Designing Health Messages: Approaches from Communication Theory and Public Health Practice


Edited by: Edward Maibach & Roxanne Louiselle Parrott

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  • Dedication

    This book is dedicated to Hilda Maibach and John Parrott, our partners in the journey.


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    There is nothing so practical as a good theory.”

    Professor KurtLewinThe Practical Theorist

    Theory. There is no other term in the field of communication that inspires such passion (positive and negative) and provokes such divisiveness. Communication researchers are often passionate about, one might even say love struck by, the theories that drive their research. Communication practitioners can be equally passionate about theory. Unfortunately, their passion often concerns the irrelevance of theory to the realities of the practitioners’ world. There are communication practitioners who value theory; however, they often face skepticism or opposition at the hands of their less academically oriented colleagues.1 Theory has also been known to polarize teachers and students. Professors tend to lecture in abstract about the importance of theory, whereas students prefer concrete guidance on how to accomplish communication objectives.

    As communication researchers who are deeply involved in the practice of public health communication, we are concerned about the division between theory and practice. The division is a false dichotomy that seriously inhibits advancement of the field of public health communication. We wholeheartedly embrace Professor Lewin's adage that “there is nothing so practical as a good theory” (Marrow, 1969). Moreover, we believe that communication researchers, practitioners, and students alike will be willing to embrace that adage once the field has advanced some “good” theories, and once these theories have been explained in a manner that makes clear their value in practice.

    Fortunately, theorists in the field of communication and other related behavioral fields have advanced many “good” theories. The challenge now is to explain these theories in ways that prove their worth.

    There are a number of obvious reasons why published discussions of theory tend to be esoteric. Theorists may consider such explanations to be a distraction from their work. After all, communication theories are conceived in abstract terms to explain communication processes and effects at an abstract level (Reynolds, 1971). It may also be that forces operative in today's academic institutions discourage academics (who do most of the writing) from writing about the practical implications of theory. For example, academic careers are generally elevated on the basis of advancing original theories or disproving other people's theories, not explaining and applying theories. Second, academic books and journals are biased against the overtly practical because their reading audience is composed primarily of other academics, not practicing professionals. Moreover, the standard format in most academic journals relegates discussions about the practical aspects of theory to the concluding section of research articles. Introductory textbooks are generally broadly inclusive, which inhibits their ability to delve deeply into theory or make an adequate case for linking theory to practice. There may be other reasons as well why so few practical explanations of “good” theories have been forthcoming.

    Rising to the challenge of explaining “good” theories in a way that proves their worth is the first goal of this book. The contributing authors in Part I (Theory-Driven Approaches to Health Message Design) were carefully selected both for their exuberance about the communication theories with which they work, and for their interest in explaining those theories in a way that proves their worth. The contributing authors were directly and explicitly challenged to prove Kurt Lewin's adage by laying bare the message design implications of their theories. As editors, we feel they have met the challenge, and in doing so have honored the memory of Professor Lewin, a founding member of the academic field of communication. Moreover, these chapters speak to what psychologist Albert Bandura (1986) has called the ultimate test of a theory: when a theory indicates methods that are “capable of effecting significant changes in human affect, thought, and action” (p. 3).

    “Good” theories of human behavior and communication processes provide only half the necessary information for effective health message design. The other half of the equation is a thorough knowledge of the target audience. A detailed, vivid knowledge of the intended audience enables the message designer to select appropriate communication objectives, to create messages that can accomplish those communication objectives, to contextualize the messages properly, and to deliver the messages through communication channels frequented and preferred by members of the audience. There are many ways that message designers can attempt to gain a thorough knowledge of their target audience. Some of these approaches are likely to be more effective than others. The more effective strategies are those that systematically use research both to identify the audience(s) and to assess what the audience currently wants, thinks, feels, and does regarding the health issue. Ideally, dais is an ongoing process throughout the campaign, with the information fed forward for the purpose of refining campaign messages to the changing situation and needs of the audience members.

    Thus, the second goal of this book is to recommend and illustrate a series of information gathering strategies from contemporary public health practice that will enable appropriate audience-centered communication planning. The contributing authors in Part II (Audience-Centered Strategies for Health Message Design) were selected for their ability to discuss and illustrate (with their own work) health communication planning activities that put a face on both the target audience and on intermediaries who stand between message planner and target audience. As editors, we are extremely pleased both with the logical and practical nature of the proposed approaches, and with the level of complementarity among ideas advanced in these chapters. These chapters will assist communication planners at all levels in refining their approaches to message design and delivery.

    As previously indicated, our motivation for editing mis book was to advance in clear terms, and to illustrate across a variety of public health problems, theory-grounded and audience-centered approaches to health message design. In our minds, the need for this book is so pressing not because of the lack of health information in the information environment, but because of the overabundance of ineffectual information. Beyond the myriad activities that can be construed as some form of health information campaign (see Rogers & Storey [1987] for an excellent discussion of what constitutes an information campaign), health messages are pervasive in our schools, health care organizations, workplaces, and in all aspects of our mass media. Moreover, Vice President Albert Gore is leading a nationwide charge to expand dramatically our information environment in the form of the National Information Infrastructure (i.e., the “information superhighway”), one major component of which will be devoted to health information (Gore, 1994).2 Not all of this health information is specifically intended to improve the health of our citizens. News and entertainment programming about health, for example, may be created with little concern about people's health. Conversely, a vast amount of health information, including news, entertainment, and advertising, is developed with health improvement as a primary or secondary communication objective. Our concern is that the majority of these health messages are produced in such a haphazard fashion as to ensure that they have little or no positive impact. By creating clutter in the health information environment, they may actually have a negative impact to the extent that they interfere with the relatively fewer well-designed and well-communicated health messages.

    We are encouraged by preliminary signs that academics in the field of communication are becoming more concerned with theory for the sake of practice (see Avery & Eadie, 1993; Monahan & Collins-Jarvis, 1993). Among other places, this change can be observed in the rapidly expanding health communication section rosters of the International Communication Association and the Speech Communication Association, the two largest professional associations in the academic field of communication. We are equally encouraged by signs that communication professionals at all levels are becoming increasingly interested in promoting health and other prosocial outcomes (see Montgomery [1990] and Nariman [1993] for discussions about the entertainment industry). The single most spectacular example of this trend is the efforts over the past decade of the Partnership for a Drug-Free America, a media industry consortium that produced and distributed approximately $1,000,000 worth of public service advertising per day for several consecutive years (the 10th largest advertising campaign in the country at that time). Our hope is that this book will encourage the continued development of these trends by focusing more health communication efforts on theory-driven, audience-centered approaches.

    Intended Users of the Book

    This book was written with a number of audiences in mind. Both editors and many of the chapter contributors teach advanced undergraduate or graduate-level courses in health communication, social marketing, and information campaigns. Students in these and related courses should find the chapters in this book refreshingly direct and instructive. The second audience is the large group of public health professionals who, as part of their job requirements, develop health messages or campaigns but without the benefit of having had specific training in health communication. An equally large audience is communication professionals who, with no public health training, find themselves directing or assisting in the development of public health messages or campaigns. The final audience is composed of our academic colleagues in departments of communication, public health, and related areas. We hope that this volume's emphasis on the practical side of theory will generate new insights and inspirations.

    Part I of the book (Theory-Driven Approaches to Health Message Design) opens with a chapter by Parrott that broadly overviews variables that affect audience members’ attention to health messages, regardless of their level of involvement with the topic. Several language-use principles are suggested for maximizing attention to health messages, and context of the message is discussed as a potential mechanism for heightening message effectiveness. In the second chapter Holtgrave, Tinsley, and Kay introduce Prochaska and DiClemente's (1984) stages of change model, and demonstrate how principles drawn from the behavioral decision-making literature can be used to help move people through the initial stages.

    In Chapter 3, Maibach and Cotton continue the discussion by presenting a complementary approach to moving people through all five stages of change using message design constructs presented in Bandura's (1986) social cognitive theory. These three chapters address the first theme within Part I of the volume: how to use behavioral theory to organize message design decisions.

    The subsequent five chapters address the second theme within Part I: a presentation of specific theory-grounded considerations in message design. In Chapter 4, Hale and Dillard initiate the theme by reviewing the theory and findings on the use of fear appeals in health campaigns, providing insights on intelligent use of this strategy. In Chapter 5, Monahan elaborates the utility of using the other end of the affective scale: positive feelings. In doing so, she presents a promising perspective on an underutilized health communication strategy.

    In Chapter 6, Pfau discusses and illustrates the importance of behavioral inoculation with (primarily) young audiences who demonstrate a predisposition to adopt unhealthful practices. In Chapter 7, Austin completes our consideration of young audiences by meticulously reviewing the developmental literature and making some bold message-related recommendations.

    In Chapter 8, Witte rounds out the section by presenting her original template for campaign message design and dissemination. Witte's approach, called the Persuasive Health Message Framework Approach, utilizes persuasion theory and research to provide a decision tree of choice points and paths for health message designers to consider in specifying plans and objectives.

    In Part II of the book (Audience-Centered Strategies for Health Message Design), we present four chapters that focus on the data gathering and related activities needed to develop effective health messages. In Chapter 9, Nowak and Siska beautifully illustrate how audience and evaluation research can be used throughout the life span of a campaign. In Chapter 10, Slater provides a deeply insightful look at audience segmentation, and recommends approaches to segmentation in both high- and low-resource situations.

    In Chapter 11, McGrath reminds us that a whole cast of characters—gatekeepers—typically stand between the message designer and the target audience. Based on his extensive experience, he presents a series of important recommendations to enlist the help of gatekeepers. In the final chapter of Part II, Lefebvre and colleagues illustrate that the brave new world of database marketing can be harnessed in service of greater goals than selling dish soap.

    Part III (Combining Theory and Practice: Additional Considerations) consists of two chapters that address several additional issues that health message designers ought to consider before and during their design activities. First, in Chapter 13, Hammond reviews steps that have been taken to increase patients’ understanding of medication regimens. These initiatives exemplify the importance of considering how media and interpersonal communication interface in the design of health messages. These efforts also illustrate how multiple media messages in the information environment supplement campaign efforts, at times reinforcing but at other times contradicting campaign messages. In the final chapter, Parrott, Kahl, and Maibach acknowledge the critical constraints imposed on message designers by health and other administrative policies, expanding on the ideas about gate keeping advanced by McGrath in Chapter 11. Such policies may facilitate or inhibit the design and delivery of health campaigns. Message designers should consider the relevance and implications of these policies before proceeding with their message design activities.

    Finally, these 14 chapters challenge everyone involved in the construction of the health information environment to practice the principles provided by “good theory.” Doing so will have two important consequences: It will help enable our citizens to live healthier and more productive lives; and it will ultimately, through its impact on subsequent research and evaluation efforts, advance our understanding of the mechanisms and dynamics of effective public health communication.


    1. This point is nicely emphasized by the third definition of the term academic in Webster's (New Riverside) Dictionary: “not practical: theoretical.”

    2. Universal service—that is, assuring all segments of society full access to the information superhighway through the use of subsidies—is a major tenet of the federal government's proposed plan. This provision is specifically intended to level the playing field between the information haves and have nots.

    Avery, R. K., & Eadie, W. F. (1993). Making a difference in the real world. Journal of Communication, 43, 174–179.
    Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
    Gore, A. (1994, February 28). We're all going to be connected. The Wall Street Journal, p. A15.
    Marrow, A. J. (1969). The practical theorist. The life and work of Kurt Lewin. New York: Basic Books.
    Monahan, J. L., & Collins-Jarvis, L. (1993). The hierarchy of institutional values in the communication discipline. Journal of Communication, 43, 150–157.
    Montgomery, K. (1990). Promoting health through entertainment television. In C.Atkins & L.Wallack (Eds.), Mass communication and public health (pp. 114–128). Newbury Park, CA: Sage.
    Nariman, H. (1993). Soap operas for change. New York: Praeger.
    Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing traditional boundaries of therapy. Homewood, IL: Dow-Jones-Irwin.
    Reynolds, P. D. (1971). A primer in theory construction. New York: Macmillan.
    Rogers, E., & Storey, J. D. (1987). Communication campaigns. In C.Berger & S.Chaffee (Eds.), Handbook of communication science (pp. 814–846). Newbury Park, CA: Sage.

    Theory-Driven Approaches to Health Message Design

    The opening and in many ways the main section of this book addresses theory-driven approaches to health message design. Theory plays many roles in helping us understand communication processes. The most basic role of theory in behavioral science involves description. Our theories describe aspects of the complex world in which we live, and in doing so, render them more comprehensible. Philosopher John Dewey commented on this role of theory by proposing the following question as a test of the adequacy of a theory: “Does it end in conclusions which, when they are referred back to ordinary life experiences, render them more significant, more luminous to us, and make our dealings with them more fruitful? Or does it terminate in rendering the things of ordinary experience more opaque than they were before?”1

    A second role of behavioral theory involves prediction of outcomes. Predictive theories extend descriptive theories to the next logical level by stating: “if X occurs, then Y is more (or less) likely to occur.” This is said to be a higher role of theory because the process of postulating and proving relationships among antecedents and outcomes confers an even greater degree of comprehensibility to the world around us.

    Yet another goal of theory, in addition to description and prediction, is explanation. Although theories that predict relationships among variables are often highly heuristic, generating volumes of testable hypotheses and research, these theories do not necessarily explain why “If X occurs then Y is more (or less) likely.” Theories that are able to answer the question “why” create greater understanding. They are often necessary to attain yet another goal of theory—the ability to prescribe effective interventions.

    The final role of theory we will discuss involves prescription. Prescriptive theories build on the other two roles of theory by extending them to the final logical level: “X can be made more likely to occur by doing A, B, and C, which, in turn, will make Y more (or less) likely to occur.” Such understanding confers the greatest degree of comprehensibility. It is the difference between understanding that apples are good food, understanding that apple trees grow from apple seeds, and understanding that an apple tree will bear the most fruit when properly watered, fertilized, and pruned. The latter degree of comprehension is clearly more useful to those people concerned with regularly putting food on the table. The prescriptive function of theory, needless to say, is the central concern of this section.

    The main challenge issued to contributing authors in this section was to explore the prescriptive value of behavioral theories. All authors responded to our challenge. Many of them even took the assignment one step farther. They integrated their description of the theories we asked them to address with descriptions of other theories, and in doing so, they extended the prescriptive value of the original theories in important ways.

    In Chapter 1, Parrott explores linguistic theories advanced in the fields of communication and psychology that contend that word choice matters. She builds the case that particular word choices lead members of the target audience to recognize some concepts as more central or important to focus on than others. The prescriptive value of these theories is seen in Parrott's recommendations for guiding the selection of the exact words to maximize audience attention to the critical message content. Parrott extends the prescriptive value of linguistic theories by integrating them with theories that specify which forms of media presentations evoke the most active thought processes. The integration provides significant insight into why people attend to and become more involved with some health messages than others, even when the messages do not initially appear to be personally relevant.

    In Chapter 2, Holtgrave, Tinsley, and Kay examine certain key behavioral decision-making constructs. Moreover, they extend the prescriptive value of these constructs by examining them within the context of Prochaska and DiClemente's stage of behavior change framework. Their discussion centers on decision-making processes at the early (decision-oriented) phases of the behavior change process. The result is an illuminating set of recommendations on how to move target audience members through early behavior change stages (Precontemplation and Contemplation).

    In Chapter 3, Maibach and Cotton explain the prescriptive value of key constructs from Bandura's social cognitive theory. Moreover, following the approach presented in Chapter 2, they examine these constructs in a stages of behavior change context. The discussion grants the reader a significant opportunity to understand an audience member's experience at each stage of the behavior change process. Explicit guidance is given, by stage of behavior change, regarding which social cognitive constructs are likely to be most influential, and recommendations are made regarding how to most reliably influence those constructs. The discussion is a direct complement to that presented in Chapter 2.

    In Chapter 4, Hale and Dillard provide a comprehensive review and integration of the theoretical perspectives advanced to explain the role of using negative affect in health message design. Fear appeals have historically been aligned with health campaigns, perhaps because some of the classic examples are so indelibly imprinted in the minds of persons exposed to them. In addition, individuals have often been presumed to perform behaviors represented as being in their own best health interests if they understand the dire consequences associated with failure to do so. As Hale and Dillard illustrate, such assumptions may be misleading, whereas other principles more appropriately and frequently lead to intended outcomes. In comparing and contrasting these issues, Hale and Dillard provide an excellent synthesis of understanding to guide the pragmatic considerations of health message designers.

    In Chapter 5, Monahan takes up where Hale and Dillard leave off, discussing the obverse—that is, the role of using positive affect in health message design. As she duly notes, this approach is far too often neglected when health campaigners are considering how to present the content of health information to an audience. Her review of theory and research relating to the impact of promoting benefits associated with behavior leads to Monahan's identification of ways to encompass this knowledge in the construction of health messages. Moreover, Monahan compares and contrasts varied approaches to utilizing positive affect, each with its own strengths and weaknesses.

    In Chapter 6, Pfau examines the issue of adolescent smoking prevention and argues that, when targeting children and early adolescents, appropriate messages are those that positively reinforce existing behavior, not those that attempt to persuade children to oppose a health risk behavior. He specifically examines the theoretical rationale for one approach to primary prevention through positive reinforcement: behavioral inoculation. Pfau presents an explicit set of theory-driven recommendations for the creation of inoculation and booster messages. This chapter is an important complement to Maibach and Cotton's chapter on social cognitive approaches because it focuses on the development of abilities and confidence to resist experimenting with and adopting risk behaviors.

    In Chapter 7, taking up where Pfau left off, Austin integrates a vast and divergent set of literatures on developmental theory and youth audiences. Her developmental stage-specific review gives readers the means to understand the cognitions, motivations, sources of influence, media use habits, and a variety of other important message design considerations for children in six age groups (0–5, 5–7, 7–10, 10–13, 13–16, and over 16). Austin's thorough review presents and defends four important message design recommendations for youth audiences: start early; segment and target by age group and environmental differences; strive for consistent messages from a variety of sources over a long period of time; and emphasize giving children control and ownership of their own destinies.

    In Chapter 8, Witte proposes a transtheoretical model to guide health message designers’ actions. In addition to integrating diverse behavior change theories, Witte's model provides a step-by-step guide to the process of designing health messages. As such, it is an important bridge to the second section of this book. The model emphasizes the interrelationships among decisions made about selecting the content of a message based on the particular audience for whom the message is designed, in conjunction with the source and channel selection.

    The specific examples used for illustration in these chapters are largely drawn from the personal experiences of the authors. The examples address a wide variety of health promotion issues including the prevention of cancer, substance use, AIDS, and accidents. The reader can thus benefit both from the authors’ efforts to integrate and extend theory into prescriptions for health message design, and by seeing these prescriptions illustrated in application to “real-world” examples along the way.


    1. Dewey, J. (1929). Experience and nature. New York: Norton.

  • About the Contributors

    Erica Weintraub Austin, Ph.D., is Assistant Professor of Communication and Head of the Public Relations sequence at Washington State University in Pullman. Her research focuses on the development of decision-making skills through uses of mass media and interpersonal sources, particularly in the realms of substance abuse and public affairs. She is also interested in how parents can affect their children's interpretations of media messages, thereby affecting the decisions children make about a variety of important issues. Recent work includes publications in Communication Research, Journal of Broadcasting & Electronic Media, Journalism Quarterly, and a contribution to Relational Communication and Health Outcomes (edited by G. Kreps and Dan O'Hair, in the SCA Applied Communication Series). She recently worked with the state of Washington to develop a statewide alcohol abuse prevention campaign aimed at the parents of 3- to 10-year-olds.

    George I. Balch, Ph.D., is Visiting Associate Professor in the Department of Marketing at the University of Illinois at Chicago. He is currently conducting social marketing research at the Prevention Research Center of the University of Illinois and consulting with the National Cancer Institute and the U.S. Agency for International Development to develop and monitor the effectiveness of communication interventions. He was formerly Vice President, Associate Director of Strategy and Research at DDB Needham Worldwide, one of the world's largest advertising agencies.

    David Cotton, Ph.D., M.P.H., is Research Psychologist in the Behavioral and Prevention Research Branch, Division of STD/HIV Prevention at the Centers for Disease Control and Prevention. He received his doctoral degree in Clinical Psychology from the University of Alabama while concurrently pursuing his public health degree at the University of Alabama at Birmingham. His current research interests are in the development of social science-based interventions modifying STD- and HIV-related risk behaviors in community-level, small group, and one-on-one settings.

    James Price Dillard, Ph.D., is Associate Professor at the University of Wisconsin in the Department of Communication Arts. His research examines compliance-gaining in interpersonal relationships and has been published in such outlets as Communication Monographs and Human Communication Research.

    Lynne Doner, M.A., is Vice President and Director of Research at the Washington, D.C., office of Porter/Novelli. Her research interests include applying commercial market research techniques and data to target audience development in social marketing programs, and developing useful process evaluation methodologies for mass media components of health promotion and disease prevention programs.

    Jerold L. Hale, Ph.D., is Associate Professor in the Department of Speech Communication at the University of Georgia. His research interests include social influence and relational communication. His research examines persuasion and influence in interpersonal relationships. His work has been published in Communication Monographs and Human Communication Research, as well as other national and regional outlets.

    Sharon Lee Hammond, Ph.D., is Adjunct Assistant Professor at the University of Maryland's Graduate School of Management and Technology, where she teaches the graduate-level quantitative research methods and marketing research methods courses. She received her Ph.D. from the University of Maryland's Health Communication Program in 1990. She has conducted survey and experimental research in the areas of cancer, AIDS, environmental health risks, and medication communication, resulting in publications in a variety of journals and edited books, including Science, Technology & Human Values, Communication Research, Health Communication, Health Education Quarterly, Communication Yearbook, and Health Education Research. She is also the editor of a special issue of Health Communication on the topic of communicating with patients about their medications.

    David R. Holtgrave, Ph.D., is the Acting Assistant Director for Behavioral Science, Office of HIV/AIDS, Centers for Disease Control and Prevention, and is an adjunct faculty member in the Emory University School of Public Health, Division of Behavioral Science and Health Education. He received his Ph.D. in Quantitative Psychology from the University of Illinois and did postdoctoral work at the Harvard School of Public Health, Interdisciplinary Programs in Health. His work on decision analysis and the psychology of decision making has been published in such outlets as Risk Analysis, Medical Decision Making, Journal of Behavioral Decision Making, Journal of Family Practice, and Archives of Internal Medicine. His research interests include behavioral decision making, risk communication, and the evaluation of prevention programs.

    Cecile Johnston, Ph.D., is the Director of Communications Research at Prospect Associates. In this capacity, she is responsible for the design, implementation, and analysis of research projects devoted to the promotion of social programs, particularly those involving health communications. As project director, she designs and oversees implementation of formative, process, outcome, and impact studies of health programs for the Office of Cancer Communications, National Cancer Institute.

    Mary Louise Kahl, Ph.D., is Assistant Professor in the Department of Communication at the State University of New York in New Paltz. Her research interests include the rhetoric of women's health care.

    Linda S. Kay, M.P.H., is a Public Health Analyst in the Behavioral Studies Section, Behavioral and Prevention Research Branch, division of STD/HIV Prevention, National Center for Prevention Services, Centers for Disease Control and Prevention. Her current research interests emphasize health communication and behavioral science, especially as it relates to HIV prevention in adolescents and in the workplace.

    R. Craig Lefebvre, Ph.D., is Chief Technical Officer and Vice President, Health Communications at Prospect Associates, a health communications firm located in Rockville, MD. He has authored more than 50 publications in the areas of social marketing, health promotion, and community-based programs. His current work includes planning, developing, implementing, and evaluating cancer communications programs; social marketing and media advocacy approaches to tobacco control; international communications efforts directed toward HIV prevention; and applications of social marketing to health reform.

    Kay Loughrey, M.P.H., R.D., is a Public Affairs Specialist in the Office of Cancer Communications of the National Cancer Institute. She directs the 5 A Day for Better Health's media campaign and coordinates nutrition education programming for NCI.

    Edward W. Maibach, M.P.H., Ph.D., is Assistant Professor in the Division of Behavioral Sciences and Health Education and Director of the Center for Health and Risk Communication at the Emory School of Public Health. He is a communication scientist with research interests in the use of mass and interpersonal communication campaigns to promote health enhancement. He is actively involved in social marketing research, and is currently conducting both experimental and evaluation research studies on effective communication strategies for the prevention of cancer, AIDS, STDs, and adolescent pregnancy. He has written a number of articles and book chapters on these topics, including several examinations of the implications of Bandura's social cognitive theory for HIV prevention campaigns.

    John McGrath is the Chief of the Communications and Marketing Section at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health in Bethesda, MD. N.H.L.B.I. coordinates national health education campaigns on blood pressure, cholesterol, asthma, and warning signs for heart attacks that make extensive use of mass media. He is a doctoral candidate at the University of Maryland.

    Jennifer L. Monahan, Ph.D., is Assistant Professor in the Department of Speech Communication at the University of Georgia. Her research focuses on emotion and affect in communication. She has published her work in such outlets as Communication Monographs and the Journal of Communication.

    Glen J. Nowak, Ph.D., is Assistant Professor in the Department of Advertising at the University of Georgia. He is also a Visiting Communication Scientist at the National AIDS Information and Education Program at the U.S. Centers for Disease Control.

    Roxanne Louiselle Parrott, Ph.D., is Assistant Professor in the Department of Speech Communication and a Fellow in the Institute of Behavioral Research at the University of Georgia. She also has an adjunct appointment in the Department of Medicine at the Medical College of Georgia. She is coauthor (with Michael Pfau) of Persuasive Communication Campaigns and primary author of Women's Health Care Campaigns: The Rhetoric of Reproduction. Her research interests include an examination of how mediated and interpersonal communication interface, affecting individuals' involvement with message content.

    Michael Pfau, Ph.D., is Professor in the School of Journalism and Mass Communication at the University of Wisconsin-Madison. He has authored more than 40 articles, many dealing with influence strategies in health campaigns, appearing in such journals as Communication Monographs, Human Communication Research, and others. He has coauthored four books, the most recent, Persuasive Communication Campaigns (1993) with Roxanne Parrott. He is a past recipient of the Speech Communication Association's Golden Anniversary Monograph Award.

    Michael J. Siska, M.S., is Health Communication Research Specialist in the National AIDS Information and Education Program of the Centers for Disease Control and Prevention.

    Michael D. Slater, Ph.D., M.P.A., is Associate Professor in the Department of Technical Journalism at Colorado State University in Fort Collins. He received his doctoral degree in Communication at Stanford University in 1988, and was a predoctoral fellow with the Stanford Center for Research in Disease Prevention; prior to that, he was a public relations executive in New York City specializing in technology, health, and education. He is currently principal investigator of a study funded by the National Institute on Alcohol Abuse and Alcoholism on adolescent responses to alcohol advertising, and recently conducted or consulted on audience research and message/channel evaluation studies for AMC-Cancer Research Center and the U.S. Department of Agriculture (on minimizing exposure to pesticides). His research on message effects, attitude influence processes, and audience segmentation has appeared in journals including Communication Research, Health Education Quarterly, Journal of Communication, Journal of Public Relations Research, and Journalism Quarterly.

    Sharyn M. Sutton, Ph.D., is currently the Director, Nutrition Marketing and Education in Food and Nutrition Services at the U.S. Department of Agriculture where she is directing the national nutrition education efforts of F.N.S. Prior to joining USDA, she was Chief of the Information Projects Branch, Office of Cancer Communications at the National Cancer Institute where she directed NCI's health communications and communications research activities. She teaches, speaks, and publishes on social marketing issues, consumer research, and human information processing.

    Barbara J. Tinsley, Ph.D., is Associate Professor in the Department of Psychology at the University of California at Riverside and Clinical Associate Professor in the Department of Gynecology and Obstetrics at Loma Linda University Medical Center. She received her M.S. and Ph.D. degrees in Human Development, Educational Psychology at the University of Illinois at Urbana. Her research interests include family health risk management, interactions in health contexts, child health socialization, and predictors of maternal and child health services utilization.

    Kim Witte, Ph.D., is Assistant Professor in the Department of Communication at Michigan State University. Her research focuses on the role of fear in public health campaigns. Recently, she has begun to examine how members of diverse cultures respond to fear appeals. Her work has appeared in International Quarterly of Community Health Education, Social Science and Medicine, Communication Monographs, and elsewhere.

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