Two (Un)Related Spheres? Understanding Administrative and Critical Research in Health Communication

Two (Un)Related Spheres?: Understanding Administrative and Critical Research in HealthCommunicationAuthor(s): Nathan WalterSource: Journal of Information Policy, Vol. 6 (2016), pp. 13-40Published by: Penn State University PressStable URL: http://www.jstor.org/stable/10.5325/jinfopoli.6.2016.0013Accessed: 13-09-2016 18:08 UTC

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Two (Un)Related Spheres?

Understanding Administrative and Critical Research in Health Communication

Nathan Walter

AbstractThis article analyzes the ongoing dialogue between administrative research and critical studies in health communication, focusing on contrasts and points of tangency. Following Lazarsfeld’s work, we conclude with a proposition to adopt an integrative approach to the study of health, balancing between administrative tools and critical concerns.Keywords: critical, administrative, healthcare policy, health communication

Introduction

In his 1941 paper “Remarks on Administrative and Critical Communication Research,” Paul Lazarsfeld provoked the young field of research to reimagine communication inquiry as a hybrid space that integrates empirical tools with a critical approach. In fact, he identified the method-ological and theoretical tensions that shaped the discipline for generations of scholars. Moreover, by focusing attention on the ethical and practical motives that influence administrative institutions, Lazarsfeld offered read-ers a glimpse at the forces that drive research and ultimately form infor-mation policy. Seventy-five years after the publication of this important document, Lazarsfeld’s call for reflexive and morally conscious research is as pertinent as ever. The current review captures the ongoing tension

The author would like to thank the organizers and participants at the ICA preconference “Admin-istrative vs. Critical Research: Implications for Contemporary Information Policy Studies” (May 21, 2015) for their feedback and inspiration, as well as Sandra J. Ball-Rokeach, Stefanie Z. Demetraides, Victor W. Pickard, and the three anonymous reviewers for their valuable comments.

Nathan Walter: University of Southern California


14 JOURNAL OF INFORMATION POLICY

between administrative and critical research in health communication, by raising questions of scope, funding, social accountability, and health policy. We situate our conclusions in a Lazarsfeldian integrative approach to propose a research agenda that tries to balance between constructivism and reflexivity.

Health communication is an interesting domain to study information policy, not merely because ethical dilemmas are inherent in this topic, but also because it is one of the most visible and grant-funded areas of scholar-ship. This visibility is also stressed by peer-reviewed journals that focus on the intersection of health, communication, and policy. Most importantly, analogous to the social scientists that Lazarsfeld envisioned many years ago, health communication scholars play significant roles in advancing theory, as well as holding the responsibility for the practical applications of their findings vis-à-vis healthcare and health promotion. Nearly three decades after scholars acclaimed the emergence of health communication as a legitimate field of inquiry, it is necessary to critically assess the scope, the tensions, the disputes, and the agenda that facilitate one of the central fields of communication research.

A Legacy of an Unfulfilled Promise

Though critical research became synonymous with the denunciation of American cultural industries by intellectuals who led the Frankfurt School as articulated in their literary milestone, Dialectic of Enlightenment,1 in order to understand the tensions between critical and administrative research, we need to start somewhat earlier. Though it is, arguably, impossible to determine when exactly the field of communication inquiry was born, there is little doubt that the first time that critical scholarship, adminis-trative research, and information policy intersected was during the Radio Research Project. Funded by the Rockefeller Foundation and directed by Paul Lazarsfeld, the project aimed to utilize measurement tools bor-rowed from sociology and social psychology in order to raise paramount questions in the mass media frame of reference: Who listens? When do they listen? Why do they listen? How are they affected by what they hear? And can radio become more democratic? Certainly, these questions have been raised before in other contexts and, to a certain degree, they echoed

1. Horkheimer and Adorno, 79.


Two (Un)Related Spheres? 15

concerns to which attention was brought by listeners2 and industry representatives.3 Yet, this project was different, owing to the fact that it was led by people who realized the boundaries of administrative agencies. It was not the first time that Lazarsfeld strived to combine social consciousness with consumer research. Indeed, as a self-proclaimed “Marxist on leave,” Lazarsfeld maneuvered between critical purism and empiricism, under-standing that communication technologies could be exploited to empower the audience or to enslave, depending on the agency that holds the reins.4

Likewise, his early writings have suggested that he was very aware of the inherent bias of the scientific method or the bias associated with the way by which the method is being practiced. Nonetheless, this project was going to be distinctive. This time, Lazarsfeld wanted to combine American and European points of view by having a European scholar with a background in critical analysis manage the music division of the project. Prima facie, he found his perfect candidate in Theodor Adorno, “a sophisticated European theoretical thinker with a knowledge of musical structure,”5 and one that was warmly endorsed by Lazarsfeld’s good friend, Max Horkheimer.

Although Lazarsfeld was excited about the prospect of integrating empirical techniques with a critical approach, welcoming concerns “over media ownership and control, the process of gatekeeping, and the prob-lem of quality and value,”6 Adorno’s undisguised elitism and unorthodox approach to research proved to be too critical for his fellow researchers assigned to the project and the funding agencies alike. Nowhere is the idea of Lazarsfeld’s ambivalence toward critical research presented more effectively than in Hardt’s7 account of the message that Lazarsfeld sent to Adorno, concluding that “you [Adorno] think because you are basically right somewhere you are right everywhere. Whereas I think that because you are right somewhere you overlook the fact that you are terrible in other respects.”8 Evidently, Lazarsfeld had a great respect for the ideas of critical scholars but an equally great objection to their disregard of system-atic empirical evidence. As maintained by Rogers,9 “Lazarsfeld saw critical

2. Pickard. 3. Siepmann. 4. Auerbach and Castronovo. 5. Morrison, 334. 6. Katz, 30. 7. Hardt. 8. Lazarsfeld, 1938, in Hardt. 9. Rogers, History of Communication, 283.



scholarship as useful for posing challenging problems and new concepts that empirical researchers could use . . . Yet, he also saw it as speculative and dangerously imprecise.”

Hence when John Marshall, the supervisor of the Humanities Division of the Rockefeller Foundation, decided to put an end to the music project led by Adorno on the grounds that the “real issue is the utility of the study, and that utility must be measured by the effect which can be anticipated,”10 it did not come as a shock. Later, it was Adorno who suggested that the project was doomed from the start, as the funding agency (i.e., Rockefeller Foundation) wanted to limit the investigation and its conclusions to the boundaries of the commercial radio system prevailing in the United States, “thereby implying that [the] system itself, its cultural and sociological consequences and its social and economic presuppositions were not to be analyzed.”11

Though he admitted that the collaboration between the Bureau of Applied Social Research at Columbia University and the Frankfurt School was anything but clear sailing, Lazarsfeld expressed optimism concerning the integration of administrative and critical theory and remained sympa-thetic toward the critical approach in his subsequent writings.12 Indeed, while Lazarsfeld felt that critical scholars were too strict in their indictment of the media, he also realized that the media were too sensitive to any type of criticism.13 Overall, Lazarsfeld’s diverse body of work can be understood as a delicate attempt to balance scientific rigor with social responsibility.

Administrative and Critical Research in Health Communication

Health communication was positioned as the perfect candidate to take up Lazarsfeld’s challenge and play a vibrant and important role in the larger discourse taking place in the communication research discipline. Those were the formative years for health communication and one way to legitimize its new academic home would have been to adopt the dialogue between administrative and critical research, signaling to the rest of the communication discipline that health was a legitimate topic for inquiry for

10. Morrison, 334. 11. Adorno in Slack and Allor. 12. Melody and Mansell; Slack and Allor, 210–11. 13. Hardt.



diverse research interests, encouraging scholars to consider health-related applications of their work.

In practice, however, health communication scholars played a minor part in this discourse for several reasons. First, the foundations of health communication were, predominantly, rooted in the psychological approach to persuasion14 and interpersonal communication.15 Historically, these branches of research sought to measure outcomes with the goal of identifying skills building exercises to train physicians and shape cam-paigns in order to construct effective messages.16 Not enough attention was given to the assertion that medical encounters tend to convey ideological messages supportive of the current social order.17 Second, health communi-cation emerged as an applied behavioral science research area. To this end, “health communication inquiry [was considered] problem-based oriented, focusing on identifying, examining, and solving health care and health promotion problems.”18 As maintained by Kreps,19 “the primary goal for health communication [was] not to break out in print but to generate health communication knowledge for directing health care policy prac-tice, and intervention.” This emphasis on praxis meant that studies were expected to design interventions and offer a set of evaluative tools that could be effectively translated into policy. In this respect, critical research was often considered to be too abstract and impractical, suggesting that existing institutional actors must be changed, without considering tangible alternatives. Thus, the inherent emphasis on applied research may have contributed to the imbalance between administrative and critical research in health communication during its formative years.

With that in mind, it is important to note that health communica-tion had critical ancestry as well. In fact, several leading predecessors of the health communication field were debating issues related to political economy, social construction of risk, and power relations embedded in the healthcare system, even before the field of health communication was officially inaugurated. For instance, critical scholars studying the ways in which hazards and risks are defined and socially negotiated were already providing numerous insights into what soon would become the bread

14. Hovland, Janis, and Kelley; McGuire. 15. Zola. 16. Dutta and Zoller. 17. Waitzkin. 18. Kreps, Bonaguro, and Query, Jr. 19. Kreps, “Setting the Agenda,” 14.



and butter of health communication. These studies were “grounded in an assumption that the public has a generalized right to know about hazards and risks”20 and that the availability of this information allows the public to make informed decisions.21 Mirroring the power balance in the larger field of communication research, though some of these studies presented clear and practical implications, the critical approach was still considered subordinate to the more popular post-positivistic approach associated with media effects.22

American, Quantitative, Atheoretical, Evaluative, and Funded by the Government

Though health communication is a large and heterogeneous terrain, stretching from medicine to sociology, from social psychology to the study of education, the formal emergence of health communication is often traced to the establishment of the Health Communication Division in 1975 (at ICA and in 1985 at NCA). Yet, it received its official stamp of approval in 1989, with the publication of the flagship journal of the field, Health Communication (HC). HC was the first scholarly journal devoted to the intersection of health and communication.23 Beck et al. and others have defined the journal as a scientific forum to discuss the relationship between communication and health in order to provide solutions for the academia and policy makers.24 If HC ’s self-proclaimed objective is to high-light the centrality of communication processes to the study of health, then its younger sibling, the Journal of Health Communication (JOHC), emphasizes the international perspective of this relationship. As elaborated in the preface to the inaugural edition, “[e]xpanding the realm of health communication to include . . . advocacy, marketing, media, persuasion, and global communication, . . . fostering a shared understanding of com-munity ideals to . . . begin to eliminate the current bureaucratic maze, simplify medical and behavioral jargon, and nurture supportive personal, family, work, and community environments.”25

20. Reynolds and Seeger. 21. For a discussion of risk communication, see Boholm, Johnson, and McComas. 22. Hannawa et al., “Identifying the Field.” 23. Thompson. 24. Beck et al.; Kim et al. 25. Ratzan.



After analyzing the first decade of publication (321 articles) in JOHC, Freimuth et al.26 presented the prototypical health communication article, suggesting that:

Its primary author is a U.S. academic. It probably focuses on smoking, HIV/AIDS, or cancer. It is an empirical research study, more likely to use quantitative, specifically survey methods, rather than qualitative methods. It probably is not driven by theory. It is much more likely to examine mass media communication than interpersonal commu-nication. Its purpose is just as likely to be audience analysis as mes-sage design, as evaluation of a planned communication intervention. If its purpose is to evaluate a planned communication intervention however, that intervention is almost certainly a successful one.27

Concurring with this conclusion, Kim et al. analyzed the depth and scope of inquiry in twenty-two years of published research in Health Com-munication (642 articles), to find that more than half of the articles were atheoretical (n = 337, 52.5 percent), quantitative (n = 372, 62.9 percent), and the samples being used were most often college/university students. Among the funded studies, government/public organization support played the most important role (n = 133, 20.7 percent), whereas university funds were less salient (n = 42, 6.5 percent).

Nonetheless, recent years have witnessed the burgeoning of a large body of literature that outlines the significance of the critical facets of health communication. Taken together, this body of research addresses the ques-tion: What can the critical approach offer to the health communication scholar? Lupton28 has mapped the tangency points between critical stud-ies and health communication. Specifically, her essay suggests that a post- positivistic perspective to the study of health overlooks the importance of political, economic, and historical factors that shape our response to disease and treatments. From this prism, “the medical encounter is not simply a self-contained microcosm but is the product of its encompassing political-economic framework, in which struggle and inequality are central features.”29

26. Freimuth, Massett, and Meltzer. 27. Ibid., 11. 28. Lupton, “Toward the Development.” 29. Ibid., 58.



Zoller and Dutta advanced this argument by presenting a critique of the linear-effect approach when analyzing some of the most dominant theoretical frameworks being utilized in health communication (i.e., the Theory of Reasoned Action, the Health Belief Model and the Extended Parallel Process Model), with the ultimate goal of using the criticism for creating a constitutive space that encourages the articulation, comparison, and synthesis of alternative approaches to media campaigns.30 Beyond the vast potential of this endeavor in creating an interconnectedness between health communication and adjacent fields of inquiry, their judgment of the theoretical perspectives in health communication also casts doubt on the post-positivistic ability to predict, control, and generalize. That is to say that if health communication’s goal is to be applicable across different contexts, its theories should not strive to explain human behavior in uni-versal terms. Instead, the authors claim that we should engage with the complexities of specific sub-populations drawing attention to the fact “that constructs in the social sciences are culturally situated and therefore need to be treated as such.”31 More recently, Hallin and Briggs have called for greater reflexivity of the field, suggesting that the mainstream health com-munication literature is rooted in a health education, not a media studies perspective.32 In other words, health communication scholars reinforce dominant power relationships, by constructing effective ways to adhere to the status quo rather than thinking of ways to challenge it. A similar reconceptualization for the role of the health communication researcher has been proposed by Rimal et al., who argue that by reframing our under-standing of the “patient” as an active citizen, we can enhance public’s decision-making competencies.33 Therefore, given the changing technolog-ical landscape and the complexities of the healthcare system, researchers should assume greater responsibility in empowering people and helping them to make active decisions about their health and general well being.

Though these critiques concerning the direction of health communi-cation scholarship emphasize different concepts relating to the intersec-tion between science and power, they also share a similar reflexive aim to revisit and debate the underlying assumptions of health communication, in order to highlight the systematic disciplinary production of knowledge.

30. Zoller and Dutta. 31. Dutta, “The Critical Cultural,” 536. 32. Hallin and Briggs. 33. Rimal et al.



While this approach has gained considerable momentum across the larger field of health communication, the critical perspective on the study of health is still considered somewhat of an oddity.34 In particular, according to several meta-analyses, the dominance of the post-positivistic approach is apparent in the health communication flagship journals.

The following four sections depict emerging issues in health commu-nication inquiry and the ways in which they apply to larger questions associated with the debate between administrative and critical research: (a) scope, (b) funding, (c) social accountability, and (d) health policy.

Scope: What We Talk about When We Talk about Health Communication

The first category deals with the boundaries of health communication as they are perceived through annual conferences, graduate programs, and the field’s major outlets. The main notion deals with the gap between health communication as it is often defined in official agendas and the research that de facto appears in its mainstream avenues. Research in com-munication can be divided into four paradigms:35 post-positivistic, inter-pretive, critical, and cultural. Specifically, the post-positivistic paradigm refers to studies focusing on empirical findings and testable quantitative research hypotheses or quantifiable patterns; the interpretive paradigm includes qualitative research seeking understanding of a phenomenon of interest from the perspective of research participants; a critical paradigm encompasses studies addressing power, structure, and/or social class issues surrounding the knowledge, attitudes, and behavior of underprivileged groups with regard to health problems or risks; and the cultural paradigm stresses matters of meaning construction and enactment of social realities in health contexts.36 It is important to note that while the validity of this typology is often contested and there are considerable limitations associ-ated with terms such as post-positivism, we adopt these general categories by virtue of their consistency with recent studies that tried to map the scope of health communication.

The dominant perception is that while the field itself is multidisci-plinary and multifaceted, there is a sense that the leading journals and the major conferences are distinctly inclined toward the social scientific

34. Kim et al. 35. Dutta and Zoller; Miller. 36. Kim et al., 491.



tradition. To some extent, this point of view is validated through recent studies that examined the scope of research published in HC. The predom-inant research paradigm is the post-positivistic (n = 569, 88.6 percent), with much less of a focus on the interpretive (n = 21, 3.3 percent) and crit-ical (n = 9, 1.4 percent). A meta-analysis that focused on published articles in JOHC37 reached a similar conclusion, with only 4 percent of the articles categorized as rhetorical studies (a category that includes critical research). Recently, Hannawa et al. suggested that only 3 percent of the articles (from a sampling frame of nearly 19,000 manuscripts that were defined as health communication articles) reflect the critical thought tradition.38

This over-fixation on the positivistic tradition is also evident in the pre-siding theoretical literature. Admittedly, this might be an acute problem since the theoretical perspective is identified as the highest-ranking rea-son for rejecting a health communication manuscript. After analyzing 99 rejected HC manuscripts and the reviews of those manuscripts, Robinson and Agne offer a list of “top transgressions” (i.e., the most common reasons articles were rejected).39 Among the identified problems with manuscripts were poor writing, flawed literature review, statistical issues, and theoretical perspective. As the authors conclude, “reviewers for this journal [HC ] are pretty quick to reject articles that have little to do with communication in general and health communication in particular. There is nothing wrong with examining variables from psychology, sociology, or public health, but if all the literature comes from outside the discipline, there is a high like-lihood for rejection.”40 Acknowledging the fact that critical scholarship is primarily associated with the European philosophical tradition, it becomes apparent that the current review process may serve as a barrier for critical manuscripts.

Beyond the difficulties associated with the publishing process, Dutta-Bergman suggests that the dominant theories and assumptions of campaign planners oversimplify human behavior and sometimes do not correlate with the complex reality of health decisions.41 In fact, although health behavior decisions are naturally affect-laden, they are not accom-modated as such within the framework of the cognitive-based theories and

37. Freimuth, Massett, and Meltzer. 38. Hannawa et al., “Identifying the Field.” 39. Robinson and Agne. 40. Ibid., 507. 41. Dutta-Bergman.



models.42 Put differently, by failing to consider issues of power, class, and materiality, the dominant research paradigms may diminish the scope of scholarship on health campaigns and health decision-making. As observed by Rogers, the scope of critical theory is by definition wider than that of empirical studies, since “critical scholars believe that a theory of commu-nication is impossible without a theory of society.”43

Yet, in recent years, there has been a noticeable effort by journal editors to integrate diverse articles in their publication. For example, HC has a senior editor that solely handles critical and cultural submissions. A call for a multidisciplinary approach is also evident in graduate programs. As mentioned by Monahan and Collins-Jarvis, “among doctoral students we see a burgeoning interest in integrating seemingly incompatible perspec-tives to create new ways of understanding communication.”44 Overall, the fact that the dominance of the positivistic approach is still apparent might suggest that either these submissions are still very much the minority or that we need more time to see the actual fruits of this approach materialize into an identifiable trend.

Funding: Who Pays for This?

There are various funding sources for humanistic and social scientific research, including the federal government, state government, academic institutions, not-for-profit organizations, and private sources. As recent reports suggest, all of these sources are gradually scaling back their invest-ments.45 This is especially worrisome for the humanities and social sciences that traditionally enjoyed a small but steady portion of federal funds. At the same time, “the social sciences have recently become the subjects of ongoing political pressure, as lawmakers at the state and federal levels have questioned peer-reviewed, curiosity-driven basic research; criticized disci-plines as diverse as anthropology and political science; and threatened to exclude them from funding through the National Science Foundation.”46 Still, health communication is one of the better-funded research areas inside the communication discipline. For example, JOHC is sponsored by the Centers for Disease Control and Prevention, The Robert Wood

42. Ibid. 43. Rogers, “The Empirical and the Critical.” 44. Monahan and Collins-Jarvis, 154. 45. Commission on the Humanities and Social Sciences. 46. Ibid., 41.



Johnson Foundation, the Joint United Nations Programme on HIV/AIDS, and the National Cancer Institute’s Cancer Information Service.

Surprisingly, it seems that the majority of articles published in HC until 2009 (n = 439, 68.4 percent) were not funded.47 Among funded studies, government/public organization support plays a significant role (n = 133, 20.7 percent) and less important are universities (n = 22, 3.4 percent) and private organizations (n = 22, 3.4 percent). A closer look reveals an alarming pattern, where government/public organization funded research is half as likely to use theory (33.3 percent theoretical vs. 66.7 percent atheoretical). Generally speaking, studies without funding tend to be slightly more theory-driven (48.5 percent vs. 45.3 percent). This data partially affirms the concerns raised earlier, with respect to the inherent bias in health com-munication against basic research. As recently maintained by Hannawa et al., theoretical development is not a major concern in medicine, thus funding agencies are less interested in focusing on theoretical propositions unless they are critically important to the goal of an intervention. Lately, a comprehensive meta-analysis has demonstrated that the prevalence of atheoretical studies is even worse outside of the two flagship journals.48

The issue of funding has been considered to be one of the departure points for administrative and critical research: While administrative research is associated with the unavoidable alignment of the research pro-cess with economic and political factors,49 critical research has considerable suspicion toward funding agencies. The emphasis on capital, dominant corporations, and elites associated with the critical approach draws from political economy research and it is part of the story of how the power-ful dominate.50 Situated in the materialism à la Marx, political economy seeks to analyze the dialectical relations between the domain of social order and the domain of economy. Several decades of applying the neo-Marxist approach to the healthcare system have been used to understand the ways in which structural dependencies are translated into health inequalities. As summarized by Muntaner et al., “when social class is viewed as a social causal mechanism it can inform social change to reduce health inequali-ties.”51 This contribution can be seen as a part of the larger neo-Marxist

47. Kim et al. 48. Hannawa et al., “Identifying the Field.” 49. Melody and Mansell. 50. Masco. 51. Muntaner et al.



project that aims to “break the chain between health inequality research and the policy mystique.”52

Keeping in mind that the “changes in the economic foundation lead sooner or later to the transformation of the whole immense superstruc-ture,”53 one might suggest that the same dependencies are exhibited in the current scope of health communication research, whereby funding agencies dictate the research agenda and the legitimate analytical tools to approach questions about health. Practically speaking, health communi-cation scholars are often hired via soft funding structures, which is some-times translated into a pressure to receive grant funding that relies on close collaborations with fields such as public health, medicine, neuroscience, and nursing.54 Obviously, the holistic approach envisioned by Marx and others55 is less amenable to strictly empirical examinations, making it less practical in the eyes of potential collaborators and administrative agencies. These trends raise the concern that in considering funding opportunities, health communication scholars might have to compromise when thinking about theory and method.

Social Accountability: Reinforcing Power Relationships or Empowering Marginalized Sectors?

A widely recognized difference between administrative research and crit-ical research relates to the frequent friction between social accountability and the prioritization of administrative agencies. In particular, health com-munication is often accused of a biased tendency to side with the interests of health providers over those of healthcare consumers.56 In fact, critical scholars who wanted to emphasize the repressive aspect of administrative studies, referred to it as “exploitive science,” contrasting it with critical “emancipatory science.”57 From this perspective, the problems confronted in the health communication field lie not strictly with methodological considerations, but with decisions as to what health disparities are worthy of examination, how should they be approached, and to what use our conclusions will be put.

52. Ibid. 53. Marx, 21. 54. Hannawa et al., “Emerging Issues.” 55. Adorno; Durkheim. 56. Freidson; Haug and Lavin; Rimal et al.; Sharf and Street, Jr. 57. Rogers, “The Empirical and the Critical.”



This assertion seems to concur with critical researchers’ concerns regarding the place of administrative research as a central component in the commodification of public health. The fact that, for instance, adminis-trative agencies “have often intended to sell certain health promoting prac-tices, such as the early detection of high blood pressure or breast cancer,”58 and that “labeling a particular physical condition as a medical condition or a disease, has serious political, economic and social consequences [that often] privilege the medical establishment,”59 reinforces the need for ethical scholarship to reassess the intentions and implications of such campaigns. This point is summed up by Wilkins and Mody, who claim that health campaigns “select and frame social conditions and groups as problematic, legitimizing particular approaches to their resolution and not others.”60

Another bias deals with concerns regarding the tendency to privilege the powerful participants of the healthcare system over marginalized groups, that is, advantaging the perspectives of participants who are west-ern, wealthy, well-educated, male, middle-aged, and members of domi-nant cultural groups and professions over the perspective of individuals who are poor, female, have only initial formal education, are elderly or are children, or are members of other stigmatized cultural groups.61 This inclination might “reinforce existing social distributions of knowledge, attitudes, and behaviors rather than reform.”62 These are the underlying power relations that a critical approach seeks to uncover.63 Accordingly, there is a paramount need to understand the role of health communication in constructing and reinforcing dominant power relationships, while mar-ginalizing underprivileged sectors of society.64 Therefore, campaigns that fail to consider questions of power and representation can lead to stigma-tization. In fact, Cho and Salmon have identified 11 types of unintended effects that result from an insufficient understanding of the social system in which scholars and practitioners operate.65 Namely, interventions can render shame and isolation by presenting oneself out of alignment with

58. Ibid. 59. Guttman, 171. 60. Wilkins and Mody, 393. 61. Beck, Ragan, and DuPré; Gabbard-Alley; Kreps and Kunimoto; Thornton, Marinelli, and Larson. 62. Cho and Salmon, 305. 63. Bryant and Miron. 64. Dutta, “Communicating.” 65. Cho and Salmon, 305.



the implicit and explicit social expectations, exposing the individual to humiliation and stigmatization.66

Another layer of complexity is added when we think of health communi-cation as situated in a global context rather than a narrow Western- centric perspective. Storey and Figueroa offer the concept of global competence to characterize the transparency in relations between and within countries, along with the commitment to join forces in order to reduce (or at least acknowledge) power inequalities.67 The shift toward an international frame of reference is also felt in recent publications (e.g., 600-entry Encyclopedia of Health Communication), which emphasize intercultural differences in norms, sociocultural environments, lifestyles, as well as economic, polit-ical, and healthcare systems.68 Beyond the fact that the global approach to the study of health provides a more adequate representation for the intersection of health and communication, it has also direct implica-tions for the ongoing divide between administrative and critical research. Specifically, the genealogy of the field of global health communication is equally rooted in empirical studies that analyze the role of communication in improving health conditions, as well as theories and models intended to study and explain the role of communication in processes of social, economic, and political development.69 Consequently, the framework of global health communication has been influenced by both approaches and by their corresponding theoretical and methodological debates.

Inversely, the concept of power is central not only in understanding who lacks voice in society but also in focusing on sites of power and those actors who inhabit them.70 This approach dictates that scholars should pay closer attention to both ends of the power hierarchy.71 Specifically, follow-ing Domhoff and Dye’s analysis of distribution of power in organizations, Finnegan, Bracht, and Viswanath suggest that power structures analyses in the healthcare system have two basic components: (a) generating a list of key actors and (b) analyzing the nature of their relationships. Both parts of the analysis can contribute to a better understanding of who has the power, and how it is translated into relevant outcomes. Thus, health campaigns that overlook such issues not only fail to ameliorate health disparities but

66. Ibid. 67. Storey and Figueroa. 68. Hannawa et al., “Emerging Issues.” 69. Obregon and Waisbord. 70. Davis. 71. For a discussion about power in media studies, see Hall; Lang and Lang, 20.



also risk reinforcing power disparities, an important political consequence which remains severely understudied.

Health Policy: How Is Health Communication Enacted in the World?

Thirty years ago, Mansell suggested that “if policy research is to influ-ence decision makers to consider public as well as vested institutional interests . . . it is not simply more policy research that is needed, but rather more penetrating analysis of institutional power relations.”72 This final category deals with the gaps between administrative and critical research as they pertain to health policy. Generally speaking, communication studies play a minor role in dictating media policy.73 Still, health com-munication is presumably one of the few exceptions from this dictum, as studies are often expected to clearly articulate practical implications for policy makers. Consequently, the intersection of research and policy is of particular relevance for administrative and critical research in health communication. Both scholarships have very different approaches to the issue of policy. Critical studies evaluate research “in terms of the degree to which it opens closed systems of meaning for assessment and provides for the possibility of changing the status-quo related to health and health outcomes.”74 Conversely, administrative studies are often evaluated by the degree of their cooperation with policy makers and institutions to find better ways to ameliorate health disparities.75

This divergence raises questions regarding the boundaries of research and whether it should go beyond the borders of the professional journal or the academic conference. Interestingly, the supposition that research can be detached from social structure and policymaking is one of the central accu-sations of critical scholars against administrative practices. As suggested by Gitlin, when researchers treat social structures as taken-for-granted, they are giving legitimacy to the elites.76 After all, if the structure (e.g., the healthcare system) is unrelated to the superstructure (e.g., media), then it is unproblematic and should remain beyond the scope of communica-tion research.77 Nonetheless, there is more to health than “healthy diets,

72. Mansell, 155. 73. Noam. 74. Dutta and Zoller. 75. Maibach and Parrott. 76. Gitlin. 77. Morrison.



smoking cessation or gym membership.”78 Indeed, health status is highly correlated with factors such as “socioeconomic status, ethnicity, gender and environmental factors including crime, housing and social cohesion and participation.” Clearly, it would be naïve to propose that health dis-parities could be resolved through health campaigns, without challeng-ing social structures that perpetuate and reinforce existing hierarchies and exclusions. As recently maintained by Lupton,79 health promotion strat-egies often “focus on individual responsibility for health and fail to rec-ognize the social, cultural and political dimensions.” Hence, those health communication scholars who perceive themselves as a link on a bigger chain that brings about social change may overestimate the willingness of healthcare organizations and policymakers to meet the needs of various communities, if this change involves altering the established order.80

Another reason that has been suggested for the deficiency of studies that evaluate health policy from a critical stance has to do with funding. Thomp-son articulated a shift in priorities for federal and state funding agencies away from basic to applied research.81 For example, congressionally funded initiatives such as the Prevention Research Centers (PRCs) program of the Centers for Disease Control and Prevention (CDC) demonstrated the potential for interdependence between academic research and public health policy. Namely, the main objective of this program was to develop innovative ways to conduct research and demonstrate activities that would result in improved public health practices. Yet a 1996 Institute of Medicine panel reviewing the PRCs concluded that the partnership between uni-versities, public health agencies, and communities fell short of legislative intent.82 Thus, to attract sufficient funding in this new era, communica-tion scientists may need to emphasize research that is directly applicable to present social problems.83 That is to say that studies that look into policies regarding power, ownership, and politics rather than administrative poli-cies might find themselves depending entirely on academic funds.

Finally, another tendency that threatens the ability of communication scholars to influence policy relates to the growing movement of health communication academics away from academia. As Wright, Sparks, and

78. Hodgetts and Chamberlain, 321. 79. Lupton, “Health Promotion.” 80. Melody and Mansell. 81. Thompson. 82. Stoto, Green, and Bailey. 83. Monahan and Collins-Jarvis.



O’Hair indicate, health communication scholars have steadily moved into important policy and administrative positions in the healthcare indus-try.84 This migration to the private or public sectors might suggest another level of unhealthy dependence for scholars on policy makers, as their self- interest may play a central role in the types of questions they raise.

To conclude, “[w]hile convenient ideas may get amplified more than those that threaten, and while the realistic set of policy options may be narrow,”85 the research community should be more involved in dictating health policy in general, and policy which directly confronts the existing social order in particular. Regardless of the specific historical, disciplinary, and practical reasons behind the decoupling of health communication research and public health policy, if health communication scholars want to keep producing impactful research projects, questions of policy should be higher on their scholarly agenda.

How to Create a Field That Is Both Constructive and Reflexive

The first question that arises from this review is whether the administra-tive and the critical perspectives can be integrated. According to Melody and Mansell, several of the sources of disagreement between administrative and critical research cannot be untied as they directly relate to the gap between different philosophical and practical stand points.86 Challenging this perspective, Lazarsfeld described some of the perceived disagreements between administrative and critical traditions as illusory. Specifically, Lazarsfeld imagined the integration of administrative and critical scholar-ship as directly related to financial relationships and conflicts of interest. For example, Lazarsfeld applied administrative tools to examine the nature of advertising policies resulting from joint ownership and how news of social importance such as that of labor disputes and racial problems were handled under varying ownership structures of newspapers and radio sta-tions.87

Thus, it seems that the perspective that deems the integration as impos-sible and the one that sees integration as realizable are both correct at the

84. Wright, Sparks, and O’Hair. 85. Haight, 231; Noam. 86. Melody and Mansell. 87. Lazarsfeld, “Some Notes,” 13.



same time. Namely, if we refer to administrative and critical research as two comprehensive worldviews, then they probably cannot be aligned. However, if we choose the specific tools that can serve us for a particular project then a multidisciplinary approach seems feasible. In reality, Lazars-feld was able to combine critical and administrative perspectives, precisely because he parceled out the epistemology of critical research, treating it as a methodological disagreement. This was the practical approach to criti-cal research that equally distanced itself from Marxist critique of society and social criticism.88 As one might expect, by following this approach, Lazarsfeld earned significant praise but also harsh criticism, suggesting that “severed from an explicit commitment to an anticapitalistic future, criti-cal communication research becomes a caricature of radical intellectual work.”89 Nonetheless, while Lazarsfeld’s deductive approach toward critical studies was deemed too technical by neo-Marxist scholars,90 it may be espe-cially compatible with health communication scholarship. The following sections present two different propositions associated with the integrative approach advanced by Lazarsfeld that can be leveraged to remedy several of the gaps in health communication scholarship, including (a) multilevel and (b) multisectoral.

Multilevel: Going Macro and Meso

Kreps suggests five distinct levels of analysis for health communication research: intrapersonal, interpersonal, group, organizational, and societal health communication.91 In the past, health communication was criticized for its overt emphasis on the intrapersonal level, as though health decisions are disconnected from social factors. When health communication prior-itizes the societal level, it is usually done vis-à-vis econometrical studies that focus solely on correlations between what is often perceived as unre-lated phenomena. In fact, there are very few studies that look at interac-tions between different levels of analysis. This sort of perspective is directly related to critical scholarship. Indeed, critical scholars who investigate the health outcomes associated with the macro-level disparities in infrastruc-tures may rely on quantitative methods such as survey-based observations

88. Hardt. 89. McChesney, 101. 90. Hardt. 91. Kreps, “The Evolution.”



to locate health outcomes in the realm of material disparities. Moreover, the combination of administrative and critical perspectives as a multilevel approach might be the antidote for the ecological fallacy associated with critical research, whereby inferences about individuals are made from the analysis of social systems.92

The adoption of a multilevel approach also suggests the broadening of the theoretical framework, as theories that are strictly situated in the post-positivistic paradigm are often futile in explaining social level phe-nomena. The apparent contenders for theoretical frameworks could be theories that account for different levels of analysis, such as critical dis-course analysis, structuration, media system dependency and diffusion of innovations. First, critical discourse analysis may be used to uncover the different facets of health discourse. This type of analysis could promote the understanding of the ways “in which such discourses reflect the dominant positions of power, and are imbedded within ideological and hegemonic configurations.”93 Second, the multilevel approach is also at the heart of structuration theory.94 Namely, structuration does not merely target the individual, “but also the individual’s social network of partners; family members; friends; communities; the infrastructure and the institutions in his or her environment; and the legal, political, and economic realities that encompass his or her life.”95 Likewise, the theory proposes an interesting understanding of agency, which is a focal concept in health promotion and critical studies. Moreover, the media system dependency theory combines system perspective with psychology, whereby audience, media, and social systems are interdependent.96 In this framework, health decisions could be the result of individual characteristics, media availability, or the level of system stability. Finally, one of the most powerful and robust articulations of social change in communication research continues to be the diffusion of innovation (DOI) model promoted by Rogers.97 Beyond its method-ological pluralism and its inherent multilevel structure,98 a critical perspec-tive is deeply embedded in Rogers’ DOI.99 For instance, this framework

92. Real. 93. Dutta and Zoller. 94. Giddens. 95. Senderowitz; Sweat and Denison. 96. Ball-Rokeach and DeFleur. 97. Smith. 98. Cody et al. 99. Haider and Kreps.



recognizes that “obesity can be blamed on the failure of individuals to add 30 minutes a day of exercise, or by the failure of city designers to assure that the locations of residential areas, schools, shopping areas and working sites encourage walking rather than car riding.”100

To conclude, the mainstream health communication literature is rooted in a narrow perspective that fetishizes the individual and the dyad, under-emphasizing the importance of higher levels of analysis. The poor eco-logical validity that tends to be associated with health communication can limit its applications of health promotion research.101 The Lazarsfeld-ian combination between an inductive-administrative perspective and a deductive-critical perspective holds the promise for a more holistic under-standing of health-related decision-making and its environmental influ-ences.

Multisectoral: From Assimilation to Diversity

One of the crucial questions of health communication deals with the inter-ests of the underprivileged sectors of social systems and their representation in the discursive space of health communication theories and applications. As meta-analyses of published articles in the behavioral sciences suggest, the standard subject tends to come from Western, educated, industrialized, rich, and democratic societies.102 Arguably, this portrait is very different from what we usually conceive as risk population or social groups that actually need to receive more support from the system. Indeed, compared to the rest of the world, our usual subjects are nothing but outliers. This is an acute issue since we often render our studies universal, when in fact they represent a narrow minority.

Another important aspect of the multisectoral approach deals with pub-lic empowerment. In an era punctuated by persistent calls for public par-ticipation, patient participation, public engagement, or user involvement in biomedical and health processes, we need to assess the multiple ways that the public already interfaces with biomedical and health knowledge formation, contestation, decision making, and practices. Hence, empow-erment equally refers both to the awareness about disease and treatments, as well as the competence for educated decision making. An example

100. Hornik, 145. 101. Kreps, “Consumer/Provider”; Schmuckler. 102. Henrich, Heine, and Norenzayan.



of the empowerment agenda in health communication can be found in textbooks dedicated to the doctor–patient communication, which try to educate the public regarding the macro-system that was often considered too complex for laypeople to understand.103

In addition, in a time when medicine and health play an increasingly prominent role in shaping the “contours of our collective, networked, and global life, we need to understand how citizens, institutions, and move-ments increasingly organize around biological, medical, and health mat-ters.”104 This suggests that we should advocate for a shift from the ideal of cultural assimilation to ethnic/racial/linguistic diversity of our study pop-ulations. As Gonzalez et al. provoke us to ask, given what would appear as different experiences that pertain to relevant health associated decisions, is it any longer defensible to aggregate Asian and Latino populations? Furthermore, can we merge African Americans with Mexican Americans, rendering them as “other”? Put differently, health communication can ben-efit by adopting “critical multisectoral lenses that focus, respectively, on issues of power and equality and linkages among multiple social domains that influence health. As such, these lenses encourage attention to rela-tionships between activism and sociopolitical and economic influences on health status at local and global levels.”105

Conclusion

If in the administrative research framework, the economic and political structures are external to the analysis, then they are the heart of critical inquiry. Hence, “the critical perspective constructs health communication as a political process, marked by power relations that determine the rela-tionship between the bourgeoisie and subaltern classes.”106 Thus, the matter in question is how to translate the critical jargon into health policy. This is a vicious circle that depicts the “basic tension at the heart of . . . policy research between a commitment to the pursuit of efficiency and a commit-ment to the pursuit of social justice.”107

103. Jones, Kreps, and Phillips. 104. Keränen, 103–04. 105. Zoller. 106. Dutta-Bergman. 107. Ball, 257.



In other words, can we think critically without completely denouncing the current power structure? Should health communication scholars clas-sify their work as being administrative or critical? Should we revisit our paradigmatic assumptions to make room for an integrative approach? Before answering these questions, we must acknowledge the fact that Lazarsfeld and many contemporary health communication scholars implicitly draw from the critical tradition either by adopting new criteria for selection of research problems, giving voice to underprivileged popu-lations, or trying to democratize media-related bureaucracies. Indeed, the popularity of Lazarsfeld’s work has been stimulated in part by his prag-matism and the capacity to solve social problems that were often con-sidered to be beyond the scope of administrative research. The rationale underlying this framework is that political and economic variables should be introduced into the analysis, and that any results obtained from these studies should be targeted toward shaping relevant health policies. At the very least, Lazarsfeld’s inclusive methodological approach, its multilevel focus, and the priority given to questions of power and structure make it a good contender for an empirical approach to the study of health commu-nication that balances administrative rigor and critical concerns.

The relationship between the administrative and the critical paradigms could be either framed as contrasting or as compensating. This is not a predestined matter nor an unsolvable paradox, but rather a choice. The current review tried to outline the practical approach à la Lazarsfeld as it pertains to health communication inquiry, emphasizing the similarities rather than the differences, even at the cost of simplifying and downplay-ing the nuances associated with administrative and critical research. We see it as an important step toward establishing a dialogue between administra-tive and critical points of view in health communication.

It is still unclear what part policy is bound to play in this framework. According to Carey, issues of policy are not inherent concerns of criti-cal inquiry as “policy priorities are not the same as the intellectual priori-ties.”108 This might be the case when thinking about policy in the narrow sense of procedures, protocols, rules, and laws. However, when assuming a nuanced understanding of policy that includes ideologies, methods of law enforcement, delineation of power, public empowerment, and the cri-teria for selection of problems to be addressed, it becomes clear that this discussion should not take place without the vital contribution of critical

108. Carey, 116.



research. To the extent that this study advances us in this direction, we have been successful in our endeavor.

bibliography

Adorno, Theodor W. Introduction to Sociology. Cambridge: Polity Press, 2002.Auerbach, Jonathan, and Russ Castronovo, eds. The Oxford Handbook of Propaganda Studies.

Oxford: Oxford University Press, 2014.Ball, Stephen J. “Policy Sociology and Critical Social Research: A Personal Review of Recent

Education Policy and Policy Research.” British Educational Research Journal 23, no. 3 (1997): 257–74. doi:10.1080/0141192970230302.

Ball-Rokeach, Sandra J., and Melvin L. DeFleur. “A Dependency Model of Mass-Media Effects.” Communication Research 3, no. 1 (1976): 3–21.

Beck, Christina S., Jose Luis Benitez, Autumn Edwards, Amanda Olson, Aarthi Pai, and Maria Beatriz Torres. “Enacting ‘Health Communication’: The Field of Health Communica-tion as Constructed through Publication in Scholarly Journals.” Health Communication 16, no. 4 (2004): 475–92. doi:10.1207/s15327027hc1604_5.

Beck, Christina S., Sandra L. Ragan, and Athena DuPré. Partnership for Health: Building Rela-tionships between Women and Health Caregivers. Hove: Psychology Press, 1997.

Boholm, Asa. “Comparative Studies of Risk Perception: A Review of Twenty Years of Research.” Journal of Risk Research 1, no. 2 (1998): 135–63.

Bryant, Jennings, and Dorina Miron. “Theory and Research in Mass Communication.” Journal of Communication 54, no. 4 (2004): 662–704.

Carey, James W. “The Ambiguity of Policy Research.” Journal of Communication 28, no. 2 (1978): 114–19. doi:10.1111/j.1460-2466.1978.tb01606.x.

Cho, Hyunyi, and Charles T. Salmon. “Unintended Effects of Health Communication Campaigns.” Journal of Communication 57, no. 2 (2007): 293–317. doi:10.1111/j.1460-2466.2007.00344.x.

Cody, Michael, Arvind Singhal, Everett Rogers, and Miguel Sabido. Entertainment-Education and Social Change: History, Research, and Practice. Mahwah, NJ: Lawrence Erlbaum Associates, 2004.

Commission on the Humanities and Social Sciences. The Heart of the Matter. Cambridge, MA. Accessed March 16, 2016. http://www.humanitiescommission.org/_pdf/hss_report.pdf.

Davis, Aeron. The Mediation of Power: A Critical Introduction. London: Routledge, 2007.Domhoff, G. William, and Thomas R. Dye, eds. Power Elites and Organizations. Vol. 82.

Newbury Park, CA: Sage Publications, 1987.Durkheim, Emile. The Rules of Sociological Method. Edited by George E.G. Catlin. London:

The Free Press of Glencoe, 1964.Dutta, Mohan J. “Communicating about Culture and Health: Theorizing Culture-Centered

and Cultural Sensitivity Approaches.” Communication Theory 17, no. 3 (2007): 304–28.———. “The Critical Cultural Turn in Health Communication: Reflexivity, Solidarity, and

Praxis.” Health Communication 25, no. 6–7 (2010): 534–39.Dutta, Mohan J., and Heather Zoller. “Theoretical Foundations: Interpretive, Critical, and

Cultural Approaches to Health Communication.” In Emerging Perspectives in Health Communication: Meaning, Culture, and Power, edited by H. Zoller and M. Joyti Dutta, 1–27. New York: Routledge, 2008.

Dutta-Bergman, Mohan J. “The Linear Interaction Model of Personality Effects in Health Communication.” Health Communication 15, no. 1 (2003): 101–15. doi:10.1207/S15327027HC1501_5.



Finnegan, John R., Neil Bracht, and K. Viswanath. “Community Power and Leadership Analysis in Lifestyle Campaigns.” In Information Campaigns: Balancing Social Values and Social Change, edited by Charles T. Salmon, 54–84. Newbury Park: Sage Publications, 1989.

Freidson, Eliot. Professional Dominance: The Social Structure of Medical Care. New Jersey: Trans-action Publishers, 1970.

Freimuth, Vicki S., Holly A. Massett, and Wendy Meltzer. “A Descriptive Analysis of 10 Years of Research Published in the Journal of Health Communication.” Journal of Health Com-munication 11, no. 1 (2006): 11–20. doi:10.1080/10810730500461042.

Gabbard-Alley, Anne S. “Health Communication and Gender: A Review and Critique.” Health Communication 7, no. 1 (1995): 35–54.

Giddens, Anthony. The Constitution of Society: Outline of the Theory of Structuration. Berkeley, CA: University of California Press, 1984.

Gitlin, Todd. “Media Sociology.” Theory and Society 6, no. 2 (1978): 205–53.Gonzalez, Carmen, Wenlin Liu, Chi Zhang, Cynthia Wang, Minhee Son, and Sandra Ball-

Rokeach. “The Challenges of Diversity for Communication Research: The Case of Civic Engagement” (forthcoming).

Guttman, Nurit. “Beyond Strategic Research: A Value-Centered Approach to Health Communication Interventions.” Communication Theory 7, no. 2 (1997): 95–124. doi:10.1111/j.1468-2885.1997.tb00144.x.

Haider, Muhiuddin, and Gary L. Kreps. “Forty Years of Diffusion of Innovations: Utility and Value in Public Health.” Journal of Health Communication 9, Suppl. 1 (2004): 3–11. doi:10.1080/10810730490271430.

Haight, R. Timothy. “The Critical Researcher’s Dilemma.” Journal of Communication 33, no. 3 (1983): 226–36.

Hall, Stuart. “The Rediscovery of Ideology: Return of the Repressed in Media Studies.” In Cul-ture, Society and the Media, edited by Michael Gurevitch, Tony Bennett, James Curran, and Janet Woollacott, 52–56. London: Methuen & Co. Ltd, 1982.

Hallin, Daniel C., and Charles L. Briggs. “Transcending the Medical/Media Opposition in Research on News Coverage of Health and Medicine.” Media, Culture & Society 37, no. 1 (2015): 85–100.

Hannawa, Annegret F., Leonarda García-Jiménez, Carey Candrian, Constanze Rossmann, and Peter J. Schulz. “Identifying the Field of Health Communication.” Journal of Health Communication 20, no. 5 (2015): 521–30.

Hannawa, Annegret F., Gary L. Kreps, Hye-Jin Paek, Peter J. Schulz, Sandi Smith, and Richard L. Street. “Emerging Issues and Future Directions of the Field of Health Communica-tion.” Health Communication 29, no. 10 (2014): 955–61. doi:10.1080/10410236.2013.814959.

Hardt, Hanno. Critical Communication Studies: Essays on Communication, History and Theory in America. New York: Routledge, 2008.

Haug, Marie R., and Bebe Lavin. Consumerism in Medicine: Challenging Physician Authority. Beverly Hills: Sage Publications, 1983.

Henrich, Joseph, Steven J. Heine, and Ara Norenzayan. “The Weirdest People in the World?” The Behavioral and Brain Sciences 33, no. 2–3 (2010): 61–83. doi:10.1017/S0140525X0999152X.

Hodgetts, Darrin, and Kerry Chamberlain. “Developing a Critical Media Research Agenda for Health Psychology.” Journal of Health Psychology 11, no. 2 (2006): 317–27.

Horkheimer, Max, and Theodor Adorno. Dialectic of Enlightenment. New York: Continuum, 1947.Hornik, Robert. “Some Reflections on Diffusion Theory and the Role of Everett Rogers.”

Journal of Health Communication 9, Suppl. 1 (2004): 145. doi:10.1080/1081070490271610.Hovland, Carl I., Irving L. Janis, and Harold H. Kelley. Communication and Persuasion; Psycho-

logical Studies of Opinion Change. New Haven, CT: Yale University Press, 1953.Johnson, Branden T. “Ethical Issues in Risk Communication: Continuing the Discussion.” Risk

Analysis 19, no. 3 (1999): 335–48.



Jones, Alfred J., Gary L. Kreps, and Gerald M. Phillips. Communication with Your Doctor: Get-ting the Most out of Health Care. Cresskill, NJ: Hampton Press, 1995.

Katz, Elihu. “Communications Research since Lazarsfeld.” Public Opinion Quarterly 51, no. 4, part 2 (1987): S25–45.

Keränen, Lisa. “Public Engagements with Health and Medicine.” Journal of Medical Humanities 35, no. 2 (2014): 103–09. doi:10.1007/s10912-014-9275-7.

Kim, Jeong-Nam, Seong-Cheol Park, Sun-Wook Yoo, and Hongmei Shen. “Mapping Health Communication Scholarship: Breadth, Depth, and Agenda of Published Research in Health Communication.” Health Communication 25, no. 6–7 (2010): 487–503. doi:10.1080/10410236.2010.507160.

Kreps, Gary L. “Consumer/Provider Communication Research: A Personal Plea to Address Issues of Ecological Validity, Relational Development, Message Diversity and Situational Constraints.” Journal of Health Psychology 6, no. 5 (2001): 597–601.

———. “The Evolution and Advancement of Health Communication Inquiry.” Communica-tion Yearbook 24 (2001): 230–53.

———. “Setting the Agenda for Health Communication Research and Development: Scholar-ship That Can Make a Difference.” Health Communication 1, no. 1 (1989): 11–15.

Kreps, Gary L., Ellen W. Bonaguro, and Jim L. Query, Jr. “The History and Development of the Field of Health Communication.” In Health Communication Research, edited by Lorraine D. Jackson and Bernard K. Duffy, 1–15. Westport, CT: Greenwood Press, 1998.

Kreps, Gary L., and Elizabeth N. Kunimoto. Effective Communication in Multicultural Health Care Settings, Vol. 3. Thousand Oaks, CA: Sage Publications, 1994.

Lang, Kurt, and Gladys Engel Lang. “Mass Society, Mass Culture, and Mass Communication: The Meanings of Mass.” International Journal of Communication 3 (2009): 20.

Lazarsfeld, Paul F. “Remarks on Administrative and Critical Communications Research.” Studies in Philosophy and Social Science 9, no. 1 (1941): 2–16.

———. “Some Notes on the Relationship Between Radio and the Press.” Journalism Quarterly 19, no. 1 (1941): 10–13.

Lupton, Deborah. “Health Promotion in the Digital Era: A Critical Commentary.” Health Pro-motion International 30, no. 1 (2015): 174–83.

———. “Toward the Development of Critical Health Communication Praxis.” Health Commu-nication 6, no. 1 (1994): 55–67.

Maibach, Edward W., and Roxanne Louiselle Parrott, eds. Designing Health Messages: Approaches from Communication Theory and Public Health Practice. Thousand Oaks, CA: Sage Pub-lications, 1995.

Mansell, Robin E. “Is Policy Research an Irrelevant Exercise? The Case of Canadian DBS Plan-ning.” Journal of Communication 35, no. 2 (1985): 154–66.

Marx, Karl. A Contribution to the Critique of Political Economy. London: Lawrence and Wishart, 1971.

Masco, Joseph. “‘Survival Is Your Business’: Engineering Ruins and Affect in Nuclear America.” Cultural Anthropology 23, no. 2 (2008): 361–98.

McChesney, Robert W. “Critical Communication Research at the Crossroads.” Journal of Communication 43, no. 4 (1993): 98–104. doi:10.1111/j.1460-2466.1993.tb01309.x.

McComas, Katherine A. “Defining Moments in Risk Communication Research: 1996–2005.” Journal of Health Communication 11, no. 1 (2006): 75–91.

McGuire, William J. “The Nature of Attitudes and Attitude Change.” The Handbook of Social Psychology 3, no. 2 (1969): 136–314.

Melody, William H, and Robin E. Mansell. “The Debate over Critical vs. Administrative Research: Circularity or Challenge.” Journal of Communication 33, no. 3 (1983): 103–16. doi:10.1111/j.1460-2466.1983.tb02412.x.



Miller, Katherine. Communication Theories: Perspectives, Processes, and Contexts. Boston: McGraw-Hill, 2004.

Monahan, Jennifer L., and Lori Collins-Jarvis. “The Hierarchy of Institutional Values in the Communication Discipline.” Journal of Communication 43, no. 3 (1993): 150–57. doi:10.1111/j.1460-2466.1993.tb01287.x.

Morrison, David E. “Kultur and Culture: The Case of Theodor W. Adorno and Paul F. Lazars-feld.” Social Research 45, no. 2 (1978): 331–55.

Muntaner, Carles, Edwin Ng, Seth J. Prins, Katia Bones-Rocha, Albert Espelt, and Haejoo Chung. “Social Class and Mental Health Testing Exploitation as a Relational Deter-minant of Depression.” International Journal of Health Services 45, no. 2 (2015): 265–84.

Noam, Eli. “Reconnecting Communications Studies with Communications Policy.” Journal of Communication 43, no. 3 (1993): 199–206. doi:10.1111/j.1460-2466.1993.tb01293.x.

Obregon, Rafael, and Silvio Waisbord, eds. “Perspectives on Communication and Global Health.” In The Handbook of Global Health Communication, edited by Rafael Obregon and Silvio Waisbord. Chicester, UK: Wiley-Blackwell, 2012.

Pickard, Victor. America’s Battle for Media Democracy: The Triumph of Corporate Libertarianism and the Future of Media Reform. New York: Cambridge University Press, 2014.

Ratzan, Scott C. “Introduction.” Journal of Health Communication 1 (1996): v–vii.Real, Michael. “The Debate on Critical Theory and the Study of Communications.” Journal of

Communication 34, no. 4 (1984): 72–80.Reynolds, Barbara, and Matthew W. Seeger. “Crisis and Emergency Risk Communication as an

Integrative Model.” Journal of Health Communication 10, no. 1 (2005): 43–55.Rimal, Rajiv N., Scott C. Ratzan, Paul Arnston, and Vicki S. Freimuth. “Reconceptualizing the

‘Patient’: Health Care Promotion as Increasing Citizens’ Decision-Making Competen-cies.” Health Communication 9, no. 1 (1997): 61–74.

Robinson, James D., and Robert R. Agne. “Kindness, Gentility, and Rejection: An Analysis of 99 Manuscript Reviews.” Health Communication 25, no. 6–7 (2010): 504–11. doi:10.1080/10410236.2010.496530.

Rogers, Everett M. “The Empirical and the Critical Schools of Communication Research.” Communication Yearbook 5 (1981): 125–44.

———. History of Communication Study. New York: Free Press, 1997.Schmuckler, Mark A. “What is Ecological Validity? A Dimensional Analysis.” Infancy 2, no. 4

(2001): 419–36.Senderowitz, Judith. “A Review of Program Approaches to Adolescent Reproductive Health.”

Poptech Assignment 20 (2000).Sharf, Barbara F., and Richard L. Street, Jr. “The Patient as a Central Construct: Shifting the

Emphasis.” Health Communication 9, no. 1 (1997): 1–11. doi:10.1207/s15327027hc0901_1.Siepmann, Charles A. “Can Radio Educate?” The Journal of Educational Sociology 14 (1941):

346–57.Slack, Daryl, and Martin Allor. “The Political and Epistemological Constituents of Critical

Communication Research.” Journal of Communication 33, no. 3 (1983): 208–18.Smith, William. “Ev Rogers: Helping to Build a Modern Synthesis of Social Change.” Journal

of Health Communication 9, Suppl. 1 (2004): 139–42. doi:10.1080/10810730490271593.Storey, Douglas and Maria E. Figueroa. “Toward a Global Theory of Health Behavior and Social

Change.” In The Handbook of Global Health Communication, edited by Rafael Obregon and Silvio Waisbord. Chicester, UK: Wiley-Blackwell, 2012).

Stoto, Michael A., Lawrence W. Green, and Linda A. Bailey, eds. Linking Research and Public Health Practice: A Review of CDC’s Program of Centers for Research and Demonstration of Health Promotion and Disease Prevention. Washington, DC: National Academies Press, 1997.



Sweat, Michael D., and Julie A. Denison. “Reducing HIV Incidence in Developing Countries With Structural and Environmental Interventions.” Aids 9, (1995): S251–57.

Thompson, Teresa L. Introduction to Handbook of Health Communication, edited by Teresa L. Thompson, Alicia M. Dorsey, Katherine I. Miller, and Roxanne Parrot, 1–8. Mahwah, NJ: Lawrence Erlbaum Associates, 2003.

Thornton, Barbara C., R. D. Marinelli, and Trudy Larson. “Ethics and Women’s Health Care.” In Perspectives on Health Communication, edited by Barbara C. Thornton, and Gary L. Kreps, 186–195. Prospect Heights, IL: Waveland, 1993.

Waitzkin, Howard. “A Critical Theory of Medical Discourse: Ideology, Social Control, and the Processing of Social Context in Medical Encounters.” Journal of Health and Social Behav-ior 30, no. 2 (1989): 220–39.

Wilkins, Karin Gwinn, and Bella Mody. “Reshaping Development Communication: Develop-ing Communication and Communicating Development.” Communication Theory 11, no. 4 (2001): 385–396.

Wright, Kevin B., Lisa Sparks, and H. Dan O’Hair. Health Communication in the 21st Century. Oxford, UK: John Wiley & Sons, 2012.

Zola, Irving K. “Culture and Symptoms—An Analysis of Patient’s Presenting Complaints.” American Sociological Review 31, no. 5 (1966): 615–30.

Zoller, Heather. “Health Activism: Communication Theory and Action for Social Change.” Communication Theory 15, (2005): 341–64. doi:10.1093/ct/15.4.341.

Zoller, Heather M., and Mohan J. Dutta. Emerging Agendas in Health Communication and the Challenge of Multiple Perspectives. New York: Routledge, 2008.


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Two (Un)Related Spheres? Understanding Administrative and Critical Research in Health Communication

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