Participatory Communication in International Context

Participation through communication has been studied internationally in analyzing social change at varying levels of analysis. In modernization theory, it was used largely at the national level for analyzing media consumption and participation in democratic political institutions, particularly voting, in newly established countries. In postmodernization theory, Paulo Freire and others employed it to analyze both interpersonal interaction and community development processes. Since that time, interest in participatory processes has proliferated in a variety of community development, social movement, and other middle-level social change efforts, including some operating via social media. In addition, with increasingly urgent threats posed by pandemics, human rights violations, global warming, and other international pressures today, transnational forms of civic and political action are increasingly treated as processes of global level participation. The idea of a global political public sphere is one of these processes. Citizen representation in multilateral organizations, global social movements, and other forms of cosmopolitan action are also treated as participation. A comprehensive understanding of participatory communication in the international context must attend to social processes at various levels of analysis, ranging from local project interventions to national political processes to global change.

Queer Healthcare Communication

Queer healthcare communication spans different literature and topic areas. The medicalization of queer bodies has historically and continues to influence how queer individuals interact and communicate within healthcare settings. Further, heterosexism is rampant within medical institutions that perpetuate the idea that all patients are heterosexual. Because of the influence of heterosexism, medical schools are designed to ignore queer bodies. If queer bodies are acknowledged, they are positioned as something exotic and not presented as a typical patient. Heterosexism is further communicated in patient and provider interactions by providers assuming their patients’ heterosexual identity and assuming all queer patients are promiscuous. In turn, queer patients may make decisions about their healthcare based on providers’ heterosexist attitudes. Providers who practice medicine have also demonstrated their limited knowledge about queer patients and how to care for them. The literature on discrimination of queer patients focuses more on how providers have used both verbal and non-verbal forms of communication. In looking at queer discrimination, queer invisibility demonstrates more covert functions of healthcare communication. Due to the invisibility of queer patients, disclosure becomes a site of interest for researchers. While some queer patients try to seek out queer-friendly providers, researchers have given recommendations on how healthcare providers can improve their queer competency. Finally, some notable topics within queer healthcare communication include queer pregnancy, HIV, and why transgender identity should be a separate topic as transgender people have their own healthcare needs.

Cultural Fusion in Physician–Patient Communication and Decision Making in Japan

The term “cinemeducation” was coined by Matthew Alexander in 2002, and according to P. Ravi Shankar, it refers to the use of clips from movies and videos to educate medical students and residents on the psychosocial aspects of medicine. As a counterbalance to the biomedicine-centric medical curricula, cinemeducation deals with the psychosocial aspects of medicine and sensitive topics in healthcare, including but not limited to depression, family and marital counseling, doctor–patient relationships, family systems, addiction, mental illness, cultural competency, and foreign patients and their healthcare beliefs. Cinemeducation is particularly useful when the viewing is followed by a discussion, which engages students in active learning of clinically relevant concepts such as informed consent (IC), palliative care, and patient-centeredness. In other words, cinemeducation provides students in the healthcare fields with opportunities to learn about the humanistic aspects of medicine by watching movies or clips that provide insight into human experiences and challenges in medicine. A famous Japanese medical TV series, Shiroi Kyoto (The Great White Tower) will be examined to discuss the cultural fusion that has occurred in Japan, specifically with regard to clinical communication. Based on a novel authored by Toyoko Yamazaki in the 1960s, this series is of interest because the novel was made into a drama twice, first in the 1970s and again in 2003. Accordingly, several significant changes in health communication are noticeable between the first and second versions. Social changes in paternalism in medicine, palliative care, and IC that were adapted from the West and localized in Japan, as cultural fusion are evident in several noteworthy scenes.

Sexual Orientation and Gender Identity Disclosure in the Medical Context

For individuals who identify as LGBTQ+, disclosing sexual orientation and/or gender identity can be a complex and risky conversation. However, in the medical context this conversation frequently becomes a central part of communication between patient and provider. Unfortunately, this conversation can also become a barrier that prevents patients from receiving or even accessing necessary medical care. LGBTQ+ individuals have reported experiencing significant discrimination in day-to-day life, and more specifically in patient–provider interactions. This discrimination leads LGBTQ+ individuals to avoid seeking necessary medical care and also frequently results in unsatisfactory care and poor health outcomes. This is of concern as LGBTQ+ individuals present with significantly higher rates of health issues and overall higher risks of cancer, chronic illnesses, and mental health concerns. Unfortunately, many medical providers are unequipped to properly care for LGBTQ+ patients and lack opportunities for education and training. This lack of experience leads many providers to operate medical offices that are unwelcoming or even inhospitable to LGBTQ+ patients, making it difficult for those patients to access inclusive care. This can be of particular concern when the patient’s sexual orientation or gender identity becomes relevant to their medical care, as they may feel uncomfortable sharing that information with a provider. Patient self-disclosure of sexual orientation or gender identity to a medical provider not only can contribute to a more positive relationship and improved quality of care but also can improve the psychological outlook of an LGBTQ+ individual. However, potential stigmatization can lead to the concealment of sexual orientation or gender identity information. These acts of concealment serve as intentional mechanisms of impression management within the patient–provider interaction. When LGBTQ+ patients do discuss their sexual orientation or gender identity with a provider, it is most often because the information is directly relevant to their health and disclosure, and therefore becomes essential and often forced. There are instances where LGBTQ+ patients are motivated to disclose to a provider who they believe will respond positively to information about their sexual orientation or gender identity. Disclosure of sexual orientation or gender identity may be direct in that it is clear and concrete. It may also be indirect in that individuals may use particular topics, such as talking about their partner, to broach the subject. Participants may also use specific entry points in the conversation, such as during taking a medical history about medications, to disclose. Some individuals plan and rehearse their disclosure conversations, whereas others disclose when they feel they have no other choice in the interaction. Increasing inclusivity on the part of providers and medical facilities is one way to promote comfortable disclosure of sexual orientation or gender identity. Additionally, updating the office environment and policies, as well as paperwork and confidentiality procedures, can also promote safe disclosure. Finally, improvements to training and education for healthcare professionals and office staff can dramatically improve interactions with LGBTQ+ patients. All of these efforts need to make integration of knowledge about how LGTBQ+ individuals can disclose comfortably and safely a central part of program design.

The Independent Media of New Zealand

New Zealand has high global measures for press freedom, democracy, and wealth. Historically, if a country has had strong index rankings for press freedom, democracy, and wealth, they also have a robust independent media system. However, that has not been the case in New Zealand where the independent media is lacking, despite the fact the country ranks extremely highly for press freedom, democracy, and wealth. The lack of a robust independent media in New Zealand may be due to five unique reasons: the small size of the country, the reliance on international news, a wariness toward the entire media landscape, the reserved culture of New Zealand, and the flood of content online.

Minority Stress and Relationships

Minority stress for the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and African American communities has been well documented over the past 30 years. Generally speaking, being a member of a stigmatized community can lead to alienation from social structures, norms, and institutions, all of which can have negative implications for mental health, well-being, and relationships. When speaking about minority stress and its impact on LGBTQ+ relationships, the research is mixed. Although there are findings that show LGBTQ+ individuals face greater discrimination and more negative health impacts than heterosexual couples, other research notes the positive coping mechanisms that highlight the resilient nature of these couples. For African Americans and other racial minorities, the disparities are greater, with research showing that racial identity is linked to an increase in overall external stressors. However, over the last few years, discrimination toward sexual and racial minorities has reached a critical tipping point. Both within the United States and worldwide, social movements are drawing attention to the historical inequalities experienced by minority groups, and demanding change. Considering minority stress research, methods, and analyses are built on the connection between an individual and their social situations, the construct is due for an evolution, one that is representative of what our world looks like today. Although conceptualizations thus far have been productive in understanding the stressors of the LGBTQ+ and African American communities, there is a need to incorporate critical concepts of intersectionality and expand understanding of what it means to be a member of a minority group.

Digital Communication Effects on Loneliness and Life Satisfaction

The question of whether and how digital media use and digital communication affect people’s and particularly adolescents’ well-being has been investigated for several decades. Many studies have analyzed how different forms of digital communication influence loneliness and life satisfaction, two comparatively stable cognitive indicators of subjective well-being. Despite this large body of empirical work, the findings remain ambivalent, with studies resulting in positive, negative, or nonsignificant effects. Several meta-analyses suggest that the overall effect of digital communication on life satisfaction is probably too small to suggest a detrimental effect. The net effect of digital communication on loneliness, by contrast, is positive, but likewise small. Yet the studies on which these meta-analyses are based suffer from several limitations. They often adopt a limited perspective on the phenomenon of interest as a disproportionate amount of work focuses on interpersonal differences instead of intra-individual, contextual, and situational effects, as well as their interactions. Furthermore, studies are often based on cross-sectional data, use unvalidated and imprecise measurements, and differ greatly in how they conceptualize digital communication. The diversity in studied applications and forms of digital communication also suggests that effects are most likely bidirectional. Passive digital communication (e.g., browsing and lurking) is more likely to result in negative effects on well-being. Active and purposeful digital communication (e.g., posting, liking, conversating), by contrast, is more likely to result in positive effects. Future research should therefore investigate how the various levels of digital communication (including differences in devices, applications, features, interactions, and messages) interact in shaping individuals’ well-being. Instead of expecting long-term effects on comparatively stable cognitive indicators such as life satisfaction, scholars should rather study and identify the spatial and temporal boundaries of digital communication effects on the more fluctuating affective components of well-being.

Global Networking of NGOs

The typology of nongovernmental and nonprofit organizations (NGOs) classifies them according to their orientations and levels of operations. The type of ties associated with NGOs and related networks are complex and pervasive. To help readers understand the structural features of these networks, several theoretical frameworks and theories (i.e., world system theory, world polity theory, organizational ecology theory, and issue niche theory) are offered as different explanations for the antecedents and consequences of NGO networks.

Challenges to Press Freedom in India

Since the late 1990s, the news media landscape in India has experienced widespread and arguably transformative shifts that are manifest in the explosive growth of media outlets and consumption at both national and regional levels. As of 2021, the country has over 100,000 registered periodicals and newspapers, with 17,000 dailies that report a combined circulation of over 240 million copies according to government data, as well as an estimated 400 news and current affairs channels and numerous news-related websites. Yet despite the existence of a seemingly dynamic and expansive news landscape, many observers have expressed significant concerns about the independence of the Fourth Estate in the world’s largest democracy. According to the annual World Press Freedom Index, compiled by the media watchdog group Reporters without Borders, India has experienced a steady decline in press freedom since 2015, slipping from a position of 135/180 in 2015 to 140/180 in 2019, and 142 in the 2020 report. At present, India ranks behind most of its neighbors, including Afghanistan (122), Bhutan (67), Nepal (112), and Sri Lanka (127). Thus, even though the writers of India’s constitution clearly recognized the right to the freedom of the press as an essential part of the freedom of speech and expression as guaranteed in Article 19(1)(a) of the Constitution, and this right has generally been upheld in court, the space for the free expression of views and critique by the press—widely recognized as crucial to democratic functioning—has been shrinking consistently in the Indian context due to a variety of threats ranging from physical violence and intimidation of journalists, and government pressure on news outlets to structural economic forces.

Celebrity, Influencer, and Brand Endorsement: Processes and Effects

A celebrity is a well-known person who commands public recognition and fascination. Given the prevailing consumption culture, the celebrity often engages in brand endorsement practices, making celebrity endorsement (CE) a major advertising strategy. The major strands of CE research highlight key players: the celebrity, consumer, and endorsed brand. In addition to factors that can be traced directly to the celebrity (e.g., trustworthiness, attractiveness, images), CE research discusses how the celebrity’s match with a product or brand and how the celebrity’s relationship with consumers (both fans and the general public) offers important contingency factors that impact the effects of CE. The emergence of influencers in the 21st century gives rise to a new breed of celebrities on social media. Influencers are ordinary-people-turned-experts who specialize in an area of interest (e.g., lifestyle, food, travel). Without the traditional celebrity’s glamour, they use “authentic” and “similar” strategies in their self-branding efforts. They are passionate, sharing their personal brand usage experiences with and providing contextualized recommendations to consumers; and their relationship with consumers is characterized by trust, intimacy, and dialogue. These practices allow an influencer to address the consumer’s instrumental and relational needs when making purchase decisions, an act that a traditional celebrity is less effective in making happen. The celebrity and influencer illustrate the industry- and socially-constructed star-making processes, respectively. On the one hand, traditional celebrities’ path to fame is supported by networked media and the entertainment system. Influencers, on the other hand, create contents that netizens can pick and choose to like and follow, making their path to fame a socially- constructed process. The star-making industries in the 21st century are embracing big data, AI, and machine-learning algorithms as a new governance to “design” and “manufacture” celebrities. In so doing, they usher in an industry-constructed process that has the power and control at an unprecedented scale. The K-pop stars and virtual influencers thus created and managed have been successful. However, their path to fame raises concerns over institutional governance, regulatory control, and ethics of the celebrity and endorsement businesses as well as the means of cultural production. These issues together render celebrity studies and endorsement research a discipline both interesting and challenging to pursue.