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Health care providers and consumers use their abilities to communicate to generate, access, and exchange relevant health information for making important treatment decisions, for adjusting to changing health conditions, and for coordinating health preserving activities. The process of communication also enables health promotion specialists to develop persuasive messages for dissemination over salient channels to provide target audiences with relevant health information to influence their health knowledge, attitudes, and behaviors.

While communication is certainly a powerful process in health care, the dynamics of communication in health contexts are also very complex, the communication channels used are numerous, and the influences of communication on health outcomes are powerful. Health communication inquiry has developed to demystify the complexity of the multifaceted roles performed by communication in health care and health promotion. Such inquiry is conducted to increase knowledge about the influences of communication on health outcomes and direct the knowledge gained toward helping participants in the modern health care system use communication strategically to accomplish their health goals.

The Complexity of Health Communication Inquiry Health communication is an extremely broad research area, examining many different levels and channels of communication in a wide range of social contexts. The primary levels for health communication analysis include intrapersonal, interpersonal, group, organizational, and societal communication.

Contributions

Intrapersonal health communication inquiry examines the internal mental and psychological processes that influence health care, such as the health beliefs, attitudes, and values that predispose health care behaviors and decisions. Group health communication inquiry examines the role communication performs in the interdependent coordination of members of collectives, such as health care teams, support groups, ethics committees, and families, as these group members share relevant health information for making important health care decisions.

Organizational health communication inquiry examines the use of communication to coordinate interdependent groups, mobilize different specialists, and share relevant health information within complex health care delivery systems to enable effective multidisciplinary provision of health care and prevention of relevant health risks. Societal health communication examines the generation, dissemination,and utilization of relevant health information communicated via diverse media to a broad range professional and lay audiences to promote health education, health promotion, and enlightened health care practice.

Health communication inquiry involves examination of a broad range of communication channels. Face-to-face communication between providers and consumers, members of health care teams, and support group members are the focus of many health communication studies. A broad range of personal telephone, mail, fax, e-mail and mass radio, television, film, billboards communication media are also the focus of health communication inquiry. Increasingly, the use of new communication technologies are also examined as important health communication media.

The settings for health communication inquiry are also quite diverse. They include all of the settings where health information in generated and exchanged, such as homes, offices, schools, clinics, and hospitals. Two Competing Perspectives in Health Communication Inquiry There are two major interdependent branches of inquiry in the field of health communication. The first is the "health care delivery" branch.

The health care delivery scholars examine how communication influences the delivery of health care. The second is the "health promotion" branch; the health promotion scholars study the persuasive use of communication messages and media to promote public health. These two branches of the health communication field parallel a division found within the larger discipline of communication between academic interest in human and in mediated communication.

The health promotion branch has attracted many mass communication scholars who are concerned with the development, implementation and evaluation of persuasive health communication campaigns to prevent major health risks and promote public health. Many health promotion scholars are also concerned with evaluating the use of mediated channels of communication to disseminate relevant health information, as well as in examining the ways that health and health care are portrayed by popular media.

Unfortunately, many of the scholars representing the two branches of the field of health communication health care delivery and health promotion have perceived themselves as being in direct competition with each other for institutional resources, numbers of conference programs, journal space, and research grants.

Yet, this competition has begun to diminish as more health communication scholars have started working in both of these areas, as health care delivery systems have begun utilizing an increasingly broader range of human and mediated channels of communication in areas such as telemedicine, health care marketing, and health education , and as health promotion specialists have enlisted more interpersonal support groups, personal appeals, family involvement programs and macrosocial neighborhood, workplace, and government interventions health promotion strategies in recent years.

Over time these two branches of the health communication field should continue to grow closer together and eventually merge. The merging of these two areas will be most advantageous because health care delivery and health promotion are closely related activities. Health promotion must be recognized as a primary professional activity of health care practice, with doctors, nurses, and other providers devoting increasing energy towards health education, and health promotion efforts must be coordinated with the many related activities and programs of the health care delivery system Kreps,a; Development of the Field: Social Scientific Influences There were many starting points in the development of the field of health communication.

The communication discipline has a long-standing history of adopting theories and methods from these social sciences, and the move towards adopting the health care context as a topic of study was a natural disciplinary trend.

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The field of psychology generated a large body of literature that was very influential in the development of health communication inquiry. This exciting body of psychological literature captured the imagination of many communication scholars. In fact, the Journal of Communication devoted an entire issue in to the topic of "Communication and Mental Health. This book was very influential in the development of the fields of interpersonal communication and health communication.

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Written from an interactional family therapy perspective, the book examined the ways communication defines and influences interpersonal relations, clearly illustrating how the quality of relational communication can lead to therapeutic or pathological outcomes. A notable example of an early health communication campaign based upon a combination of social scientific theories is the Stanford Heart Disease Prevention Program.

This landmark study illustrated the role of communication in health promotion with a longitudinal field experimental evaluation of a multi-city health promotion intervention program. The medical sociology literature Freeman, ; Jaco, ; Mechanic, was also influential in the development of the field of health communication.

Medical sociologists have long been interested in the doctor-patient relationship and the social structure of health care delivery systems. There were also important literature from the field of medicine that increased interest is health communication. Institutionalization of the Field of Health Communication A field of study is largely defined by the body of literature it generates, and the field of health communication has a rich and varied literature.

These first three texts were followed by a rapid succession of important health communication books, edited volumes, and a burgeoning literature of journal articles too numerous to list here , solidifying and enriching the field of health communication.


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As literature concerning the role of communication in health care and health promotion began to increase, there was a growing need for academic legitimization for communication scholars studying the role of communication in health. In response to this growing need, communication scholars interested in health care and health promotion banded together in to form the Therapeutic Communication interest group of the International Communication Association ICA. The formation of this professional group is one of the most influential moments in the genesis of the modern field of health communication because it provided an academic home for an eclectic group of scholars, communicated to the rest of the communication discipline that health was a legitimate topic for communication research, and encouraged scholars in the discipline to consider health-related applications of their work.

All Research

The annual ICA conventions were very important sites for an emerging group of health communication scholars to meet, present their research, and generate new ideas and new directions for this new field of study. At the ICA convention, held at the LaSalle Hotel in Chicago, another important milestone in the development of this field of study transpired. The members of the Therapeutic Communication Division voted at this conference to change the name of the group to the broader title of "Health Communication," recognizing the many ways that communication influences health and health care.

This was an important change because the new name represented a much larger group of communication scholars than the title therapeutic communication did. The therapeutic communication title was most attractive to interpersonally-oriented communication scholars, while the name health communication appealed broadly to scholars interested in persuasion, mass communication, communication campaigns, and the organization of health care services, as well as those interested in interpersonal communication.

The ICA Health Communication Division not only provided academic legitimization for a growing body of college faculty and graduate students, but the conference programs encouraged other communication scholars to conduct health communication research and submit it for presentation at ICA conferences. The ICA Health Communication Division began publishing the ICA Newsletter in , communicating relevant information about health communication research, education, and outreach opportunities to a growing body of scholars. In the ICA began publishing the influential Communication Yearbook annual series, which included very important chapters about the emerging field of health communication.

In the first four volumes of the Communication Yearbook annual series each of the divisional interest groups including the Health Communication Division was allotted dedicated sections of the book to present research overviews and exemplar studies. These overview chapters along with the accompanying research reports provided an excellent showcase for the developing field of health communication. Later issues of Communication Yearbook moved to a revised format of showcasing major review chapters along with accompanying responses from accomplished scholars representing the different ICA Divisions.

The major review chapters concerning health communication were instrumental in defining this field of inquiry and the chapter responses helped to frame the major issues in the field for a large audience of scholars see Kreps, ; Reardon, ; Pettegrew, for an example of a series of important health communication chapters in Communication Yearbook Many of the members of the ICA Health Communication Division also became members of the SCA Commission on Health Communication and a large body of communication scholars who had limited exposure to health communication because they did not participate in the ICA, now learned more about this field of inquiry.

Health Communication Conferences and Mini-Conferences The health communication conference programs at ICA and SCA became increasingly popular within the field, and in the mid eighties several health communication mini-conferences were founded to meet the burgeoning scholarly interest in this area.

This very successful conference, which included a proceedings volume of contributed conference papers, began a popular trend of small research conferences focusing on health communication inquiry. The Northwestern conference was followed by the first of several very effective annual "Communicating With Patients" conferences sponsored by the Communication Department of the University of South Florida and hosted by David Smith, Loyd Pettegrew, and others.


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  • Since then there have been several additional international health communication conferences, which has expanded international interest in health communication inquiry. Emerson College, under the direction of Scott Ratzan, also has initiated a series of conferences on health communication. These health communication mini-conferences spurred the growth of health communication inquiry both by serving as channels for disseminating health communication research information to a very large and often diverse audience of scholars and also by providing health communication scholars with attractive outlets for presenting their work.

    Dedicated Health Communication Journals In a momentous occasion occurred in the life of the field of health communication. The first refereed scientific quarterly journal, Health Communication, dedicated exclusively to health communication inquiry, was introduced by its Founding Editor, Teresa Thompson. The publication of this journal marked the coming of age of this young field of study and encouraged scholars from around the globe to take this field of study seriously. The first issue of Health Communication showcased five important invited essays by noted health communication experts evaluating the current status of the field of health communication and recommending directions for future development of the field.

    The lead article, by Barbara Korsch , reviewed current knowledge about doctor-patient communication and identified fruitful directions for future inquiry. The next article, by Gary Kreps, describes the theory-building, theory-testing, discipline building, and pragmatic health care delivery system benefits of rigorous and relevant health communication inquiry.

    The third article, by David Smith, examines the ways health communication research has debunked the traditional medical model of doctor control and patient compliance, and advocates a sophisticated view of communication in future communication inquiry. The final invited essay in this inaugural issue of Health Communication, written by Jon Nussbaum, provides a charge to scholars to conduct important, sophisticated, and influential health communication research.

    This first issue of Health Communication marked an important point in the academic maturation of the field of health communication inquiry, and over the years the journal has provided the field with a respected outlet for health communication research. In a second dedicated refereed quarterly health communication journal, the Journal of Health Communication, was introduced, under the Founding Editorship of Scott Ratzan.

    This journal differs from the established journal Health Communication, by taking a more international orientation and health care practice perspective to health communication. While the important journal Health Communication is a rigorous research journal, the new journal, the Journal of Health Communication, is more of a research and practice journal. The two journals complement each other and provide important scholarly outlets for health communication scholarship, indicative of the growth and maturation of this field of study.

    Curricular Growth in Health Communication Along with the growth of health communication literature and professional organizations came the introduction of both undergraduate and graduate health communication courses. Some of the earliest health communication courses were housed in Departments of Speech Communication at large research universities such as the University of Minnesota taught by Don Cassata , Pennsylvania State University taught by Gerald M.

    Several medical schools also began offering health communication courses focusing on interviewing skills for physicians at the University of Illinois taught by Barbara Sharf , Southern Illinois University taught by Susan Ackerman-Ross , University of North Carolina taught by Don Cassata , and the University of Calgary taught by Suzanne Kurtz.

    These courses were precursors to the development of many more undergraduate and graduate health communication courses in colleges both nationally and internationally. The Emerson College health communication graduate program is unique. This level of innovative interdisciplinary and for that matter, interprofessional and inter-institutional collaboration is unique and offers the students in this program an opportunity for a health communication education that emphasizes the intricacies of both the communication process and the health care delivery system.

    Recently several Internet web-pages concerning health communication have been introduced that support curriculum development in the field. The American Communication Association sponsors one of the web-pages, which has links to many sources of information about communication and health care.

    Stuart Ainsworth, currently a graduate student at the University of Georgia, has also established a health communication web-page with information about the field of study, programs of health communication study, relevant health communication literature, and links to other health communication pages. The Emerson College Department of Communication has also developed a health communication web-page where they provide information about their innovative health communication graduate program, the new Journal of Health Communication that is edited by Emerson College faculty member Scott Ratzan, and about current news, conferences, and research opportunites in health communication.

    Important curricular information gathered by Kim Witte of Michigan State University and Scott Ratzan of Emerson College describing the many different health communication educational programs available at colleges and universities is also available on these web-pages. Clearly, these electronic information sources provide many people with access to the field of health communication, and serve important public relations, academic community building, and information dissemination functions for the health communication field.

    Future Directions in Health Communication Inquiry Health communication inquiry has come a long way and is moving in a very positive direction. Health communication inquiry has become increasingly sophisticated and directed towards addressing significant social issues. With the growing sophistication of health communication has come increasing interdisciplinary and institutional credibility for health communication scholars.

    Health communication scholars are more likely now than in any time in the past to attract federal research funding. Federal agencies, such as the Centers for Disease Control, the National Cancer Institute, and the National Institute for Drug Abuse have become increasingly more familiar with the field of health communication and receptive to health communication research. Similarly, the Federal Agency for Health Care Policy and Research has increasingly emphasized the importance of health communication research and interventions in their many publications, conferences, and outreach programs.

    Health communication scholars are increasingly in demand by communication programs at universities and colleges.