communication programs do now to serve the diverse audiences they must address? How might what they do be improved?

In the process of examining this central question, the committee addressed a series of closely related questions:

  • What is the role of theory in the construction of communication programs in the context of diversity? In particular, is there a need to modify theory for different subgroups of the population?

  • Given concerns about diversity, do special ethical issues arise in health communication?

  • Is the promise of communication and diversity different according to the health behavior(s) and disease process addressed? Is there evidence that targeting or tailoring messages for different cultural groups makes a difference in the effects of these messages on behavior change? The committee contrasted two important cases to help us consider this issue. Mammography was chosen to represent a discrete behavior that is recommended to occur every year or two for women age 40 and over; it is relevant to a large segment of the healthy population. Diabetes was selected as a contrast. Its treatment requires a complex set of continuing behaviors that is responsive to an evolving illness and relevant to those who have the illness and those around them.

  • Large-scale communication campaigns are widely used as a mechanism for affecting the behaviors of broad populations when risk is widespread. Thus, as a third area of focus, the committee considered evidence from such large-scale campaigns. What is known about the best ways of constructing such programs in the context of diversity?

  • The application of newer communication technologies to the problems of health promotion has an extraordinary dynamism. What are the implications of the rapid development of new technology-based health behavior interventions for the health of diverse audiences?

  • How helpful are the conventional categories of diversity in constructing communication interventions? Are there other, more useful, approaches to thinking about diversity?

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