Rachel A. Smith

A meta-analysis of disclosure of one's HIV-positive status, stigma and social support

Abstract This study provides an analysis of the relationships among perceived stigma, reported disclosure and perceived social support for those living with HIV. The meta-analytic summary of 21 studies (4104 participants) showed, as predicted, a positive, heterogeneous correlation between disclosure and social support (ŕ=.159), a negative, heterogeneous correlation between stigma and social support (ŕ=−.344) and a negative, homogenous correlation between stigma and disclosure (ŕ=−.189). The heterogeneity of the first two relationships indicates the presence of moderators, which may include participants’ age and publications’ year.

Media depictions of health topics: Challenge and stigma formats

This article explored the notion that media depictions of health concerns come in one of two formats: challenge and stigma. After explicating the five features that should appear in challenge format and the seven features of stigma formats, we analyzed the content of health messages in magazines, brochures, and posters (n = 75) in a metropolitan area. The results of a two-factor confirmatory factor model showed that the five suggested features for challenge formats did, indeed, appear together (alpha = .76), and the seven features for stigma formats, also, appeared together (alpha = .90), and showed no residual relationship. In other words, the results suggest that media depictions of health topics appear in either challenge or stigma formats (r = − .87). Health issues appearing in magazine advertisements and articles presented messages in challenge formats, while brochures and posters from largely nonprofit and government groups depicted health issues in stigma formats. Some health topics appeared most often in challenge formats (including cancer, heart disease, and scoliosis), while others appeared in stigma formats (including tuberculosis, hepatitis, smoking, and sexually transmitted diseases [STDs]). Findings suggest that media depictions of health differ, and the implications of stigma and challenge formats are discussed.

Drama Theory and Entertainment Education: Exploring the Effects of a Radio Drama on Behavioral Intentions to Limit HIV Transmission in Ethiopia

This study investigated a model of entertainment education that combined drama theory (Kincaid, 2002) and social cognitive theory (Bandura, 1986) and tested it in a field study of a government-sponsored health campaign in Ethiopia. Specifically, we explored if the relationships between reported exposure to the Journey of Life radio drama and intentions to practice at least one behavior to prevent HIV transmission (abstinence, monogamy, or condom use) were mediated by emotional involvement, character identification, and perceived efficacy. As listeners (n=126) reported listening to more episodes of the radio serial drama, they identified more with the female protagonist and felt more emotionally involved in the drama. In turn, they reported stronger perceptions of personal efficacy in HIV prevention behaviors, and consequently, reported stronger intentions to practice at least one prevention behavior. Additionally, identification with another character, one who contracts HIV due to noncompliance with these behaviors, correlated positively with stronger behavioral intentions. The results of this study indicate that both drama theory and social cognitive theory explain behavioral intentions.

Antibiotic resistance: a primer and call to action.

During the past century, discoveries of microorganisms as causes of infections and antibiotics as effective therapeutic agents have contributed to significant gains in public health in many parts of the world. Health agencies worldwide are galvanizing attention toward antibiotic resistance, which is a major threat to public health (Centers for Disease Control and Prevention, 2013; World Health Organization, 2014). Some life scientists believe that we are approaching the post-antibiotic age (Davies & Davies, 2010). The growing threat of antimicrobial resistance is fueled by complex factors with biological, behavioral, and societal aspects. This primer provides an overview of antibiotic resistance and its growing burden on public health, the biological and behavioral mechanisms that increase antibiotic resistance, and examples of where health communication scholars can contribute to efforts to make our current antibiotic drugs last as long as possible. In addition, we identify compelling challenges for current communication theories and practices.

The Impact of Video Streaming on Mathematics Performance

Relying on a series of four experiments, F. J. Boster, G. S. Meyer, A. J. Roberto, C. Inge, and R. E. Strom (2006) demonstrated that students exposed to videostreaming exhibited more improvement in examination performance than control students. In extension, this study tests the effect of using videostreaming with a very different topic (mathematics), with a very different student population (large urban), and with different grades (sixth and eighth). The results replicated Boster et al. (2006) and indicate that the mean examination performance for those in the video-streaming condition exceeds the mean examination performance of the control group.

“Psst … What Do You Think?” The Relationship between Advice Prestige, Type of Advice, and Academic Performance

This study investigates the relationship between classmates seeking out a student for advice (advice prestige) and that students academic performance. Students’ conversations could inhibit or encourage their academic performance depending on the conversations topic. Specifically, it is hypothesized that as more classmates report asking a student for general advice, then the student would perform less well. In contrast, it is hypothesized that as more classmates report asking a student for class advice, then the student would perform better. Hypotheses (n =139) were supported. Even after controlling for sex and GPA, less general-advice prestige and higher class-advice prestige relates to higher academic performance.

Surveillance considerations for malaria elimination.

Constant malaria monitoring and surveillance systems have been highlighted as critical for malaria elimination. The absence of robust monitoring and surveillance systems able to respond to outbreaks in a timely manner undeniably contributed to the failure of the last global attempt to eradicate malaria. Today, technological advances could allow for rapid detection of focal outbreaks and improved deployment of diagnostic and treatment supplies to areas needing support. However, optimizing diffusion activities (e.g., distributing vector controls and medicines, as well as deploying behaviour change campaigns) requires networks of diverse scholars to monitor, learn, and evaluate data and multiple organizations to coordinate their intervention activities. Surveillance systems that can gather, store and process information, from communities to national levels, in a centralized, widely accessible system will allow tailoring of surveillance and intervention efforts. Different systems and, thus reactions, will be effective in different endemic, geographical or socio-cultural contexts. Investing in carefully designed monitoring technologies, built for a multiple-acter, dynamic system, will help to improve malaria elimination efforts by improving the coordination, timing, coverage, and deployment of malaria technologies.

Label Management: Investigating How Confidants Encourage the Use of Communication Strategies to Avoid Stigmatization

In modified labeling theory, Link and colleagues (1987, 1989) explicate how people use communication to cope with being labeled as members of a stigmatized group. In this paper, we change perspectives and investigate how a confidants awareness of discrimination and devaluation associated with being labeled as a member of a stigmatized group (“mentally ill” or “smoker”) motivates him or her to encourage a labeled loved one to engage in secrecy, withdrawal, or education to avoid the adverse actions associated with stigmatization. Results showed that a model of relationships among perceived devaluation and discrimination, coping strategies, and future disclosures extended well to unexpected confidants of a labeled loved one. This advice included encouraging the labeled loved one not to tell different people about their condition, which included health care providers. These findings also showed that people with experience in the labeling condition may have particular concern about stigmatization or rejection from different types of listeners, including close friends and health care providers.

Defining Genes Using “Blueprint” Versus “Instruction” Metaphors: Effects for Genetic Determinism, Response Efficacy, and Perceived Control

Evidence supports mixed attributions aligned with personal and/or clinical control and gene expression for health in this era of genomic science and health care. We consider variance in these attributions and possible relationships to individual mind sets associated with essentialist beliefs that genes determine health versus threat beliefs that genes increase susceptibility for disease and severity linked to gene–environment interactions. Further, we contribute to theory and empirical research to evaluate the use of metaphors to define genes. Participants (N = 324) read a message that varied the introduction by providing a definition of genes that used either an “instruction” metaphor or a “blueprint” metaphor. The “instruction” metaphor compared to the “blueprint” metaphor promoted stronger threat perceptions, which aligned with both belief in the response efficacy of genetic research for health and perceived behavioral control linked to genes and health. The “blueprint” metaphor compared to the “instruction” metaphor promoted stronger essentialist beliefs, which aligned with more intense positive regard for the efficacy of genetic research and human health. Implications for health communicators include societal effects aligned with stigma and discrimination that such findings portend.

An Experimental Test of Stigma Communication Content with a Hypothetical Infectious Disease Alert

Recent interest in the role of communication in stigma creation, diffusion, and copying has inspired theorizing. This study presents the first empirical test of one model of stigma communication (Smith, 2007), with a hypothetical infectious disease alert. This study uses an experiment (N=333) to illustrate how changing several words and monitoring four cognitive and affective reactions and a personality trait becomes predictive of almost half (R 2=.49) of the variance in support for intervention policies, including removing and isolating infected persons, forcing treatment, and generating a publicly accessible map of infected persons. Message content and reactions also predicted perceptions of normative stigma beliefs toward infected persons (R 2=.26) and the likelihood of disseminating content of the alert to others (R 2=.15). Results generally support the model of stigma communication and indicate places for refinement.