Kate Magsamen-Conrad

Assessing Health Diagnosis Disclosure Decisions in Relationships: Testing the Disclosure Decision-Making Model

Illness affects millions of Americans each year, and the disclosure of health conditions can facilitate access to social support, in addition to other physical and physiological benefits. This article tests the Disclosure Decision-Making Model (DD-MM; Greene, 2009) to predict factors that influence the likelihood of disclosing (and past disclosure of) nonvisible physical or mental health-related information. One hundred eighty-seven (n = 187) people were recruited for a study to report on both disclosing and not disclosing a nonvisible health condition. Measured variables included information assessment, relational quality, anticipated reactions (support, relational consequences), confidence in response, disclosure efficacy, and disclosure (likelihood of disclosure and depth of disclosure). Structural equation modeling results supported many of the proposed hypotheses, with a great deal of similarity across models. Specifically, assessing information predicted efficacy, and to some extent relational outcomes. Closeness was related to response overall and to efficacy in one model. Response predicted outcome overall and likelihood of disclosure in one model. Finally, efficacy predicted likelihood of disclosure and depth of disclosure. The article discusses the implications of the findings for understanding information, relationship assessments, and efficacy in disclosing health diagnoses.

Patients' and Partners' Perspectives of Chronic Illness and Its Management

This study is framed in theories of illness uncertainty (Babrow, A. S., 2007, Problematic integration theory. In B. B. Whaley & W. Samter (Eds.), Explaining communication: Contemporary theories and exemplars (pp. 181-200). Mahwah, NJ: Erlbaum; Babrow & Matthias, 2009; Brashers, D. E., 2007, A theory of communication and uncertainty management. In B. B. Whaley & W. Samter (Eds.), Explaining communication: Contemporary theories and exemplars (pp. 201-218). Mahwah, NJ: Erlbaum; Hogan, T. P., & Brashers, D. E. (2009). The theory of communication and uncertainty management: Implications for the wider realm of information behavior. In T. D. Afifi & W. A. Afifi (Eds.), Uncertainty and information regulation in interpersonal contexts: Theories and applications, (pp. 45-66). New York, NY: Routledge; Mishel, M. H. (1999). Uncertainty in chronic illness. Annual Review of Nursing Research, 17, 269-294; Mishel, M. H., & Clayton, M. F., 2003, Theories of uncertainty. In M. J. Smith & P. R. Liehr (Eds.), Middle range theory for nursing (pp. 25-48). New York, NY: Springer) and health information management (Afifi, W. A., & Weiner, J. L., 2004, Toward a theory of motivated information management. Communication Theory, 14, 167-190. doi:10.1111/j.1468-2885.2004.tb00310.x; Greene, K., 2009, An integrated model of health disclosure decision-making. In T. D. Afifi & W. A. Afifi (Eds.), Uncertainty and information regulation in interpersonal contexts: Theories and applications (pp. 226-253). New York, NY: Routledge) and examines how couples experience uncertainty and interference related to one partners chronic health condition. Specifically, a model is hypothesized in which illness uncertainty (i.e., stigma, prognosis, and symptom) and illness interference predict communication efficacy and health condition management. Participants include 308 dyads in which one partner has a chronic health condition. Data were analyzed using structural equation modeling. Results indicate that there are significant differences in (a) how patients and partners experience illness uncertainty and illness interference and (b) how appraisals of illness uncertainty and illness interference influence communication efficacy and health condition management. We discuss the findings and implications of the study.

Technology addiction's contribution to mental wellbeing

This research examines the effect of online social capital and Internet use on the normally negative effects of technology addiction, especially for individuals prone to self-concealment. Self-concealment is a personality trait that describes individuals who are more likely to withhold personal and private information, inhibiting catharsis and wellbeing. Addiction, in any context, is also typically associated with negative outcomes. However, we investigate the hypothesis that communication technology addiction may positively affect wellbeing for self-concealing individuals when online interaction is positive, builds relationships, or fosters a sense of community. Within these parameters, increased communication through mediated channels (and even addiction) may reverse the otherwise negative effects of self-concealment on wellbeing. Overall, the proposed model offers qualified support for the continued analysis of mediated communication as a potential source for improving the wellbeing for particular individuals. This study is important because we know that healthy communication in relationships, including disclosure, is important to wellbeing. This study recognizes that not all people are comfortable communicating in face-to-face settings. Our findings offer evidence that the presence of computers in human behaviors (e.g., mediated channels of communication and NCTs) enables some individuals to communicate and fos ter beneficial interpersonal relationships, and improve their wellbeing.

“You can't tell anyone but …”: Exploring the Use of Privacy Rules and Revealing Behaviors

This three-part study examines how privacy rules function to protect shared information from further revelation. Communication Privacy Management served as a theoretical framework to investigate issues related to boundary management. In the pilot study, college students (N = 409) described privacy rules and their use, and participants reported not further revealing the information when privacy rules were expressed by disclosers. In Study 1, participants (N = 167) reported on disclosing health-related information, and participants did not anticipate that recipients would further reveal especially when they used a privacy rule. In Study 2, dyads (dyad N = 257) reported on shared disclosure experiences, including both anticipated and actual boundary management. Study 2 findings include that privacy rules have limited effectiveness. The article discusses implications of privacy rule use when sharing private information.

Life-span differences in the uses and gratifications of tablets

This study extends Uses and Gratifications theory by examining the uses and gratifications of a new technological device, the tablet computer, and investigating the differential uses and gratifications of tablet computers across the life-span. First, we utilized a six-week tablet training intervention to adapt and extend existing measures to the tablet as a technological device. Next, we used paper-based and online surveys (N=847), we confirmed four main uses of tablets: 1) Information Seeking, 2) Relationship Maintenance, 3) Style, 4) Amusement and Killing time, and added one additional use category 5) Organization. We discovered differences among the five main uses of tablets across the life-span, with older adults using tablets the least overall. Builders, Boomers, GenX and GenY all reported the highest means for information seeking. Finally, we used a structural equation model to examine how uses and gratifications predicts hours of tablet use. The study provides limitations and suggestions for future research and marketers. In particular, this study offers insight to the relevancy of theory as it applies to particular information and communication technologies and consideration of how different periods in the life-span affect tablet motivations.

Decision Making in Cancer-Related Topic Avoidance

In this article, the authors use the Disclose Decision-Making Model to explore cancer-related topic avoidance among cancer patients and their partners. Participants include 95 dyads in which 1 partner had been diagnosed and/or treated for cancer. Variables of interest include death-, future-, sexuality-, and burden-related topic avoidance and dimensions of the Disclosure Decision-Making Model including information assessment, receiver assessment, relational quality, and discloser efficacy. Data were analyzed using linear regressions. Findings suggest that lack of reciprocity and efficacy are predictors of topic avoidance. The authors discuss implications of findings and suggests direction for future research.

A dyadic approach: applying a developmental-conceptual model to couples coping with chronic illness.

The purpose of the present study was to apply Berg and Upchurch’s developmental-conceptual model toward a better understanding of how couples cope with chronic illness. Specifically, a model was hypothesized in which proximal factors (relational quality), dyadic appraisal (illness interference), and dyadic coping (partner support) influence adjustment (health condition management). The study was cross-sectional and included 308 dyads in which one partner has a chronic health condition. The actor partner interdependence model shows how congruence and noncongruence in relational quality, dyadic appraisal, and dyadic coping influence dyadic adjustment.

“Drinking Won't Get You Thinking”: A Content Analysis of Adolescent-Created Print Alcohol Counter-advertisements

Involvement in creating antialcohol advertisements generates enthusiasm among adolescents; however, little is known about the messages adolescents develop for these activities. In this article, we present a content analysis of 72 print alcohol counteradvertisements created by high school (age 14–17 years old) and college (18–25 years old) students. The posters were content analyzed for poster message content, persuasion strategies, and production components, and we compared high school and college student posters. All of the posters used a slogan to highlight the main point/message of the ad and counterarguments/consequences to support the slogans. The most frequently depicted consequences were negative consequences of alcohol use, followed by negative–positive consequence comparison. Persuasion strategies were sparingly used in advertisements and included having fun/one of the gang, humor/unexpected, glamour/sex appeal, and endorsement. Finally, posters displayed a number of production techniques including depicting people, clear setting, multiple colors, different font sizes, and object placement. College and high school student-constructed posters were similar on many features (e.g., posters displayed similar frequency of utilization of slogans, negative consequences, and positive–negative consequence comparisons), but were different on the use of positive consequences of not using alcohol and before–after comparisons. Implications for teaching media literacy and involving adolescents and youth in developing alcohol prevention messages are discussed.

Perceived Benefits and Drawbacks of Disclosure Practices: An Analysis of PLWHAs’ Strategies for Disclosing HIV Status

People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non–face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.

Improving Prevention Curricula: Lessons Learned Through Formative Research on the Youth Message Development Curriculum

This article describes formative research (a pilot study, interviews, and focus groups) conducted as part of a feasibility test of 2 versions (Analysis vs. Planning) of a brief media literacy intervention titled Youth Message Development (YMD). The intervention targets high school student alcohol use with activities to understand persuasion strategies, increase counter-arguing, and then apply these new skills to ad analysis or a more engaging ad poster planning activity. Based on the theory of active involvement (Greene, 2013), the Planning curriculum is proposed to be more effective than the Analysis curriculum. Overall, results of the formative research indicated that students (N = 182) and mentors/teachers (N = 53) perceived the YMD Planning curriculum as more interesting, involving, and novel, and these ratings were associated with increased critical thinking about the impact of advertising, lower alcohol use intentions, and fewer positive expectations about the effects of alcohol use. Qualitative feedback indicated a need to supplement alcohol-focused ad stimuli with ads targeting other advertising images, use incentives and competition-based activities to further enhance student motivation, and provide flexibility to enhance the appropriateness of the curriculum to various settings. These concerns led to the development of a revised curriculum and plans for further study.