Providing free HIV screening within public housing sites offers the potential for increased participation of at-risk populations. Residential-based screening, however, raises concerns about privacy because of the stigma attached to HIV/AIDS and even to the testing for HIV. This study examined the effectiveness of offering HIV screening within a public housing high-rise in upstate New York. Through interviews with both women who obtained testing and those who did not, this study explored the tension between convenience and privacy concerns. The findings suggest that offering HIV screening where people live could encourage participation in the screenings, as well as lead to a destigmatization of HIV testing over time. Some women chose to eschew the convenience of on-site testing in favor of a more private venue for screening, whereas some women responded positively to the accessibility of on-site testing, using communicative strategies to manage privacy concerns.

Searching for ways to reach wider audiences in more comprehensible ways, health promotion agencies might add videos to their current web offerings. While potentially costly and time consuming to create, the effect of these videos on websites has not received much attention. This study translated research about the potential breast cancer risk for young girls associated with the household chemical PFOA into two websites mothers with young daughters were randomly assigned to view (website with videos vs. website without videos). Results revealed participants in the video condition found the advocated risk protective behaviors easier to perform and stated they were more likely to perform them than those in the non-video condition. Approximately 15 days after exposure, those in the video condition performed on average one more protective behavior than those in the non-video condition. Results also suggest that agencies' efforts should focus on creating one quality video to place on a homepage, as video views declined the deeper people navigated into the site. Behaviors advocated should also be ones that can have lasting impacts with one-time actions, as effects wore away over time. Additional strategies are discussed for health promoters seeking to create videos to add to their current websites.

This paper discusses the applied aspects of our Drug Resistance Strategies Project. We argue that a new definitional distinction is needed to expand the notion of "applied" from the traditional notion of utilizing theory, which we call "applied.1", in order to consider theory-grounded, theory testing and theory developing applied research. We label this new definition "applied.2" research. We then explain that our descriptive work describing the social processes of adolescent substance use, identity and use, and drug norms, as well as the subsequent development and dissemination of our keepin' it REAL middle school substance use curriculum are examples of "applied.1" work. In the "applied.2" realm, we include our theory testing (e.g., tests of multiculturalism, narrative and performance theories, the Focus Theory of Norms) and theory-developing (e.g., parent-child communication, cultural grounding) research as well our new directions in theory development (e.g., adaptation processes). We conclude with a call for space in the discipline for "applied.2" work that builds and tests theory through application to significant social issues that contribute to our communities. We note obstacles in departmental and scholarly norms but express optimism about the prospects for "applied.2" research in the future of communication research.

This study examines how a sample of African American women understands the uncertainties fundamental to cancer risk communication. Utilizing data from four focus groups, Problematic Integration (PI) theory is applied as an interpretive lens for illustrating their felt difficulties of talking openly about cancer and breast cancer in everyday life. The women describe worry about cancer and its prevalence among African American women; ambivalence and uncertainty; belief that what is not uncertain is certain and awful; fear and avoidance; contradictions in "claiming" and "rebuking" cancer; and hopefulness.

This study examined the effects of sequencing different types of antismoking threat and efficacy appeals on smoking cessation intentions for smokers with low and high levels of readiness to quit. An experiment was done to test predictions based on Witte's (1992) Extended Parallel Process Model and research by Cho and Salmon (2006). A national probability sample of 555 adult smokers was recruited to take part in this study. Results found a positive two-way interaction effect between message threat and perceived level of message efficacy on intentions to seek help for quitting. A three-way interaction effect was found between message threat, perceived level of message efficacy, and readiness to quit on quitting intentions. Both threat and efficacy were important for smokers with low readiness to quit, whereas efficacy was most important among smokers with high readiness to quit. Implications of the results for antismoking campaigns are discussed along with limitations and future directions.

This study seeks to identify how rural adolescents make health decisions and utilize communication strategies to resist influence attempts in offers of alcohol, tobacco, and other drugs (ATOD). Semi-structured interviews were conducted with 113 adolescents from rural school districts to solicit information on ATOD norms, past ATOD experiences, and substance offer-response episodes. Rural youths' resistance strategies were similar to previous findings with urban adolescents - refuse, explain, avoid, and leave (the REAL typology) - while unique features of these strategies were identified including the importance of personal narratives, the articulation of a non-user identity, and being "accountable" to self and others.

Changes to the United States Preventive Services Task Force (USPSTF) recommendations for cervical cancer preventive services have led to patient confusion, especially in medically underserved populations. We investigated how patient uncertainty concerning cervical cancer screening guidelines is appraised and managed through communication with healthcare providers by conducting in-depth, face-to-face interviews with 24 adult women between the ages of 24 and 65 ( = 41, = 14) living in Appalachia Kentucky. In general, participants expressed a high degree of uncertainty about the updated cervical cancer screening guidelines and appraised this uncertainty as both a danger and an opportunity. Communication with healthcare providers served both to exacerbate and to mitigate patient uncertainty. The study identifies how health care providers may use the change in USPSTF guidelines as a 'teachable moment' to productively counsel patients on the importance of timely screening, the typical progression of certain types of high-risk HPV infection to cervical cancer, and the importance of follow-up care.

Young adults from Montana have a higher rate of suicide than their national counterparts. There is a clear need for targeted interventions to address this disparity. The authors evaluate a community-based, narrative theater project designed to increase awareness and use of suicide prevention resources among eastern Montana youth. As a first step, seven group interviews with Montana young adults (n = 27) were conducted to identify current perceptions about suicide and suicide prevention. Interviews were conducted before and after subjects were exposed to a community-based theater production about suicide. Emergent thematic categories were organized using the four main constructs of the extended parallel process model. After the performance, participants expressed increased awareness of prevention resources; perceived susceptibility to the threat of suicide and depression; and self-efficacy for accessing help and assisting others. There were mixed results for perceived response efficacy. Implications and recommendations for intervention development are discussed.

People affected by rare diseases often have limited coping resources and sometimes face stigma. They build communities with others who share their conditions, but not all members may benefit from these communities. This study investigated how adults with a rare genetic health condition (Alpha-1 antitrypsin deficiency; AATD) think about both the Alpha-1 community and public stigma about AATD, and how these cognitions were associated with their communication responses and well-being. The results showed that people with AATD encountered stigmatization from various sources, including family, employers, healthcare providers, and insurance companies. Stronger public stigma predicted more secrecy, more stress, and less available support. Stronger group identification with the Alpha-1 community predicted less secrecy; stronger group activism predicted more available support and more communication to challenge stigmatizers. Post-hoc analyses showed significant interactions between public stigma and group cognitions on communication to challenge stigmatizers. Practical implications for bolstering communities to improve the well-being of people with rare diseases were discussed.

The theory of stigma management communication has helped identify and categorize the communication tactics people use to manage stigmatization, yet communication research has provided little insight into predictors of these tactics. To address this gap, we considered stigmatization through the lens of interpersonal influence: as an act in which stigmatizers attempt to persuade their targets to accept categorization and de-individualization into a social group and, further, to accept its marginalized status in the society at large. We used the obstacle hypothesis, a theory of resistance to interpersonal influence, to derive predictors of stigma management strategies. Participants (=124) facing possible stigmatization due to their genetic risk for a chronic health condition completed an online survey and shared memories of their initial test disclosures. The empirical tests showed that having a stronger sense of meaning in life, more unsafe experiences, and a broader information network predicted resisting stigmatization. Guilt predicted greater use of avoidance strategies (e.g., secrecy and avoiding risky interpersonal settings). We discussed practical implications of bolstering one's sense of meaning in life and argumentation skills and their connections to resilience research.

Participatory interventions enable active user engagement, but research is needed to examine the longitudinal mechanisms through which engagement may generate outcomes. This study investigated the social processes following a web-based participatory media literacy intervention. In this program, young women were asked to create a digital counter message against the media content that promotes risk behavior. The effects of the message production were assessed at an immediate post-test and three- and six-month follow-ups. Message production increased collective efficacy at immediate post-test, which then stimulated the sharing of self-generated messages and interpersonal conversation at three-month follow-up. These sharing behaviors, in turn, led to critical media use and negative attitude toward risk behavior at six months. Collective efficacy and sharing behavior sequentially mediated the effects of message production on outcomes. Theoretical and pragmatic implications are discussed.

In the coal mining regions of Eastern Kentucky, access to potable water has been diminished due to industrial pollution and aging infrastructure. Current communications regarding contaminated water are often too inaccessible and too infrequent to appropriately address the issues in target communities. To explore possible improvements to the community's communication infrastructure, the researchers explored what types of stories should be used to communicate about water quality risks, who should communicate about these stories, and how these stories should be communicated. Researchers enlisted a key community member to conduct 24 individual interviews with community members, using snowball sampling. Open and axial coding was used to conduct a constant comparative analysis of the data for emergent themes. Analyzing the verbatim interviews, the researchers concluded communication infrastructure should be enhanced to engage the public about water quality risks. Risk messaging should share water quality information through stories that are designed to be easily digested and frequently distributed using laypeople's terms, visuals, graphs, and maps. These stories should be shared using an integrated communication infrastructure where key community storytellers, such as local news, social media, and interstitial agents, work together to share risk information across platforms and channels.