Employees can provide invaluable input to organizations when they can freely express their opinions at work. Employees, however, may not believe that it is safe or efficacious to voice their concerns. How features of communication channels affect employees’ safety and efficacy perceptions is largely ignored in existing voice models. Therefore, this study seeks to understand how the anonymity and visibility affordances of a communication channel influence employees’ safety and efficacy perceptions, and, thus, their intention to engage in prohibitive voice at work. Two between-subjects experiments were conducted to test how these channel affordances affect voicing behavior in organizations. The results indicate that the more anonymous and less visible participants perceive a voicing channel to be, the safer and the more efficacious they evaluate the channel. Theoretical and practical implications, limitations, and future research directions are discussed.

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The use of messaging features within online patient portals could be beneficial to patients, but many patients do not utilize these features. Furthermore, it remains uncertain the reasons why patients may (or may not) use messaging features to communicate with a care provider. This study proposes and tests an extended Technology Acceptance Model (TAM), which incorporated perceived affordances (editability and persistence) and communication efficacy. An online survey was conducted with a sample of 525 young adults. Results showed that the editability affordance was conducted with perceived usefulness, while communication efficacy was associated with perceived ease of use of messaging. Editability and communication efficacy also were positively associated intention to use online patient portal messaging features, whereas persistence was negatively associated. Results suggest practitioners should emphasize editability and communication efficacy to increase patient intentions to use messaging features to communicate with a care provider.

Aims: Cigarette passing and sharing contribute to early smoking onset among Chinese male youth. Refusal efficacy, considered pivotal in smoking prevention, has not been addressed in published research regarding specific refusal tactics and resistant communication behaviors. This focus group study aimed to uncover cigarette resistance responses, cigarette-offering agents' reactions to refusal, social barriers, and contextual characteristics among targeted Chinese male adolescents. Methods: Twenty focus groups with 7-10 male smoking and nonsmoking students per group from vocational and junior colleges (N = 165) were interviewed in two cities in China. The data were coded and analyzed. Findings: Nonconfrontational refusal tactics were frequently used. Of the nine identified cigarette refusal categories, consistent and firm declarations of the nonsmoking status were considered most effective. Upon rejection, a majority of people offering cigarettes made no further attempts. Most participants expressed neutral attitudes toward cigarette refusals, in contrast with the assumption in the literature that teenagers pervasively dislike such refusals. Conclusions: Health educators likely can use the finding of peer agents' general neutral (rather than negative) attitudes toward cigarette refusal to relieve teenagers' apprehension about rejecting cigarettes and thereby help build their refusal confidence. The reported effective strategies should be further tested prior to implementation for training teenagers.

A large number of early smoking activities occurred in homes and schools, and teenagers considered school toilets and dorms safe havens for smoking. Many participants' first cigarettes were offered to them by peers, others first smoked during social interactions, and some started smoking of their own volition. Teenagers were curious about the attributes of cigarette products, smoking techniques, and physical reactions. More participants disclosed negative first smoking experiences than positive experiences. Negative first physical experiences motivated some participants to acquire better smoking techniques. Smoking experimentation was sustained in part by reciprocated cigarette offers. Heavy experimentation occurred before graduation from high school. Conclusions/Importance: The current findings provide an empirical basis for developing intervention strategies that are alternative or complementary to the current conventional health education. These strategies include cognitive response methods to enhance antismoking beliefs, smoke-free social interaction norms, and school-based (e.g., peer education) and home-based (e.g., involving family members) intervention programs.