An Examination of Visually Impaired Individuals' Uncertainty Management.

Being visually impaired or legally blind (having vision that is uncorrectable or cannot be corrected to a legally acceptable level) is inherently uncertain. Although uncertainty can result in positive, negative, or neutral consequences, little is known about how uncertainty is experienced and negotiated in this understudied population. Thus, through in-depth, semi-structured interviews of 24 individuals with a visual impairment, we apply uncertainty management theory (UMT) to examine the communication strategies visually impaired individuals used to manage the personal, vision-related, and social uncertainty they experienced. Many participants appraised the uncertainty negatively and consequently aimed to reduce it by seeking social support and information, using instrumental strategies, and proactively disclosing their visual impairment. Interviewees who preferred to remain uncertain maintained it by avoiding thinking about their visual impairment or worsening vision and/or by concealing their low vision and passing as sighted. Last, some participants, particularly those who were born with low vision or had been visually impaired longer, learned to adapt to the uncertainty through reframing and accepting, self-care, and by turning to God. The study also uncovered that some participants' uncertainty management was limited by ableist constraints, such as inadequate support systems, systemic barriers, and stigma. The study also underscores the universal and fluid nature of uncertainty and uncovers tangible ways individuals with visual impairment can navigate uncertainty within a pervasive cultural biomedical model of disability.

A Qualitative Model of Weight Cycling.

Weight cycling is a likely consequence of striving to lose weight after internalizing body image ideals, making upward social comparisons, and experiencing weight stigma. Despite weight cycling's potential physical and psychological consequences, the interplay of weight cycling, social pressures, and experienced and internalized stigma have not been qualitatively explored. Thus, through in-depth interviews of 36 weight-cycling adults, this study sought to understand how people negotiate weight cycling. Interviews informed the development of a qualitative model of weight cycling, which was derived from a theory-neutral inductive analysis. The model's stages included entering the cycle, undergoing the cycle, and challenging the cycle. Participants were triggered to enter the cycle due to weight stigma caused by social pressures. Within the cycle, interviewees internalized weight stigma and engaged in disordered weight management behaviors. Some participants challenged the cycle by becoming more self-aware and mitigating their toxic dieting behaviors. However, it was very difficult, if not impossible, for many to fully exit weight cycling and the restraints of previous weight management thinking and patterns. Our investigation underscores the seriousness of weight cycling and suggests ways to combat weight cycling on both macro and individual levels. It may also be useful to consider weight cycling as disordered eating in hopes of shifting society's dangerous focus on rapid weight loss.

How People in Recovery Manage the Stigma of Being an Alcoholic.

Although stigma can jeopardize the recovery efforts of people who formerly misused substances, potentially leading to relapse, how people in recovery for alcoholism manage stigma has not been comprehensively or systematically examined. Using stigma management communication theory (SMC) and in-depth interviews of 22 adults in recovery, this investigation uncovered the six main strategies participants used to negotiate the stigma of being an alcoholic. Consistent with the tenets of SMC, interviewees accepted, evaded responsibility for, reduced offensiveness of, avoided, denied, and/or ignored/displayed the stigma, depending on whether they accepted or challenged that the stigma of being an alcoholic applied to themselves and/or the public's perception. Findings inform practical strategies to help individuals in recovery effectively manage stigma while sustaining their sobriety. The study also suggests ways programs such as Alcoholics Anonymous and treatment centers can use communication to break down recovery barriers.

Denying and Accepting a Family Member's Illness: Uncertainty Management as a Process.

Doubt is a common, yet challenging form of uncertainty to have about another's illness. Although navigating illness uncertainty is a process of continual (re)appraisal and management, existing research narrowly examines windows of uncertainty experience. To illustrate how uncertainty management in the context of doubt is recursive, nonlinear, and ongoing, we apply a process approach to communication to uncertainty management theory. Drawing on interviews with 33 U.S. adults, our findings explicate a prominently teleological (i.e., goal-driven) process wherein participants' uncertainty management served to accept or deny illness, depending on the extent individuals valued their own and the other's identity and the relationship. Participants generally moved through this process along one of three trajectories: growth, stagnation, or resentment. We also observed dialectical, evolutionary, and life cycle processes in the data. Findings demonstrate the heuristic value of studying uncertainty management as a multiple motor process.

An Examination of How People Appraise and Manage Health-Related Financial Uncertainty.

While health care is one of the largest stressors across all incomes and political affiliations, it is unclear how people with health-related financial uncertainty appraise and manage this ambiguity. Using the lens of Uncertainty Management Theory (UMT) and a thematic analysis of semi-structured, in-depth interviews with 17 individuals facing financial and health struggles, we uncovered how intersecting financial and medical uncertainty exacerbated participants' medical worries, worsening and compromising their mental and physical health. Additionally, we revealed how participants managed health-related financial uncertainty through seeking social support, seeking information to reduce financial burden, enacting financial concessions, making health sacrifices, avoiding information and thoughts about health costs, and adapting to chronic financial uncertainty. This study extends UMT by foregrounding the ways individuals' environmental resources (i.e., limited financial means) can jeopardize tending to their health, illustrating how uncertainty management is connected not only to communication strategies but also to health behaviors, such as tapering or skipping medications or procedures.

How College Students Communicatively Manage Uncertainty about University Health Services.

Despite university health services' critical role in addressing students' health, students frequently underutilize on-campus healthcare, in part due to uncertainty. This study used Uncertainty Management Theory and 41 interviews with college students and health center staff and providers to uncover the types of health services uncertainty students experienced and how students used communication to manage uncertainty. Students experienced institutional uncertainty pertaining to services, logistics, and quality-of-care. Participants who viewed this uncertainty negatively sought to reduce it via passive- and experiential-information seeking. Students who appraised uncertainty neutrally or positively maintained it by ignoring or avoiding information. Other students increased uncertainty by seeking second opinions. Findings suggest that promoting health services year-round and incentivizing patient referrals may help students manage both uncertainty and their health.

An Exploration of How Individuals with an Ostomy Communicatively Manage Uncertainty.

Individuals with an ostomy (a surgical diversion of part of the digestive tract through the abdomen) face a variety of uncertainties, due to the chronic and anatomy-altering nature of living with an ostomy, as well as the perceived stigma attached to having one. However, little is known about how these individuals negotiate uncertainty, and more specifically, how they manage the information they receive and disclose in the uncertainty management process. Thus, through 21 semi-structured interviews of individuals with an ostomy and the use of Uncertainty Management Theory as a theoretical framework, the current study found individuals with an ostomy attempted to negotiate uncertainty by managing information received and disclosed and by adapting to chronic uncertainty. This investigation recommends practical applications for medical professionals, supportive others, patients with an ostomy, as well as future surgical candidates to help manage uncertainty.

Communicatively Exploring Uncertainty Management of Parents of Children with Type 1 Diabetes.

Parents of children with type 1 diabetes (T1D) face uncertainty about the illness. This uncertainty can have negative health consequences for parents and their children. However, little is known about the types of uncertainty associated with T1D diagnosis and subsequent treatment and how this uncertainty is managed. Using uncertainty management theory (UMT) as a framework and 29 in-depth interviews with parents of children with T1D, this study found that parents experienced medical, social, and financial forms of uncertainty. Most parents viewed uncertainty negatively and sought to reduce it by seeking information, joining support groups, and turning to technology. However, some parents preferred uncertainty to the certainty of knowing their child had T1D and, at least initially, chose to maintain uncertainty about the disease by avoiding information. This study also provides practical outcomes that health-care providers can use to help parents of children with T1D reduce and manage uncertainty.

The Buddy Benefit: Increasing the Effectiveness of an Employee-Targeted Weight-Loss Program.

It is well known that significant others (particularly romantic partners) can influence people's weight management efforts. However, what constitutes effective support-and from which type of individual (e.g., romantic partner, family member, friend)-is unclear. Thus, framed by confirmation theory, we assessed the effectiveness and types of communication of a weight-loss "buddy" through reports of 704 individuals enrolled in a 15-week synchronous online weight-loss program. Roughly 54% of participants chose buddies; and those who did lost more weight and waist inches than those who were involved in the program without buddy support. We also found that a combination of high accepting and high challenging messages from buddies was associated with the greatest decrease in body mass index (BMI) as well as the greatest reduction in waist size. Furthermore, the support by romantic partners paralleled support by other types of buddies. Having a supportive buddy who was not a romantic partner was just as effective as turning to a romantic partner for assistance. This study underscores the important role of a buddy in supporting weight-loss program involvement and encourages individuals to consider enlisting the help of a buddy, as opposed to losing weight alone, in order to maximize weight management effectiveness.

An Examination of How People Who Have Lost Weight Communicatively Negotiate Interpersonal Challenges to Weight Management.

The vast majority of Americans are overweight, and those who are able to lose weight typically regain at least the amount they lost. Some people are confronted with sabotage, criticism, and declines in social support during and following weight loss. However, how individuals negotiate these interpersonal barriers is not very well understood. Such an understanding could help individuals maintain their weight loss while minimizing the risk of adverse health or relational consequences. Thus, through a thematic analysis of 40 interviews of people who were identified as previously overweight or obese and a facework lens (Cupach & Metts, 1994; Goffman, 1967), this study examined how people were communicatively able to sustain their weight loss in the face of challenges from friends, family, and colleagues. The investigation found that altered weight management behaviors (particularly healthy eating) can threaten others' face and uncovered several communication strategies people used to prevent and mitigate face threat. To avoid face threat, participants proactively issued cognitive disclaimers about weight management or designated cheat days, accepted but did not consume food, avoided social situations involving food, or ate unhealthy food in smaller portions to assimilate with the in-group. To remediate face threat, participants provided personal choice and health excuses to save face and accomplish their dual goals of maintaining their weight management practices without compromising their relationships.

College Students' Drinking and Posting About Alcohol: Forwarding a Model of Motivations, Behaviors, and Consequences.

College drinking continues to remain a public health problem that has been exacerbated by alcohol-related posts on social networking sites (SNSs). Although existing research has linked alcohol consumption, alcohol posts, and adverse consequences to one another, comprehensive explanations for these associations have been largely unexplored. Thus, we reasoned that students' personal motivations (i.e., espousing an alcohol identity, needing entertainment, and adhering to social norms) influence their behaviors (i.e., alcohol consumption and alcohol-related posting on SNSs), which can lead to alcohol problems. Using structural equation modeling, we analyzed data from 364 undergraduate students and found general support for our model. In particular, espousing an alcohol identity predicted alcohol consumption and alcohol-related SNS posting, needing entertainment predicted alcohol consumption but not alcohol-related SNS posting, and adhering to social norms predicted alcohol-related SNS posting but not alcohol consumption. In turn, alcohol consumption and alcohol-related SNS posting predicted alcohol problems. It is surprising that alcohol-related SNS posting was a stronger predictor of alcohol problems than alcohol consumption. We discuss the findings within their applied applications for college student health.

How Formerly Overweight and Obese Individuals Negotiate Disclosure of Their Weight Loss.

Overweight and obese individuals frequently experience weight-based stigma, and reducing stigma is one reason people want to lose weight. However, research suggests even after individuals become a normal weight, knowledge of their old body size can result in stigma. Through interviews of 30 formerly overweight or obese individuals and the framework of Communication Privacy Management theory, this study found the vast majority of participants perceived more benefits from disclosing their larger identity than risks, regardless of weight-loss method. Participants revealed their weight loss in order to inspire others, build relationships, or hold themselves accountable. Conversely, a few participants concealed to protect their thinner identity (i.e., they feared stigma) or to avoid coming across as boastful. In contrast to previous studies, this investigation suggests most participants were not dissuaded from revealing their former body size due to a threat of residual stigma. Participants' disclosure was overwhelmingly met with encouraging and supportive responses.

"Coming out" as an alcoholic: how former problem drinkers negotiate disclosure of their nondrinking identity.

Although communication is critical for former problem drinkers to reject drinks, socialize with others, minimize stigma, and maintain their health and sobriety, recovering alcoholics' communication has not been examined beyond alcohol self-help groups. Using a Communication Privacy Management framework and in-depth, semistructured interviews, this study examined how former problem drinkers negotiate the disclosure of their nondrinking status. As participants perceived not drinking in the United States as deviant and socially risky, the investigation found participants primarily concealed their nondrinking status in order to fit in. Participants enacted specific communicative behaviors to regulate their privacy boundaries, only disclosing their struggles with alcohol when benefits outweighed costs (e.g., inspiring others, maintaining sobriety, or building relationships). This study offers practical disclosure strategies for former problem drinkers to protect their private information, manage social interactions, and stay sober.

Mother-teen communication about weight management.

Although research shows family members can influence each other's diet and exercise behaviors, the specific strategies that most effectively motivate individuals to enact healthy behaviors have not been revealed. Toward this goal, this study employed confirmation theory to assess how the quality of weight management (WM) communication between 107 mother-teen dyads was related to their diet and exercise behaviors as well as their subjective perceptions of the productivity of WM conversations. Confirmation theory proposes two components of confirmation: acceptance and challenge. Analyses revealed that accepting and challenging communication were both positively related to the perceived productivity of WM conversations. However, more complex associations emerged for diet and exercise. Acceptance was more helpful in motivating better eating habits for mothers with low health motivation and teens with high health motivation. For exercise, challenge was helpful in motivating teens with higher sensitivity about communicating about weight issues; however, counter to predictions, challenge was negatively related to exercise for teens with low health motivation and low sensitivity. These interactions, however, explained less variance than analyses for perceived effectiveness and satisfaction.

Weighty dynamics: exploring couples' perceptions of post-weight-loss interaction.

Although romantic couples can use communication to help one another lose weight and maintain weight loss, the effect of weight loss on partner interaction is less understood. However, an examination of the interpersonal context in which partners manage their weight is important to help partners negotiate their weight, their relationship, and the U.S. obesity epidemic. Guided by systems theory, this study explored partners' perceptions of post-weight-loss interaction in relationships in which one partner lost weight and the other did not. Through qualitative questionnaires of 42 adults (21 romantic couples), the dyadic investigation revealed that while losing weight resulted in positive interaction for many partners (e.g., engaging in a shared healthy lifestyle), shedding weight also yielded some negative consequences (e.g., non-weight-loss partner criticism). The extent to which partners embraced new weight management rules and patterns largely influenced post-weight-loss communication and behavior.

"Above the influence": how college students communicate about the healthy deviance of alcohol abstinence.

Consumption of alcohol is widespread in U.S. culture, particularly among college students. Using a communication privacy management framework ( Petronio, 2002 ), this study examined how college students who abstain from alcohol negotiate communication of their nondrinking status and establish meaning in a culture in which drinking is the norm. Through 25 face-to-face interviews, this article explores the experiences of "healthy deviants"-individuals who engage in healthy behavior that violates traditional norms. Interviews identified that participants relied on privacy rules when determining whether and how to disclose their nondrinking status. If participants perceived more costs from the disclosure than rewards, they did not disclose. Participants enacted specific strategies to manage (non)disclosure of their abstinence from alcohol, providing practical ways for people who engage in healthy deviance to avoid or manage stigma.