• 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?

  • Are there special ethical issues that arise in health communication because of diversity?

  • Is the promise of communication for diverse populations different according to the health behavior(s) and disease process addressed?

  • What are the implications of the rapid development of new technology-based health behavior interventions for health disparities?

  • What are the most useful categories of diversity to be used in designing communication interventions?

With the issue of differential disease burden in mind, the committee chose as its exemplars the following: promotion of primary and secondary prevention strategies conveyed through mass health communication campaigns; secondary prevention of breast cancer with screening mammography; and primary, secondary, and tertiary prevention of Type 2 diabetes. These exemplars offer different communication challenges for behavior change in diverse populations.

We chose large-scale communication campaigns because they are widely used as a mechanism for affecting the behaviors of broad populations when the risk is widespread. We chose mammography because it involves a discrete behavior that should occur every year or two in a large segment of the healthy population. Diabetes was selected as a contrast to mammography; its treatment requires a complex set of continuing behaviors responsive to an evolving illness by those who have the illness as well as those around them. As noted, the focus of the committee’s review and analysis of the exemplars was to examine the effects of health communication on the health behavior of diverse populations. To ensure completeness of coverage, the review included studies in which communication campaigns were combined with other interventions (such as



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