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Autoimmune disease disproportionately afflicts women of color (i.e., Black/African American, Hispanic/Latina, Multiethnic-racial) of childbearing age. Social determinants of health (SDOH) and dismissive healthcare provider (HCP) interactions exacerbate these disparities in health outcomes for women of color with autoimmune disease. Guided by the theory of communicative (dis)enfranchisement, this study assesses whether disenfranchising talk (DT) mediates the relationship between SDOH (i.e., race/ethnicity, insurance status, income, employment, education, and sexual orientation) and health outcomes including patient satisfaction, overall well-being, and tangible social support for women of color with autoimmune disease. Findings affirmed the mediating role of DT, such that Multiethnic-racial patients and those with less insurance coverage and lower household income reported less tangible social support, poorer overall well-being, and lower patient satisfaction when they experienced HCP DT. We offer theoretical and practical implications. [ABSTRACT FROM AUTHOR]

This activity extends the rich pedagogical scholarship on impromptu speaking by integrating visual imagery into the impromptu speaking exercise. The goal of this semester-long series of exercises is to provide students with the opportunity to apply effective delivery skills across general purposes of speaking, receive feedback, and thus develop the ability to self-correct behaviors and strengthen core public speaking competencies over the course of a semester. The integration of visual imagery offers an engaging medium through which these quick-thinking skills are developed and refined for both the speaker and the audience. Courses: Introductory Public Speaking, Advanced Public Speaking, Business and Professional Speaking, Interview Communication, Mass Communication, Public Relations. Objectives: After repeated participation in impromptu speech exercises for varying general purposes, students should be able to (a) demonstrate an increased awareness of nonverbal behaviors, (b) apply practices of effective delivery across general purposes of speaking, and (c) demonstrate increased ability to speak extemporaneously.

Guided by the theory of communicative (dis)enfranchisement (TCD), this study interrogates how interactions in which chronic pain patients are force tapered from their prescribed opioids are constrained and afforded by the hegemonic ideologies. To interrogate the harms caused for chronic pain patients by ideological policies enacted by the Centers for Disease Control and Prevention and assess what communicative mechanisms reify and resist such ideologies, this research analyzes 238 posts authored by chronic pain patient Reddit users. Reflexive thematic analysis illuminated a hegemonic ideology of opiophobia, (im)material ramifications of (a) discrimination by doctors, and (b) political and legal interference; mechanisms of reification: (a) positioning suicide as a rational option, (b) advocating for the use of illicit substances, and (c) stopping opioids voluntarily; and mechanisms of resistance: (a) counter-organizing and (b) counter-generating knowledge. We offer theoretical implications for the TCD and practical implications for patients, providers, patient advocacy organizations, and policymakers. [ABSTRACT FROM AUTHOR]

Addressing calls for increased communication scholarship that interrogates power in stigma processes, we develop a critical postmodern approach to stigma management communication (SMC) theory and demonstrate how it can be used in the context of difficulty orgasming. Semi-structured interviews with mostly white, cisgender women experiencing orgasm difficulties in mixed-sex relationships (N = 31) revealed how dominant discourse creates an idealized standard of sexual behavior that stigmatizes women with orgasm difficulties, and how stigma management strategies act as discursive practices that reify, resist, and transform the status quo. We extend SMC theory by articulating a critical postmodern approach that can be used to interrogate power in stigma processes, and by illuminating how stigma management strategies are enacted in varied ways and toward different ends. Practically, our findings underscore the need for multifaceted interventions aimed at addressing the underlying causes of stigma and offer recommendations for reducing stigma through health campaigns, programming, and care. [ABSTRACT FROM AUTHOR]

Guided by the integrative theory of communication work, we present a computational and qualitative analysis of Reddit comments authored by patient-users living with chronic overlapping pain conditions. We first employed computational text analysis to compress the data corpus via structural topic modeling. The community detection algorithm Louvain was employed to identify communities of topics within the data. Then, we extracted a subset of the data and performed a computer-aided qualitative thematic co-occurrence analysis. Topic modeling revealed 35 topics and five thematic communities. The qualitative analysis revealed that these topics mapped onto and extended the typology of communication work and contributing factors and identified co-occurrence patterns both among and across research questions. Our findings offer methodological, theoretical, and practical implications. [ABSTRACT FROM AUTHOR]

In this essay, we set forth the theory of communicative (dis)enfranchisement (TCD). The TCD is useful for exploring the ramifications of the hegemonic ideologies which constrain and afford our everyday lives, and which are constructed and reflected in disenfranchising talk (DT). The TCD also asks what communication mechanisms work to reify and resist these hegemonic ideologies. We first introduce the warrant for this theorizing, then overview the assumptions of critical postmodernism and propositions of the TCD. We offer guidance for using the TCD via example research questions, suitable contexts, methodological tools, and conclusions researchers can potentially render. We offer criteria for evaluating the TCD regarding its consistency with critical postmodernism, utility as a heuristic framework, and capacity for claims-making. We respond to potential critiques of the TCD by distinguishing the TCD from six related bodies of communication theorizing, and by addressing the purported opaqueness of critical theorizing. Finally, we offer an example analysis to illustrate the TCD in research practice. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 (COVID-19) pandemic introduced many challenges and nuances that have transformed medical practice and research. The uncertainty caused by COVID-19 led to inevitable challenges to patient–provider relationships. The ever-changing landscape of COVID-19 research and policy proved to be challenging for the medical community and patients. These challenges also exacerbated long-standing issues regarding patient–provider communication and trust. On the other hand, these challenges gave voice to a burgeoning patient advocacy community. Through social media, advocacy and patient organizing, patients harnessed their power and organized over challenges relating to COVID-19 fears and concerns, ramifications of "Long COVID," and much more. During this unprecedented pandemic, there was a realization that the science and research surrounding COVID-19 is evolving and that there may be a benefit to embracing the dynamic nature of research and the scientific process. We propose that providers and the medical community should consider epistemological humility, which acknowledges insufficiencies related to the state of medical knowledge with a sense of understanding and respect for not having all of the answers. We argue that there is untapped potential in saying, "We don't know" and explaining why. There is an implicit culture that providers should be responsible for knowing everything and solving every problem. Epistemological humility challenges this culture, and inherently gives credence and voice to patient perspectives. We assert that epistemological humility is necessity when addressing contemporary health challenges such as COVID-19. [ABSTRACT FROM AUTHOR]

The post-positivist articulation of the theory of communicative disenfranchisement (TCD) asserts that people subjected to disenfranchising talk (DT; talk that discredits, silences, and stereotypes) experience proximal consequences (PCs; reduced agency, perceived credibility, and ability to exercise rights and privileges) and make negative inferences about others’ future interactional goals (negative goal inferences [NGIs]). Through the mediators of PCs and NGIs, DT is theorized to lead to more distal health and well-being outcomes. This article developed measures of DT, PCs, and NGIs to test the TCD’s post-positivist model in the context of chronic pain. Items were developed and refined in a pilot study. Then, in two validation studies, exploratory and confirmatory factor analyses were conducted and health and well-being outcomes were assessed. Findings offer initial empirical support for the reliability and convergent, divergent, and predictive validity of the DT, PCs, and NGIs measures, as well as the model proposed in the post-positivist articulation of the TCD. [ABSTRACT FROM AUTHOR]

One in ten U.S. patients has an internally implanted medical device. Yet, lax regulation by the U.S. Food and Drug Administration (FDA) has resulted in the approval of medical devices disproportionately harming women, including Bayer Pharmaceutical's Essure, a permanent female sterilization device. Victims of Essure often suffer adverse events, including serious injuries, device malfunctions, and death. Guided by critical feminist theorizing, this case study examines 500 public docket comments written to the FDA by female patients recounting their experiences of adverse events with Essure. Reflexive thematic analysis revealed how women: (a) voiced their experiences to contest meanings of 'safety,' expressed identification with their 'E-Sisters,' and protected future women from harm; (b) identified forces of greed, deception, and gender bias as creating the conditions for harm to befall them; and (c) enacted resistance and called for a change in the status quo by the FDA and Bayer. Theoretical and practical implications for health communication researchers, medical practitioners and educators, and regulatory agencies are offered. [ABSTRACT FROM AUTHOR]

Reintegration after a military service member returns home from deployment is a time of uncertainty that requires adjustment by all family members. Building on accounts (i.e., story-like constructions that help make sense of stressful events) scholarship, this study documents (a) turning points (TPs) and (b) patterns in partners' levels of concern about post-deployment adjustment and investigates (c) how romantic partners account for why changes in adjustment concern occurred. Findings from interviews with 26 military partners reveal that accounts (a) involve multifaceted explanations spanning many domains of life, (b) explain why certain TPs increased and/or decreased concern, and (c) engage the meaning of time in varied ways. The importance of integrating an account-making framework with the TP methodology, theoretical implications for relational turbulence theory, and practical suggestions are discussed. [ABSTRACT FROM AUTHOR]

Interactions between female patients with chronic pain and their medical providers in which providers question or contest the "realness" or nature of their illness experience (e.g. "It's all in your head") have been reported extensively in the extant qualitative literature, particularly for poorly understood ("contested") chronic pain syndromes. Many terms have been offered to describe this talk (e.g. invalidating, dismissive), resulting in conceptual fragmentation and isolated silos of research which together report about one communicative phenomenon. To rectify this fragmentation, the present study offers a meta-synthesis which explores, analyzes, and integrates the findings of 82 qualitative interview studies representing the patient-provider communication experiences of 2,434 female patients living with one or more of 10 chronic overlapping pain conditions (COPCs). COPCs are costly, gendered, and poorly understood. From the meta-synthesis, three key concepts are identified: (1) Functions of disenfranchising talk: Discrediting, silencing, and stereotyping; (2) Effects of disenfranchising talk: Harmed agency, credibility; access to care, support, and resources; and perception of patient-provider relationship; and (3) Responses to disenfranchising talk: Submission, critique, and resistance. Findings confirm the centrality of gender in the experience of disenfranchising talk, underscore the need to adopt an intersectional approach to the study of this talk along additional axes of race and class, and offer heuristic value toward conceptually unifying research about female COPC patients' experiences of disenfranchising talk from providers. [ABSTRACT FROM AUTHOR]

Guided by communication theory of resilience (CTR), we analyze 453 narrative accounts by Reddit user healthcare workers (HCWs) of their experiences with COVID-19-related personal protective equipment (PPE) shortages between March and May 2020. Via thematic analysis and sensitized by CTR concepts, we examine PPE shortages as a disruptive trigger event that catalyzes the enactment of resilience processes. Findings problematize PPE shortages as material, discursive, and symbolic triggers and explore how HCWs communicatively construct resilience given PPE shortages. This study extends CTR by: (a) underscoring the multidimensional nature of disruptive trigger events, (b) distinguishing the temporal element in cascading trigger events during periods of sustained disruption, and (c) attending to the transformational processes within the adaptation-transformation dialectic with the inclusion of a sixth resilience process, critiquing and resisting the status quo. Critiquing and resisting the status quo interrelates to other resilience processes of maintaining and using communication networks, employing alternative logics, and affirming identity anchors. Practical implications are offered. [ABSTRACT FROM AUTHOR]

This brief study applies the four tenets of the communication approach to social justice (CSJ) to illustrate how a social justice sensibility can be promoted via communicative micro-practices during a qualitative research study. By analyzing ethically important moments (which revealed both participants' motivations for research participation and social justice needs) occurring during interviews with 26 women with vulvodynia, the CSJ framework elucidates the relationship between research practices, ethics, and social justice. Findings explore how foregrounding ethical principles, analyzing the structural issues affecting research participation, adopting an activist orientation, and engaging in identification and solidarity uphold a social justice sensibility. Theoretical and practical implications are offered. [ABSTRACT FROM AUTHOR]

This work extended the communication theory of resilience by examining how individuals construct anticipatory resilience through narratives of disruptive life events. Guided by postmodern antenarrative theory, we analyzed the emplotment of 25 individuals' narratives of disruptive events to understand how participants make sense of these events and prospectively craft resilience as storied logics of the future. The findings challenged extant resilience theorizing by centering narrative incoherence and conceiving of anticipatory resilience as a communicated logic of the future rather than as discursive-material resource. The analysis also suggested theoretical implications for this reframed understanding of anticipatory resilience and narrative incoherence as a site for critical investigation of resilience processes. [ABSTRACT FROM AUTHOR]

Chronic pelvic and genital pain conditions (CPGPCs) often go undiagnosed and untreated in women for years after symptom onset. This is due, in part, to communication challenges experienced by patients such as difficulties describing pain and the stigmatized nature of CPGPCs. However, studies have yet to explore how early messages about menstruation, a context similar in its stigmatized and painful nature, may contribute to undertreatment and diagnostic delays for adult women experiencing CPGPCs by normalizing pelvic and genital pain when they are young girls. Guided by critical feminist theorizing (CFT) and sensitized by an existing typology of negative messages communicated by mothers to daughters about menstruation, this study analyzes interviews with 17 women with CPGPCs to explore how features of negative messages about menstruation (i.e., information restriction and omission) appear and recur in women's descriptions of their later CPGP experiences. Findings suggest that early life talk about menstruation forms a communicative precedent for young girls which later constrains how they talk about CPGP in adulthood. Findings also problematize early-life communication about menstruation, which normalizes women's pain, and suggest connections to outcomes (e.g., diagnostic delays) for women with CPGPCs. Theoretical and practical implications are offered. Limitations and future directions are described. [ABSTRACT FROM AUTHOR]