Austin S. Babrow

From "reducing" to "coping with" uncertainty: reconceptualizing the central challenge in breast self-exams.

An ideology of uncertainty reduction pervades scholarly and popular discourse on breast self-exams (BSE). Women are encouraged to understand BSE as an activity that reduces uncertainty about their health. Moreover, uncertainties about the procedure itself are conceived as barriers to BSE. In turn, reducing these uncertainties is seen as the key to promoting BSE. We argue that the ideology of uncertainty reduction is both descriptively and prescriptively inadequate and potentially a threat to womens health. We further contend the ideology should be replaced by a framework that illuminates processes of coping with uncertainty. Several major characteristics of such a framework, as well as implications for medical practice, are discussed and illustrated within the context of BSE.

Dialysis patients' preferences for family-based advance care planning.

Patients generally do not want to participate in advance care planning with physicians. On the basis of face-to-face interviews with dialysis patients, this study found that most patients wanted to...

Social support messages and the management of uncertainty in the experience of breast cancer: An application of problematic integration theory

This article synthesizes past studies of illness, stress, coping, and social support and offers a model of communicative support, based on problematic integration theory, that emphasizes two major dimensions of meaning in the breast cancer experience. The model suggests that supportive messages are designed to help the breast cancer patient manage both perceptions of the likelihood (e.g., uncertainty) of various illness experiences and evaluations of those experiences. Support messages are designed to facilitate coping by reducing, maintaining, or increasing the supportees level of uncertainty; variations in message design are expected to be related to perceptions of the supportees pre‐message uncertainty about and evaluation of the potential experience. These expectations were tested by asking breast cancer patients to formulate supportive messages in response to several hypothetical scenarios. The same patients were then asked to judge the likely junction of their messages. These judgments were assess...

The Role of Empathy in Responses to Persuasive Risk Communication: Overcoming Resistance to HIV Prevention Messages

This article offers a theoretical analysis of the role of empathy as a key mediator of the suasive effects of health messages, and it discusses the testing of an empirical tool for studying the state of empathy in responses to persuasive messages. It is argued that felt empathy evokes cognitive and emotional processing conducive to important health-promoting responses. This assertion was tested by operationalizing empathy as a response state via a new measure, the Empathy Response Scale (ERS). Two pilot tests and one major study, all set in the challenging area of HIV/AIDS prevention, provided preliminary data supporting the theoretical analysis and the ERS as a measure of the state of empathy. The article concludes with discussions of directions for future tests of the empathy theory and scale, as well as applications of the current framework for developing persuasive messages.

Student motives for watching soap operas

Soap operas recently have begun to receive scholarly attention commensurate with their importance. Despite the ascendancy in the number of shows produced to attract a younger audience, reasons for exposure remain unclear, especially for student viewing. This investigation used two alternative procedures to elicit motives. It identified 16 categories, reported their prevalence in two data sets, and considered the degree of convergence in findings of the two procedures. The diversity of motives and the resultant implications for subgroup analyses also were discussed.

Communication and problematic integration: Milan Kundera's “lost letters” in the book of laughter and forgetting

This essay uses the theory of problematic integration to analyze Milan Kunderas writing, particularly the central segment, entitled “Lost Letters,” in his first novel written as an emigre. The theory is concerned with the role of communication when desires and expectations diverge, or when we face ambiguity, ambivalence, or impossibility (i.e., when it is difficult to integrate evaluative and probabilistic orientations). Communication plays many significant roles in experiences with such difficulties. The essay reviews problematic integration theory and presents a case study of Kunderas writing designed to illuminate both the theory and a work by one of the most significant of modern novelists. The essay concludes by discussing the relevance of problematic integration theory to other approaches to the study of communication and by identifying questions for future communication research.

Disentangling Antecedents of Audience Exposure Levels: Extending Expectancy-Value Analyses of Gratifications Sought from Television News.

This work extends previous applications of expectancy‐value theory to gratifications research in a study of student exposure to television news. It offers several conceptual refinements, a more complete account of the system of forces in which the central constructs operate, and illustrates methods of analysis more suited to emerging theory. The present findings suggest that expectancy‐value and gratification‐seeking orientations are highly related but distinctly different judgments. In the context of television news viewing, the former influence intentions and exposure levels through their impact on attitude, whereas the latter appear to have more direct effects on both intention and exposure levels. The report concludes with a brief discussion of issues in research on emotion‐cognition and problems in attitude scaling as they relate to the present findings and possible future extensions.

An Expectancy-Value Analysis of the Student Soap Opera Audience

Soap operas constitute the most popular form of daytime television. Students are a large portion of the soap opera audience. The reasons for high student interest are unclear, however. The present investigation uses expectancy-value theory to untangle student perceptions of soap opera viewing, and it weaves these perceptions into the broader fabric of social psychological forces behind viewing levels. Among other things, the study indicates that desires for learning and romantic fantasy play little role in determining student exposure levels, whereas anticipated entertainment and social interaction are powerful expectations. Affective and cognitive factors mediate the effects of these expectations, however. Self-concept also plays a major role in determining exposure levels.

From coping with life to coping with death: problematic integration for the seriously ill elderly.

Decisions made by and for elderly patients nearing death frequently perpetuate unwanted suffering and dependence. This article extends the argument that Babrows (1992, 1995) problematic integration theory can provide insights into why communication fails to produce desired outcomes for such patients. Open-ended responses obtained in face-to-face interviews with 142 elderly dialysis patients and mailed surveys of 393 dialysis unit nurses were examined to better understand how patients and nurses reconciled incompatible probabilistic and evaluative judgments. Results indicate that patients seek information that will enable them to cope with debilitating dialysis treatments rather than information nurses believe is necessary for them to make informed choices about whether to undergo such treatments. The tension between the information patients want to successfully cope with life and the information they need to decide intelligently about treatments that forestall death constitutes a key reason why communication about end-of-life issues is frequently flawed. Our analysis of these communication flaws leads to specific recommendations for how this tension can be eased, which in turn may better prepare patients to make the transition from coping with life to coping with death.

Identification of Campaign Recruitment Strategies for a Stepped Smoking Cessation Intervention for a College Campus

A rapprochement of the Stepped Approach Model of health care delivery and Ajzens Theory of Planned Behavior was used to identify campaign recruitment strategies for a stepped smoking cessation intervention for a college campus. The study examines outcome expectancies, outcome evaluations, and interest in participating in smoking cessation programs presented in graduated steps of intervention intensity. Telephone surveys were conducted with a probability sample of 191 student smokers. A significant negative trend indicates that the steps are ordered cost-effectively. Scheffé a posteriori tests also reveal that interest in Step 1 (pamphlets and brochures) was significantly higher than interest in any other step, including those representing traditional health care services (i.e., groups and individual treatments). The two strongest predictors of interest in each step were attitudes about participation and control beliefs; normative expectations about program participation discriminated between respondents with high or low interest in Steps 2 through 5. It was concluded that attitudes and control beliefs should be the focus of initial program promotion for college smoking cessation campaigns. Emphasis on attitudes, control beliefs, and especially perceived norms could be helpful in advancing unsuccessful participants to the next more intensive program in a stepped intervention.