Understanding the audience in framing research: empirical evidence from three studies examining HIV framing in China.

Guided by framing theory, this three-phase mixed-methods study explored (a) how Chinese government-sponsored newspapers frame HIV and (b) framing effects on people's HIV beliefs. A content analysis of two government-sponsored newspapers and a survey of 210 readers showed discrepancies in frame and frame valence. In-depth follow-up interviews with 15 media and public health experts revealed that the discrepancies were related to people's attitudes toward the media and beliefs about HIV, which could further be explained by the political environment, media ecology, historical framing, and cultural identities in China.

Oncologists' Perceptions of Strategies for Discussing the Cost of Care with Cancer Patients and the Meaning of Those Conversations.

To better understand what makes cost-of-care communication between oncologists and cancer patients more or less successful, we conducted in-depth interviews with 32 oncologists (22 male, 10 female) who were board-certified in medical, surgical, or radiation oncology. Through qualitative descriptive analysis by four coders, we found that oncologists used six broad strategies to discuss cost with patients: open discussion, avoidance, reassurance, warning, outsourcing, and educating. We also found that oncologists invoked certain meanings of cost conversations: cost conversations as holistic care, coercion, a matter of timing, risking patient suspicions, advocacy, unwanted distraction, transparency, bad news delivery, problem-solving, pointless, informed decision making, or irrelevant.

Patients' attitudes toward deprescribing and their experiences communicating with clinicians and pharmacists.

Purpose: Developing effective deprescribing interventions relies on understanding attitudes, beliefs, and communication challenges of those involved in the deprescribing decision-making process, including the patient, the primary care clinician, and the pharmacist. The objective of this study was to assess patients' beliefs and attitudes and identify facilitators of and barriers to deprescribing.

Methods: As part of a larger study, we recruited patients ⩾18 years of age taking ⩾3 chronic medications.

Examining gain- and loss-framed messages in a novel breast cancer screening/cardiovascular context: Does framing matter?

Objective: Digital mammography can reveal not only breast cancer but also breast arterial calcification (BAC), which can indicate potential coronary artery disease. To explore ways to inform women of their BAC status in the context of a standard mammography results letter, we conducted a preliminary study comparing gain- and loss-framed messages to encourage follow-up cardiovascular care.

Methods: U.

Evaluation of a medication optimization intervention and predictors of medication adherence, patient satisfaction and medication adverse events in patients with rheumatoid arthritis.

Background: Because effective treatment for rheumatoid arthritis (RA) is dependent on medication use, medication optimization is critically important. Medication adherence, patient satisfaction with care and medication adverse events are core concepts of medication optimization that are either a significant problem and/or understudied in patients with RA.

Objective: To (1) evaluate treatment effects from a medication optimization intervention; (2) assess treatment differences and changes over time in medication adherence, patient satisfaction, and medication adverse events; and (3) to determine whether age, gender, provider trust, and disease activity affect these outcomes.

Competencies for Health Communication Specialists: Survey of Health Communication Educators and Practitioners.

For more than two decades, health communication educators and practitioners have been working toward establishing a competency model to guide health communication education. This article reports the results of a survey to identify competencies for health communication specialists with master's degrees. To prepare the survey, a working group drafted a competency list through reviewing the literature and soliciting feedback from attendees at a professional society meeting, resulting in lists of items reflecting 18 knowledge domains, 11 skill sets, and 14 application bundles labeled "abilities.

Are Cost-of-Care Conversations Best Practice? A Qualitative Study of Oncologists' Attitudes and Practice.

Purpose: Patients' desire for cost conversations exceeds the incidence of such conversations, and many oncologists report avoiding cost conversations despite reporting willingness to have them. Our objective was to examine oncologists' attitudes toward cost conversations and how those attitudes affect practice.

Methods: An experienced investigator conducted individual interviews with oncologists practicing in Kentucky.

A Model of Determinants Influencing the Development of Child and Adolescent Psychiatrist Self-efficacy for Discussing Substance Use with Patients.

Child and adolescent psychiatrists are well situated to have meaningful conversations with a population at high risk of substance use: youth receiving psychiatric care. However, there has been a dearth of research about behavioral determinants that may influence psychiatrists' willingness to engage in these discussions. This study proposes a model of determinants to help identify influences on psychiatrists' levels of self-efficacy, which theoretically should predict their discussions about substance use.

On Changing Beliefs in the Closed Human Mind.

About a hundred years ago, the world was faced with a pandemic that would ultimately infect 500 million people and kill 50 million. Today, we face a potentially similar situation. Although at times like these, the discipline of communication is essential to promoting public health and welfare through its knowledge of persuasive messaging and mass communication campaigns, to increase our effectiveness, we need to be more aware of and better account for the influence of political ideology on response to messaging.

Identifying Conversational Strategies for Psychiatrists in Discussing Substance Use with Adolescent Patients.

Child and adolescent psychiatrists are uniquely positioned to discuss substance use with high risk patients; however, there has been little research about these conversations and their characteristics. To identify communication strategies for navigating conversations about substance use with adolescent patients, we conducted 21 in-depth interviews with practicing child and adolescent psychiatrists. Findings from this study identify four strategies that child and adolescent psychiatrists reported as being successful: expressing empathy, avoiding resistance, honoring autonomy, and managing family involvement.

Intention to Behavior: Using the Integrative Model of Behavioral Prediction to Understand Actual Control of PrEP Uptake Among Gay Men.

PrEP is an effective daily prevention medicine used to reduce risks of HIV infections. Previous research has pointed out the intention-behavior gap on PrEP uptake among gay men. The current study built on research examining how the integrative model of behavioral prediction (IMBP) factors influences PrEP uptake among gay men to explore how actual control variables, namely skills and environmental constraints, moderated the intention-behavior relationship.

Working toward evidence-based guidelines for cost-of-care conversations between patients and physicians: A systematic review of the literature.

Rationale: As healthcare costs continue to rise, so does the importance of having cost-of-care conversations during medical office visits, especially for patients from vulnerable populations and patients with high-cost illnesses such as cancer. Such conversations remain relatively rare, however, even though physicians and patients say they want to have them. Furthermore, there is a lack of evidence-based guidelines for encouraging cost conversations and improving their quality.

Uncertainty Management and Decision Making: Parents' Experiences During their First Visit to a Multidisciplinary Clinic for their Child's Vascular Anomaly.

Purpose: To gain a better understanding of parental decision making in situations of uncertainty and multidisciplinary care, we explored parents' decision-making experiences while seeking care for their child's vascular anomaly at a multidisciplinary clinic at a large Midwestern children's hospital.

Design And Methods: We collected data using semi-structured interviews with 29 parents after they met with multiple specialists for the care of their child's vascular anomaly.

Results: The findings revealed parents' attempts to manage decision-related uncertainty about their child's vascular anomaly included seeking information, avoiding information, and seeking support from the specialists.

Primary Care Physicians' Strategic Pursuit of Multiple Goals in Cost-of-Care Conversations with Patients.

Despite the importance of cost-of-care conversations between physicians and patients, such discussions are not well understood. We used multiple goals theory to examine the specific goals that are salient in these discussions and how physicians pursue these goals. We used qualitative descriptive coding to analyze the verbatim transcripts from in-depth interviews with 36 primary care physicians.

Communication apprehension mediates the effects of past experience discussing substance use on child and adolescent psychiatrists' self-efficacy.

Objective Child and Adolescent Psychiatrists (CAPs) treat patients who are at an increased risk of developing a substance use disorder in their lifetime. However, CAPs often experience apprehension when it comes to discussing substance use with their patients, and this apprehension may come from past experiences when these discussions have gone poorly. This study seeks to understand whether or not apprehension moderates the relationship between past experiences and self-efficacy for CAPs when discussing substance use with their patients.

Using the integrative model of behavioral prediction to understand college students' STI testing beliefs, intentions, and behaviors.

Objectives: To identify salient behavioral determinants related to STI testing among college students by testing a model based on the integrative model of behavioral (IMBP) prediction.

Participants: 265 undergraduate students from a large university in the Southeastern US.

Methods: Formative and survey research to test an IMBP-based model that explores the relationships between determinants and STI testing intention and behavior.

Using the Theory of Planned Behavior to Guide Focus Group Development of Messages Aimed at Increasing Compliance With a Tobacco-Free Policy.

Purpose: This study details the persuasive message development for a theory-based campaign designed to increase compliance with a university's tobacco-free policy.

Approach: The theory of planned behavior (TPB) guided message design and evaluation for focus group-tested messages that were adapted to the context of complying with a tobacco-free policy.

Setting: The study was conducted at a university located in the tobacco belt.

Communication and the Appraisal of Uncertainty: Exploring Parents' Communication with Credible Authorities in the Context of Chronic Childhood Illness.

Individuals with chronic illnesses must manage long-term uncertainty as they cope with the ways the illness influences their lives. In the context of pediatric illnesses, parents must manage uncertainty during the diagnosis and treatment of their child's illness. It is common for children with complex chronic illnesses to see multiple specialists for the treatment of their condition.

Nurse Handoff Communication.

Objective: To describe the communication behaviors identified by nurses as key to a competent patient handoff at change of shift.

Data Sources: Qualitative analysis of nurse descriptions of best and worst handoffs from the incoming and outgoing nursing perspective.

Conclusion: Competent, quality nursing handoffs include specific information exchange and socioemotional (relational) communication behaviors.

Using the Integrative Model of Behavioral Prediction to Understand College Students' Hookup Sex Beliefs, Intentions, and Behaviors.

Guided by the integrated model of behavioral prediction, this study explored the attitudinal, normative, and perceived control beliefs that predict college student hookup intentions and behavior. We first conducted elicitation research with six focus groups of undergraduate students to identify salient beliefs to inform questionnaire development, and then we collected and analyzed questionnaire data from 268 undergraduate students to explore the direct and indirect determinants that drive hookup behaviors. We compared proposed models that tested separate paths from determinants to intention and behavior to theoretical models that treated intention as a mediator of the determinant-behavior relationship.

Rethinking Risk: Prospect Theory Application in Health Message Framing Research.

Although prospect theory conceptualizes risk as uncertainty, health message framing research based on the theory typically conceptualizes risk as severity. This study reports the results of two experiments designed to explore these alternative conceptualizations of risk and their effect on health decision making. Participants (N = 768, N = 532) were randomly assigned to one of four conditions that presented a hypothetical scenario of a sexually transmitted disease (STD) outbreak.

Programmatic research to increase the effectiveness of health communication campaigns.

This article reviews a long program of research designed to investigate ways to increase the effectiveness of televised antidrug public service announcements. The review highlights the importance of audience targeting (adolescent and young adult high sensation seekers) and message design (message sensation value) in campaign research. It also emphasizes the role of theory and evaluation in programmatic research.

Introduction to the special issue: message design in health communication research.

Message design is one of the most complex and vibrant research areas in the communication discipline. Based on the preconference of the 2014 Kentucky Conference on Health Communication, this special issue of Health Communication is focused on a broad range of message design concerns. It features 10 original articles addressing topics ranging from fundamental questions related to theory and method to questions of message adaptation for translation and dissemination.