About Katharine J. Head, Ph.D.: Katharine J. Head is Associate Professor of Communication Studies at Indiana University-Purdue University Indianapolis (IUPUI), where she also serves as Director of the Ph.D. Graduate Program in Health Communication and is faculty in the Fairbanks Center for Medical Ethics and the Medical Humanities and Health Studies Program. A prolific scholar of public health and health campaigns focused on HPV vaccination and cancer screenings, Dr. Head’s research has appeared in top health communication journals such as Health Communication, Qualitative Health Research, and Journal of Women’s Health.
Dr. Head describes herself as a translational scholar and is engaged in bringing her academic research to public audiences through media appearances, workshops, and other forms of community engagement. She has worked with a number of public health organizations, including the Indiana Immunization Coalition, on community outreach and health campaigns, and is a member of the Health Communication Working Group at the American Public Health Association. Dr. Head received her Ph.D. from the University of Kentucky, and both her M.A. and B.A. from Texas A&M University, all in communication.
[MastersinCommunications.com] Could we have a brief overview of your academic and professional background? How did you first become interested in health communication, health campaigns, and the impact of family and interpersonal communication on health behaviors?
[Dr. Katharine Head] I went to Texas A&M University as an undergraduate and majored in communication. I had a background in speech and debate in high school and I wanted to become a lawyer, so I declared a major in communication. A&M has a great program in rhetoric and argumentation. Around my first semester of my sophomore year, I took a persuasion class with Brian Quick who was a Ph.D. student at the time and was teaching as part of his teaching assistantship. He taught about messaging and persuasion and reactance and health behaviors, and I just remember having one of those lightbulb moments where I thought, “I can’t believe we can use communication to do this kind of work.”
Being the nerdy little undergrad I was, I went to his office hours and I bugged him. Looking back now, he was this busy graduate student and I was this annoying little undergrad, but he told me to talk to his advisor, Dr. Mike Stephenson [Michael T. Stephenson], about my interests. I changed direction. I didn’t realize it at the time, but A&M had an embarrassment of riches in health communication work. I got to study with people like Mike Stephenson, and Barbara Sharf and learn about illness narratives. I got to work with Antonio La Pastina who was doing great ethnography work, and I got to work with Rick Street [Richard L. Street] who does such important work in patient-provider communication.
At the time I was also sadly experiencing the toll that cancer was taking on several friends and family members, so I knew very early on that I wanted to focus on cancer screening and preventative messaging. I ended up staying at A&M for my Master’s as well and I wrote my thesis on health messages about tanning bed use among college-aged women.
After that I took a break, and I worked on a project with the VA in Houston. There’s a research center there. We interviewed health care providers at rural VA clinics and conducted a needs assessment about some of their issues, looking at things like telemedicine and community engagement and some of the barriers that they were facing in these rural areas. It was a really great experience in terms of honing my skills and going into communities and getting to know people. Then I headed off to the University of Kentucky to do my Ph.D., which is another great place to study health communication.
I want to talk about one very formative project that I got to work on while I was there. As soon as I got there, I was fortunate enough to join a CDC-funded research project as a research assistant that was focused on addressing cancer disparities in Appalachian Kentucky. This project had several components. I worked as a research assistant on part of it that was dedicated to cervical cancer prevention, which focused on education and promotion of cervical cancer screening and HPV vaccination. I had grown up in a very rural community, and I always had a desire to help communities, but this project really introduced me to the practice of community-based participatory research.
During this project I learned the importance of working with communities, not just in communities. Our research team included paid community members as well as academics. I had never experienced a research project like that. I learned that we, as researchers, can recognize that a research problem exists – we can see that, for example, a community is experiencing health disparities in cancer rates – but we also have to recognize our own limitations in how we approach these problems, and working with communities to address these problems is of real benefit.
While we, as academics, worked with our community partners to produce an evidence-based, theoretically informed intervention, our community members offered really important input such as where the interventions should take place, whom to get on board with the project so that community members would come be a part of it, even what kind of actresses to cast in our educational videos and what language to use. It was a really formative research project for me that has informed all the work that I’ve done since then.
Finally, after I graduated from the University of Kentucky, I came to Indiana University-Purdue University Indianapolis, which, yes, is one of the longest university names in the country. It was a Jeopardy question at one point. [laughs]. This is the Indianapolis location of Indiana University. The IU School of Medicine and Nursing is here. It’s a big, great, urban campus. There’s a lot of really amazing work that happens here, and it’s a wonderful place for someone like me who does applied, translational, community-based work to make connections and do the work I want to do.
[MastersinCommunications.com] A major focus of your research and work on health campaigns has been the prevention of Human Papillomavirus (HPV) and cervical cancer through vaccination and screenings. Are there certain key findings from your research and campaign work on HPV and cervical cancer that you would highlight? Are there important commonalities or differences between the findings of your work in this area and other health behaviors you have studied, such as COVID-19 vaccination?
[Dr. Katharine Head] Like any health behavior, vaccination and cancer screening can be approached in a variety of ways. As a health communication scholar, I approach these health issues from a communication perspective, which is different from how my colleagues in medicine, or public health, or sociology, or nursing approach them. I think that’s an important distinction: that communication scholars can problematize these issues as communication issues.
Once we do that, we can ask different questions. Are we promoting HPV vaccination to the right groups? Are we designing our vaccination messages to educate and promote individuals to get vaccinated? Are we taking into account different vaccine perceptions, based on age, or gender, or race, or geographic location? Are we integrating those into our message design tactics? Are parents and patients accessing credible information on the internet, and if not, what can we do about that? What strategies as communication practitioners do we have?
When health care providers recommend a vaccine, are they engaging in the patient-provider communication that leads to vaccination behaviors? We know, for example, that one of the strongest predictors of HPV vaccination, or any vaccination, for those who are vaccine hesitant is a strong provider recommendation. If that’s not happening, how can we address that and provide training to providers?
For those who aren’t familiar, HPV is the most common sexually transmitted infection. It causes the majority of cases of cervical cancer. When we get an HPV vaccine, we are preventing cervical cancer as well as five other types of cancer that HPV causes. So, we often talk about cervical cancer screenings and HPV vaccination together, but they’re slightly different health behaviors. When it comes to cancer there are other communication issues at play, such as the very real importance of people understanding that this STI can cause cancer and precancers and women understanding changing cervical screening guidelines over the past few years. There have been some major changes. You’re not just getting an annual Pap test. There are other tests involved, and there are expanded screening intervals.
That represents a communication problem. Patient-provider communication about cancer screening findings is also very important. It’s not just getting people in the door but about understanding how, if they have an abnormal finding or a positive finding, we communicate about that and engage in follow up care.
A big commonality across my research and my campaign work, then, is that when you approach a health issue from a communication perspective you can identify communication solutions to that issue or challenge. I think about some of our training as communication scientists and social scientists: utilizing strong, formative research to get to know your audience. A lot of what I do is formative research so I can understand what that one nugget of a message is that might make a difference and design targeted and tailored messages that address these various communication issues. I do a lot of work in the community promoting health behaviors like vaccination and cancer screenings, but that’s only one part of it. It’s also the clinical communication that happens once people get in the door. We have to understand there are multiple communication issues along the way that have to be addressed.
I think it’s so incredibly important to remember that the training we receive as communication scholars — our methods, our campaigns classes, and our intervention classes — won’t steer us wrong. These are tried and true methods and help us to be able to justify our work to funding agencies like NCI [the National Cancer Institute] or other groups. Finally, while HPV and cancer screening makes up a big part of my work, those tried and true methods and that ability to problematize something as a communication issue has meant that people from other disciplines have approached me to work with them on things like breast cancer treatment decisions, Alzheimer’s screening, and even making sense of genetic testing results. Making a reputation for yourself as an applied communication scholar means other people are going to ask, “Hey, can you maybe come over here and help us do the same thing?” This is a great opportunity to make an impact.
[MastersinCommunications.com] You recently became engaged in studying COVID-19 vaccination as well as other factors related to combatting the pandemic, like perceptions of the ethicality of travel restrictions. As we enter a new wave of the pandemic associated with the variant BA.5, are there insights in your research that you think are especially important to understanding where we are in the fight against COVID and where we go from here?
[Dr. Katharine Head] I think one of the things that the COVID-19 pandemic has taught us is that we have big problems and we need to listen to everybody, and we need to respect the sources of expertise that people have. Unfortunately, health communication scholars, and social and behavioral scientists in general, were not always consulted and listened to in the early stages of the pandemic. Sure, we were doing community level work and doing excellent research studying COVID and vaccination messaging, but much of this was not incorporated into state and national responses. In fact, late last year the outgoing NIH [National Institute of Health] director acknowledged this, saying we need to put more research into health communication and how to do messaging. I would tell him, “Yes, we’d welcome funding and opportunities, but we also could have really helped you from the start. We were here and we have a huge field of research that could have helped.”
Let me talk a little bit about some of the research my group has engaged in. Communication and especially health communication media scholars have been able to shed light on audience segmentation and targeting when it comes to COVID vaccination and other COVID behaviors. In the United States, the world, or even across an individual state or region, people are not all the same. We have to understand different audiences and then we can develop strategies to address different issues in those audiences.
Take political partisanship in the responses to this pandemic. My team put out one of the first nationwide surveys about COVID-19 vaccination intentions in the summer of 2020, and even back then we found that those leaning conservative were least likely to get a vaccine when it came out. Unfortunately, that political divide has only exacerbated since then, and our understanding of media, as media and communication scholars, helps shed light on why that might be.
For example, we understand that those who were exposed to right-leaning versus left-leaning media sources and social media sites are getting vastly different information in terms of content, agenda setting, and even how information is framed. These echo chambers that people live in have a strong influence on their beliefs, attitudes, and behaviors. You can see in this one example how multiple parts of the communication discipline can inform our understanding of what’s happening.
Another important consideration is the role of a strong provider recommendation. I mentioned earlier that a provider recommendation, a communication behavior, is one of the strongest predictors of vaccine uptake for someone who’s vaccine hesitant. But the rollout of the COVID vaccine threw our playbook out the window. We weren’t getting our vaccines at the doctor’s office, and many of us weren’t even going to our primary care providers for regular checkups. We can see from a communication perspective that the rollout of the vaccine meant that a lot of vaccine hesitant patients weren’t getting any effective intervention to help them decide to get the vaccine.
How can we fill that gap? Much of what we did in Indiana, and what happened in a lot of other communities across the country, was engaging in community outreach with trusted community grassroots organizations. Here in Indiana, I worked with the Indiana chapter of the American Red Cross to launch a campaign called “Have the Talk,” which was about providing community organizations with tools and strategies and opportunities to talk about vaccines and vaccine hesitancy with their stakeholder groups. It makes a difference to have those positive conversations in the community, if we’re not able to have them in our provider offices.
I think that the lesson here is that big problems require multiple perspectives and one of those perspectives has to be communication. With so many of the world’s problems, if we just bring in a communication perspective, we can start to address the underlying issues that drive them.
[MastersinCommunications.com] Part of your work explores the importance that interpersonal and family communication has on health promotion. You have also explored the impact of experiences with cancer on cancer survivors and their families, as well as the significance early screening for Alzheimer’s may have on the families and caregivers of Alzheimer’s patients. What do family and interpersonal communication dynamics help us grasp about health promotion that we might not otherwise see?
[Dr. Katharine Head] If you think about it, the majority of health conversations that we engage in and the majority of health decisions we make don’t happen in the clinical setting. They happen in our everyday lives. It’s those conversations and social influences from family and friends and coworkers and peers that shape much of what we believe about health and wellbeing. Those things also prompt whether we go to the doctor or whether we decide to engage in health behavior.
Whenever I talk about this, I joke about how, in my undergraduate health communication class, I always ask students, “Okay, you’re feeling kind of sick. You’re feeling off. What’s the first thing that you do?” Without fail, they always say, “I call my mom first.” It’s not the doctor. It’s not the student health clinic. It’s a consultation with someone in their interpersonal, everyday life to really make sense of something that’s happening with their body and their health.
My colleague Dr. Jennifer Bute and I have written a couple of articles over the last few years in which we urge the field of health communication to better study and identify the connections between health promotion and patient-provider and clinical communication and this everyday interpersonal communication context that we know is so important for health.
In the study you mention about young adult cancer survivors and their family members, my coauthor Nicholas Iannarino and I found that the cancer survivors and family members were both transformed as a result of the cancer experience. They change their mindsets, their eating patterns, their willingness to talk about health among themselves, even their likelihood to go to the doctor if they felt sick. All of this was happening in that everyday interpersonal context. It was influencing and being influenced by the more formal cancer care the patient was experiencing. In other words, when we start to see something like cancer treatment and survivorship as a social experience happening in this everyday interpersonal context, we start to conceptualize that experience as something much more than a patient going through a treatment.
[MastersinCommunications.com] Your research also considers how vaccination, cancer screenings, and other health behaviors are mediated by factors like socioeconomic status and race. Could you explain some of the key differences, disparities, or barriers these factors create? How can health campaigns seek to address structural and cultural disparities like these?
[Dr. Katharine Head] Health campaigns and health promotion efforts can play an important role in addressing health disparities. First, we know our field has experience in designing messages and targeting them to different groups. But we know that health interventions and health campaigns can be really important to addressing what you call these more structural or cultural disparities. As we problematize things from a communication perspective, when we talk about inequality in terms of health care some of the biggest inequalities that we know exist are communication inequalities. The question becomes how we can design our campaigns and messaging and address those things from a communication perspective.
For example, in a study we did on recruiting older Black individuals to a community clinical trial for glaucoma, we partnered with the Black community not only to design the messages but also for them to explain to us, “We don’t want the messages coming from a healthcare organization or a doctor or something like that. We need to put these messages on the Black owned radio station, and people will listen, and they will trust it, and they will come in.” We found that that worked.
In related work with my doctoral student Katherine E. Ridley-Merriweather we studied how clinical trials across all diseases, but especially cancer, had done a really poor job of recruiting racial minorities to participate, which has exacerbated poor outcomes for these groups, which are excluded from clinical trials. If your own biogenetic makeup is not represented in a clinical trial, then we’re not able to test medicines to see if they work or are equally effective for different groups. This exacerbates health disparities from a systemic perspective. In other words, we see here how a failure in communication — not doing good recruitment messaging — leads to real health disparities.
These are not separate issues. Communication and these structural and cultural barriers are very much related. In my own work on cervical cancer disparities, I studied groups from rural, white individuals living in Appalachian Kentucky to low socioeconomic racial minority populations living in urban Indianapolis. While there are commonalities, again, what our strong formative research allows us to do is identify what are the key differences in terms of messages and sources trusted and the barriers we need to address.
In Appalachian Kentucky we see things like fear and embarrassment about seeking out reproductive and sexual healthcare. Privacy is a very important value in those communities. For instance, in one of the counties we worked with –and remember, these are very rural areas so there are only a couple of clinics maybe in the whole country — one of the issues that women mentioned to us was that there was a separate, identifiable entrance for people who were going to the women’s health clinic and everyone knew you were there and you were going to that clinic. The idea of privacy helps us to understand that women would benefit from a common entrance, which would mean people didn’t know what they were there for.
These things, again, help us to really understand the recommendations we might make. This helps us see that, when we really get to know our audiences, we can design interventions that can address whatever barriers there might be to helping solve that problem.
[MastersinCommunications.com] You often work to bring your research to nonacademic audiences. You have made appearances on a number of radio programs and news broadcasts, and written public-facing articles for media publications and newspapers. You also hold positions at public health institutions, serving as a member of the steering committee for the Health Communication Working Group at the American Public Health Association and the advisory committee for the Indiana Immunization Coalition. How would you compare the process of working to make a popular impact through public-facing writing and media appearances to applying your work in guiding public health institutions? Could you speak to the importance you place in these forms of public engagement?
[Dr. Katharine Head] I think one of the core skills for an applied and translational scholar is being able to collaborate with and talk with nonacademic audiences and to bring our work to those audiences. If we don’t do it, who will? I love to get to work with groups like the Indiana Immunization Coalition, which is a collaboration that is 100% mutually beneficial. This group is a nonprofit organization that serves statewide. They’re a leader in vaccine promotion, education, and advocacy. They’re well connected, well-funded, and very focused on their mission. This is a dream collaboration for someone like me who is an applied health comm scholar, who wants to do the research, but also take it out into the community to make a difference.
For example, I regularly serve as an expert speaker at their training events for healthcare providers, I give research webinars to their members, I even collaborated with them on developing and launching two vaccine promotion programs. The first is a comprehensive evidence-based online tool kit for college campuses called “Project HPV Free.” Studying and promoting HPV vaccination to young adult women on college campuses goes back all the way to my dissertation research, and here was an opportunity to take what we know about HPV vaccination promotion on college campuses and turn it into a tool kit for other universities to use. It has been adopted by many universities across the country. We consult with these schools to problem solve and figure out how to do the work. We presented this tool kit as a workshop back in May at the American College Health Association.
Another program I’ve worked with them to develop is a web-based provider education program we call “Vax Champ.” Recently our Indiana state legislature voted to expand the ability for nontraditional vaccinators, for example pharmacists or dentists, to provide more vaccinations to different patient populations. As these providers’ scopes of practice changed, the coalition said, “We need to give them training so they can better prompt vaccination to their patient populations.” I worked with them to develop those trainings so that they’re evidence-based and they have that communication practice embedded in them.
This work isn’t easy. It takes adjusting to different timelines, priorities, and working styles. But at the heart of it, it is the applied scholarship I think a lot of us want to do. And, as you mentioned, I do a lot of media appearances, which is also a very different approach. Especially since the start of COVID, I’ve done interviews with newspapers and podcasts and news broadcasts and radio outlets. I’ve written a couple of articles, and I was even asked to be a Twitter ambassador for Indiana University’s research office. I approach these opportunities [media appearances and interviews] very much as part of my mission to make sure our field’s expertise and contributions are heard. Sometimes this involved talking about findings from my own research, but sometimes this involved offering an expert perspective about an issue.
It can be very intimidating to be interviewed by the media, but I saw people like Dr. Jennifer Mercieca at Texas A&M and Dr. Tomeka Robinson at Hofstra doing all these great media appearances and rocking it and really showing how our field has something to say. I said, “You know what, I want to do that too.” Like many people in our field, I grew up with speech and debate experience and taught public speaking for years. I realized I had the tools to do these things, I just needed to learn to do it.
At the end of the day, just like my work with community organizations, I see media appearances as a way to further promote and disseminate my work. It does take some extra effort and some extra thinking about how to approach these things, but I think that people in our field — if no other field, people trained in communication — should be able to go out to different audiences and talk about our work.
[MastersinCommunications.com] Is there advice you would give to students interested in health communication, health campaigns, or family and interpersonal communication in health contexts, who are considering pursuing a graduate degree in communication studies?
[Dr. Katharine Head] I have three pieces of advice here. First, you should really research the graduate program you are interested in and the people who are there. See if there are potential mentors you can work with and learn about the culture of the department. This is really important. I know how it feels when you apply to graduate school: you just want to see if you get in. You need to make sure, though, that you’re as good a fit for them as they are for you. This includes meeting with current graduate students in the program. You want to go to a strong academic program, but you also want to go to a program where the people are kind and supportive. By the way, make sure you are that kind of peer — that you are a kind and supportive person. One of my mentors, Dr. Kellie Carlyle, likes to say, “We are all smart. Distinguish yourself by being kind.” What a great piece of advice in thinking about how you approach graduate school.
Second, take every opportunity to engage in research and community engaged work. I’m not saying overwhelm your schedule with too many projects. But, even if it’s a little outside your area or interest or wheelhouse, know you will gain valuable experience the more you put yourself out there. One of the very first studies I worked on as a graduate student was a Delphi Study in the field of group communication with Dr. [Marshall] Scott Poole. It was far outside of any interest I had ever had, but I learned a lot and I grew from that experience, and I got to work with a great faculty member.
And when I was a Ph.D. student at Kentucky I worked for a short time with Dr. Derek Lane on a funded project with the state of Kentucky to help their waste water management office revise their training materials for people who do waste water management across the state. We were talking about things like sewage, and pipes, and the ratio of chlorine [laughs]. Again, this is not something I ever thought I would do, but I gained so much experience working with that office, advising them on clear and effective messaging and pedagogical practices, and I had a great mentor in Dr. Lane who showed me a lot about how to work with government agencies.
Obviously, as you move farther along in your career you’re going to want to focus and choose projects that are more specific to your interests, but as a young scholar you will not regret adding more experience and tools to your tool belt.
Third, there’s going to come a moment when you are reading an article, or sitting in a class, or watching a news story, or going through a personal health experience, or having a conversation with someone where you say, “Wow that’s really interesting. I can see so clearly how health communication is in play here” – just like the experience I mentioned before in Brian Quick’s class all those years ago. I want to encourage you to trust that instinct, fan that little flame, and pursue that passion.
Thank you, Dr. Head, for sharing your research and insight on health communication, health campaigns, and beyond!
Please note: Our interview series aims to represent the diverse research being pursued by scholars in the field of communication, which is often socially and politically engaged. As a result, all readers may not agree with the views and opinions expressed in this interview, which are independent of the views of MastersinCommunications.com, its parent company, partners, and affiliates.