James O Olufowote

Although previous inquiry into resistance to the polio vaccines in northern Nigeria has been launched from several disciplines, inquiry has been limited to the 2003 revolt and has rarely been informed by theory. This study drew on the culture-centered approach to health communication to argue that the exclusion of marginalized communities from decision making by the Global Polio Eradication Initiative (GPEI) resulted in a vaccine resistance which found expression in health activism that engaged the local news media. To recover the excluded voices, this study examined community members’ narratives of resistance to the vaccines in Nigerian news from 2012 to 2018. Upon providing a backdrop for these narratives through a chronology of GPEI milestones in northern Nigeria developed from Nigerian newspapers, the study then engaged with 168 speech acts of resistance in Nigerian news to co-construct alternative meanings of health. Drawing on a local cultural meaning of the vaccines as covertly carrying out a Western family-planning agenda, narrators negligibly associated “family planning” with health. Narrators further articulated health as access to foods and as religious practice. These findings have implications for the inclusion of voices from sub-Saharan Africa in GPEI decision making.

In the wake of the devastating impact of the Ebola crisis in West Africa, the international community is identifying areas of growth as it grapples with how to improve its response to health crises in African nations. These considerations extend beyond Ebola as African nations struggle with other health problems such as cardiovascular disease, HIV/AIDS, infant and maternal mortality, and malaria (Airhihenbuwa, Ford, & Iwelunmor, 2014; Belue et al., 2009; Birn, Pillay, & Holtz, 2009). One important focus and area of growth for the international community—in its response to recent health crises in Africa—is knowledge of African cultures and cultural practices (e.g., burial traditions, cultural taboos, kinship care roles and patterns) and their positive as well as negative impacts on public health. An existing cultural model, PEN-3, popular in global health research, is uniquely qualified to contribute to this area of growth. Although PEN-3 has had a broad impact on global health research (see Iwelunmor, Newsome, & Airhihenbuwa, 2014), it has had less of an impact on the development of health campaigns and interventions in African nations. This chapter forwards PEN-3 as a useful tool—for both research and campaign interventions—in the contemporary response to health crises in African nations . 

The PEN-3 cultural model was developed by Dr. Collins O. Airhihenbuwa to foreground the role of the socio-cultural context in assessments of and interventions into community health problems (Airhihenbuwa, 1990; Olufowote & Airhihenbuwa, 2014). The model’s emphasis on the socio-cultural context (e.g., community health beliefs and values, cultural traditions involving family and friends that nurture health behaviors) highlights some absences and deficits in the international community’s initial response to the Ebola crisis. P, E, and N are acronyms for the three dimensions within each of the model’s three domains. One domain contains the dimensions of perceptions, enablers, and nurturers. Another domain contains the dimensions of positive, existential, and negative. A third domain consists of the dimensions of person, extended family, and neighborhood. Airhihenbuwa developed PEN-3 in reaction to limitations he perceived in traditional health communication theories such as the Health Belief Model. In his evaluation of the uses of such theories to stem the tide of the HIV/AIDS epidemic in Africa, Airhihenbuwa argued they contain assumptions (e.g., individualism, lack of attention to context) that limit their relevance to non-Western communities (Airhihenbuwa & Obregon, 2000). Rather than focus on individual and psychological determinants of health (common in traditional health communication theories), PEN-3 problematizes the socio-cultural factors that shape community health (Airhihenbuwa et al., 2014). Moreover, whereas previous researchers positioned culture as a barrier to health, particularly in non-Western communities, PEN-3 positions culture as both a barrier to and an enabler of health (Airhihenbuwa & Webster, 2004). 

This chapter contends that the international community’s response to the Ebola crisis in West Africa exposed absences and deficits in knowledge of the cultures and cultural practices of African communities. This type of knowledge is crucial to anticipating the socio-cultural factors that shape community health and to formulating more effective responses to contemporary health crises in Africa. To forward PEN-3 as a viable tool for the conduct of research and for the development of contemporary health interventions in African nations, this chapter reviews the defining elements of the PEN-3 model, considers a corpus of knowledge developed from the model’s uses in Africa, outlines interventions for the recent Ebola crisis based on this corpus of knowledge, and provides a critical evaluation of the PEN-3 model that yields future directions for health communication campaigns and research in African contexts.

Although health communication research on HIV/AIDS has acknowledged the work of HIV/AIDS non-governmental organizations (NGOs), we know little about how such NGOs are collaborating in their response to the epidemic in sub-Saharan Africa (SSA). UNAIDS estimated that over two-thirds of worldwide HIV infections and AIDS-related deaths take place in SSA and normative models have highlighted organizational collaborations as an important part of the response to public health risks and crises. This study advanced the New Communications Framework for HIV/AIDS by drawing on a constitutive model of communication to develop a discursive perspective on HIV/AIDS NGO collaborations. Analyses of interviews with 36 leaders of Tanzanian HIV/AIDS NGOs resulted in (a) networks of organizations of people living with HIV/AIDS (PLWHA) and (b) networks expressing the following identities: as single entities that unify PLWHA organizations in/across administrative divisions, as structures for reaching grassroots PLWHA and facilitating their participation in decision-making forums at various scales, and as vehicles for various social impacts such as advocacy for PLWHA.

Although health communication research and popular literature have heightened awareness of the dualisms physicians face, research is yet to focus on the discourse of physician educators who assimilate medical students into the profession for dualisms of the biomedical (BMD) and biopsychosocial (BPS) ideologies. This study drew on a dualism-centered model to analyze the discourse of 19 behavioral science course directors at 11 medical schools for the emergence of dualisms in instantiations of BPS ideologies and for the management of dualism in educator discourse that instantiated both BMD and BPS ideologies. Dualism emerged in the BPS ideologies of “patient-centeredness” and “cultural competence.” Whereas a dualism between “patients’ stories” and “patients’ data” emerged in the patient-centeredness ideology, a dualism between enhancing “understanding” and “interaction skill” emerged in the cultural competence ideology. Moreover, the study found educator discourse managing dualism between BMD and BPS ideologies through the strategies of “connection” and “separation.” The study concludes with a discussion and the implications for theory and research.

"This article offers reflections and insights on Management Communication Quarterly from a younger scholar in the field of organizational communication. After providing a brief history of the journal, topics of internationality, interdisciplinarity, and identity are explored. This is followed by a discussion among other “emerging scholars” in the field of organizational communication about these topics. The article concludes with a discussion about the role and format of Management Communication Quarterly in the digital age."

"Identity implications theory (IIT) is applied to analyze how young adults manage identity concerns associated with the goals of initiating, intensifying, and disengaging from romantic relationships. Participants wrote their responses to one of six hypothetical romantic (re)definition scenarios, indicated whether they actually would pursue the relational goal if their scenario were real, and rated degree of threat to both parties’ face. Responses were coded for positive and negative politeness strategies. Participants in different relational goal conditions perceived different face threats, varied in their likelihood of pursuing the relational goal, and employed different politeness strategies. Relationship (re)definition goal also moderated associations between perceived face threats and goal pursuit as well as politeness strategies. The findings show how multiple goal theories such as IIT can be applied to situations where relational goals are primary as well as how, to varying degrees, identity concerns shape and constrain how young adults pursue relational (re)definition goals."

"Employee upward influence for role changes implicates involvement in decision making, fit, and organizational functioning.Porter, Allen, and Angle’s framework is used to explore employee upward influence with supervisors during role change. Tactic selection is hypothesized to vary as a function of role change goals (i.e., magnitude of change and degree of personal and organizational benefit sought) and the quality of the leader-member exchange (LMX). Regression analyses of employee surveys (N = 128) indicate that employee goals (i.e., both personal and organizational) and the magnitude of role change interact to predict employee use of rationality and coalition. Furthermore, LMX and the magnitude of change interact to predict employee rationality. Implications for research and practice are discussed."