Handbooks in Communication and Media

This series aims to provide theoretically ambitious but accessible volumes devoted to the major fields and subfields within communication and media studies. Each volume sets out to ground and orientate the student through a broad range of specially commissioned chapters, while also providing the more experienced scholar and teacher with a convenient and comprehensive overview of the latest trends and critical directions.

The Handbook of Children, Media, and Development, edited by Sandra L. Calvert and Barbara J. Wilson

The Handbook of Crisis Communication, edited by W. Timothy Coombs and Sherry J. Holladay

The Handbook of Internet Studies, edited by Mia Consalvo and Charles Ess

The Handbook of Rhetoric and Public Address, edited by Shawn J. Parry-Giles and J. Michael Hogan

The Handbook of Critical Intercultural Communication, edited by Thomas K. Nakayama and Rona Tamiko Halualani

The Handbook of Global Communication and Media Ethics, edited by Robert S. Fortner and P. Mark Fackler

The Handbook of Communication and Corporate Social Responsibility, edited by Øyvind Ihlen, Jennifer Bartlett and Steve May

The Handbook of Gender, Sex, and Media, edited by Karen Ross

The Handbook of Global Health Communication, edited by Rafael Obregon and Silvio Waisbord


The Handbook of Global Media Research, edited by Ingrid Volkmer

The Handbook of International Advertising Research, edited by Hong Cheng

The Handbook of Global Online Journalism, edited by Eugenia Siapera and Andreas Veglis


To Laura, Camilo, Andres and Yenis

To Nora and Luis

                                                 R. O.

To Sophia, Simone and Julie

                                                 S. W.

Notes on Contributors

Rukhsana Ahmed, PhD, is Assistant Professor in the Department of Communication, University of Ottawa. Her primary area of research is health communication with an emphasis on interpersonal communication across cultures and within organizations. She is also interested in issues of development, gender, religious diversity, and ethnic media. Her research has been published in Communication Studies, Intercultural Communication Studies, Women’s Health and Urban Life: An International and Interdisciplinary Journal, Journal of Cancer Education, Medical Informatics and the Internet in Medicine, and in several book chapters. She is currently coediting a book on health communication in media contexts.

Collins O. Airhihenbuwa, PhD, MPH, is Professor and Head of the Department of Biobehavioral Health, the Pennsylvania State University. He is the author of the PEN-3 model used to centralize culture in public health, health promotion, and health communication projects. He has published over 90 articles and book chapters. His books include Health and Culture: Beyond the Western Paradigm (1995); the UNAIDS Communications Framework for HIV/AIDS: A New Direction (1999); and Healing Our Differences: The Crisis of Global Health and the Politics of Identity (2007). He is a fellow of the American Academy of Health Behavior and the Academy of Behavioral Medicine Research.

Jesus Arroyave, PhD, is Director of the School of Communication and Associate Professor at Universidad del Norte in Barranquilla, Colombia. His professional interests focus on health communication and development, and journalism and media studies. He is the author and coauthor of three books and several journal articles and book chapters.

Stella Babalola, PhD, is Associate Professor and teaches Health Communication in the Department of Health, Behavior, and Society at Johns Hopkins University. She is also Senior Research Advisor at the Center for Communications Programs of the same university. Dr. Babalola has a wealth of experience in international health, teaching, communication, and research. She has published extensively. During the last five years, Dr. Babalola’s research has been largely in the areas of HIV risk reduction, childhood immunization, and adolescent reproductive health.

Gary Barker, PhD, is International Director of Instituto Promundo, a Brazilian NGO, with offices in Rio de Janeiro and Washington, DC, that works locally, nationally, and internationally to promote gender equity and to reduce violence against children, women, and youth. He has carried out research on masculinities, violence, gender, health, and conflict in Latin America, sub-Saharan Africa, and Asia and coauthored numerous training materials, including the Program H series.

Peter Benjamin, PhD, MSc, BSC, is the managing director of Cell-Life. His professional interests are in information and communications technology for social change, now focusing on mHealth. He is the author of over 20 chapters and published papers, and has presented at over 50 conferences.

Jane T. Bertrand, PhD, MBA, is the chair of the Department of Global Health Systems and Development at the Tulane School of Public Health and Tropical Medicine. She also holds the Neal A. and Mary Vanselow endowed chair. Her professional interests focus largely on program evaluation and behavior change communication in the areas of HIV prevention and international family planning.

William J. Brown, PhD, is Professor and Research Fellow in the School of Communication and the Arts at Regent University. His academic research interests include health communication, media, and social influence, and the use of entertainment-education for social change. He has published extensively in academic journals and books, including articles in Health Communication, the Journal of Health Communication, Communication Research, the Journal of Communication, Mass Communication & Society, International Communication Gazette, and The Asian Journal of Communication.

Ailish Byrne, PhD, is Senior Research Associate with the Communication for Social Change Consortium and a Nairobi-based consultant. Professional interests focus on participatory research and evaluation, action research, and capacity development across sectors, with keen interest in systemic and complexity-informed approaches. She is the coauthor of the Innovations in the Evaluation of Social Change Communication (UNAIDS, 2011); the external review report on IDRC’s Evaluation Unit, 2005–2010 (2010); Pushing the boundaries: New thinking on how we evaluate, MAZI 19, 2009; Evaluating social change and CFSC: New perspectives, MAZI 17, 2008; and Working toward evidence-based process: Evaluation that matters, MAZI 13, 2007.

Catherine Campbell, PhD, is Professor of Social Psychology at the London School of Economics, and Program Director of the MSc in Health, Community, and Development. Her research focuses on the role of collective action in tackling health inequalities, against the background of her interest in the role of transformative communication in building social capital for health in marginalized communities. She is author of Letting Them Die: Why HIV Prevention Programmes Fail (Indiana UP, 2003), and numerous articles in international health journals.

Ketan Chitnis, PhD, is the Regional HIV/AIDS Specialist with UNICEF Asia Pacific Shared Services Centre, Thailand. His professional and research interests are in health, communication, and empowerment in international development. Currently his work focuses on social protection for children and AIDS, and previously he advised and supported programs to manage behavior and social change interventions across child and maternal health issues. He has published in The International Communication Gazette, Journal of Creative Communications, Keio Communication Review, and Investigación y Desarrollo, among others.

Nicola Christofides is senior lecturer in the School of Public Health, University of the Witwatersrand, where she heads up the Masters in Public Health Program. Nicola was responsible for coordinating and developing a new field of study in Social and Behavior Change Communication at the School of Public Health. Prior to this she was a specialist scientist at the Gender and Health Research Unit, Medical Research Council. She has more than 10 years research experience in the area of gender-based violence, HIV/AIDS, reproductive health, and evaluating social and behavior change communication programs and interventions. She has published in a range of different journals.

Katherine de Tolly, MPhil, BA, is mHealth Project Manager and Senior Researcher at Cell-Life. Her professional interests include mHealth (the use of mobile technology in healthcare) and Web communications, with a particular emphasis on government, research, and HIV-related communications. She published her first journal article in 2011 and has presented at five conferences.

Lucía Durá, PhD, is Assistant Professor of Rhetoric and Writing Studies in the Department of English at the University of Texas at El Paso. Her dissertation focused on cultivating a rhetorical disposition for the practice of positive deviance action research, and her research interests focus on rhetoric for social change, methodology, medical rhetoric, technical and professional writing, and organizational communication. Her research collaborations have yielded numerous national conference presentations and publications on positive deviance, social change, methodology, and health education, including a coauthored monograph, Protecting Children from Exploitation and Trafficking: Using the Positive Deviance Approach (2009).

Mohan J. Dutta, PhD, is Professor of Communication at Purdue University, where he teaches and conducts research in international health communication, critical cultural theory, poverty in healthcare, health activism in globalization politics, indigenous cosmologies of health, subaltern studies and dialogue, and public policy and social change. Currently, he serves as senior editor of the journal Health Communication and sits on the editorial board of seven journals. He is the Associate Dean for Research and Graduate Education in the College of Liberal Arts at Purdue University, a Service Learning Fellow, and a fellow of the Entrepreneurial Leadership Academy at Purdue University where he has been developing a project on communication leadership in social change. He also directs the Center on Poverty and Health Inequities at Purdue University.

Eliana Elias is the cofounder and Executive Director of Minga Perú. Trained in social communication from the University of Lima, Eliana has been recognized as an Ashoka fellow and an AVINA leader and is committed to promoting social justice and human dignity among women in the Peruvian Amazon. She has been designing and implementing communication strategies for social change in the Peruvian Amazon since the early 1990s.

W. Douglas Evans, PhD, is Professor of Prevention and Community Health in the School of Public Health and Health Services at the George Washington University. He has published over 80 peer-reviewed articles and chapters on the effectiveness of health communication and social marketing behavior change interventions. He conducts research on health branding and the development and evaluation of new health technologies. He works both in the United States and in developing countries. In 2008 he published the volume, Public Health Branding, and is currently finishing two other books, Global Social Marketing Research and the SOPHE-APHA Guide to Health Communication.

Merissa Ferrara, PhD, is Assistant Professor at the College of Charleston. Her research interests include health communication and interpersonal communication. Her current line of research investigates social support (or lack thereof) for maintaining a healthy lifestyle. She has published several articles on such topics. She was also a researcher with Johns Hopkins University, working to increase collective efficacy regarding the adoption of certain medications and family planning in hopes to reduce the prevalence of HIV/AIDS in Namibia.

Maria Elena Figueroa, PhD, is Director, Research and Evaluation Division and Director, Global Program on Water and Hygiene, at the Center for Communication Programs at Johns Hopkins University. Dr. Figueroa’s research has focused on the understanding of health behavior in developing country settings. She is interested in the use of interdisciplinary research and the use of different theoretical approaches and methodologies for a more comprehensive study of cultural, household, and individual factors that account for health behavior differentials. Dr. Figueroa’s current research interests include: developing a better understanding of the social and cultural factors that explain safe water, sanitation and hygiene behaviors, including the role of the household and community traits in such practices.

Elizabeth Fox, PhD, is the Director of the Office of Health, Infectious Diseases, and Nutrition at USAID. Her office is responsible for global leadership in maternal and child health, environmental health, nutrition, health system strengthening, and the prevention and mitigation of infectious diseases, including TB, malaria, and avian and pandemic influenza. Before joining USAID, she was the manager of strategic planning at the International Bureau of Broadcasting, formerly USIA. She lived and worked in Bogota, Colombia, and Buenos Aires, Argentina, between 1968 and 1984, spending 10 years as the social sciences representative for Latin America at the International Development Research Centre of Canada. She worked in Paris between 1984 and 1989 as a consultant to UNESCO. In 1990 she held the first UNESCO chair in communication at the Universidad Autónoma de Barcelona, She has an honorary doctorate from the Pontificia Universidad Católica of Peru (2007). She is currently adjunct faculty at the School of International Service of American University. She is the author, among other books, of TV y Comunidad: Cinco Falacias, Santiago: CENECA, 1986, and Dias de Baile: El Fracaso de la Reforma de la Televisión en America Latina, Mexico: Felafacs, 1991.

Karen Greiner, PhD, is postdoctoral scholar at the University of South Florida. Her research focuses on communication interventions designed to promote community-level social change in creative, innovative, and inviting ways. She is the author of “Participatory communication processes as infusions of innovation: The case of ‘Scenarios from Africa’ ” (2009) and “Performance activism and civic engagement through symbolic and playful actions” (2008).

Ron Hess, MPS, currently serves as Director of Private Sector Programs, JHU/CCP. Mr. Hess has worked in communication for over 25 years, beginning as a media producer and entering the field of public health after studying communication theory and research at Cornell University. His work with JHU/CCP has involved alliances with governmental, civil society, and private sector organizations, and has included programs in the Middle East, Asia, the former Soviet Union, and East Africa. He served recently as a Country Director for the USAID-supported Communication for Healthy Living (CHL) project in Egypt.

Virginia Lacayo has more than 18 years of experience in the field of communication for social change. Her professional interests and experience focus on innovative approaches to communication for social change, complexity theory applied to international development and organizational change, and program design and evaluation. These issues have been the topic of her recent publications, presentations, and seminars. She finished her Master’s Degree on Communication and Development at Ohio University and is currently working on her doctoral dissertation, focusing on the application of system thinking principles and ideas to communication for social change and social movement building strategies.

Kim Longfield is the Director for Research and Metrics at PSI and has worked for the organization since 2001. She is responsible for a team of more than 40 international researchers and the quality of research implemented in approximately 60 countries. Kim’s expertise is in social marketing, qualitative research, and studies among populations at high risk of HIV/AIDS. She earned a PhD in Sociology and International Health and a MPH in International Health/Health Communication and Education, both from Tulane University. She is the author of more than two dozen published journal articles, reports, book chapters, and working papers.

Linje Manyozo, PhD, is lecturer and director of the MSc Programme in Media, Communication, and Development at the London School of Economics and Political Science. His professional interests focus on interrogating citizen voices and participation in development policy formulation and implementation. He is the author of People’s Radio: Communication Change across Africa.

Dominique Meekers, PhD, is Professor at Tulane University’s School of Public Health and Tropical Medicine. He has conducted extensive research on the determinants of health behaviors, and on the effect of social marketing and health communication programs on health behaviors in developing countries. Dr. Meekers served as the principal investigator for the external evaluation of the Health Communication Partnership, of which the Communication for Healthy Living program, Egypt, was a part. His current research agenda focuses on the social and behavioral aspects of global health, with particular emphasis on developing countries.

Srinivas R. Melkote, PhD, is Professor in the Department of Telecommunications at Bowling Green State University. He has worked in the field of communication and media studies for over 30 years. His research interests include the role of communication and media in directed social change, media effects, and health communication. His most recent publications include the widely used text Communication for Development in the Third World (coauthored with Leslie Steeves) and Critical Issues in Communication (co-edited with Sandhya Rao).

Carmen R. Mendivil Calderón, MA, is professor in the Social Communication and Journalism Program at Universidad Autónoma del Caribe, Colombia. She has worked in the design, implementation, and evaluation of communication strategies for social change on issues related to community media, human rights, ethnic and sexual diversity, gender equality, youth, and sexual and reproductive health. She has worked at regional and international nongovernmental organizations and international cooperation, including agencies and programs of the United Nations. She has published in Colombian communication journals.

Rafael Obregon, PhD, is Associate Professor in the School of Media Arts and Studies and Director of the Communication and Development Studies Program at Ohio University. He has taught and served as director of the Department of Social Communication at Colombia’s Universidad del Norte and has taught and conducted research in Africa, Asia, and Latin America. He serves on the editorial boards of several journals, including the Journal of Health Communication, and has published articles and book chapters on communication, health, and development. His research interests are communication for development and social change, health communication, capacity strengthening, and monitoring and evaluation. As of September 2011, he joined UNICEF, New York as Chief of Communication for the Development Unit.

Gregory Alonso Pirio, PhD, is President of EC Associates (Empowering Communications) – a firm providing consulting and project implementation services on a variety of international communications, media, and conflict resolution issues. Dr. Pirio has been a global leader in the use of media and communications for constructive social change and a pioneer in the innovate use of ICT-based distance learning for health care professionals. Dr. Pirio is also a Visiting Scholar at the School of Conflict Analysis and Resolution, George Mason University, where he has launched the “Voices of Marginalized Youth Initiative.”

Julie Pulerwitz, ScM, ScD, is the Director of the HIV/AIDS and TB Global Program at PATH, managing a diverse portfolio of HIV and TB projects addressing prevention, diagnosis, care, and treatment. She has particular expertise in behavior-change research and programs, as well as gender and male engagement, and stigma. Dr. Pulerwitz has authored over 20 articles in peer-reviewed journals and book chapters. She regularly participates in technical advisory groups, reviews for scientific journals, and guest-lectures at universities.

Andry Rabemanantsoa has a Diploma in Statistics and Information Management and a Diploma in Mathematics and Physics from the Faculty of Science, Antananarivo. He is Senior Research Coordinator at PSI. He has extensive experience with the design, implementation, supervision, and evaluation of large multi-round household studies in a variety of health areas involving different target groups. Prior to joining PSI, Mr. Rabemanantsoa worked as a statistician and information officer for a rural food security program financed by GTZ/Germany.

Scott C. Ratzan, MD, MPA, is Vice President, Global Health, Johnson & Johnson and Editor-In-Chief of the Journal of Health Communication: International Perspectives. Dr. Ratzan is co-chair of the United Nations Secretary General’s Joint Action Plan on Women’s and Children’s Health Innovation Working Group. He also serves on the Non-Communicable Disease Network (NCDNet) of the World Health Organisation, officially representing the pharmaceutical industry. His books include The Mad Cow Crisis: Health and the Public Good; Attaining Global Health: Challenges and Opportunities; and AIDS: Effective Health Communication for the 90s.

Ietje Reerink, MPH, MA, currently works as a Senior Technical Advisor for research and communications with PSI Madagascar. She previously held the position of Director, Reproductive Health Department, also for PSI in Madagascar and worked in a similar position for PSI in Myanmar. She has more than 12 years professional experience managing reproductive health programs across the world, and has held positions at the Royal Tropical Institute in Amsterdam and at Family Care International in New York. Her expertise is in strategic planning, applied research for decision making, social franchising, BCC, and monitoring and evaluation.

Jose Rimon II, PhD, is senior officer in the global health policy and advocacy group of the Bill and Melinda Gates Foundation. He covers nutrition, reproductive, maternal, neonatal, and child health. Prior to joining the foundation, he was at Johns Hopkins University as the Director of the Health Communication Partnership, the Senior Deputy Director of the Center for Communication Programs, and a Senior Associate faculty at the Department of Health, Behavior and Society.

Anthony J. Roberto, PhD, is Associate Professor with the Hugh Downs School of Human Communication. His research and teaching interests focus primarily on social influence and health communication. Professor Roberto is lead author of Influence In Action (Allyn and Bacon, 2002), and has published over 27 peer-reviewed research articles in a variety of journals, including Communication Research, Health Communication, Human Communication Research, the Journal of Applied Communication Research, and the Journal of Health Communication. He has also authored four book chapters, and five lessons he created have been published in Communication Teacher.

Kerry Scott, MA, has worked in community health and community-based monitoring of public health services in collaboration with SATHI, a health advocacy NGO in Maharashtra, India. She has also conducted research in Manicaland, Zimbabwe on community-level facilitators and hinderers of ART access and adherence. She remains involved in the Manicaland Project through work on the links between community mobilization, social capital, and HIV in the region. She is currently in a PhD program at Johns Hopkins’ Bloomberg School of Public Health.

Ami Sengupta, PhD, is a communication and development specialist. She has conducted extensive research on women’s rights and community-led processes in international development and has published in several peer-reviewed journals. Presently, Ami is an independent consultant based in Bangkok, Thailand. She has over a decade of experience spanning research, training, and consulting with international development agencies.

Navendu Shekhar, MPA, MSc, works at Pathfinder International (PI) as Research and Metrics Advisor. He has 12 years of research experience spanning market research, causal econometric analyses, behavior change research, and large international surveys such as UNICEF’s MICS. Prior to PI, he worked at Population Services International where he provided technical assistance and trained teams on research in eight countries of Southern Africa. He has also worked as Senior Project Director at the Indian Market Research Bureau, New Delhi.

Arvind Singhal, PhD, is the Samuel Shirley and Edna Holt Marston Endowed Professor of Communication and Director of the Social Justice Initiative in UTEP’s Department of Communication. He is also appointed as the William J. Clinton Distinguished Fellow at the Clinton School of Public Service, Little Rock, Arkansas. Singhal teaches and conducts research in the diffusion of innovations, the positive deviance approach, organizing for social change, and the entertainment-education strategy. He is coauthor or editor of 11 books, including Inviting Everyone: Healing Healthcare through Positive Deviance (2010); Protecting Children from Exploitation and Trafficking: Using the Positive Deviance Approach (2009); Entertainment-Education Worldwide: History, Research, and Practice (2004); and Combating AIDS: Communication Strategies in Action (2003).

Joanna Skinner, MHS, MA, is a public health specialist with a focus on health communication for HIV/AIDS prevention among women and youth. She has worked at the United Nations Population Fund, the Johns Hopkins University Center for Communication Programs, and the United Nations Secretariat.

Suruchi Sood, PhD, is currently Assistant Professor in the Department of Medical Science and Community Health at Arcadia University. Prior to this appointment, she was Assistant Professor, Department of Health Behavior, and Society and Senior Program Evaluation Officer, Center for Communication Programs, both within the Johns Hopkins University, Bloomberg School of Public Health.

Jeremy Snider, MPH, is currently pursuing a PhD in Health Services at the University of Washington in Seattle. Mr. Snider has previously worked for the President’s Emergency plan for AIDS Relief and with a USAID-funded Health System Strengthening project. He has also served as a consultant and data analyst for a number of public health studies. His research experience includes using primary data, at the domestic and international level, to examine health resource allocations and evaluate the impact and effectiveness of clinical and public health interventions.

J. Douglas Storey, PhD, is Director for Communication Science at the Johns Hopkins Center for Communication Programs and faculty member in the Department of Health, Behavior, and Society at the Bloomberg School of Public Health. He has 30 years of experience in health and development communication and evaluation research, and has lived and worked in more than 25 countries. He is the author of numerous articles and book chapters on a wide range of topics including health communication theory, communication campaigns, program evaluation, population and reproductive health, maternal/child health and nutrition, emergency preparedness and response, and strategic communication planning.

L. Suzanne Suggs, PhD, MS, CHES, is Assistant Professor of Health Communication and Social Marketing, Institute of Public Communication and Education, Faculty of Communication Sciences at the Università della Svizzera Italiana, Lugano, Switzerland. Dr. Suggs’ principal research examines the use of communication technologies and messaging strategies to improve health status and health outcomes, and to facilitate health behavior change. She is an Editorial Review Board member of the Journal of Health Communication: International Perspectives and is co-chair of the European Social Marketing Network.

María Beatriz Torres, PhD, is Assistant Professor of Communication at Gustavus Adolphus College. She has worked in different capacities in the field of communication for the last 24 years. She was awarded Mexico’s National Council of Science and Technology and Fulbright scholarships. She delivers workshops and presentations on intercultural health communication and effective cross-cultural communication for profit health care and nonprofit organizations. She has produced TV and Radio programs in Mexico, Argentina, and the United States.

Thomas Tufte, MA, PhD, is Professor of Communication at Roskilde University, Denmark. He is co-director of Ørecomm (). Since 2000, he has conducted research and undertaken consultancies on health communication, mainly in Africa and related to HIV/AIDS prevention. From 2009–2013, he is the coordinator of a research project: “Media, Empowerment and Democracy in East Africa” (MEDIeA, ). He is also a member of the advisory board for the Division of Social and Behaviour Change Communication, School of Public Health, University of the Witwatersrand, South Africa. He is also a member of Editorial Review Board of the Journal of Health Communication (2001–2011).

Shereen Usdin, MBBCh, MPH, is an Executive and founding member of the Soul City Institute for Health and Development Communication. Her professional work includes development communication with a focus on HIV and AIDS, gender, and social justice. She is a co-founder and board member of the Alliance for Children’s Entitlement to Social Security. She has received a Shoprite/Checkers Women of the Year award for her contributions to health as well as a Gordon’s Institute of Business Science award for social entrepreneurship. She is the author of a book on the politics of global health and another on HIV and AIDS.

Jair Vega Casanov, MSc, is Professor and Researcher at the Social Communication Department at Universidad del Norte, Colombia. His areas of interest are communication and social change, health communication, and communication and politics. He has published in social sciences journals and coauthored Internationalizing Media Studies (University of Westminster, Routledge, 2009), and Trazos de una Otra Comunicación en América Latina (Ediciones Uninorte, 2011). He has been consultant for the Pan-American Health Organization, PCI, Friederich Ebert Stiftung, Communication for Social Change Consortium, and the Communication Initiative.

Ravi Verma is the Regional Director of the Asia regional office of the International Center for Research on Women (ICRW), based in New Delhi. With a background in social sciences and social demography, he has worked extensively and continues to work on promoting gender equality, working with men and boys in various settings and institutions.

Robin Vincent, BSc, PhD is currently the Senior Advisor for Learning, Evaluation, and Impact at the Panos Institute, London. Robin is a social anthropologist with an interest in understanding complex social change, social movements, and communicative culture. Robin has 14 years experience of working in HIV and health communication for development, and facilitating learning and evaluation in development work and designing communication strategies. Robin has published on complexity and social change in HIV responses, social movements, and learning in development partnerships.

Silvio Waisbord, PhD, is Professor and Associate Director in the School of Media and Public Affairs at George Washington University. He is the editor-in-chief of the International Journal of Press/Politics. He has published books and articles about journalism and politics, and the role of media and communication in social change and global health.

Kim Witte, PhD, is an International Health Communication expert with over 75 publications. Dr. Witte has conducted research with approximately 40 different populations worldwide on more than 35 different health-related topics, with a special focus on culturally appropriate risk messages. She has been recognized with the Outstanding Health Communication Scholar Award, the Distinguished Article Award by the National Communication Association (Applied Communication), the Distinguished Book Award by the National Communication Association (Applied Communication), with the Teacher-Scholar Award from Michigan State University, and with nearly a dozen Top Three Papers from national and international conferences. Dr. Witte has received funding from the CDC, the National Institute of Occupational Safety and Health, the American Cancer Society, and elsewhere.


We are thankful to the many people who have made this project possible. At Wiley-Blackwell, Elizabeth Swayze believed in this book when it was a rough draft and supported us along the way. Julia Kirk and Allison Kotska superbly shepherded the book throughout the process. Stephen Curtis was a wonderful copy-editor. Hazel Harris made sure the project was completed in due time. The anonymous reviewers who provided feedback on our handbook proposal helped sharpen its focus.

Obviously, this project wouldn’t have been possible without the commitment, enthusiasm, and ideas of the contributors. They deserve credit for writing thoughtful chapters that invite us to think rigorously. We are very proud of having assembled a formidable collection of top-notch scholars and practitioners, who made our job intellectually rewarding and helped us turn an idea into a solid book.

It is hard to pin down exactly when we started to develop the idea for the book. We are sure, however, that the support, motivation and many ideas here presented originated in conversations about global health communication and social change with numerous friends and colleagues. We thank Jose Amar, Jesus Arroyave, Gloria Coe, Tito Coleman, James Deane, Warren Feek, Jesus Ferro, Elizabeth Fox, Karen Greiner, Chris Morry, David Mould, Ellyn Ogden, Thad Pennas, Julia Rosenbaum, Bill Smith, Jair Vega and Susan Zimicki.

Finally, we are grateful to our families for their unconditional support and love. To them, we dedicate this book.


Over the past decades significant investments have been made in international health and development programs. That effort is illustrated by significant investments that governments and donors have made to address major public health issues. Examples include investments made by the Bill and Melinda Gates Foundation, Rotary International, and the Government of India to eradicate polio; the commitment of the government of Botswana to provide ARVs (antiretrovirals) for people who live with HIV; the USA’s PEPFAR program also to provide ARVs to millions of HIV-positive people, especially in Africa; and the international investments to curb emergent pandemics such as avian influenza and SARS. In each of those efforts, communication has played an important role in advocating for healthy policies and environments, mobilizing communities, creating trust between users and providers, promoting healthier behaviors or the adoption of new behaviors, and raising awareness to rapidly and effectively respond to disease outbreaks.

The 66th General Assembly of the United Nations (UN), held in New York in 2011, may be remembered for one reason: the diplomatic efforts of Palestine to be recognized as a full member of the UN, and the subsequent diplomatic efforts for a negotiated solution between Israel and Palestine. Yet, for the international health and development community the main reason to reflect back on that General Assembly is likely to be the high-level meeting on noncommunicable diseases (the second ever to focus on health, after HIV/AIDS), which included a political declaration for the control of noncommunicable diseases (UN Declaration A/66/LI). United Nations Secretary-General Ban Ki-moon stated that “the summit in September in New York is our chance to broker an international commitment that puts noncommunicable diseases high on the development agenda, where they belong.”

The human and economic cost of noncommunicable diseases (NCDs) is shocking. An analysis based on the four main NCDs (cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases) indicates that “under a ‘business as usual’ scenario where intervention efforts remain static and rates of NCDs continue to increase as populations grow and age, cumulative economic losses to low- and middle-income countries (LMICs) from the four diseases are estimated to surpass US$ 7 trillion over the period 2011–2025” (World Health Organisation/World Economic Forum, 2011, p. 3). Reports indicate that nearly 36 million deaths were attributed to NCDs worldwide in 2008. Beyond the obvious alarm that such figures have caused, another important discovery in the past years is that the burden of NCDs has become a global health concern that affects both developed and developing countries.

One of the many events organized to raise awareness about the need for a global response to NCDs was the launch of a special edition of the Journal of Health Communication titled “Communicating the Non-Communicable” (Volume 16, Supplement 2, September 14, 2011). This special issue of the journal highlights the role of communication in addressing the main social and behavioral determinants associated with NCDs (unhealthy diet, tobacco and alcohol use, salt intake, and physical inactivity). For each of those determinants communication can also play a pivotal role through strategies and interventions that seek to address individual, community, and social and political factors.

The year 2011 also marked the start of the last five-year period of the Millennium Development Goals (MDGs). At the end of 2015 the international health community will assess to what extent those goals have been achieved. However, three years before the end of MDGs efforts, it is already known that many countries will not have reached the MDGs by 2015. While that outcome should be the focus of many international debates for a few years, what is more important about the MDGs is that they have provided clear goals and targets against which the international development and health community can measure progress. For our purpose, what is most interesting is that six of the eight MDGs focused on, or were related to, health. International and national efforts to address the MDGs have included huge investments in communication. From campaigns aimed at preventing HIV/AIDS and diseases such as malaria and TB to reduction of maternal and child mortality and the empowerment of women and girls, communication is at the core of those efforts.

The international health and development community is at a crossroads. On the one hand, it still faces, and will continue to face, a significant test represented by diseases that are preventable as well as by the quality of health services and systems, particularly in poorer countries. On the other hand, international pressure and advocacy have increased to a point where it is imperative to mobilize globally in order to prevent diseases that affect populations in emerging economies and low- and middle-income countries. The convergence of communicable and noncommunicable diseases somehow closes a circle that, more than ever, demands a collective and coordinated response by international agencies, donors, governments, civil society organizations, communities, and individuals.

This is a particularly important moment in international efforts to address health issues, in which the response of the international health community will require a solid understanding of health communication approaches, lessons learned, and challenges and opportunities at the international and global level. Reflecting upon the role of communication in addressing the health issues we have described above is imperative to understanding the key contributions that communication can make to global efforts to address disease and improve health. The many chapters included in the handbook provide important lessons that should inform research and practice in health communication with an increasingly global perspective.

The Handbook offers a comprehensive view of contemporary theoretical and applied research issues in global health communication, framed from a development and social change perspective. It explores multiple theories and approaches in the study of communication, health, and development, and examines new perspectives such as communication for social change and their application to health issues. Few dispute the centrality of communication in global public health and development efforts, given the extensive research and applications in local and international aid programs. Yet, new questions remain unanswered and new challenges have emerged about the role of communication processes in improving health conditions among communities, and promoting broader social change in international health contexts. This volume provides a comprehensive and up-to-date analysis of these issues through a collection of original contributions that review and analyze the historical, institutional, social, cultural, and political dimensions of global health communication.

In response to the variety and depth of challenges in global health communication and development, the Handbook espouses a broad understanding of communication that transcends conventional divisions between informational and participatory approaches. It offers an integrated view that links communication to the strengthening of health services, the involvement of affected communities in shaping health policies and improving care, and the empowerment of citizens in making decisions about health, and by extension their own, development.

The Handbook features contributions from leading scholars and practitioners in the field who address different communication dimensions and questions in current global health programs primarily in developing regions. The chapters make four key contributions: they propose an understanding of communication as collective actions to redress health inequities and development challenges through a variety of mediated and interpersonal interventions; put forth a vision that synthesizes current perspectives in both research and practice in the field; bring together both research and programmatic perspectives to discuss a common set of theoretical questions; and foster a conversation between academics and practitioners around questions of common interest to inform further research.

The Handbook covers a wide range of communication approaches as well as health issues, and draws insights and experiences from health programs and interventions from around the world. It also addresses key crosscutting issues that are central to institutional and programmatic aspects of global health communication. Such diversity of health topics and communication approaches illustrates the depth of the theoretical perspectives and conceptual debates, and the richness of the field and its many contributions to the study of communication, development, and social change.

This volume attempts to offer a truly global perspective, discuss a broad range of theoretical approaches and case studies drawn from recent health programs, and address a common set of questions that are central for comparative research across health systems, cultures, and politics. It features a cross-cultural selection of cases, and examines long-standing debates and innovative approaches in communication applied to a range of health issues across geographic regions. In structuring it, we have worked towards bringing together chapter contributions around key questions that offer a coherent and integrated set of debates and analyses. Because the Handbook offers a comprehensive survey of the field in terms of conceptual approaches, health and development issues, and communication interventions, we believe that it will be useful for students, scholars and practitioners who are interested in identifying and examining key research questions and arguments.

Organization of the Handbook

In order to address issues and challenges outlined above, the book is divided into four thematic sections:

I.   Contemporary Issues and Perspectives in Communication, Global Health, and Development
II.  Theoretical Perspectives on and Approaches to Global Health Communication, Development, and Social Change
III. Innovation in Research and Practice in Global Health Communication in Development Contexts
IV. Cross-Cutting Issues for Research and Practice in Global Health Communication and Development.

Part I identifies and discusses key questions and theoretical debates and challenges of global health, communication, and development perspectives. Part II explores the multiplicity of communication theories, processes and approaches that guide research and practice in global health communication and development. Part III focuses on the application of theoretical notions in innovative interventions that put forth new research questions and themes. Finally, Part IV identifies and explores critical dimensions for further research and practice.

Chapters in each section follow a common structure in order to provide a coherent flow and organization. The first section analyzes the state of the art, reviews theoretical debates, identifies and discusses research directions, and analyzes the implications of theoretical developments for research and practice. The second discusses key theoretical concepts, debates, and developments, analyzes how theory informs research and practice, examines the contributions of recent research and practice to refining theoretical concepts, discusses innovative lines of research and programmatic experiences, and identifies questions for future research and debate. The third section provides several innovative case studies; discusses theoretical dimensions of specific projects, and puts forward key recommendations for research and practice. The Handbook concludes with two chapters that draw key lessons from the contributions, and lays out key issues and perspectives for future research and practice in global health communication.

It is our hope that this Handbook will contribute to enriching teaching and learning in many ways and stimulate critical debates and interest among students, scholars, and practitioners to further explore critical global health communication issues and enhance the knowledge base in the field.


World Health Organisation/World Economic Forum (2011). From Burden to “Best Buys”: Reducing the Economic Impact of Non-Communicable Diseases in Low and Middle-Income Countries. Geneva, Switzerland: World Health Organisation/World Economic Forum.

Part I

Perspectives on Communication and Global Health