The Actual Message No One Is Safe until Everyone Is Safe Discussion

Now that you’ve read the majority of the textbook, it’s time for you to apply some of that theoretical knowledge to a practical concern. For this assignment, I’d like you to consider the following scenario:

Like the rest of the world, for the past few years the United States has experienced a pandemic that has drastically altered daily life (at least for the short term). Currently, we are again facing uncertainty with the emergence of the omicron variant of COVID. This new strain threatens us within the context of politically-motivated resistance to mask mandates as well as vaccines to help prevent the disease.

I’d like you to synthesize what we’ve learned in our study of communication in relation to this public health crisis. Begin by focusing your attention on Chapter 19: Health Communication (in particular the sections on “Communicating Health and Illness in the Community” and “Communicating Public Health Campaigns”).  Then, use a theory, concept, or model from  Chapter 14: Argument, Persuasion, and Influence to craft a message designed to potentially persuade a target audience of those who are resistant to getting vaccinated or who argue against mask mandates. There are two basic aspects to the assignment:

  • The creation of a health-related message regarding masks or vaccination. Craft the actual message, then describe the audience for whom the message is designed, and suggest how you might disseminate such a message. Be creative, but realistic, and make sure to understand the seriousness of the issue.
  • A rationale for the message construction based on a theory, concept, or model derived from the chapter on persuasion/influence. In order to justify its use, you must also give a brief overview of the theory or model and how it work.
  • 4:12
    affected by the environments in which we live, our social
    networks, lack of poverty and social-economic depriva-
    tion, and sustainability over time, all have to be addressed
    if we are to succeed in promoting health and well-being
    (Organisation for Economic Co-operation and Develop-
    ment, 2011). Communicating happiness and cooperative
    behaviors through our social networks promote health
    and well-being.
    272 Part III: Knowing Where We Are and What Our Communication Is Doing
    Variations in concepts of health and illness exist across
    cultural categories. Culture is a broad and encompassing
    concept but can be understood as all the intergenerational
    patterns of behavior, belief, value, custom, and ritual of an
    identifiable group (e.g., nationality, ethnicity, or religion).
    Some scholars discuss cocultures as analogous subgroup
    patterns (e.g., sexual orientation, transgender, self-selected
    groups such as goths, tribes, etc.). Cocultures are enduring
    yet evolving groups identified by shared behaviors, beliefs,
    and rituals. Cultural variations have the power to alter
    outcomes of patient-provider communication and health
    campaigns. This section introduces the vital role that cul-
    ture plays in shaping perceptions, how communities as
    micro cultures may influence campaign effectiveness, and
    opportunities for using social support to promote health
    outcomes and campaign effectiveness.
    Communicating Health and
    Illness in the Community
    Cultural Conceptions of Health and Illness
    Understanding the way different cultures understand
    issues related to health and illness is important for
    promoting effective patient-provider communication.
    Variations in cultural conceptions of health and illness
    can affect how individuals explain illness regarding dis-
    ease progression, and appropriate treatment (Thompson,
    Whaley, & Stone, 2011). Interpersonal communication
    in one’s social network often helps an individual deter-
    mine if symptoms warrant healthcare-seeking behavior
    (Hay, 2008) and provides additional opportunities for
    defining beliefs surrounding the level of harm posed
    by a health threat (Aikens, Nease, & Klinkman, 2008).
    As part of these conversations, lay ideas (Leventhal,
    Leventhal, & Cameron, 2001) about causes and effects of
    health-related issues are exchanged and used to convey
    < Previous Page AA K R + .... explanations for understanding and managing health threats. p. 272 Variations in how individuals explain health and ill- ness can affect access to health care and mortality rates (Furnham & Baguma, 1999). According to Thompson et al. (2011), these factors can influence a healthcare pro- vider's response to a patient's description of his or her health-related experiences and recommendation for a suit- able course of action. In addition, such cultural variations often present challenges in patient-provider communica- tion interactions because healthcare providers may hold perspectives on illness and health that differ from how patients explain health-related issues in question. Prior research has shown that when healthcare providers ignore the importance of cultural patterns in conceptualizing health and illness, effective delivery of care and treatment can be compromised (Knibb & Horton, 2008). Because healthcare decisions often depend on what patients communicate to their healthcare providers about symptoms they experience, ignoring how these experi- ences are shaped by cultural notions about risk, sensations, and perceptions of the impact of illness on daily routines presents challenges to enhancing quality of care (Garro, 2000). One way to avoid minimizing the role of cultural variations in shaping beliefs about health and illness is to encourage healthcare providers to give patients ample opportunities to describe their symptoms in their own words (Galland, 2005). This allows for patients and health- care providers to coconstruct explanations for illnesses more effectively (Frosch & Kalpan, 1999). Community Health Campaigns Health campaigns, in general, are organized collective com- munication efforts to facilitate public health-promoting attitudes, values, beliefs, and/or behaviors regarding a particular health-related domain of activity or risk. Health campaigns seeking to promote behavior change encounter challenges among disadvantaged communi- ties in developed and developing countries (Roberto, Murray-Johnson, & Witte, 2011). Scholars have identi- fied a variety of factors that contribute to difficulties in reaching some communities, including stigmatization of certain behaviors and health conditions, marginaliza- tion of community members, and shortage of essential resources (Hogan & Palmer, 2005). In such cases, win- ning support and commitment of community members Ć 000= 4:12 273 becomes key for the success of any health campaign. In order to achieve this, a people-centered approach known as community mobilization can be implemented (Dear- ing, Gaglio, & Rabin, 2011). Community mobilization empowers community members and the target audience as invested stakeholders (i.e., any entity or party whose outcomes are affected by the health risk or campaign) and gaining their support for attainment of campaign objectives (e.g., Bigdon & Sachitanandam, 2003). K A few theories help explain how changes can be achieved through community-level interventions. Under the umbrella of community change theory, Thompson and Kinne (1999) surveyed studies using change theories across individual, organizational, societal, and environ- mental levels. Under this framework, the use of individual behavioral change theory to explain population-level phe- nomena is based on a systems perspective of a community (Rice & Foote, 2013). This perspective considers commu- nity to be part of a larger dynamic system that is connected to other sectors and organizations. Within such a system, a change in one sector signifies a change in others. Theories explaining human behavior and social advocacy strategies offer another set of models for promoting change within a community. Often, these models work best when used in tandem to promote behavior change in a community. Health campaigns targeting individual-level outcomes, such as lower smoking initiation rates among minors combined with efforts involving greater enforcement of laws penalizing tobacco sales to youth under the age of 18 (Dorfman & Wallack, 2012), can increase likelihood of attaining public health objectives compared to using one approach alone. < Another strategy for developing of community health campaigns is social marketing. Social marketing applies marketing techniques developed in the commercial sector to develop campaigns that are prosocial in nature and can promote social good (Lee & Kotler, 2011). These techniques rely on ideas of exchange between the target population and health communication campaign sponsors, ongo- ing research for understanding the needs of the target population, and marketing mix (Lee & Kotler, 2011). The marketing mix refers to the combination of the four Ps AA R + .... Chapter 19: Health Communication p. 273 of marketing. The first of the four Ps is the product, or the new behavior or idea being "sold," and what benefits it offers the target audience when adopted. The second is price, or any barriers to adopting the new behavior or idea. The third is promotion, which includes the com- munication strategy used to convey and publicize the message content. The fourth is the place where the target audience can gain access to the product. Positioning, or the strategy used to position the product in the context of competitors, although technically not part of the four Ps, is often used in conjunction with them. Community-based prevention programming (CBPM) projects combine social marketing and community-based approaches to achieve desired results. Some recent examples of CBPM cam- paigns have addressed issues such as alcohol and tobacco use prevention (Bryant et al., 2007) and physical activity promotion among youth (Bryant et al., 2010). In order to correctly execute the process of launch- ing community-level interventions, a number of steps are required. These steps represent a five-stage process outlined by Bracht, Kingsbury, and Rissel (1999). The first step is to conduct a thorough community analy- sis to provide a profile of important qualities, such as resources, norms, beliefs, and values, that characterize the community. The second step calls for the design and initiation of campaign activities that include organiz- ing partnerships with community members, increasing community participation, and laying the framework to launch the campaign to the wider community. The third step involves implementation of the campaign, which includes monitoring and refinement of the campaign strategy and coordination with community partners. During the fourth step, the community foundation for maintaining and consolidating campaign efforts is established, and campaign elements are incorporated into the community for the long term. Determin- ing effectiveness of campaign activities in achieving objectives, identifying lessons learned for improving campaign activities, and revising the community analy- sis for future campaigns represent the types of activities typically performed at the fifth step. This step also assists with future campaign development. 000 Next Page Ć4:12 ● . 274 | Part III: Knowing Where We Are and What Our Communication Is Doing 274 Box 19.1 Ethical Issues It should be clear from this chapter that health communication is multifaceted and pervasive. Two broad ethical issues discussed here elaborate on principles presented in this chapter. 0 K R + Paternalism and Therapeutic Privilege All new physicians pledge the Hippocratic Oath, originally written about 2,500 years ago. It includes a promise for physicians to use their best ability and judgment on behalf of their patients. For centuries, this was practiced by physicians making treatment decisions "for" patients rather than "with" patients. Many patient advocates and health ethicists now argue that such a paternalistic approach to practicing medicine disrespects patients and their families (du Pré, 2014). The paternalistic model of provider-patient communication privileges the physician's priorities and biomedical knowledge over the patient's priorities and experiential knowledge. Support is increasing for replacing such paternalism with a partnership model that includes multiple perspectives when making health and treatment decisions. Communicating Public Health Campaigns In the study of health communication, health campaigns research is at the intersection of public health and health communication research. The use of the term communica- tion in a public health communication campaign indicates < The concept of therapeutic privilege is related to paternalism in that it refers to physicians withholding infor- mation from patients if they think disclosing the formation would do more harm than good (du Pré, 2014). Therapeutic privilege is more complex than patient-provider communication, however. Family relationships, family communication rules, as well as cultural norms involving health, illness, and death also come into play in how individuals view therapeutic privilege. Sometimes patients' families request that physicians withhold information from patients for the sake of emotional well-being. As an advanced student of communication, it would be an interesting exercise for you to discuss therapeutic privilege with your family members. Health Literacy According to the CDC (2019), health literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (p. 3). Health literacy affects how patients and their families understand causes, treatments, and outcomes of health conditions and how they use that understanding to guide their behavior and decisions. Lower health literacy may lead patients to allow others to make their healthcare decisions for them rather than being active participants in their healthcare decisions. The American Medical Association (AMA) encourages patients to ask their healthcare providers three questions: What is my main problem? What do I need to do? AA .... • Why is it important for me to do this? You can see the physician privilege in this attempt to address the health literacy gap between patients and provid- ers. How might these questions be revised to account for a partnership model of patient-provider communication? Some public health and communication researchers encourage the use of "plain language" in written materials about health to account for different levels of health literacy. This includes carefully evaluating the grade level of written materials and how numbers, graphs, and pictures can be used to improve understanding for a wide range of patients and their families. p. 274 that a campaign message is doing more than hoping to improve health. According to Atkin and Rice (2013), public health communication campaigns are a "purposive attempt to inform or influence behaviors in large audi- ences within a specified time period using an organized set of communication activities and featuring an array of Next Page Ć= 4:12 275 mediated messages in multiple channels generally to pro- duce noncommercial benefits to individuals and society" (p. 3). In other words, health communication campaigns have important characteristics of being strategic- (i.e., not accidental), theory- and research-driven efforts that use mediated communication channels to improve health. < K Communication campaigns can be an effective strategy for reaching mass audiences. Meta-analytic studies have consistently found support for carefully designed cam- paigns to improve health behavior (e.g., Derzon & Lipsey, 2002; Snyder & LaCroix, 2013). Campaigns are developed and tested via three stages of campaign evaluation: for- mative evaluation, process evaluation, and summative evaluation (Atkin & Freimuth, 2013). The formative evaluation stage is the design stage in which campaign planners make critical decisions regard- ing the theoretical framework, goals, audience, channel(s), and materials (Atkin & Freimuth, 2013). The most common theoretical frameworks used in campaigns are discussed at the end of this section. Successful campaigns are focused on very specific goals. Campaign planners are responsible for understanding the research landscape related to the primary campaign goals, including relevant trends and previous research on the (a) behavior (e.g., stop smoking, eat more vegetables), (b) type of change (e.g., awareness, attitudinal, behavioral), and (c) level of change (e.g., individual, organizational, societal) being sought. When determining a segmented audience to target, a clear group of similar individuals (e.g., adults, youth, ethnic groups, teachers, community members) and the mediated communication channel most likely to reach those individuals should be identified (Atkin & Freimuth, 2013). Few modern campaigns adhere to only one channel; most campaigns use multiple channels, one of which is typically Internet based (Helme, Savage, & Record, 2015). Finally, the campaign materials must be designed. Cam- paign materials are most often adapted from previous campaigns that were successful. With careful testing and retesting, new materials can also be designed. Regard- less of whether materials are adapted or designed from scratch, messages should be tested with focus groups of the target population before implementation (Atkin & Freimuth, 2013). Research has found that thorough for- mative evaluation processes contribute most significantly to the success of a campaign (Noar, 2006), and that a lack of thorough formative evaluation is a primary reason for an unsuccessful campaign (Smith, 2002). AA R + .... Chapter 19: Health Communication The process evaluation stage occurs when campaign materials are implemented. This stage consists of activ- ities that can confirm that the implementation plan is going forward (Valente & Kwan, 2013). Decisions made during the formative evaluation stage that are relevant here include the channels the message will appear on (e.g., specific stations, papers, websites), the frequency with which the messages will be distributed (e.g., air once an hour, run constantly on a website, placed in 100 locations), and how long the messages will be viewable to audiences (i.e., the amount of time the campaign will run). Activities for confirming that the campaign implementation plan is on track include checking that messages are airing on the chosen channels at the desired time (e.g., on the radio and TV) and periodically visiting locations where mes- sages were placed to confirm that they are still present and undamaged; this includes confirming that Internet-based channels are still operating correctly. The process evalua- tion stage is critical because if the implementation plan is not being implemented as planned, then campaign effec- tiveness can be significantly compromised. The final stage is the summative evaluation stage, in which campaign effectiveness is assessed. During this stage, researchers determine whether they have achieved their campaign goals of improving health among their target population (Valente & Kwan, 2013). Effectiveness is primar- ily determined using quantitative data collected through large-scale quasi-experiments to compare behavioral dif- ferences in the target population before, during, and after campaign implementation. Importantly, campaigns do not seek to cause massive amounts of change; a small amount of change can be statistically supported as a significant change in behavior, and thus an effective campaign (Helme et al., 2015). The most important step in this stage is the sharing of results for future campaign planners to learn from. In short, public health communication campaigns are an effective way to change and improve health behavior (Derzon & Lipsey, 2002; Snyder & LaCroix, 2013). Conclusion Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the king- dom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place. (Sontag, 1977, p. 3) p. 275 Next Page Ć= 4:14 197 attitude and behavior change. This chapter presents theoret- ical and practical understandings of argumentation and the process of persuasion. In particular, three categorizations of argument formation are reviewed (deductive, inductive, abductive), as well as theoretical understandings of the persuasive process as it appears generally, interpersonally, and socially. Although mass mediated communication is also essential to understanding persuasive processes, the role of media for persuasive processes (referred to as media effects) is examined in the media chapter. Argumentation Some days it can feel like the sole purpose of communi- cation is to argue. Everyone wants something, and almost everything seems to seek to influence. In the contemporary media environment, people are inundated by text, smell, sound, touch, image, and social forms of influence. This is not surprising; control over one's environment is a funda- mental survival advantage and reflects an intrinsic tendency. One of the most elemental discursive approaches we use to influence others is that of argument (see also: Chapters 3 and 4). Arguments are forms of convergence-seeking discourse that refer to "communicative attempts to reach accord with the minds or behavior of another person" or persons (Canary & Seibold, 2010, p. 12). Thus, argument is inherently an attempt to seek agreement-attempts that often share similarities across contexts. There are at least four primary forms in which arguments are structured: deductive, inductive, abductive, and warrantable. K Deduction Ancient philosophers were greatly concerned with seek- ing some form of argument that produced more reliable claims to truth. In speculating on the need for an ethical approach to influence, they formalized a way of thinking that has come to be known as deduction. Deduction is a form of reasoning from general to particulars. Its ideal- ized structure is summarized by the syllogism (Hacking, 2013). Deduction is involved in the form of a highly flexible structural template. For example, consider the following deductive chain of hypotheses: Major premise (MjP): Communication majors are more rhetorically competent than other college majors. < AA R + .... Chapter 14: Argument, Persuasion, and Influence Minor premise (MnP): Rhetorical competence is pos- itively related to career success. Conclusion (Cncl): Therefore, communication majors will have greater career success than other majors. There are many derivations of such syllogisms that represent causal schemata or informal ways of think- ing (Khemlani, Barbey, & Johnson-Laird, 2014). See the following example: MjP: A causes B (e.g., recessions cause unemployment). MnP: B prevents C (e.g., lowering taxes produces economic recovery). Cncl: Therefore, A prevents C. (e.g., we should lower taxes to reduce unemployment). Aristotle recognized the challenges of example and syllogism as forms of persuasion and formulated an alter- native form of persuasion he named enthymeme, which is a syllogism with one or more suppressed propositions that is filled in by the audience. Suppose a presidential candidate says, "My opponent still has not released his tax returns, so what is he hiding?" The implication of this statement is for audience members to think, "Why would anyone refuse to release his or her taxes? It must be because that person is hiding something incriminat- ing." At no point did the candidate's statement explicitly say, "My opponent is a criminal." But, it is assumed that the audience is likely to think this, and, consequently, it does not need to be expressly stated. Many advertisements operate using an enthymematic structure. An ad for men's fragrance that shows beautiful women leaping to caress a man after he sprays on the fragrance is essentially making an enthymeme: MjP: Absent this fragrance, the character in the com- mercial was alone. MnP: Having sprayed this fragrance, the character in the commercial attracted women. Cncl: If I buy and use this fragrance, I will attract women. p. 197 There are at least two attractive features to this form of argument. First, by not making all the claims of the Next Page Ć

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