Health Communication
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, Hoofdstuk 1
Health communication: the study of messages that create meaning in relation to physical, mental,
and social well-being.
Health communication research is multidisciplinary, interdisciplinary, and transdisciplinary. Research
can be conducted from scientific, interpretive, or critical–cultural paradigmatic perspectives. Research
results can be translated to have positive impact on the health and well- being of society.
Multidisciplinary research: involves researchers from multiple disciplines independently investigating
the communication dimension of a health problem.
Interdisciplinary research involves researchers from multiple disciplines collaboratively investigating
multiple dimensions of either a health problem in general or the communication aspect of a health
problem.
Translational research: taking research results and translating them from an experimental context to
an actual community setting.
Transdisciplinary research: research that spans disciplinary boundaries to create new theories and
methods that integrate knowledge from multiple disciplines to address complex social problems.
Basic research: designed to test and refine theoretical models.
Applied research: designed to solve a problem.
In essence, metatheory encompasses a paradigmatic perspective, or a way of “looking at the world.”
It makes assumptions about the nature of reality (ontology), the nature of knowledge
(epistemology), and the role of values in research (axiology). These assumptions matter because they
influence the way you do your research.
According to the scientific paradigm (a.k.a., post- positivist, objectivist), there is one objective “Truth”
that is out there to be discovered.
The interpretive paradigm (a.k.a., humanistic) has little interest in conducting experiments and
counting words or doing anything that attempts to make generalizations or predict or control
behavior. Instead, the real interest lies in uncovering and understanding the subjective, situated
meanings of human behavior.
The critical–cultural paradigm is similar to the interpretive paradigm in its orientation to ontology,
epistemology, and axiology, but it distinguishes itself by its focus on power: the social, political,
economic, and cultural means of oppression by the haves of the have- nots. Its methods strive to give
voice to people who have been marginalized and to empower them to create social change. In the
health communication context, the critical–cultural perspective forces us to question the assumptions
we make about what it means to be healthy or sick and who has the authority to say what counts as
health promotion or disease prevention behavior.
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Risk communication is a process of informing people about risks and persuading them to modify
their behaviour to reduce risks.
Some risk exigencies require a multidisciplinary approach, particularly when a risk manifests into a
crisis. Despite the fact that risks almost always have a chance of becoming a crisis and the research on
risk and crisis exigencies is rather fluid, in practice, crisis communication has only recently been
applied to health concepts. Crises create challenges for health communicators who must coordinate
with other response agencies to address unexpected, fast-moving events in which there is often a
great deal of uncertainty and threat. Public health has, therefore, had to adjust to an expanded set of
responsibilities.
These new responsibilities include a complex set of communication obligations that incorporate
elements of both risk communication and crisis communication. As a function of public relations, the
purpose of crisis communication is to prevent or lessen the negative outcomes of a crisis and
primarily to protect the interests of the organization at the heart of the crisis. Responses include
instructional information for physical protection, adjusting information to help stakeholders cope
psychologically with the crisis, and reputation management responses to protect the reputation of
the organization both during and following the crisis.
A significant difference between health risk communication messages and crisis communication
responses is that, in addressing a risk that has not yet evolved into a crisis, communicators have the
luxury of time to fully develop and test messages in an effort to maximize their effectiveness.
Key elements when crafting a message during a crisis:
The recipients of the information must (a) receive the information, (b) understand that information,
(c) understand that the message relates to them directly, (d) understand the risks they face if they do
not follow the protective action provided, (e) decide that they should act on the information, (f)
understand the actions they need to take, and (g) actually be able to take action. Ultimately, a
3
, response should include clear, concrete, and consistent messages with suggested actions to mitigate
risk, presented by a trusted source.
Public health officials must seek to understand the complex needs, background, and culture of
audiences to determine the stressors impacting them and provide messages that reestablish a sense
of personal control and thus reduce fears that may be unwarranted in the midst of a crisis.
Fink (1986) was one of the first to develop a crisis stage model. Fink described crisis through the
metaphor of a medical illness with four stages: (1) prodromal, when warning signals of a potential
crisis emerge; (2) acute, when the trigger event and ensuing damage of the crisis occur; (3) chronic,
when lasting effects of the crisis continue and clean up begins; and (4) resolution, when the crisis is
no longer a concern to stakeholders.
Mitroff (1994) suggested there are opportunities to interrupt the crisis lifecycle. Also specific to
organizational crises, his approach focused on strategic actions for crisis prevention through (1) signal
detection, when warning signs can be identified and acted upon to prevent a crisis; (2) probing and
prevention, when organization members should be searching for known crisis risk factors and working
to reduce potential harm; (3) damage containment, the onset of crisis during which organization
members try to limit the damage; (4) recovery, working to return to normal business operation as
soon as possible; and (5) learning, which involves reviewing and critiquing the crisis management
process. González-Herrero and Pratt (1995) extended Mitroff’s work to include learning as a
continuation of the recovery phase that will improve signal detection for organizations at the start of
the cycle.
Drawing from emergency management and the work of Fink and Mitroff, Coombs (2007) described
the crisis lifecycle through four interrelated factors: (1) prevention, detecting warning signals and
taking action to mitigate the crisis; (2) preparation, diagnosing vulnerabilities and developing the
crisis plan; (3) response, applying the preparation components and attempting to return to normal
operations; and (4) revision, evaluating the crisis response to determine what was done right or
wrong during the crisis management performance.
The three- stage approach is most commonly used to separate the events surrounding a crisis for
further analysis (e.g., Seeger et al., 2003): (1) precrisis includes crisis preparation and planning; (2)
crisis includes the trigger event and ensuing damage; and (3) post crisis includes learning and
resolution, which then informs the precrisis stage.
One of the most widely adopted models for risk and crisis communication in a health context is Crisis
and Emergency Risk Communication (CERC). CERC follows a five-stage model of crisis and includes
specific communication activities for each stage: (1) precrisis, risk messages, warnings, preparations;
(2) initial event, uncertainty reduction, self-efficacy, reassurance; (3) maintenance, ongoing
uncertainty reduction, self- efficacy, reassurance; (4) resolution, updates regarding resolution,
discussions about cause and new risks/understandings of risk; and (5) evaluation, discussions of
adequacy of response, consensus about lessons, and new understandings of risks.
CERC advocates six principles of effective risk and crisis communication.
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Hoofdstuk 12........................................................................................................................................26
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1
, Hoofdstuk 1
Health communication: the study of messages that create meaning in relation to physical, mental,
and social well-being.
Health communication research is multidisciplinary, interdisciplinary, and transdisciplinary. Research
can be conducted from scientific, interpretive, or critical–cultural paradigmatic perspectives. Research
results can be translated to have positive impact on the health and well- being of society.
Multidisciplinary research: involves researchers from multiple disciplines independently investigating
the communication dimension of a health problem.
Interdisciplinary research involves researchers from multiple disciplines collaboratively investigating
multiple dimensions of either a health problem in general or the communication aspect of a health
problem.
Translational research: taking research results and translating them from an experimental context to
an actual community setting.
Transdisciplinary research: research that spans disciplinary boundaries to create new theories and
methods that integrate knowledge from multiple disciplines to address complex social problems.
Basic research: designed to test and refine theoretical models.
Applied research: designed to solve a problem.
In essence, metatheory encompasses a paradigmatic perspective, or a way of “looking at the world.”
It makes assumptions about the nature of reality (ontology), the nature of knowledge
(epistemology), and the role of values in research (axiology). These assumptions matter because they
influence the way you do your research.
According to the scientific paradigm (a.k.a., post- positivist, objectivist), there is one objective “Truth”
that is out there to be discovered.
The interpretive paradigm (a.k.a., humanistic) has little interest in conducting experiments and
counting words or doing anything that attempts to make generalizations or predict or control
behavior. Instead, the real interest lies in uncovering and understanding the subjective, situated
meanings of human behavior.
The critical–cultural paradigm is similar to the interpretive paradigm in its orientation to ontology,
epistemology, and axiology, but it distinguishes itself by its focus on power: the social, political,
economic, and cultural means of oppression by the haves of the have- nots. Its methods strive to give
voice to people who have been marginalized and to empower them to create social change. In the
health communication context, the critical–cultural perspective forces us to question the assumptions
we make about what it means to be healthy or sick and who has the authority to say what counts as
health promotion or disease prevention behavior.
2
, Hoofdstuk 16
Risk communication is a process of informing people about risks and persuading them to modify
their behaviour to reduce risks.
Some risk exigencies require a multidisciplinary approach, particularly when a risk manifests into a
crisis. Despite the fact that risks almost always have a chance of becoming a crisis and the research on
risk and crisis exigencies is rather fluid, in practice, crisis communication has only recently been
applied to health concepts. Crises create challenges for health communicators who must coordinate
with other response agencies to address unexpected, fast-moving events in which there is often a
great deal of uncertainty and threat. Public health has, therefore, had to adjust to an expanded set of
responsibilities.
These new responsibilities include a complex set of communication obligations that incorporate
elements of both risk communication and crisis communication. As a function of public relations, the
purpose of crisis communication is to prevent or lessen the negative outcomes of a crisis and
primarily to protect the interests of the organization at the heart of the crisis. Responses include
instructional information for physical protection, adjusting information to help stakeholders cope
psychologically with the crisis, and reputation management responses to protect the reputation of
the organization both during and following the crisis.
A significant difference between health risk communication messages and crisis communication
responses is that, in addressing a risk that has not yet evolved into a crisis, communicators have the
luxury of time to fully develop and test messages in an effort to maximize their effectiveness.
Key elements when crafting a message during a crisis:
The recipients of the information must (a) receive the information, (b) understand that information,
(c) understand that the message relates to them directly, (d) understand the risks they face if they do
not follow the protective action provided, (e) decide that they should act on the information, (f)
understand the actions they need to take, and (g) actually be able to take action. Ultimately, a
3
, response should include clear, concrete, and consistent messages with suggested actions to mitigate
risk, presented by a trusted source.
Public health officials must seek to understand the complex needs, background, and culture of
audiences to determine the stressors impacting them and provide messages that reestablish a sense
of personal control and thus reduce fears that may be unwarranted in the midst of a crisis.
Fink (1986) was one of the first to develop a crisis stage model. Fink described crisis through the
metaphor of a medical illness with four stages: (1) prodromal, when warning signals of a potential
crisis emerge; (2) acute, when the trigger event and ensuing damage of the crisis occur; (3) chronic,
when lasting effects of the crisis continue and clean up begins; and (4) resolution, when the crisis is
no longer a concern to stakeholders.
Mitroff (1994) suggested there are opportunities to interrupt the crisis lifecycle. Also specific to
organizational crises, his approach focused on strategic actions for crisis prevention through (1) signal
detection, when warning signs can be identified and acted upon to prevent a crisis; (2) probing and
prevention, when organization members should be searching for known crisis risk factors and working
to reduce potential harm; (3) damage containment, the onset of crisis during which organization
members try to limit the damage; (4) recovery, working to return to normal business operation as
soon as possible; and (5) learning, which involves reviewing and critiquing the crisis management
process. González-Herrero and Pratt (1995) extended Mitroff’s work to include learning as a
continuation of the recovery phase that will improve signal detection for organizations at the start of
the cycle.
Drawing from emergency management and the work of Fink and Mitroff, Coombs (2007) described
the crisis lifecycle through four interrelated factors: (1) prevention, detecting warning signals and
taking action to mitigate the crisis; (2) preparation, diagnosing vulnerabilities and developing the
crisis plan; (3) response, applying the preparation components and attempting to return to normal
operations; and (4) revision, evaluating the crisis response to determine what was done right or
wrong during the crisis management performance.
The three- stage approach is most commonly used to separate the events surrounding a crisis for
further analysis (e.g., Seeger et al., 2003): (1) precrisis includes crisis preparation and planning; (2)
crisis includes the trigger event and ensuing damage; and (3) post crisis includes learning and
resolution, which then informs the precrisis stage.
One of the most widely adopted models for risk and crisis communication in a health context is Crisis
and Emergency Risk Communication (CERC). CERC follows a five-stage model of crisis and includes
specific communication activities for each stage: (1) precrisis, risk messages, warnings, preparations;
(2) initial event, uncertainty reduction, self-efficacy, reassurance; (3) maintenance, ongoing
uncertainty reduction, self- efficacy, reassurance; (4) resolution, updates regarding resolution,
discussions about cause and new risks/understandings of risk; and (5) evaluation, discussions of
adequacy of response, consensus about lessons, and new understandings of risks.
CERC advocates six principles of effective risk and crisis communication.
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