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Renata Schiavo

Cover design: JPuda Cover image :C Pixman/Imagezoo/Getty

CopyrightC 2014 by Renata Schiavo. All rights reserved.

Published by Jossey-Bass AWiley Brand One Montgomery Street, Suite 1200, San Francisco, CA 94104-4594—www.josseybass.com

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, or on the Web at www.copyright.com. Requests to the publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, 201-748-6011, fax 201-748-6008, or online at www.wiley.com/go/permissions.

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Library of Congress Cataloging-in-Publication Data Schiavo, Renata, author. Health communication : from theory to practice / Renata Schiavo.—Second edition.

pages cm.—(Jossey-Bass public health ; 217) Includes bibliographical references and index. ISBN 978-1-118-12219-8 (pbk.)—ISBN 978-1-118-41912-0 (pdf)—

ISBN 978-1-118-41639-6 (epub) 1. Communication in medicine—United States. 2. Health promotion—United States. 3. Health planning—United States. I. Title R118.S33 2014 610.1′4—dc23

2013025596

Printed in the United States of America SECOND EDITION HB Printing 10 9 8 7 6 5 4 3 2 1

CONTENTS

Tables, Figures, Exhibits, and Numbered Boxes • • • • • • • • ix Preface • • • • • • • • • • • • • • • • • • • • • xv Acknowledgments • • • • • • • • • • • • • • • • • xvii The Author • • • • • • • • • • • • • • • • • • • • xxi Introduction • • • • • • • • • • • • • • • • • • • xxiii

Part One: Introduction to Health Communication 1

Chapter 1 What Is Health Communication? • • • • • • • • • • 3

In This Chapter • • • • • • • • • • • • • • • • • • • 3 Defining Health Communication • • • • • • • • • • • • • 4 Health Communication in the Twenty-First Century: Key Characteristics and Defining Features • • • • • • • • • 9

The Health Communication Environment • • • • • • • • • 22 Health Communication in Public Health, Health Care, and Community Development • • • • • • • • • • • • • • 23

The Role of Health Communication in the Marketing Mix • • • • 25 Overview of Key Communication Areas • • • • • • • • • • 26 The Health Communication Cycle • • • • • • • • • • • • 28 What Health Communication Can and Cannot Do • • • • • • 29 Key Concepts • • • • • • • • • • • • • • • • • • • 31 For Discussion and Practice • • • • • • • • • • • • • • 32 Key Terms • • • • • • • • • • • • • • • • • • • • 32

Chapter 2 Current Health Communication Theories and Issues • • • 33

In This Chapter • • • • • • • • • • • • • • • • • • 33 Use of Communication Models and Theories: A Premise • • • • 34 Key Theoretical Influences in Health Communication • • • • • 35 Select Models for Strategic Behavior and Social Change Communication • • • • • • • • • • • • • • • • • • 57

Other Theoretical Influences and Planning Frameworks • • • • 62 Current Issues and Topics in Public Health and Health Care: Implications for Health Communication • • • • • • • • • 64

Key Concepts • • • • • • • • • • • • • • • • • • • 81

iv CONTENTS

For Discussion and Practice • • • • • • • • • • • • • • 82 Key Terms • • • • • • • • • • • • • • • • • • • • 82

Chapter 3 Culture and Other Influences on Conceptions of Health and Illness • • • • • • • • • • • • • • • 83

In This Chapter • • • • • • • • • • • • • • • • • • 83 What Is Culture? • • • • • • • • • • • • • • • • • • 84 Approaches in Defining Health and Illness • • • • • • • • • 85 Understanding Health in Different Contexts: A Comparative Overview • • • • • • • • • • • • • • • • • • • • 88

Gender Influences on Health Behaviors and Conceptions of Health and Illness • • • • • • • • • • • • • • • • • 91

Health Beliefs Versus Desires: Implications for Health Communication • • • • • • • • • • • • • • • • • • 94

Cultural Competence and Implications for Health Communication • • • • • • • • • • • • • • • • • • 97

Key Concepts • • • • • • • • • • • • • • • • • • • 99 For Discussion and Practice • • • • • • • • • • • • • • 99 Key Terms • • • • • • • • • • • • • • • • • • • • 100

Part Two: Health Communication Approaches and Action Areas 101

Chapter 4 Interpersonal Communication • • • • • • • • • • 103

In This Chapter • • • • • • • • • • • • • • • • • • 103 The Dynamics of Interpersonal Behavior • • • • • • • • • 104 Social and Cognitive Processes of Interpersonal Communication • 106 Community Dialogue as an Example of Interpersonal Com- munication at Scale • • • • • • • • • • • • • • • • 111

The Power of Personal Selling and Counseling • • • • • • • 112 Communication as a Core Clinical Competency • • • • • • • 116 Implicationsof InterpersonalCommunication forTechnology- Mediated Communications • • • • • • • • • • • • • 128

Key Concepts • • • • • • • • • • • • • • • • • • • 129 For Discussion and Practice • • • • • • • • • • • • • • 131 Key Terms • • • • • • • • • • • • • • • • • • • • 132

Chapter 5 Mass Media and New Media Communication, and Public Relations • • • • • • • • • • • • • • • 133

In This Chapter • • • • • • • • • • • • • • • • • • 133 Health Communication in the New Media Age: What Has Changed and What Should Not Change • • • • • • • • • 134

CONTENTS v

The Media of Mass Communication and Public Relations • • • 138 Public Relations Defined: Theory and Practice • • • • • • • 139 Mass Media, Health-Related Decisions, and Public Health • • • 149 New Media and Health • • • • • • • • • • • • • • • 157 Reaching the Underserved with Integrated New Media Communication • • • • • • • • • • • • • • • • • 170

Mass Media– and New Media–Specific Evaluation Parameters • • • • • • • • • • • • • • • • • • • 171

Key Concepts • • • • • • • • • • • • • • • • • • • 174 For Discussion and Practice • • • • • • • • • • • • • • 176 Key Terms • • • • • • • • • • • • • • • • • • • • 177

Chapter 6 Community Mobilization and Citizen Engagement • • • 179

In This Chapter • • • • • • • • • • • • • • • • • • 179 CommunityMobilizationandCitizenEngagement:ABottom- Up Approach • • • • • • • • • • • • • • • • • • 180

Community Mobilization as a Social Process • • • • • • • • 182 Engaging Citizens in Policy Debates and Political Processes • • • 188 Implications of Different Theoretical and Practical Perspec- tives for Community Mobilization and Citizen Engagement Programs • • • • • • • • • • • • • • • • • • • • 190

ImpactofCommunityMobilizationonHealth-RelatedKnowl- edge and Practices • • • • • • • • • • • • • • • • • 194

Key Steps of Community Mobilization Programs • • • • • • 203 The Case for Community Mobilization and Citizen Engage- ment in Risk and Emergency Communication • • • • • • • 212

Key Concepts • • • • • • • • • • • • • • • • • • • 216 For Discussion and Practice • • • • • • • • • • • • • • 217 Key Terms • • • • • • • • • • • • • • • • • • • • 218

Chapter 7 Professional Medical Communications • • • • • • • 219

In This Chapter • • • • • • • • • • • • • • • • • • 219 Communicating with Health Care Providers: A Peer-to-Peer Approach • • • • • • • • • • • • • • • • • • • • 220

Theoretical Assumptions in Professional Medical (Clinical) Communications • • • • • • • • • • • • • • • • • 224

How to Influence Health Care Provider Behavior: A Theo- retical Overview • • • • • • • • • • • • • • • • • 226

Key Elements of Professional Medical Communications Programs • • • • • • • • • • • • • • • • • • • • 228

Overview of Key Communication Channels and Activities • • • 235

vi CONTENTS

Using IT Innovation to Address Emerging Needs and Global Health Workforce Gap • • • • • • • • • • • • • • • 237

PrioritizingHealthDisparities inClinicalEducation to Improve Care: The Role of Cross-Cultural Health Communication • • • 239

Key Concepts • • • • • • • • • • • • • • • • • • • 240 For Discussion and Practice • • • • • • • • • • • • • • 242 Key Terms • • • • • • • • • • • • • • • • • • • • 242

Chapter 8 Constituency Relations and Strategic Partnerships in Health Communication • • • • • • • • • • • 243

In This Chapter • • • • • • • • • • • • • • • • • • 243 Constituency Relations: A Practice-Based Definition • • • • • 244 Recognizing the Legitimacy of All Constituency Groups • • • • 246 Constituency Relations: A Structured Approach • • • • • • • 247 Strategies to Develop Successful Multisectoral Partnerships • • • 251 Key Concepts • • • • • • • • • • • • • • • • • • • 260 For Discussion and Practice • • • • • • • • • • • • • • 261 Key Terms • • • • • • • • • • • • • • • • • • • • 262

Chapter 9 Policy Communication and Public Advocacy • • • • • 263

In This Chapter • • • • • • • • • • • • • • • • • • 263 Policy Communication and Public Advocacy as Integrated Communication Areas • • • • • • • • • • • • • • • 264

Communicating with Policymakers and Other Key Stakeholders • 267 The Media of Public Advocacy and Public Relations • • • • • 271 Influencing Public Policy in the New Media Age • • • • • • • 274 Key Concepts • • • • • • • • • • • • • • • • • • • 277 For Discussion and Practice • • • • • • • • • • • • • • 278 Key Terms • • • • • • • • • • • • • • • • • • • • 278

Part Three: Planning, Implementing, and Evaluating a Health Communication Intervention 279

Chapter10 Overview of the Health Communication Planning Process • • • • • • • • • • • • • • 281

In This Chapter • • • • • • • • • • • • • • • • • • 281 Why Planning Is Important • • • • • • • • • • • • • • 283 Approaches to Health Communication Planning • • • • • • • 285 The Health Communication Cycle and Strategic Planning Process 287 Key Steps of Health Communication Planning • • • • • • • 289 Elements of an Effective Health Communication Program • • • 295 Establishing the Overall Program Goal: A Practical Perspective • • 299

CONTENTS vii

Outcome Objectives: Behavioral, Social, and Organizational • • • 300 Key Concepts • • • • • • • • • • • • • • • • • • • 303 For Discussion and Practice • • • • • • • • • • • • • • 305 Key Terms • • • • • • • • • • • • • • • • • • • • 306

Chapter11 Situation and Audience Analysis • • • • • • • • 307

In This Chapter • • • • • • • • • • • • • • • • • • 307 How to Develop a Comprehensive Situation and Audience Analysis • • • • • • • • • • • • • • • • • • • • 308

Organizing, Sharing, and Reporting on Research Findings • • • 333 Common Research Methodologies: An Overview • • • • • • 335 Key Concepts • • • • • • • • • • • • • • • • • • • 353 For Discussion and Practice • • • • • • • • • • • • • • 354 Key Terms • • • • • • • • • • • • • • • • • • • • 354

Chapter12 Identifying Communication Objectives and Strategies • • • • • • • • • • • • • • • 355

In This Chapter • • • • • • • • • • • • • • • • • • 355 How to Develop and Validate Communication Objectives • • • 356 Outlining a Communication Strategy • • • • • • • • • • 364 Key Concepts • • • • • • • • • • • • • • • • • • • 372 For Discussion and Practice • • • • • • • • • • • • • • 372 Key Terms • • • • • • • • • • • • • • • • • • • • 373

Chapter13 Designing and Implementing an Action Plan • • • • 375

In This Chapter • • • • • • • • • • • • • • • • • • 375 Definition of an Action (Tactical) Plan • • • • • • • • • • 376 Key Elements of an Action (Tactical) Plan • • • • • • • • • 379 Integrating Partnership and Action Plans • • • • • • • • • 398 Planning for a Successful Program Implementation • • • • • • 400 Key Concepts • • • • • • • • • • • • • • • • • • • 404 For Discussion and Practice • • • • • • • • • • • • • • 405 Key Terms • • • • • • • • • • • • • • • • • • • • 405

Chapter14 Evaluating Outcomes of Health Communication Interventions • • • • • • • • • • • • • • • 407

In This Chapter • • • • • • • • • • • • • • • • • • 407 Evaluation as a Key Element of Health Communication Planning • 408 Overview of Key Evaluation Trends and Strategies: Why, What, and HowWeMeasure • • • • • • • • • • • • • 409

Integrating Evaluation Parameters That Are Inclusive of Vul- nerable and Underserved Populations • • • • • • • • • • 425

viii CONTENTS

EvaluatingNewMedia–Based Interventions: EmergingTrends and Models • • • • • • • • • • • • • • • • • • • 426

Monitoring: An Essential Element of Program Evaluation • • • 430 Linking Outcomes to a Specific Health Communication Intervention • • • • • • • • • • • • • • • • • • • 432

Evaluation Report • • • • • • • • • • • • • • • • • 434 Key Concepts • • • • • • • • • • • • • • • • • • • 437 For Discussion and Practice • • • • • • • • • • • • • • 439 Key Terms • • • • • • • • • • • • • • • • • • • • 440

Part Four: Case Studies and Lessons from the Field 441

Chapter15 Health Communication in the United States: Case Studies and Lessons from the Field • • • • • • 443

In This Chapter • • • • • • • • • • • • • • • • • • 443 From Theory to Practice: Select Case Studies from the United States • • • • • • • • • • • • • • • • • • 444

Emerging Trends and Lessons • • • • • • • • • • • • • 464 Key Concepts • • • • • • • • • • • • • • • • • • • 465 For Discussion and Practice • • • • • • • • • • • • • • 466 Key Term • • • • • • • • • • • • • • • • • • • • 466

Chapter16 Global Health Communication: Case Studies and Lessons from the Field • • • • • • • • • • 467

In This Chapter • • • • • • • • • • • • • • • • • • 467 From Theory to Practice: Select Case Studies on Global Health Communication • • • • • • • • • • • • • • • 468

Emerging Trends and Lessons • • • • • • • • • • • • • 490 Key Concepts • • • • • • • • • • • • • • • • • • • 492 For Discussion and Practice • • • • • • • • • • • • • • 493 Key Terms • • • • • • • • • • • • • • • • • • • • 493

Appendix A ExamplesofWorksheetsandResourcesonHealth Communication Planning • • • • • • • • • • • 495

Appendix B Sample Online Resources on Health Communication • 509

Glossary 523

References 539

Name Index 593

Subject Index 601

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