management
Designing the Message
Theoretical Foundations: Message Framing
Community Expectations
Box 14.5 Theoretical Foundations: What Does Science Say About Peer Pressure?
Narrative Messages
Logical Appeals
Emotional Appeals
Novel and Shocking Messages
Box 14.6. Something is Missing
Step 6: Piloting and Implementing the Campaign
Step 7: Evaluating and Maintaining the Campaign
Evaluation
Maintenance
Summary
Key Terms and Theories
Discussion Questions
Answers to Can You Guess?

References
Credits
Author Index
Subject Index