HealthCommunication&
RationalDecisionMaking.
An Overview
RationalChoiceTheory in CommunicationResearch
Lugano, May 7, 2009
Marco Bardus
Institute of Communication and Health
Faculty of Communication Sciences
UniversitàdellaSvizzeraitaliana
marco.bardus@lu.unisi.ch
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Table of contents
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How are youtoday?
HOW DO
YOUFEEL?
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http://flickr.com/photos/ufosightings/3269808057/

What is Health?
“a state of complete physical, mental, and social well-
beingand notmerely the absenceofdisease or infirmity.”
(World HealthAssembly, 1948)
“a resourceforeveryday life, not the objectiveof living. Healthis a
and personal
positive conceptemphasizingsocial
resources, aswellasphysicalcapacities.”
(World HealthOrganization, 1986)
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What is Health Communication?
Healthcommunicationencompasses the study and
useofcommunicationstrategiestoinformand influenceindividual and community
decisionsthatenhancehealth. […]
Healthcommunication can contributetoallaspectsofdiseaseprevention and health promotion
and isrelevant in a numberofcontexts, including
relations,
(1) healthprofessional-patient
individuals’ exposureto, searchfor, and useofhealth information,
(2)
individuals’ adherencetoclinicalrecommendationsand regimens,
(3)
the constructionofpublic healthmessages and campaigns,
(4)
the disseminationofindividual and populationhealthrisk information, thatis,
(5)
riskcommunication,
imagesofhealth in the mass media and the culture at large,
(6)
the educationofconsumersabouthowtogainaccessto the public health and health
(7)
care systems, and
(8) the developmentoftelehealthapplications.
(US Office ofDiseasePrevention and Health Promotion)
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LiteratureSearch
Databaseses
ISI Web ofKnowledge, Jstor, ScienceDirect, SpringerLink,
PsycINFO, EBSCOhost (Communication& Mass Media
complete), CSA Illumina (Medline) and Scholar Google.
Keywords1
“rationalchoice”, “rationalchoicetheory”,
“rationaldecisionmaking”, “informeddecisionmaking” +
“health”, “healthbehavio*”, “self-management”,
“medicalcompliance” or “medicaladherence”,
“treatment adherence” or “treatment compliance” =
+1000 entries.
Keywords2
“rationalchoicetheory” or “rationalchoicemodel” +
“healthbehav*” or “healthdecisionmaking” = 70 entries
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In a Nutshell
Health topics
Risk and Sexual behavior: HIV-AIDS prevention
(Bell et al., 1998; Eifler, 2004; Eskridge&Weimer, 1994;
Reyna&Farley, 2006; Takyi, 2000)
Addictive behaviors
(Monterosso &Ainslie, 2007; Suranovic, Goldfarb& Leonard,
1999)
Prenatal diagnosis
(Bekker, Hewison& Thornton, 2004)
Diabetesself-management (Baker, 2006)
Health Care Professional’sperspective
(Freemantle, 1996; Friedman, 1965)
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Open Questions&Limitations
Rational Decision Making (Broadstock&Michie, 2000) => Naturalistic
approach is preferable; it does not work for all health issues; HIV
Epidemics does not work (Eskridge& Weimer, 1994)
TPB & TRA (Armitage, Conner& Norman, 1999) => applies to some
extent and to some behaviors: mood influences performance
Habit vs. Rational Choice (Lindbladh&Lyttkens, 2002) =>non-reflective
and repetitivebehaviors (applytolower social positions)
HealthLifestyleTheory (Cockerham, 2005): Abandon the
individualisticparadigm in favourof a agency and structureapproach
=>
Social DeterminantsofHealthbehaviors (Chinet al., 2000) =>QoL
(Ormelet al., 1997):
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Healthbehaviordecisionmaking: isthatrational?
CRITICISMS AND LIMITATIONS.
WHAT DO YOUTHINK?
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YOU
THANK
FOR THE ATTENTION!
Marco Bardus
marco.bardus@gmail.com
marco.bardus@lu.unisi.ch
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References - 1
Glanz, K., Rimer, B. K., & Marcus Lewis, F. (2002). Healthbehavior and healtheducation: Theory, research, and practice San
Francisco: Jossey-Bass.
Montano, D.E., &Kasprzyk, D. (2002). The TheoryofReasonedAction and the TheoryofPlannedBehavior. In Glanz, K., Rimer,
B. K., & Lewis, F. M. (Eds.). Healthbehavior and healtheducation: Theory, research, and practice San Francisco:
Jossey-Bass.
Armitage, C. J., Conner, M., & Norman, P. (1999). Differentialeffectsof mood on information processing: Evidencefrom the
theoriesofreasonedaction and plannedbehavior. European Journal of Social Psychology, 29, 419-433.
Baker, R. M. (2006). Economicrationality and health and lifestylechoicesfor people withdiabetes. Social Science & Medicine,
63(9), 2341-2353.
Bekker, H. L., Hewison, J., & Thornton, J. G. (2004). Applyingdecisionanalysisto facilitate
informeddecisionmakingaboutprenataldiagnosisfor down syndrome: A randomisedcontrolled trial. Prenatal Diagnosis,
24, 265-275.
Bell, D. C., Richard, A. J., Montoya, I. D., Elwood, W. N., Goush, S. N., & Matta, B., N. (1998). Social network utility and the
economicsofrisk: The case of HIV. Journal ofEconomicBehavior&Organization, 33, 195-205.
Broadstock, M., &Michie, S. (2000). Processesofpatientdecisionmaking: Theoretical and methodologicalissues. Psychology
and Health, 15, 191-204.
Chin, N. P., Monroe, A., & Fiscella, K. (2000). Social determinantsof (un)healthybehaviors. EducationforHealth, 13(3), 317-
328.
Cockerham, W. C. (2005). Healthlifestyletheory and the convergenceofagency and structure. Journal ofHealth and Social
Behavior, 46(1), 51-67.
Eifler, S. (2004). Rationalchoice, personality and HIV-preventivebehavior in the presenceofopportunities. Journal ofApplied
Social Psychology, 34(6), 1251-1280.
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References - 2
Eskridge, W. N., &Weimer, B. D. (1994). The economicsepidemic in an AIDS perspective. The Universityof Chicago
LawReview, 61(2), 733-774.
Freemantle, N. (1996). Are decisionstakenbyhealth care professionalsrational? A non systematicreviewofexperimental and
quasi experimentalliterature. Health Policy, 38, 71-81.
Friedman, J. F. (1965). The valueof free choice in health care. Medical Care, 3(2), 121-127.
Lindbladh, E., &Lyttkens, C. H. (2002). Habit versus choice: The processofdecision-making in health-relatedbehaviour. Social
Science & Medicine, 55, 451-465.
Monterosso, J., &Ainslie, G. (2007). The behavioraleconomicsofwill in recoveryfromaddiction. Drug and AlcoholDependence,
90S, 100-111.
Ormel, J., Lindenberg, S., Steverink, N., &Vonkorff, M. (1997). Qualityof life and social production functions: A
frameworkforunderstandinghealtheffects. Social Science & Medicine, 45(7), 1051-1063.
Reyna, V. F., &Farley, F. (2006). Risk and rationality in adolescentdecisionmaking. implicationsfortheory, practice and public
policy. Psychological Science in the Public Interest, 7(1), 1-44.
Suranovic, S. M., Goldfarb, R. S., & Leonard, T. C. (1999). An economictheoryofcigaretteaddiction. Journal
ofHealthEconomics, 18, 1-29.
Takyi, B. K. (2000). AIDS-relatedknowledge and risks and contraceptivepractices in ghana: The early 1990s. African Journal
ofReproductiveHealth / La Revue Africane De La SantéReproductive, 4(1), 13-27.
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