Finding the Invisible Leader: When A Priori Opinion Leader Identification is Impossible.

Opinion leaders are increasingly recruited to diffuse information, attitudes, and behaviors to serve communication campaigns. However, this has historically required opinion leader identification before launching the campaign. A priori identification is impossible in many contexts, such as when addressing unfamiliar topics or insular communities. The authors introduce a two-stage campaign approach that resolves this problem, and a public health campaign is used to demonstrate it. This approach is applicable to a wider variety of contexts than traditional a priori opinion leader identification.

Speaking of Values: Value-Expressive Communication and Exercise Intentions.

This study introduces the concept of value-expressive communication and examines its relationship with behavioral intent. Value-expressive communication is conceptualized as the verbal output of a value-expressive attitude. Value-expressive communication about exercise is examined in relationship to strength of religious faith, exercise attitudes, communication frequency, and intentions to exercise among a sample of self-identified Christians. The data indicate a significant interaction between value-expressive communication and communication frequency explains significant variance in exercise intentions. Interact to and exercise attitudes is significantly associated with intentions to exercise. Suggestions for using value-expressive communication in health communication research and practice are discussed.

"Sharing Hope and Healing": A Culturally Tailored Social Media Campaign to Promote Living Kidney Donation and Transplantation Among Native Americans.

In this article, the authors discuss a community-based participatory research (CBPR)-driven and culturally tailored social media campaign to promote living kidney donation and transplantation (LKDT) serving Native American communities, who are disproportionately burdened by kidney failure. The effort represents a collaboration among researchers, tribal leaders and community members, medical centers, and other stakeholders to facilitate health promotion related to LKDT among the broader Native American community. Campaign objectives were collaboratively established by the researchers and stakeholders, and the campaign approach and materials were likewise developed in consultation with the community. The results indicated that the use of success stories about LKDT within campaign materials was a statistically significant predictors of heightened campaign engagement (p = .003, ß = .223). Recommendations are offered for partnering with tribal communities and other stakeholders, as well as for building tailored health promotion strategies.

Native Americans' Memorable Conversations About Living Kidney Donation and Transplant.

Living kidney donation and transplant (LKDT) offers a path of hope for patients on indefinite dialysis treatment. However, identification of a living donor can be challenging; initiating these conversations is difficult. Our study analyzes memorable conversations about LKDT that occurred in response to an LKDT campaign targeted to Native Americans. Our analysis of n = 28 memorable conversations revealed that the campaign prompted conversations and increased communication efficacy about LKDT. Based on these findings, we suggest that campaign designers utilize narratives within campaigns to model communication self-efficacy and then analyze the content of postcampaign conversations as an indicator of campaign effectiveness.

Breastfeeding Support in the Workplace: The Relationships Among Breastfeeding Support, Work-Life Balance, and Job Satisfaction.

BACKGROUND: Women are increasingly faced with decisions about how to combine breastfeeding with work, but few researchers have directly measured how breastfeeding relates to the work-life interface. Research aim: The authors examined how perceptions of work enhancement of personal life and work interference with personal life were influenced by workplace breastfeeding support, including organizational, manager, and coworker support, as well as adequate time to express human milk. Then, we examined how workplace breastfeeding support predicted work-life variables and job satisfaction. METHODS: Using a self-report, survey design, the authors analyzed online surveys from 87 women in a rural, community sample who indicated that they had pumped at work or anticipated needing to pump in the future. RESULTS: According to regression results, provision of workplace breastfeeding support, particularly providing adequate time for human milk expression, predicted work enhancement of personal life. Conversely, we found that as workplace support diminished, employees perceived greater work interference with personal life. Results of path analysis further suggested that providing time for expressing milk improved job satisfaction via a partially mediated relationship where work enhancement of personal life acted as a mediator. CONCLUSION: These results suggest that employers can enhance the lives of their breastfeeding employees both at work and at home by providing workplace breastfeeding support, especially through providing time for expressing human milk in the workplace.

Brookings supports breastfeeding: using public deliberation as a community-engaged approach to dissemination of research.

Empirical evidence demonstrates myriad benefits of breastfeeding for mother and child, along with benefits to businesses that support breastfeeding. Federal and state legislation requires workplace support for pumping and provides protections for public breastfeeding. Yet, many are unaware of these laws, and thus, support systems remain underdeveloped. We used a community-based approach to spread awareness about the evidence-based benefits of breastfeeding and breastfeeding support. We worked to improve breastfeeding support at the local hospital, among local employers, and throughout the broader community. Our coalition representing the hospital, the chamber of commerce, the university, and local lactation consultants used a public deliberation model for dissemination. We held focus groups, hosted a public conversation, spoke to local organizations, and promoted these efforts through local media. The hospital achieved Baby-Friendly status and opened a Baby Café. Breastfeeding support in the community improved through policies, designated pumping spaces, and signage that supports public breastfeeding at local businesses. Community awareness of the benefits of breastfeeding and breastfeeding support increased; the breastfeeding support coalition remains active. The public deliberation process for dissemination engaged the community with evidence-based promotion of breastfeeding support, increased agency, and produced sustainable results tailored to the community's unique needs.

Communicatively Making Sense of Doulas within the U.S. Master Birth Narrative: Doulas as Liminal Characters.

Doulas-or designated women experienced in childbirth who provide support to a birthing mother-have been shown to improve mothers' medical outcomes, but they are relatively underused in U.S. births. We assert that doulas are rarely used, in part, because it is difficult to situate them within the contemporary U.S. master birth narrative that places family and medical staff as expected characters in the birth story. This qualitative study uses narrative theorizing to describe the communicatively situated position of doulas in light of the dominant U.S. master birth narrative. Through an analysis of interviews and focus groups with mothers, expectant parents, doulas, and medical staff (n = 52) at a community hospital, we explain how individuals communicatively located the doula as a character who occupied a liminal space that is (a) between borders, (b) crossing borders, and (c) outside borders. Although doulas' liminal location enables individuals to creatively explain and promote doulas to important publics, doulas' conceptual ambiguity in the birth narrative can also be constraining. We conclude with theoretical and practical implications.

Policies aren't enough: the importance of interpersonal communication about workplace breastfeeding support.

BACKGROUND: Formal policies can establish guidelines and expectations for workplace breastfeeding support. However, interpersonal communication between employees and managers is the context where such policies are explained, negotiated, and implemented. As such, this article focuses on interpersonal communication about breastfeeding support in the workplace. OBJECTIVE: The objective of this article is to describe interpersonal communication related to workplace breastfeeding support. METHODS: We conducted 3 focus groups with 23 business representatives from a rural city in the Midwest United States. Participants were recruited through the area chamber of commerce. We analyzed the transcripts of the focus groups and derived themes related to the study objective. RESULTS: Our analysis of responses from business representatives in the focus groups revealed 3 major themes about interpersonal communication concerning breastfeeding support in the workplace: (1) interpersonal communication may be more important than written communication for enacting breastfeeding support, (2) multiple factors (age, sex, and power dynamics) complicate the interpersonal communication required to enact breastfeeding support in local businesses, and (3) positive interpersonal communication strategies may improve the success of workplace breastfeeding support. CONCLUSION: Interpersonal communication between employees and managers is where the specifics of workplace breastfeeding support (eg, policies) are determined and applied. Interpersonal communication about breastfeeding can be challenging due to issues such as age, sex, and power dynamics. However, positive and open interpersonal communication can enhance workplace breastfeeding support.

Social networks and the communication of norms about prenatal care in rural Mexico.

Many normative beliefs are shared and learned through interpersonal communication, yet research on norms typically focuses on their effects rather than the communication that shapes them. This study focused on interpersonal communication during pregnancy to uncover (a) the nature of pregnancy-related communication and (b) normative information transmitted through such communication. Results from interviews with pregnant women living in rural Mexico revealed limited social networks; often, only a woman's mother or the baby's father were consulted about prenatal care decisions. However, women also indicated that communication with others during pregnancy provided important normative information regarding prenatal care. First, most referents believed that women should receive prenatal care (injunctive norm), which was conceptualized by participants as biomedical, nonmedical, or a blend of both. Second, family members often received prenatal care, whereas friends did not (descriptive norms). These findings highlight the key role of personal and social networks in shaping personal pregnancy-related beliefs and behaviors.

Combating weight-based cyberbullying on Facebook with the dissenter effect.

Weight-based cyberbullying is prevalent among youth and adolescents and can have lasting negative psychological effects on the victims. One way to combat these negative effects is through modeling dissenting behavior. When a bystander challenges the bully or supports the victim, this models dissenting behavior. In this study, 181 participants were exposed to message manipulations posted on a Facebook page aimed at testing the conformity effect, the dissenter effect, and the bystander effect in response to enactment of weight-based bullying. Facebook is a common social media site where cyberbullying is reported. Results indicate that in the dissenting condition, participants' comments were significantly more positive or supporting for the victim, as compared to other conditions. This effect was more pronounced for men than for women. In addition, in the dissenting condition, men were less likely to consider the victim unhealthy than women and men in other conditions. These results support the effectiveness of efforts to model dissenting behavior in the face of bullies and extend them to online contexts. Implications are discussed.

The Impact of Personal Metaphors and Memorable Interpersonal Communication on Body Satisfaction.

Memorable messages about body size can have profound negative psychological and emotional effects on body image and personal health. We found that both men and women recalled more negative than positive memorable messages about their body appearance and size. Participants who reported receiving negative memorable messages also revealed stronger current body dissatisfaction and poorer self-image than participants who reported positive memorable messages. Participants who received negative body comments also described their own body using negative metaphors. Negative memorable messages often occurred in front of third parties who expressed approval for the message, sometimes in the form of laughter. We discuss the mental health consequences of negative messages about body size and the implications for public health campaigns.

Social influence in child care centers: a test of the theory of normative social behavior.

Child care centers are a unique context for studying communication about the social and personal expectations about health behaviors. The theory of normative social behavior (TNSB; Rimal & Real, 2005 ) provides a framework for testing the role of social and psychological influences on handwashing behaviors among child care workers. A cross-sectional survey of child care workers in 21 centers indicates that outcome expectations and group identity increase the strength of the relationship between descriptive norms and handwashing behavior. Injunctive norms also moderate the effect of descriptive norms on handwashing behavior such that when strong injunctive norms are reported, descriptive norms are positively related to handwashing, but when weak injunctive norms are reported, descriptive norms are negatively related to handwashing. The findings suggest that communication interventions in child care centers can focus on strengthening injunctive norms in order to increase handwashing behaviors in child care centers. The findings also suggest that the theory of normative social behavior can be useful in organizational contexts.

Communicating stigma about body size.

Body-size stigma is a well-documented phenomenon, particularly for large bodies (Puhl & Brownell, 2003), but few studies have investigated the features of body-related stigma communication. This article uses Smith's (2007a) stigma communication framework to analyze descriptions of male and female bodies of various sizes for their stigma content. Analyses reveal that elements of stigma communication appeared in 46.5% of comments across all bodies. The most common elements of stigma communication were severe labeling and negative comparison to body ideals. The most stigmatized body was the large male body; the second most stigmatized body was the very small female body. This article shows that stigmatizing communication occurs across the spectrum of body sizes for both genders. The implications of weight-based stigma communication on emotional and physical health are discussed. Implications for future health communication interventions aimed at decreasing body size stigma are presented.