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Item Fostering Interdisciplinary Boundary Spanning in Health Communication: A Call for a Paradigm Shift(Taylor & Francis, 2022) Hoffmann-Longtin, Krista; Kerr, Anna M.; Shaunfield, Sara; Koenig, Christopher J.; Bylund, Carma L.; Clayton, Margaret F.; Communication Studies, School of Liberal ArtsScholarship in the field of health communication is broad, with interdisciplinary contributions from researchers trained in a variety of fields including communication, nursing, medicine, pharmacy, public health, and social work. In this paper, we explore the role of “health communication boundary spanners” (HCBS), individuals whose scholarly work and academic appointment reflect dual citizenship in both the communication discipline and the health professions or public health. Using a process of critical reflective inquiry, we elucidate opportunities and challenges associated with HCBS across the spectrum of health communication in order to provide guidance for individuals pursuing boundary spanning roles and those who supervise and mentor them. This dual citizen role suggests that HCBS have unique skills, identities, perspectives, and practices that contribute new ways of being and knowing that transcend traditional disciplinary boundaries. The health communication field is evolving in response to the need to address significant healthcare and policy problems. No one discipline has the ability to single-handedly fix our current healthcare systems. Narrative data from this study illustrate the importance of seeing HCBS work beyond simply being informed by disciplinary knowledge. Rather, we suggest that adapting ways of knowing and definitions of expertise is an integral part of the solution to solving persistent health problems.Item Exploring peer coaches’ outcomes: Findings from a clinical trial of patients with chronic pain(Elsevier, 2020-07) Matthias, Marianne S.; Daggy, Joanne; Ofner, Susan; McGuire, Alan B.; Kukla, Marina; Bair, Matthew J.; Communication Studies, School of Liberal ArtsObjective Although peer coaching can help patients manage chronic conditions, few studies have evaluated the effects of peer coaching on coaches, and no studies have systematically examined these effects in the context of chronic pain coaching. Methods Peer coach outcomes were assessed as part of a randomized trial of peer coaching for chronic pain. In this exploratory analysis, linear mixed models were used to evaluate changes in peer coaches’ pain and related outcomes from baseline to 6 and 9 months. The Šidák method was used to account for multiple comparisons. Results Peer coaches (N = 55) experienced statistically significant increases in anxiety and pain catastrophizing from baseline to 6 months, which were no longer significant after adjustment. All other changes were not statistically significant. Conclusions Despite prior studies suggesting that peer coaches benefit from serving as a coach, the current study failed to support that conclusion. Practice Implications Peer coaching remains a promising model, with high potential for implementation, for a number of chronic conditions requiring self-management. However, to maximize the benefits of such interventions, it is essential to monitor both those being coached and the coaches themselves, and not to assume that serving as a coach is inherently beneficial.Item Innovations in Addressing Mental Health Needs in Humanitarian Settings: A Complexity Informed Action Research Case Study(Frontiers, 2020-12) Parrish-Sprowl, Susan; Parrish-Sprowl, John; Alajlouni, Samia; Communication Studies, School of Liberal ArtsAddressing mental health challenges in humanitarian settings, where needs are many and resources are scarce, requires innovative solutions. In this manuscript, we describe a quantum complexity informed intervention, Communication for Whole Health (CWH), developed at the request of a large Jordanian healthcare NGO to address mental health needs of patients and staff. In the humanitarian aid context, this health domain is referred to by the acronym MHPSS (mental health and psychosocial support). The focus of this participatory action research project, presented here as a case study, was the collaborative elaboration of an MHPSS intervention in an urban primary healthcare clinic serving mostly Syrian refugees. The intervention capitalizes on the synergistic effects generated from the systemic nature of communication where every interaction is an intervention, and the health implications of research demonstrating communication is bioactive. Rather than treating mental health as an add-on medical specialty targeting patients with “psychiatric disorders,” systemic MHPSS starts from the premise that everyone has mental health, which is inextricably linked to physical and social health. Emphasis is on integrating awareness of mental health as part of whole health and taking advantage of every interaction to facilitate well-being for patients and staff. The intervention facilitated the transformation of the communication ecology of the clinic from a culture of reactivity to a culture of receptivity by strengthening communication resources and practices. Staff reported feeling more empowered to help patients and displayed increased motivation to find innovative ways to use available resources. They felt better equipped to manage their own stress response and support coworkers. Patients learned basic stress management skills, helping them better manage chronic health conditions, and reported sharing this information with family members. Staff reported many examples of patients responding positively to interventions to reduce patient reactivity, leading to beneficial behavior change and improved health outcomes. Results suggest a systemic MHPSS approach can contribute to ameliorating health inequities by expanding resources for patients and staff, empowering them to act into their current circumstances to support whole health. The CWH approach has potential in similar contexts to address mental health needs in a cost-effective and impactful way.Item “It’s Hidden, After All”: A Modified Delphi Study Exploring Faculty and Students’ Perceptions of a Graduate Professional Seminar in Communication(Central States Communication Association, 2020) Hoffmann-Longtin, Krista; Brann, Maria; The Professional Seminar Delphi Working Group; Communication Studies, School of Liberal ArtsGraduate student socialization has been studied in multiple disciplines, including communication. As their career trajectories change, faculty must consider how to socialize students into the field and their subsequent careers. Using a modified Delphi survey, we examined the differences in faculty and students’ perceptions regarding the content of a graduate professional seminar in communication. Results indicate that students would prefer a focus on implicit norms and the hidden curriculum, while faculty would prefer to focus on disciplinary content. We offer recommendations for developing a course that addresses both needs and, thus, simultaneously attends to the changing job market.Item If I Quit in the Clinic and Do Nothing but Teach, I'm Going to Be Looking for a New Job: An Exploration of Uncertainty Management in Medical Education(Taylor & Francis, 2020) Hoffmann-Longtin, Krista; Hernandez, Rachael; Communication Studies, School of Liberal ArtsAcademic medicine in the United States is a complex field, changing regularly in response to new healthcare knowledge, emerging technologies, and evolving funding models. Uncertainty management theory (UMT) provides scholars a lens to make sense of how individuals experience uncertainty. This study employs UMT to explore the experiences of clerkship and course directors (CDs), faculty in U.S. medical schools who serve in education administration roles. Fifteen semi-structured, in-depth interviews with eight CDs over 14 months indicate complicated relationships with uncertainty at work. Interpreted through UMT, these results reveal that some CDs manage uncertainty discursively, and at times, leverage uncertainty to maintain agency within their roles. These findings indicate that it may be important to recruit CDs who feel comfortable with and can manage uncertainty and provide them with appropriate socialization and ongoing support. Broadly, the results suggest that a more nuanced understanding of uncertainty management experiences can benefit both employees and institutions; as employees gain more role clarity, institutions receive information on how to better meet employees’ needs.Item The Conscientious Use of Images Illustrating Diversity in Medical Education Marketing(Wolters Kluwer, 2020) Hernandez, Rachael; Hoffmann-Longtin, Krista; Patrick, Shawn; Tucker-Edmonds, Brownsyne; Livingston, Nikki; Communication Studies, School of Liberal ArtsAn institution's marketing materials are an important part of presenting its culture. In 2018, communication professionals in the Office of Faculty Affairs, Professional Development, and Diversity at the Indiana University School of Medicine recognized after reviewing the literature that using images illustrating diversity in marketing materials may have unintended negative consequences and could potentially reflect poorly on the institution. Representations of diversity that are discordant with the actual demographics of an institution can create distrust among faculty, students, and staff who discover an institution is not as diverse or supportive of diversity as their marketing materials suggest. If institutions adopt an aspirational approach to images and depict more diversity than actual demographics reflect, the authors of this Perspective recommend that they both develop marketing materials that present a widely diverse selection of images and demonstrate transparency in their communication strategies.To improve their promotional materials, the authors conducted an analysis of their institution's strategy for selecting images for these materials, identified institutional goals related to the strategic use of images, created training materials for staff, and drafted a public-facing statement about diversity in images. These measures are a significant step forward in cultivating the ethical use of images illustrating diversity. In the future, institutions should highlight their approaches to using images to portray diversity, as well as photograph and document a wide range of events that represent diverse topics and individuals. When these images are used for marketing purposes, it is also important to ensure that they are used in an appropriate context and not selected with the single goal of presenting diversity. Future research should focus on how underrepresented students and faculty interpret the use of diverse images in marketing, as well as their preferences for the use of their own images in marketing materials portraying diversity.Item Like Peas in a Pod: A Strategy for Creatively Transposing Interaction-based Classes into an Online Learning Environment(Indiana University, 2021) Krause, Andrea; Goering, Elizabeth M.; Communication Studies, School of Liberal ArtsThe sudden shift to online learning thrust upon universities worldwide by the COVID-19 crisis created unique challenges related to effective online education. Challenges were most acute for highly interactive classes that were forced to move to asynchronous online learning environments. In response to these challenges, we developed an instructional model, rooted in group communication theories and concepts, designed to promote meaningful online learner-to-learner interaction. In this paper, we provide an analytical assessment of our communication-based interaction model, which was implemented in five classes taught at a German university during the COVID shutdown. Part 1 describes the model, its development, and its implementation. Part 2 analyzes learners’ perceptions of the model’s effectiveness using a mixed-methods approach. Results demonstrate the viability of the model, indicating that it is possible to provide meaningful interaction in asynchronous online classes, even in the midst of a pandemic, if communication goals are clearly articulated and strategically implemented.Item Development of a patient-centric food allergy research program: A model for action(Wiley, 2018) Bute, Jennifer J.; Broome, S. Brantlee; Marcus, Jessica N.; Mikulcik, Sandy; Vickery, Brian; Communication Studies, School of Liberal ArtsItem Communicating to promote informed decisions in the context of early pregnancy loss(Elsevier, 2017) Brann, Maria; Bute, Jennifer J.; Communication Studies, School of Liberal ArtsObjective. To evaluate residents’ ability to engage standardized patients in informed decision making during a pregnancy loss scenario. Methods. Forty patient encounters between interns and standardized patients were coded to assess informed decision-making practices, exploration of unexpressed concerns, and support provision. Results. Interns engaged in minimum informed decision making but did not address all of the communicative elements necessary for informed decisions, and most elements were only partially addressed. Patients in this study did not receive information about all management options, their concerns were not addressed, and there was limited support communicated for their decision. Conclusion. This study offers an initial assessment of a communicative approach to evaluate and improve decision making during early pregnancy loss. A comprehensive approach to making informed decisions must include discussion of all management options, exploration of patient preferences and concerns, and support for the patient’s decision. Practice Implications. Healthcare providers could benefit from communication skills training to communicate more effectively with patients to help them make more informed decisions.Item Parents’ Communication Work in the Management of Food Allergies(Taylor & Francis, 2021-02-02) Bute, Jennifer J.; Bowers, Clarissa; Park, Daniel; Communication Studies, School of Liberal ArtsThe National Academies of Sciences, Engineering, and Medicine (NASEM) has identified food allergies as a critical public health issue that significantly affects quality of life for patients and their families. Despite the crisis-level status of food allergies, especially in children, there are currently no curative treatments. As a result, impacted families must learn how to carry the burden of disease management. Using an expanded application of the concept of communication work, this study features data from interviews with 26 parents of food allergic children and explores how parents navigate the nuances of food allergy maintenance while negotiating and preserving valued relationships and identities through everyday talk. Results revealed that parents used communication to legitimate food allergy, balance potential face-threats with identity and relational goals, and coordinate care with spouses. Due to the lack of therapeutic treatment options, we found that parents utilize communication work, which is both demanding and effortful, as a form of disease management.