▼ This dissertation examines health care provider-receiver intercultural interaction processes and measures health care receivers’ experience of health care providers’ cultural competence. To this end, cultural competence has been conceptualized as a dynamic and complex process of being aware of and recognizing individual differences and differences across cultures. Communication accommodation theory, which assumes that communicators adapt their communicative acts to a given context, was used as a theoretical framework. Appalachian Ohio, a medically underserved region, was chosen as a context. The research was carried out in three sequential phases. First, scenarios demonstrating cultural difference or sameness between patient and physician and physicians’ cultural competence or incompetence in health care interactions were developed and pre-tested employing 175 undergraduate students. In the second phase, validated scenarios were used along with a survey questionnaire of 201 members of the public from Athens and Columbus, Ohio to measure public perception of cultural competence in health care interactions, which resulted in the development of a three-factor scale, the PPPCC. In the third phase, the PPPCC scale along with measures of ethnocentrism, fear of physicians, and health professionals’ CAT goals and strategies was refined using 306 health care receivers from the patient base at Holzer Clinic in Athens, Jackson, and Gallipolis to develop a patient satisfaction instrument to measure physicians’ cultural competence. A five-factor scale emerged, the PCCPS. This research found important connections among Appalachian patients’ perceptions of physicians’ cultural competence in health care and patients’ ethnocentric views, fear of physicians, and perceptions of physicians’ use of communication accommodation strategies of divergence and convergence. The findings indicate that research on cultural competence in health care should adopt a holistic definition of cultural competence. The findings also indicate that cultural competence in health care is one strategy for providing quality and effective care in intercultural, cross-cultural, and multicultural contexts. This dissertation research offers important directions to the design of cultural competence interventions for health care delivery and outcome. Further research should study unique cultural settings to expand cultural competence beyond cultural markers of race and ethnicity to include other social justice efforts. Advisors/Committee Members: Bates, Benjamin R.

▼ Research on the communication of grief and loss has overlooked the stories told by adults who have lost one or both of their parents. This research applies narrative analysis to the stories told by twenty orphaned adults in search of narrative form and function. Three sets of narrative coding revealed consistencies among the narrative events, people, and themes. Most notably, the story form consisting of seven narrative constructs appears to serve the function of managing a guilt-innocence dialectic providing the narrator with a restorative story end. Conclusions suggest that the form and function of these loss narratives of orphaned adults might be compared to other loss narratives as researchers seek to identify a universal loss narrative schema. Advisors/Committee Members: Miller, Jerry.

▼ This dissertation explores everyday communication patterns among ethnic Malays and Chinese in multicultural Malaysia. Specifically, the study examines communication strategies and the concept of sensemaking (Weick, 1969, 1979, 1995) in interethnic interpersonal communication processes. Because interethnic communication requires individuals, as social organisms (Blumer, 1969), to possess intercultural sensitivity (Condon and Yousef, 1975; Orbe, 1995), the notions of ethnicized knowledge and sensemaking in interactions involving different Asian groups merit further examination. In order to engage in this work, researchers must get inside the defining process of the socially diverse actors to further understand their symbolic (inter)actions (Blumer, 1969). This study demonstrates how ethnic sensemaking is co-constructed and represented through the dynamics of negotiated strategies including tactical ambiguities in interpersonal interethnic relationships. Data for the study were collected through a qualitative interpretive approach which included in-situ observations in a natural setting and in-depth interviews among selected individuals from two ethnic groups, and a study of relevant government documents and media coverage on the subjects. The data were analyzed using a rhetorical framework that focused on sensemaking. The study demonstrates that an understanding of interethnic communication as a social phenomenon is very critical in programs promoting societal integration in multicultural contexts. Advisors/Committee Members: Hale, Claudia L.

▼ Using the Spring Festival (the Chinese New Year) as a springboard for fieldwork and discussion, this dissertation explores the rise of electronic media and mobility in contemporary China and their effect on modern Chinese subjectivity, especially, the collective imagination of Chinese people. Informed by cultural studies and ethnographic methods, this research project consisted of 14 in-depth interviews with residents in Chengdu, China, ethnographic participatory observation of local festival activities, and analysis of media events, artifacts, documents, and online communication. The dissertation argues that “cultural China,” an officially-endorsed concept that has transformed a national entity into a borderless cultural entity, is the most conspicuous and powerful public imagery produced and circulated during the 2001 Spring Festival. As a work of collective imagination, cultural China creates a complex and contested space in which the Chinese Party-state, the global consumer culture, and individuals and local communities seek to gain their own ground with various strategies and tactics. This dissertation has five chapters: Chapter one introduces the project and situates it within a theoretical, historical, and scholarly context. Chapter two details the methodological framework and lays out a specific design for the fieldwork in Chengdu, China. Chapter three probes Chinese mediascapes with the focus on two image-centered media—television and the Internet. Discussion includes the transformation of the annual festival into a mediated national ritual, the China Central Television (CCTV) Spring Festival eve gala, as well as the virtual celebration of the festival on the Internet. Chapter four concerns holiday consumption and tourism as China undergoes a profound transition from a production-oriented to a consumer-oriented economy. The chapter examines the reconfiguration of urban spaces by market forces, a collective desire for festival consumption, and the revival of folk traditions as packaged tourist spectacles. Chapter five, the conclusion, reiterates the researcher’s interpretations, reflects on the methodology, and acknowledges limitations and implications of the present study. Advisors/Committee Members: Arvind Singhal, Timothy A. Simpson.

▼ In spite of advances in all spheres of human life, majority of the world continues to suffer from hunger, poverty, and disease on a daily basis. Facilitating social change to create a more equitable society, though possible, continues to be an uphill struggle. I began this study seeking to understand how issues of health, gender and human rights can be communicated more efficaciously. Further, I sought to enhance our understanding of how poor, isolated, and marginalized community members perceive, experience, and participate in social change efforts. In so doing, I present a case study of Minga Peru, a non-profit community-based, communication for social change organization that promotes social justice, gender equality and human rights in the Peruvian Amazon. Central to Minga’s efforts is the entertainment-education based radio program Bienvenida Salud, which is complemented by a network of over 56 peer facilitators. Minga also trains women in income generation skills such as handicraft production and fish and poultry farming. This interpretive study draws upon both feminist and participatory research paradigms. The findings are based on six weeks of fieldwork in Peru, divided between Lima and the Loreto Region. The research design utilizes ethnographic methods including interviews, focus group discussions, audience letters, and participatory sketches and skits, involving a total of 124 participants and 160 hours of observation. I co-construct my analysis with the narratives of the Minga team, including its co-founders, program implementers and peer facilitators, and men, women, and adolescents from riverine communities. The findings resulted in 14 themes clustered around three research questions. Through my findings, I put forth that enabling social change necessitates an alternative approach that privileges community perspectives. Further, social change initiatives benefit from being contextualized and cognizant of the lived realities of the people they are working with. Finally, transformation of hegemonic gender norms occurs through a holistic understanding of gender as including men and social structures. Renegotiating established power hierarchies leads to resistance and conflict as men and women begin to gain agency and contest the normative order. Ultimately, the research strengthens the reflexive and interconnected relationship between theory-praxis. Advisors/Committee Members: Singhal, Arvind.

▼ This research analyzes the communicative dimensions of Nautanki, a highly popular folk performance tradition in rural north India. It explores how Nautanki creates participatory dialogue, builds community, and opens up possibilities for social change in rural India. It also tries to understand the position of Nautanki as a traditional folk form in a continuously changing global world. This research uses Mikhail Bakhtin’s concept of performance as carnival and Dwight Conquergood’s notion of performance as an alternative to textocentrism to understand Nautanki as a community folk form and an expression of ordinary rural Indian culture. The research employed reflexive and native ethnographic methods. The author, himself a Nautanki artist, used his dual position as a performer-scholar to understand Nautanki’s role in rural communities. Specifically, the method included observation of participation and in-depth interviews with Nautanki performers, writers, troupe managers, owners, their clients, and audience members in the field. The present research suggests that Nautanki enhances the feeling of community in rural India and provides community members an opportunity to connect to their cultural heritage. The research also shows that Nautanki helps its audiences to challenge various oppressive social traditions such as dowry and adopt certain pro-social thoughts and behaviors, including gender equality and better health practices. However, this research also shows that Nautanki faces numerous challenges, including competition from an expanding mass media, changing audience preferences, and non-professionalism among its ranks. However, it seems that community folk performance traditions will continue to hold their place in the changing media atmosphere as they are more immediate and connect to their audiences in an intimate manner. Unfortunately, ordinary folk forms have not been given their due respect by Indian elites. In this respect, Nautanki performances and this dissertation represent sites of struggle to reclaim dignity for “ordinary culture.” Advisors/Committee Members: Singhal, Arvind.

▼ The study attempts to analyze, interpret, and understand sojourner parents' perceptions of the communication changes and conflicts that their younger children experience with peers, teachers, and family members as a result of the process of adaptation to the US. This thesis seeks to adopt a communication perspective in examining the dialectical tensions and conflicts that emerge as sojourners strive to negotiate the preservation of their native values, behaviors, and communication styles while simultaneously adapting to their new cultural environment. Sixteen families of international graduate students with children between 5 to 12 years of age were interviewed. In addition, two interviews with school personnel and observations of children's playground were conducted. Results suggest that sojourner children acquire many communication changes during their stay in the US. Some of those changes are perceived positively by their parents while others are considered disrespectful to family and collective values. Advisors/Committee Members: Hale, Claudia.