Health Communication Commons^™

Rural Community Perspectives On Hurricane Helene In Western North Carolina, Jennifer A. Horney, Lilly Moreau, Search Wnc

Journal of Appalachian Health

Introduction: After making landfall on the Florida Gulf Coast in September 2024, Hurricane Helene impacted Western North Carolina (WNC) with historic flooding, landslides, and hurricane-force winds. More than 100 deaths in the region were attributed to the storm’s direct impacts.

Purpose: The purpose of this study was to assess community perspectives of long-term recovery in Mitchell and Yancey Counties, two rural WNC counties severely impacted by Hurricane Helene.

Methods: A 14-question interview guide was developed based on prior disaster research and the community engagement work of Sustaining Essential and Rural Community Healthcare (SEARCH). Questions covered post-Helene experiences related to access …

Response Efficacy And Discrete Emotions In Message Design: Testing Emotional Pathways To Help-Seeking Intentions And Engagement, Marian Jaitto-Jeffrey

Theses and Dissertations--Communication

Research on fear appeals shows that threat-framed messages promote adaptive outcomes when accompanied by efficacy information. According to the extended parallel process model (EPPM), danger-control responses, including message acceptance, positive attitudes toward recommended behaviors, and help-seeking intentions, are most likely to occur when efficacy appraisals, particularly perceptions of response efficacy, are sufficient to meet perceived threat. When efficacy appraisals fall short of perceived threat, fear-control responses, such as message derogation, denial, or resistance to seeking help, are most likely to emerge. Beyond reducing defensive processing, response efficacy cues may also evoke positive emotions such as hope. Whereas fear is often …

Cybersecurity Training As Risk Communication: A Theory-Informed Model Of Employee Learning And Behavior Change, Daniel Chaney

Theses and Dissertations--Communication

Cybersecurity threats like phishing remain a persistent and costly challenge for organizations. Despite widespread corporate cybersecurity training (CCT) programs, many fail to produce lasting behavior change. This dissertation introduces the Training Knowledge Flow (TKF) Model to assess why such efforts often fall short. Grounded in communication theory, risk messaging, and adult learning principles, the TKF Model conceptualizes cybersecurity training as a staged process of learning, application, and behavioral adaptation. The model includes three phases: (1) Employee as Learner, focusing on message clarity and cognitive engagement; (2) Employee as Practitioner, assessing workplace transfer and training relevance; and (3) Employee …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Breaking The Silence: A Mixed Methods Study On Opioid Education, Overdose Risks, And Treatment Education Among College Students, Anita Silwal

Theses and Dissertations--Communication

The opioid crisis is a national public health emergency in the United States. Opioid education, naloxone training, and medication for opioid use disorder treatment (MOUD) are evidence-based practices to mitigate opioid overdose. The opioid crisis is affecting people of all ages, including college students. Research indicates the gap in research among college students on how they perceive this public health emergency and how it is affecting them; thus, this dissertation aims to address the gap by examining college students' knowledge, attitude, and behavioral intentions toward opioid education, naloxone training, and referral to MOUD to those struggling with opioid addiction. The …

Evaluating The Caring Cards Program And Its Effect On Mental Health Indicators Among A Self-Defined Agricultural Group In Rural Kentucky, Katrina Clontz

Theses and Dissertations--Community & Leadership Development

Suicide is currently the 11^th leading cause of death in the Unites States (American Foundation for Suicide Prevention, 2024), and is especially high among the farming and agricultural population (Kennedy et al., 2021; Klingelschmidt et al., 2022; Monteith et al., 2020). Additionally, mental health access and outcomes are worse among this population, partially due to the inaccessibility of care in rural areas (Taylor, 2019). Communication among caring individuals is thought to be an effective suicide prevention strategy (Long, 2023; Ross & Bassilos, 2019). The Caring Cards program was developed as a way to facilitate mental health communications among a …

Paper Gowns, Cold Hands, Or Something Else? Black Women's Barriers To Gynecologic Screening, Nadia Ayesha Sesay

Theses and Dissertations--Communication

Cervical cancer mortality burden is carried disproportionately by African American women. Early indicators of cervical cancer are identified through prevention screening, a procedure typically performed by a gynecologist. Ideally, the patient group with the most severe mortality would likewise be the group with the most robust communication exchange with their physician to prevent cervical cancer incidence. However, a slew of factors contributes to continued mortalities among Black women. This study uses semi-structured interviews (n=10) and the health belief model to examine one barrier to Black women’s prosocial behaviors regarding routine gynecologic care—awkwardness, which here is conceptualized as social anxiety. The …

And The Survey Says ... A Qualitative Exploration Of Structurational Divergence From The Perspectives Of Nurse Managers Who Are Accountable For Patient Experience Measures, Lisa Carpenter Huddleston

Theses and Dissertations--Communication

For more than a decade, hospital leaders have focused on boosting patient experience scores as part of the federal government’s value-based purchasing (VBP) program. Hospitals that receive federal financial assistance (such as Medicare) are mandated to participate in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a standardized survey that measures patients’ perceptions of their care. Results are publicly reported, and hospitals may be penalized on their reimbursements if they do not reach established benchmarks for patient experience. However, much debate has occurred about whether VBP has increased the quality of healthcare and whether the HCAHPS is an …

Deep Community Partnerships: The Future Of Community-Based Senior Care In A Value-Driven Era, Diana Wilcox

DSW Capstone Projects

This capstone reviews three scholarly products that examine how chronically ill older adults interact with healthcare systems and senior service delivery systems in the United States. The systematic literature review examines how community-based senior programs that are funded by the Older Americans Act (OAA) positively impact health outcomes and promote health and wellness among the older adult population. The conceptual paper examines how Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), Area Agencies on Aging (AAA) interact with the patient and with one another using the lens of Systems Theory. The practice application paper examines best practices regarding care coordination …

Assessing The Intention, Attitudes, And Social Influences On Covid-19 Preventive Behaviors Among Non-Rural Black And Rural Appalachian White Populations: A Faith-Based Community Study, Maria L. Gomez, Tofial Azam, Jean Edward, Hannah Bowman, Lovoria B. Williams

Journal of Appalachian Health

Introduction: The COVID-19 pandemic has had detrimental impacts in non-rural Black and rural Appalachian populations. Yet despite the pandemic’s magnitude, there is a scarcity of research exploring potential influences of attitudes and social influences within these populations on their adherence to COVID-19 public health preventive behaviors.

Purpose: This study examines the intention, attitudes, and social influences to adhere to COVID-19 preventive behaviors among non-rural Black and rural Appalachian congregants in Kentucky by integrating the Theory of Planned Behavior (TPB).

Methods: Secondary analysis of cross-sectional data was used to assess the association between the TPB constructs and four key public health …

Prevalence And Correlates Of Invitation To Participate In Clinical Trials Among Us Adults, Aurora Occa, Allison Leip, Allison S. Merritt, Jerod L. Stapleton

Communication Faculty Publications

Clinical trials are essential to modern medicine, but several barriers, including poor communication, hamper their successful completion. We examined the prevalence and correlates of invitation to participate in clinical trials among a nationally-representative sample of US adults using survey responses from the 2020 HINTS (Cycle 5). Analyses were conducted in 2021.

Overall, 9% of respondents reported being invited to a clinical trial, a prevalence that is nearly half of previously reported rates in convenience samples recruited from health care settings. Compared to non-Hispanic Whites, Black respondents reported the higher prevalence of invitation (16.0%) whereas Asian respondents reported the lowest (2%). …

Turning The Tides: An Inoculation Theory And Theory Of Planned Behavior Approach To Developing Mental Health Help-Seeking Interventions For Gen Z, Sarah Ann Geegan

Theses and Dissertations--Communication

Extensive research, predating and during the COVID-19 pandemic, demonstrates the rising prevalence of anxiety and depression among Gen Z college students in the United States—findings which are accompanied by rising rates of suicide, the second leading cause of death among people aged 15-24. Although college campuses often offer mental health resources, the number of college students utilizing them is significantly less than the number of students reporting mental health challenges. A dearth of empirical evidence, focused on Gen Z specifically, exists as a basis for developing interventions to address this issue. This investigation addressed this gap through two component studies. …

A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl

Theses and Dissertations--Communication

Though fibroadenomas are clinically benign in most cases, clinical research suggests that these lesions can cause diagnosis-related physical health complications and psychological distress. However, this research is limited and should be investigated further. Thus, this study aimed to explore how patients appraise their fibroadenoma diagnosis uncertainty. Additionally, this study sought to determine if a correlation existed between appraisal and decision making as well as identify the factors that influence the most common treatment decision: removal. Data was retrieved from Reddit discussions for a content analysis. These discussions were then qualitatively analyzed using codebooks associated with this study’s research questions. Findings …

Predictors And Outcomes Of The Occurrence And Valence Of Campaign-Related Talk: The Interplay Between New Media Use, Conversations, And Vicarious Learning In The Context Of Reproductive Health, Carina Mazariegos Zelaya

Theses and Dissertations--Communication

Study 1 explored the dominant or deciding barriers and facilitators, beyond environmental and systemic factors, influencing women’s LARC uptake (RQ1, RQ2). Moreover, it examined pregnancy ambivalence and motivation to prevent unintended pregnancy as distal variables to LARC information seeking and uptake (H1, H3). Additionally, it examined embodied experience as an important source of information about contraception (H4). Furthermore, it explored how informal and formal sources support reproductive health decision-making, specifically focusing on social networks as sources of information, knowledge (RQ3, H2), and norms regarding LARC uptake (RQ4, RQ4a, RQ5). Study 2 examined the influence of social learning and LARC knowledge …

Coordinating Boundaries And Negotiating Mental Health Diagnoses And Disclosure: An Exploration Of Stigma And Communication Privacy Management, Paige Anne Von Feldt

Theses and Dissertations--Communication

For quite some time, researchers have tried to reduce stigma and misconceptions about individuals diagnosed with a mental illness. Researchers have examined stigma towards individuals diagnosed with a mental illness, and the internalized stigma that can result. Additionally, researchers have analyzed the dialectical push and pull that occurs between privacy and confidentiality for self-disclosures. Past research has explored disclosure of a mental illness in the context of family members, psychiatrists, employers, friends, and in academic settings. However, there is a lack of research examining how risk perceptions are affected by internalized stigma, thus impacting young adults’ intentions to disclose their …

Is This Going To Be The End? Understanding Problematic Integration Among Appalachian Patients In Colorectal Cancer Screening Navigation, Audrey Smith Bachman

Theses and Dissertations--Communication

Colorectal cancer (CRC) is preventable through regular screening; however, incidence and mortality rates in Appalachia are among the highest in the United States. Public health programs and interventions meant to mitigate the higher CRC burden and increase screening rates are ongoing in the U.S. and Appalachia. In continuing the efforts to reduce the burden of CRC in Appalachian communities, this dissertation uses a two-part study to investigate communication practices relative to problematic integration and health beliefs in CRC screening conversations from the perspective of both patients and patient navigators in the region. As part of efforts directed by the Rural …

Applying The Causal Network Model To Advance Care Planning Messages, Katherine Leigh Harville

Theses and Dissertations--Communication

The process of advance care planning often involves conversations that focus on worst case scenarios and discussions of end-of-life, which makes the topic a daunting one. Most of these conversations occur with older adults or individuals who are seriously ill. However, advance care planning is of importance to those who are healthy, young adults as well. Narrative messages could help simplify the process of approaching such conversations and provide tools for conducting them in a more effective manner.

The proposed study makes use of the causal network model, a model that proposes that the location of information within narratives impacts …

Safety In The Woods: Studying The Effectiveness Of The Kentucky Master Logger Program, Austin Winn Leake

Theses and Dissertations--Community & Leadership Development

Logging is a dangerous field; in this study the researcher looks to see the knowledge both before and after professional loggers participate in the Kentucky Master Logger Program. This information was used to see the overall effectiveness of the Kentucky Master Logger Program. The researcher found an overall improvement in logging professionals’ perceptions and understanding of logging safety. The researcher recommends creating an emphasis on a safe work culture through safety incentives and a greater focus on less used personal protective equipment such as insecticide

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Effects Of Website Interactivity On Skin Cancer-Related Intentions And User Experience: Factorial Randomized Experiment, Zhaomeng Niu, Jessica Fitts Willoughby, Elliot J. Coups, Jerod L. Stapleton

Health, Behavior & Society Faculty Publications

BACKGROUND: Digital media technologies provide users with the ability to interact with content and to receive information based on their preferences and engagement.

OBJECTIVE: We used skin cancer and sun protection as a health topic to explore how modality interactivity, interface tools that afford users greater activity, resulting in greater depth and breadth of mentally representing and experiencing mediated content, and message interactivity, the extent to which the system allows users to exchange messages back and forth on health websites, influenced users' attitudes, knowledge, behavioral intentions, and experience.

METHODS: We employed a 2×2 (modality interactivity: high vs low; message interactivity: …

A Multiple Goals Perspective On Burnout Disclosure And Support Among Attending Physicians, Alison N. Buckley

Theses and Dissertations--Communication

Burnout is a common experience among physicians and has been identified as a precursor to substance abuse and suicide ideation. When not addressed, burnout can have many negative personal, relational and professional consequences. Research about the burnout experience is limited due to the taboo nature of the topic. The present study used a multiple goals theoretical perspective to examine how physicians disclose burnout in order to access social support. Attending physicians from various specialties (N = 30) participated in one-on-one interviews and were asked to discuss their burnout experience, conversational goals during burnout disclosure, catalysts and barriers for disclosure, and …

Exploring Health And Risk Information Seeking In The Context Of Covid-19: Testing The Comprehensive Model Of Information Seeking And Risk Information Seeking And Processing Model As Competing Explanatory Models, Xianlin Jin

Theses and Dissertations--Communication

Facing a pandemic caused by a novel coronavirus (COVID-19), the public feels uncertainty and fear. To cope with the pandemic and reduce uncertainty, the public needs accurate and prompt information. By theoretically and empirically comparing the Comprehensive Model of Information Seeking (CMIS) and the Risk Information Seeking and Processing Model (RISP), this dissertation aims to unpack the core mechanism of health and risk information seeking. Built on the two models, the author proposed an Integrated Model and explored which variables are the significant predictors of health and risk information seeking.

The author recruited 729 adult participants and analyzed 394 completed …

Communication Strategies To Intervene In Intimate Partner Violence Among Young Adult Couples, Kaylee Marie Lukacena

Theses and Dissertations--Communication

Intimate partner violence (IPV) is a social and behavioral health issue of importance among the young adult population (Cupp et al., 2015). IPV includes acts of physical violence, sexual violence, psychological aggression, and stalking enacted by an intimate partner (Smith, Zhang, Basile, Merrick, Wang, Kresnow, & Chen, 2018). In the United States., approximately one in three women and one in ten men experience IPV during their lifetime (Smith et al., 2018). Furthermore, over more than 70% of women who experience indicate that the first act occurred before the age of 25. One approach to preemptively address IPV on college campuses …

An Examination Of Communication Sequencing In Enacted Support Interactions For People With Major Depressive Disorder, Madison Adams

Theses and Dissertations--Communication

Social support is integral to helping one manage Major Depressive Disorder [MDD], but enacted social support, or the supportive behavior itself, is not always beneficial. Using a normative theoretical perspective on social support and theory related to sequencing as guiding frameworks, in this thesis I examined common sequential patterns of enacted support between support providers and individuals with MDD. Moreover, I investigated how individuals with MDD evaluated the helpfulness of each of the different sequential patterns. To examine the sequential patterns and how individuals with MDD evaluated their helpfulness, I interviewed 20 participants who had been diagnosed with MDD. The …

Toward Improving Physician/Patient Communication Regarding Invisible Chronic Illness (Ici): The Potential Of Mhealth Technology In Instructional Communication, Jami Leigh Warren, Karen Clancy, Christy F. Brady, Kendall Rump, Tayla New-Oglesby

Health and Clinical Sciences Faculty Publications

Patients that suffer from invisible chronic illness (ICI) such as autoimmune conditions, neurological conditions, and gastrointestinal problems often struggle to obtain a proper medical diagnosis due to a lack of objective indicators to help health-care providers diagnose patients with ICIs. Thus, researchers conducted interviews with 21 participants with Postural Orthostatic Tachycardia Syndrome (POTS) to determine what messages they received from health-care providers as they pursued a diagnosis, how they interpreted those messages, and what role mHealth technology may play in improving patient/provider communication and effective diagnosis/treatment of ICIs. Several themes regarding potential instructional communication intervention content emerged from the interview …

Developing A Health Communication Campaign For Disposal Of Unused Opioid Medications, Kathleen L. Egan, Mark Wolfson, Kaylee M. Lukacena, Carina Mazariegos Zelaya, Monique S. Mcleary, Donald W. Helme

Communication Faculty Publications

Introduction

Communities throughout the United States have implemented medicine disposal programs to prevent diversion of unused opioid analgesics from homes but a general lack of awareness may contribute to low rates of utilization. The objective of this study was to develop and test community-based campaign messages promoting appropriate disposal of unused opioids at disposal programs.

Methods

In Fall 2019, 491 residents (79% female, 97% White, mean age: 40 years) of five rural, Appalachian counties (3 in Kentucky and 2 in North Carolina) completed a web-based, experimental survey. Participants were randomly exposed to two of four messages and rated each message …

The Landscape Of Connected Cancer Symptom Management In Rural America: A Narrative Review Of Opportunities For Launching Connected Health Interventions, Ming-Yuan Chih, Anna Mccowan, Sadie Whittaker, Melinda Krakow, David K. Ahern, Eliah Aronoff-Spencer, Bradford W. Hesse, Timothy W. Mullett, Robin C. Vanderpool

Journal of Appalachian Health

Background: The 2016 President’s Cancer Panel called for projects focusing on improving cancer symptom management using connected health technologies (broadband and telecommunications). However, rural communities, like those in Appalachia, may experience a “double burden” of high cancer rates and lower rates of broadband access and adoption necessary for connected health solutions.

Purpose: To better understand the current landscape of connected health in the management of cancer symptoms in rural America.

Methods: A literature search was conducted using four academic databases (PubMed, CINAHL, MEDLINE, and PsycINFO) to locate articles published from 2010 to 2019 relevant to connected cancer symptom management in …

Misinformation More Likely To Use Non-Specific Authority References: Twitter Analysis Of Two Covid-19 Myths, Joseph Mcglynn, Maxim Baryshevtsev, Zane A. Dayton

Communication Graduate Research

This research examines the content, timing, and spread of COVID-19 misinformation and subsequent debunking efforts for two COVID-19 myths. COVID-19 misinformation tweets included more non-specific authority references (e.g., “Taiwanese experts”, “a doctor friend”), while debunking tweets included more specific and verifiable authority references (e.g., the CDC, the World Health Organization, Snopes). Findings illustrate a delayed debunking response to COVID-19 misinformation, as it took seven days for debunking tweets to match the quantity of misinformation tweets. The use of non-specific authority references in tweets was associated with decreased tweet engagement, suggesting the importance of citing specific sources when refuting health misinformation.

Appalachian Environmental Health Literacy: Building Knowledge And Skills To Protect Health, Anna G. Hoover, Annie Koempel, W. Jay Christian, Kimberly I. Tumlin, Kelly G. Pennell, Steven Evans, Malissa Mcalister, Lindell E. Ormsbee, Dawn Brewer

Journal of Appalachian Health

Environmental health literacy (EHL) is an emerging, multidisciplinary field that promotes understanding of how environmental exposures can affect human health. After discussing the regional relevance of environmental health knowledge and skills, this article describes three ongoing Appalachian projects that are focused on measuring and building EHL.