ABSTRACT Patients’ trust in their providers is a key indicator in determining their satisfaction with care and communication with their providers. Guided by the relationship-centered care framework, the purpose of this study is to examine the impact of patients’ perceptions of clinician trust, patient sociodemographic factors, and communication apprehension with providers on patients’ willingness to communicate with their primary care clinicians. Participants (N = 251) completed a survey assessing nine dimensions of trust, communication apprehension with providers, and their willingness to communicate with providers. The results suggest that issues such as access, location, and identity are important factors in how patients assess their clinicians’ trust. Trans patients, LGBTQAIT+ patients, and patients from rural communities reported the lowest levels of trust with their providers. Annual visitation with primary care clinicians was also an important factor in developing trust with providers. Trust also significantly correlated with communication apprehension with providers’ and patients’ willingness to communicate with their providers. A regression identified four factors in patients’ willingness to communicate with their primary care providers: communication apprehension, clinicians’ ability to evaluate a problem thoroughly and order the correct diagnostic tests, annual visits, and patients’ biological sex. These results suggest that a multidimensional approach to trust is crucial and could help to reduce health disparities among underserved or marginalized groups.

ABSTRACT Inadequate hygiene is a key driver of adverse health outcomes among impoverished populations. In many underdeveloped countries, hygiene-focused health promotion programs are often integrated into broader poverty alleviation initiatives. Drawing on a critical health communication approach and Scott’s framework of public and hidden transcripts, this study investigates hygiene promotion campaigns targeting rural migrants in China, led by poverty alleviation officials. Semi-structured interviews with 42 participants, including both officials and migrants, reveal divergent narratives surrounding these efforts. In the public transcript co-constructed by officials and the public, hygiene promotion is portrayed as a governmental endeavor aimed at benefiting the populace, garnering gratitude and support from impoverished migrants. This contrasts sharply with the hidden transcripts of both parties. Officials perceive hygiene promotion as a potent instrument capable of revolutionizing the perceived ignorant, backward, and disorderly agricultural lifestyle of migrants, thereby catalyzing a profound societal metamorphosis toward modernization. Nevertheless, migrants emphasize the autonomous and thoughtful nature of their hygienic choices. These findings uncover the modernization agenda underlying hygiene-based poverty alleviation, shedding light on the intricate dynamics of domination and resistance while critiquing how the imposed Western-centric framework marginalizes impoverished populations by undermining their cultural and social identities.

ABSTRACT Previous studies have investigated how the valence of comments – whether they support or oppose the reported issue – and the prevalence cue in comments – whether others engage in the reported behavior or not – affect norm perception among those who are exposed to online news with comments. The present study advances this research by testing the combined effects of prevalence and valence cues on readers’ perceived descriptive norms through the lens of the theory of evolutionary norm formation and the exemplification theory. The e-cigarette use in Hong Kong was chosen as the context due to its controversy. A 2 (Prevalence cue: high e-cigarette-use norm vs. low e-cigarette-use norm) × 2 (Valence cue: pro-e-cigarette vs. anti-e-cigarette) between-subjects experiment (N = 955) was conducted. Results indicated that comments suggesting a high prevalence of e-cigarette use were perceived as unrepresentative of the public, rendering the pro- or anti-e-cigarette valence of the comments irrelevant for inferring descriptive norms.

ABSTRACT The fear of death is a fundamental human anxiety. From the perspective of terror management theory (TMT), this study examines the potential of music to alleviate death anxiety. We conducted a 2 (salience: mortality vs. control) × 2 (song type: nostalgic vs. non-nostalgic) × 2 (relationship type: romantic vs. parent-child) between-subjects factorial experiment with 335 middle-aged participants (ages 35–40) who were married, had children, and had living parents. Multiple interaction effects among mortality salience, nostalgia, and relationship type indicated that romantic songs – especially nostalgic romantic songs – were more effective in reducing death anxiety than parent-child relationship songs. The findings highlight the defensive function of romantic relationship songs within the TMT framework, offering new insights for clinical interventions and public mental health practices aimed at managing death anxiety.

ABSTRACT This study investigates the pathways linking general vaccine conspiracy beliefs to the conditional acceptance of the dengue vaccine, with a particular focus on the mediating role of secondary risk perceptions and the spillover effects of prior COVID-19 vaccination experiences. Based on an online survey of 1,001 Singaporeans and permanent residents, we found that stronger vaccine conspiracy beliefs were associated with heightened perceptions of secondary risk severity and susceptibility related to dengue vaccination, which, in turn, were linked to less favorable attitudes toward the dengue vaccine. These attitudes were positively associated with conditional acceptance of the dengue vaccine. Moreover, perceived secondary risks and attitudes toward the dengue vaccine served as sequential mediators in the relationship between vaccine conspiracy beliefs and conditional acceptance. Additionally, a multigroup analysis revealed that the associations between perceived secondary severity and susceptibility of dengue vaccination and attitudes toward the dengue vaccine varied depending on the level of side effects individuals experienced from their prior COVID-19 vaccination. Theoretical and practical implications are discussed.

ABSTRACT Pre-exposure prophylaxis (PrEP) is a biomedical intervention that dramatically lowers one’s risk of acquiring HIV. However, PrEP uptake has been slow among young-adult men who have sex with men (YMSM) – one group highly vulnerable to HIV infection in the US. Drawing from health communication scholarship on information seeking and scanning, as well as on concepts from the health belief model, we convened individual interviews and focus groups with N = 50 PrEP-eligible YMSM in the US to understand how and where YMSM acquire information about PrEP. Our qualitative analyses yielded four sets of findings. First, we identified five common sources of PrEP information acquisition (online information, word-of-mouth, strategic messaging, health-care providers, miscellaneous sources). Second, we identified linkages between sought and scanned information sources, with word-of-mouth and strategic messaging functioning as incidental cues to action sparking purposeful PrEP information seeking. Third, although these themes emerged across participant characteristics, some differences emerged: Hispanic participants were more inclined to acquire PrEP information from friends, and participants who had never used PrEP expressed the greatest desire for information about the newer, injectable form of PrEP. Fourth, when it comes to promotional communication about injectable PrEP, our findings suggest strategic messaging should address concerns around side effects and convey how injectable PrEP compares to oral PrEP.

ABSTRACT This survey study (N = 446) examined the influence of various culturally sensitive factors – personal stigma, empathy, communication style, and self-construal – on the quality of supportive messages Chinese individuals provide (measured by interaction involvement, reciprocal self-disclosure, person-centeredness, and politeness) in response to online posts seeking help for depression. Also, we examined the role of self-construal and communication style as moderators in moderating the effect of personal stigma and empathy on the quality of support messages. Results showed that higher levels of personal stigma regarding depression lead to longer and more polite responses to individuals seeking support for depression but also emotional and psychological distancing. Further, independent self-construal negatively predicts the quality of support messages. Both communication style and interdependent self-construal moderate key relationships: communication style shapes how stigma relates to cognitive processing and politeness, as well as how empathy relates to politeness; interdependent self-construal influences the links between stigma and politeness, stigma and person-centeredness, and empathy and politeness. Implications of the findings are discussed.

ABSTRACT The COVID-19 pandemic has profoundly impacted global health. Considering the benefits of physical activity (PA) for improving health, this study focuses on enhancing PA among groups with different COVID-19 experiences. Guided by self-efficacy and self-regulation theories, this study examines how health self-efficacy (HSE) increases PA, with using health information technology (IT) for self-regulation serving as a mediating factor across three groups: uninfected (Group 1), infected without symptoms (Group 2), and infected with symptoms (Group 3). Specifically, this study investigates the moderating role of COVID-19 experiences in the indirect effects of HSE on PA through health IT use. Additionally, we conduct supplementary multiple comparisons of HSE across different groups. An online survey was conducted among 5,516 Chinese adults, with data analyzed using ANOVA and structural equation modeling (SEM). The findings revealed the mediating role of health IT use. Moreover, the interaction effect of HSE and adults with post-COVID symptoms (vs. adults without COVID-19 infection) on using health IT for self-regulation was significant. Differences in HSE were found across groups, with the highest level observed in Group 2.

ABSTRACT Drawing on the theory of communicative disenfranchisement (TCD) and based on qualitative interviews with 27 women living in the U.S. this study illuminates the enduring and persistent role of deep-seated “ideological formations’’ (i.e. essentialized and oversimplified assumptions and worldviews) in medical interactions. Specifically, the analysis uncovers three core ideological formations that shape the communicative disenfranchisement (CD) encountered by women: (a) assumptions around the superiority of biomedicine, (b) assumptions about women’s voice, agency, and decision-making capacities, and c) assumptions (and scrutiny) around women’s reproductive capacities and physical features. Women experienced CD at the intersection of essentialized worldviews surrounding biomedicine and the “humanness” of women. These ideological assumptions meant that women routinely encountered a masculinist and patriarchal biomedical model of medicine, stereotypes about women’s bodies, agency, and reproductive facilities, and in some instances, women endured sexist macroaggressions. Theoretically, the study advances TCD by elaborating upon core ideological formations that create and sustain CD in medical settings. In practical terms, the study calls for refocusing the healthcare system using a women-centered approach that recognizes the limitations of biomedicine and women’s agentic struggles to be seen as “fully human.”