(Re)making Scales: Communicative enfranchisement in Women's Narrative Discourses About Health Dismissal.

Dismissal of women's health concerns is a discursive phenomenon with social and material consequences. A burgeoning literature documents how women experience dismissal through various forms of disenfranchising talk. Yet, women are not only subjected to disenfranchising talk; they are called to respond to it. Meaning, analyses of disenfranchisement should also examine efforts toward enfranchisement. One process by which scholars can study communicative (dis)enfranchisement is through people's scalar activity, or how they contextualize experiences at different levels of social reality. Studies of scale demonstrate that the language people use to narrate their personal experiences has meaning for how they position themselves in relation to other social actors, as well as how they make statements about what matters, how much, and to whom. Drawing on 36 interviews with women whose health issues have been dismissed, we apply scale as a theoretical lens and methodological tool to study how women use language in particular, meaningful, and patterned ways in narratives about health dismissal. Our findings suggest that women's narrative discourse is enfranchising in so much as women critique, resist, and transform the contexts of their dismissal. We document how they and others scale "realness" and "normality" across narrated and narrating events. We also note how women scale up from their own experiences to women's experiences writ large, asserting truth claims about issues borne of the broader U.S. healthcare system. Findings have implications for how critical health communication researchers study how women's health issues are constructed in talk.

Development and Initial Assessment of an Emotional Support Provision Training Intervention for Interpersonal Support Providers in the Context of Chronic Illness.

This study reports on the development and pilot testing of an emotional support provision training intervention for interpersonal support providers to those with chronic illnesses. Using findings from a needs assessment in combination with existing theory and research, we created a training framework consisting of verbal person-centered message design, empathic listening, and communicated perspective-taking. Then, we recruited 282 individuals to participate in a pre-training questionnaire, the online training module, a post-training questionnaire, and a two-week post-training questionnaire. Outcome variables included emotional support knowledge, efficacy, and intentions, as well as general support efficacy, response efficacy, and quality. Repeated measures MANCOVA revealed significant increases from T1 to T2 for all variables of interest. These increases were sustained at T3 for emotional support knowledge and efficacy, and support provision response efficacy. Participants rated the training favorably and provided helpful suggestions for improvement. This study answers the call for more theoretically-grounded support interventions that not only assess theory in real-world settings, but also help people better their supportive communication skills.

An Examination of Visually Impaired Individuals' Uncertainty Management.

Being visually impaired or legally blind (having vision that is uncorrectable or cannot be corrected to a legally acceptable level) is inherently uncertain. Although uncertainty can result in positive, negative, or neutral consequences, little is known about how uncertainty is experienced and negotiated in this understudied population. Thus, through in-depth, semi-structured interviews of 24 individuals with a visual impairment, we apply uncertainty management theory (UMT) to examine the communication strategies visually impaired individuals used to manage the personal, vision-related, and social uncertainty they experienced. Many participants appraised the uncertainty negatively and consequently aimed to reduce it by seeking social support and information, using instrumental strategies, and proactively disclosing their visual impairment. Interviewees who preferred to remain uncertain maintained it by avoiding thinking about their visual impairment or worsening vision and/or by concealing their low vision and passing as sighted. Last, some participants, particularly those who were born with low vision or had been visually impaired longer, learned to adapt to the uncertainty through reframing and accepting, self-care, and by turning to God. The study also uncovered that some participants' uncertainty management was limited by ableist constraints, such as inadequate support systems, systemic barriers, and stigma. The study also underscores the universal and fluid nature of uncertainty and uncovers tangible ways individuals with visual impairment can navigate uncertainty within a pervasive cultural biomedical model of disability.

Living with Long COVID: A Longitudinal Interview Study of Individuals' Communicative Resilience Through the "Long Haul".

It is estimated that there are 65 million people globally - 19 million U.S. adults alone - who have long COVID, or persistent symptoms and conditions that continue or develop after an initial SARS-CoV-2 infection. Amidst their suffering and the ambiguity surrounding their health, people with long COVID engage processes of reintegrating from disruptions brought upon by their COVID-19 infection and its fallout, as well as the pandemic writ large. This process is communicative resilience (Buzzanell, 2010, 2017, 2019), and the purpose of this study is to document the experiences of people with long COVID as they sensemake, adapt, and transform their lives through communication. We employed longitudinal interviewing during the middle stages of the pandemic (Summer 2021 to Summer 2022), talking to 19 people with long COVID over the course of one year (five interviews each; 89 total interviews). Grounded in the six processes of communicative resilience, findings center the temporal and dialectic nature of resilience, with throughlines of grief, patience, and hope set against a tumultuous sociopolitical backdrop. Findings of this study have implications for how resilience is studied across time; how people learn to live with chronic illnesses; and how to support people living with long COVID and those who provide them care.

The Role of Interpersonal Communication in Mental Health Literacy Interventions for Young People: A Theoretical Review.

School-based mental health literacy (MHL) programs can increase knowledge, reduce stigma, and encourage help-seeking behaviors in school-aged children. Yet, MHL intervention effects are inconsistent and unsustainable over time, and scholars have called for more theoretical work to address these limitations. The purpose of this theoretical review is to investigate how theory is utilized in MHL interventions, explore the interpersonal communication processes integrated in MHL interventions, and uncover the theoretical assumptions made in MHL interventions about interpersonal communication. We identified 27 articles for inclusion and utilized both content and interpretive analyses. Findings suggest that very few MHL interventions are based in theory; interpersonal communication is a central component within MHL programming; and numerous assumptions are made about interpersonal communication within MHL interventions that need to be addressed theoretically and empirically. Accordingly, we recommend that MHL intervention content and delivery practices are grounded in interpersonal communication theory related to disclosure and social support (seeking and provision). Additionally, teaching disclosure and social support skills may be a productive way for MHL interventions to help students build self-efficacy in communication about mental health for themselves and others.

Women's Experiences of Health-Related Communicative Disenfranchisement.

Women's inequitable healthcare experiences are epistemic injustices by which women are discredited and harmed in their position as knowers of their health and their bodies. Drawing on the theory of communicative disenfranchisement (TCD), we sought to amplify voices of women experiencing communicative disenfranchisement (CD) and to unify their stories according to theoretical premises, namely, attention to power, material conditions, discourse, identities and relationships, and process. We interviewed 36 women living in the United States whose health issues have not been taken seriously by health care providers, friends, and family - pervasive sources of disenfranchising talk surrounding health. Mapping onto the TCD framework, our findings explicate the process of CD, including the material and immaterial consequences of disenfranchising talk and women's responses to such talk. CD unfolded as a protracted and often circular process of women seeking care but encountering health dismissals and minimalizations, blaming and shaming, normalizing of their pain, and psychologizing. We unpack how disenfranchising talk rendered women crazy and dehumanized them and inflicted shame and loss. Women responded to disenfranchising talk with silence, and they (re)claimed their voice by resisting psychogenic explanations for their problems, critiquing women's healthcare, asserting their needs, and advocating for others. We discuss the implications of this research for theory and praxis.

The Longitudinal Effects of Expressive Writing on Victims of Relational Transgressions.

This study investigated the longitudinal effects of written disclosure on physiological and communicative health outcomes for victims of severe relational transgressions in dating relationships. Participants were assigned to a two-step writing condition, a benefit-finding condition, or a control condition to write once a day for three consecutive days on the same topic. Testosterone and forgiveness communication were assessed twice over the course of one-month. The results demonstrate that conditional forgiveness levels were higher for participants in both experimental conditions than in the control condition, whereas neither of the experimental conditions reduced testosterone levels. Across the writing conditions, testosterone levels were negatively associated with conditional forgiveness and positively associated with direct forgiveness. Finally, the results revealed that linguistic features in the writing predicted levels of testosterone and conditional forgiveness.