T HE field of health communication has grown significantly during itsroughly 20 years of existence (Ray & Donohew, 1990). Indeed, giventhe concrete achievements of increasing emphasis on communication in both medical education and practice, the establishment of the journal of Health Communication, and growing membership in the health communication commissions of the Speech Communication Association and the International Communication Association, it is safe to say that the fledgling is no more. Efforts to provide a meaningful order to this adolescent burst of growth

have been forthcoming in the form of in-depth reviews of research trends (Cassata, 1978, 1980; Costello, 1977; Finnegan & Viswanath, 1990; Kreps, 1988; Thompson, 1984) and reflective essays suggesting future directions for research (Arntson, 1985; Korsch, 1989; Kreps, 1989; Nussbaum, 1989; Pettegrew, 1988; Smith, 1989). These articles provide significant testament to the importance of communication in the management of health.