Rhetorical functions of language and media in health education : effects of metadiscourse and the Internet on readers' attitudes and knowledge about stress management
Much of what technical communicators know about language use is based on spoken or written communication; however, newer media complicate those boundaries. Spoken and written language differ primarily in the use of metadiscourse, language that aids interpretation of propositions. While research shows that metadiscourse aids in retention and attitude change in both print and speech, none exists to show whether this is true in a medium like the Internet, which has qualities of both. Technical communicators need this information because they must compose similar messages in several media: advertising, system help, business training, and health education are commonly delivered in multimedia formats, primarily in print and the Internet.Most critical of these messages is health education, in which technical communicators must make treatment accessible to patients at home. Not only does this task require clear communication, but also it requires convincing patients to attend to the information, have positive attitudes about illness or self-care, and remember the information-these are the ingredients needed for learning. With good reason, healthcare providers are investing many resources into Internet health education, but technical communicators lack guidance on effective use of the medium. Research in this area focuses on measuring outcomes of existing programs rather than on systematically identifying what works and why.The present study examined language use (i.e., metadiscourse) and medium (i.e., Internet) in health education about stress management. This study reviews existing research in these areas and posits persuasion and social influence theory as a basis for understanding the persuasive abilities of health educational materials, or the abilities of the materials to convince patients to learn health information, change attitudes about illness and treatment, and change health-related behaviors.To test this theory, 120 students from a Southern university voluntarily read interventions developed to isolate the effects of metadiscourse and media on cognitive processing, attitudes, behavior intentions, and knowledge. Repeated measure multivariate analyses revealed that regardless of metadiscourse or medium, participants' knowledge about stress management increased and was maintained over time; however, favorable attitudes were not maintained over time. Results indicate that peripheral rather than central route persuasion occurred, and, therefore, knowledge gains are likely to be short-term. Suggestions for future research are provided and recommendations for theoretical development are discussed.