Medical messages in the media--barriers and solutions to improving medical journalism

Canadian Newspapers Support Mifepristone Medication Abortion to Improve Fulfillment of the AAAQ Right to Health Framework (2015-2019)

BACKGROUND

In 2015, mifepristone in combination with misoprostol, the international gold standard for medication abortion, was approved for use in Canada. By 2019, all Canadian provinces had included the medication as a publicly insured health benefit.

METHODS

Our content analysis of Canadian newspaper coverage describes arguments in favor of or against medication abortion and the evolving regulatory framework for mifepristone from 6 months before regulatory approval until the last significant regulatory barrier to use was removed (2015-2019).

RESULTS

Our study found an exceptionally high level of support for the approval of, introduction of, and removal of regulatory barriers to mifepristone for medication abortion. Of 402 pieces, 67% were pro-medication abortion, 25% presented balanced or neutral coverage, and only 8% presented solely anti-medication abortion viewpoints. Of the 761 individuals quoted, more than 90% made positive or neutral statements about medication abortion. Most pieces discussed medication abortion as a health issue and described how liberalization of the regulatory framework would improve abortion availability (68%), accessibility (87%), acceptability (34%), and quality (28%).

CONCLUSIONS

Rather than formal balance, which presents contrasting arguments as equally valid even when the scientific evidence for one vastly outweighs the other, our study identified evidentiary balance, in which coverage aligned with the weight of evidence and expert opinion. Our results differ from analyses in other high-income countries (United Kingdom, United States) where media outlets frame abortion in relation to morality or electoral politics rather than as a health issue. The Canadian print media presented overwhelmingly favorable arguments toward the expansion of mifepristone medication abortion and framed the introduction and universal coverage of medication abortion as advancing the "Availability, Accessibility, Acceptability, and Quality" (AAAQ) Right to Health Framework that establishes international human rights standards for health information, facilities, goods, and services.

Topic Analysis of Traditional and Social Media News Coverage of the Early COVID-19 Pandemic and Implications for Public Health Communication

OBJECTIVE

To characterize and compare early coverage of coronavirus disease 2019 (COVID-19) in newspapers, television, and social media, and discuss implications for public health communication strategies that are relevant to an initial pandemic response.

METHODS

Latent Dirichlet allocation (LDA), an unsupervised topic modeling technique, analysis of 3271 newspaper articles, 40 cable news shows transcripts, 96,000 Twitter posts, and 1000 Reddit posts during March 4-12, 2020, a period chronologically early in the timeframe of the COVID-19 pandemic.

RESULTS

Coverage of COVID-19 clustered on topics such as epidemic, politics, and the economy, and these varied across media sources. Topics dominating news were not predominantly health-related, suggesting a limited presence of public health in news coverage in traditional and social media. Examples of misinformation were identified, particularly in social media.

CONCLUSIONS

Public health entities should use communication specialists to create engaging informational content to be shared on social media sites. Public health officials should be attuned to their target audience to anticipate and prevent spread of common myths likely to exist within a population. This may help control misinformation in early stages of pandemics.

Formal Training Improves Resident Understanding and Communication Regarding Brain Death/Death by Neurologic Criteria

OBJECTIVE

Residents often are involved in discussions with families regarding brain death/death by neurologic criteria (BD/DNC); however, they receive no standardized training on this topic. We hypothesized that residents are uncomfortable with explaining BD/DNC and that formal didactic and simulated training will improve residents' comfort and skill in discussions surrounding BD/DNC.

DESIGN

We partnered with our organ procurement organization (OPO) to create an educational program regarding BD/DNC consisting of a didactic component, and role-play scenarios with immediate individualized feedback. Residents completed pre- and post-training surveys.

SETTING

This study included participants from 16 academic and community institutions across New Jersey, Pennsylvania, and Delaware that are within our OPO's region.

PARTICIPANTS

Subjects were recruited using convenience sampling based on the institution and training programs' willingness to participate. A total of 1422 residents at participated in the training from 2009 to 2020.  1389 (97.7%) participants competed the pre-intervention survey, while 1361 (95.7%) completed the post-intervention survey.

RESULTS

Prior to the training, only 56% of residents correctly identified BD/DNC as synonymous with death. Additionally, 40% of residents had explained BD/DNC to families at least once, but 41% of residents reported never having been taught how to do so. The biggest fear reported in discussing BD/DNC with families was being uncomfortable in explaining BD/DNC (48%). After participating in the training, 99% of residents understood the definition of BD/DNC and 92% of residents felt comfortable discussing BD/DNC with families.

CONCLUSIONS

Participation in a standardized curriculum improves residents' understanding of BD/DNC and their comfort in discussing BD/DNC with families.

Conceptualization of the Public Health Model of Reporting through Application: The Case of the Cincinnati Enquirer's Heroin Beat

This case study seeks to demonstrate the Cincinnati Enquirer's use of the public health model of reporting and public health news frames. The Enquirer created the first newspaper heroin beat in January 2016. Enquirer reporters framed the heroin epidemic as a public health issue, focusing on solutions, contextualizing the issue through societal determinants of health, and incorporating the voices of constituent groups. Findings are discussed using news framing and the public health model of reporting.

A Media Biopsy: Examining the Quality of Cancer Reporting in Australia, 1997 and 2017

This article investigates the quality of cancer reporting from a time of prosperity to a time of austerity for the press. Australia is a useful case study because of its concentrated press media market that has experienced a decline in the number of newsroom reporters from the 20^th to the 21^st century. We undertake a content analysis of news stories published in 1997 and 2017 about cancer treatments and cancer medical research. Using keyword searching techniques of the news database Factiva, 633 news reports about cancer were detected. Of these, 120 stories met the research criteria. Each story was assessed across eight variables using a coding tool, the Media Quality Index (MQI). The study finds 2017 stories had lower scores (equating to less quality) across all eight variables compared to the 1997 cohort. Of statistical significance, 2017 stories were less likely to quantify the benefits of a proposed intervention, while stories discussing medical research were less comprehensive about research findings. The 2017 stories were less likely to discuss side effects or the potential for harm, and were more sensational, with incongruent headlines compared to content. The empirical evidence pointing to a deterioration in mainstream media reporting about cancer has implications for broader health literacy. It may foster unrealistic patient expectations about clinical practice and treatment options, with public policy implications such as overutilization of health services. The study serves as a reminder to medical practitioners that health communication directly with patients is vital as media reporting alone cannot reliably inform patients about their cancer diagnosis and treatment.

Contrasting Fake News in Oncology: The First Declaration of Good Communication

PURPOSE

Nowadays, websites, online journals, and social media give access to an extraordinary amount of medical information. Misleading news are often disseminated generating false expectations, exaggerated anxiety, and confusion; in oncology setting, disinformation is perhaps more deleterious than in other fields, with a considerable impact on single patients as well as on families and, more in general, on Public Health. We aimed to promote a better interaction between the health care and the world of communication.

MATERIALS AND METHODS

A regional technical table was established with the aim of drafting a shared document through the consensus conference method in the RAND/University of California Los Angeles variant, identifying strategies to overcome barriers between communication and health care as well as to propose common criteria for an effective dissemination of medical information.

RESULTS

Sixteen articles met the inclusion criteria, from which 72 recommendations were drawn to the communication and health field (40 related to specific issues and 32 transversal to all the specific topics). Following an evaluation of relevance by the panel of experts, it was found that 57 recommendations scored more than 7, 13 between 4 and 6.9, and 2 below 4.

CONCLUSION

This consensus and the drawn up document represent a concrete attempt to find a renewed and strategic alliance between key figures in health care and communication operators. As the American Declaration of Independence, our Declaration of Good Communication has identified high-impact recommendations for the best management of patients, providing simple but fundamental concepts and recommendations about effectiveness especially in oncology setting.

Media coverage and framing of road traffic safety in India

Background

Media coverage of road traffic collisions (RTCs) may influence preventative action. India experiences some of the highest RTC mortality and morbidity rates globally, but advocacy and effective action to mitigate this has been limited. We conducted an analysis of Indian media in English to assess whether coverage met the WHO’s Reporting on Road Safety guidelines for evidence-based reporting of RTCs.

Methods

English-language articles published online between March 2018 and February 2019 were assessed against the seven recommended story angles and seven recommended key elements in the WHO guidelines.

Results

458 articles were included in the analysis. The most common story angle was descriptions of single collisions, which was not a WHO-recommended story angle. These included limited key elements such as use of human story or linking to road safety risks or evidence-based solutions. However, some articles did follow the WHO-recommended story angles, with 22.1% discussing specific road safety solutions and a further 6.3% discussing vulnerable groups. Almost all articles avoided the use of technical language, but only 2.0% explicitly stated that RTCs were preventable. More than half identified at least one evidence-based solution. Very few articles discussed economic or health impacts of RTCs, including the burden they present to the public health system.

Conclusion

Indian media in English can improve reporting by focusing on human stories and documenting experiences of those injured in RTCs. Coverage should also focus more on evidence-based solutions, emphasising the systems approach which encourages government action rather than changes to individual behaviour.

Journalists' views on media coverage of medical tests and overdiagnosis: a qualitative study

OBJECTIVE

Promotional media coverage of early detection tests is an important driver of overdiagnosis. Following research evidence that global media coverage presents the benefits of testing healthy people far more frequently than harms, and gives little coverage to overdiagnosis, we sought to examine journalists' views on media reporting of tests, overdiagnosis, and strategies to improve critical reporting on tests.

DESIGN

Qualitative study using semistructured telephone interviews. Interviews were conducted between February and March 2020 and were audiorecorded and transcribed verbatim. Framework thematic analysis was used to analyse the data.

PARTICIPANTS AND SETTING

Twenty-two journalists (mainly specialising in health reporting, average 14.5 years' experience) based in Australia.

RESULTS

This sample of journalists acknowledged the potential harms of medical tests but felt that knowledge of harms was low among journalists and the public at large. Most were aware of the term overdiagnosis, but commonly felt that it is challenging to both understand and communicate in light of strong beliefs in the benefits of early detection. Journalists felt that newsworthiness in the form of major public health impact was the key ingredient for stories about medical tests. The journalists acknowledged that factors, like the press release and 'click bait culture' in particular, can influence the framing of coverage about tests. Lack of knowledge and training, as well as time pressures, were perceived to be the main barriers to critical reporting on tests. Journalists felt that training and better access to information about potential harms would enable more critical reporting.

CONCLUSIONS

Effectively communicating overdiagnosis is a challenge in light of common beliefs about the benefits of testing and the culture of current journalism practices. Providing journalists with training, support and better access to information about potential harms of tests could aid critical reporting of tests.

Newspaper media representation of electronic cigarette use during pregnancy

BACKGROUND

Smoking during pregnancy is associated with many adverse foetal outcomes, and electronic cigarettes (EC) have the potential to aid women to quit smoking in pregnancy. The mass media influence how people feel about products and treatments, so it is important to establish how they portray EC use during pregnancy.

METHODS

UK newspaper articles which mentioned EC use during pregnancy were identified using the database Lexis Library. Articles were assigned a category (positive, negative or neutral), and an inductive thematic analysis was conducted to identify themes within the articles.

RESULTS

Of the 55 newspaper articles, 16 (29%) were positive, 32 (58%) were negative and 7 (13%) were neutral. Four overarching themes were found within the 55 articles: 'advice', 'impact on health of the foetus', 'uncertainty' and 'awareness'. Large increases in the frequency of articles reporting on EC were noticed between November 2015 and March 2016 and between February and March 2018.

CONCLUSIONS

The UK mass media mainly portray EC use during pregnancy as negative, which could impact women's decisions to use these devices in pregnancy. More research is needed to investigate the true effectiveness of EC to aid smoking cessation in pregnancy.

Information sources, practices and barriers: a situated and context-bound model of Pakistani electronic media reporters

Purpose

This study presents a situated and context-bound model of electronic media reports by exploring their detailed information practices within the workplace actions. It further investigates the information sources they usually consult for news or story-making process and barriers that hinder them to acquire required information.

Design/methodology/approach

The data were collected through semistructured, face-to-face interviews of electronic media reporters from the top news channels of Pakistan. These reporters had international exposure while having 7–20 years of work experience with different news channels.

Findings

In relation to information practices, the model also highlights the seven steps involved in news-making process of electronic media. Initially inspired from Mckenzie's (2003) model of information practice, which was developed within the everyday life context, this model attempts to see the information practices of electronic media reporters situated at their workplaces and might be seen as an extension of previous works.

Originality/value

This study is a unique attempt to find patterns of information practices situated in their workplace actions. The results of this study would be helpful for librarians and information specialists, who are working in media house libraries for the planning and designing of library services.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-07-2020-0308

Why medical journalism wins public health journalism: systems thinking recommendations for health-promoting media

Purpose

Health-related issues are widely covered in news agencies by medical and health journalists. The quantity, format and quality of their coverage influence the general public as well as policymakers and professions. Current studies and observations suggest that news agencies are more dominated by medical topics (disease, symptoms, epidemiology, treatment and medicines) than general public health issues (risk prevention, health protection, education and promotion). This study explores the causes of the current situation in Iran and generates solutions for supporting health-promoting media that may also prove beneficial for other countries.

Design/methodology/approach

A qualitative study was conducted to explore the coverage of health-related topics in selected news agencies. Stakeholders, including health journalists, health professionals and public relations staff at the Iranian Ministry of Health and Medical Education were interviewed. Data were collected until data saturation was reached. The transcripts of all the 17 interviews conducted were analyzed using conventional content analysis.

Findings

Four groups of causes were identified, including individual factors, organizational factors, socioeconomic factors and the different nature of medicine and public health. The participants proposed several solutions that were classified into three categories, including the empowerment of stakeholders through capacity development, organizational change and mutual communication and culture change.

Originality/value

Creating health-promoting media is a complex but urgent task, and providing a comprehensive and deep understanding of the dynamic interdependencies of the multiple factors at play in it and developing and implementing the most effective interventions for it requires a systematic approach.

Journalism, public health, and COVID-19: some preliminary insights from the Philippines

In this essay, we engage with the call for Extraordinary Issue: Coronavirus, Crisis and Communication. Situated in the Philippines, we reflect on how COVID-19 has made visible the often-overlooked relationship between journalism and public health. In covering the pandemic, journalists struggle with the shrinking space for press freedom and limited access to information as they also grapple with threats to their physical and mental well-being. Digital media enable journalists to report even in quarantine, but new challenges such as the wide circulation of health mis-/disinformation and private information emerge. Moreover, journalists have to contend with broader structural contexts of shutdown not just of a mainstream broadcast but also of community newspapers serving as critical sources of pandemic-related information. Overall, we hope this essay broadens the dialogue among journalists, policymakers, and healthcare professionals to improve the delivery of public health services and advance health reporting.

COVID-19 prevention and treatment information on the internet: a systematic analysis and quality assessment

OBJECTIVE

To evaluate the quality of information regarding the prevention and treatment of COVID-19 available to the general public from all countries.

DESIGN

Systematic analysis using the 'Ensuring Quality Information for Patients' (EQIP) Tool (score 0-36), Journal of American Medical Association (JAMA) benchmark (score 0-4) and the DISCERN Tool (score 16-80) to analyse websites containing information targeted at the general public.

DATA SOURCES

Twelve popular search terms, including 'Coronavirus', 'COVID-19 19', 'Wuhan virus', 'How to treat coronavirus' and 'COVID-19 19 Prevention' were identified by 'Google AdWords' and 'Google Trends'. Unique links from the first 10 pages for each search term were identified and evaluated on its quality of information.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

All websites written in the English language, and provides information on prevention or treatment of COVID-19 intended for the general public were considered eligible. Any websites intended for professionals, or specific isolated populations, such as students from one particular school, were excluded, as well as websites with only video content, marketing content, daily caseload update or news dashboard pages with no health information.

RESULTS

Of the 1275 identified websites, 321 (25%) were eligible for analysis. The overall EQIP, JAMA and DISCERN scores were 17.8, 2.7 and 38.0, respectively. Websites originated from 34 countries, with the majority from the USA (55%). News Services (50%) and Government/Health Departments (27%) were the most common sources of information and their information quality varied significantly. Majority of websites discuss prevention alone despite popular search trends of COVID-19 treatment. Websites discussing both prevention and treatment (n=73, 23%) score significantly higher across all tools (p<0.001).

CONCLUSION

This comprehensive assessment of online COVID-19 information using EQIP, JAMA and DISCERN Tools indicate that most websites were inadequate. This necessitates improvements in online resources to facilitate public health measures during the pandemic.

Media coverage of drug regulatory agencies' safety advisories: A case study of citalopram and denosumab

AIMS

Drug regulators issue safety advisories to warn clinicians and the public about new evidence of harmful effects of medicines. It is unclear how often these messages are covered by the media. Our aim was to analyse the extent of media coverage of two medicines that were subject to safety advisories from 2007 to 2016 in Australia, Canada, the United Kingdom and the United States.

METHODS

Two medicines widely used to treat mental health or physical conditions were selected: citalopram and denosumab. Media reports were identified by searching LexisNexis and Factiva. Reports were included if they stated at least one health benefit or harm. A content analysis of the reports was conducted.

RESULTS

In total, 195 media reports on citalopram and 239 on denosumab were included. For citalopram, 43.1% (84/195) of the reports mentioned benefits, 85.6% (167/195) mentioned harms and 9.7% (19/195) mentioned the harm described in the advisories (cardiac arrhythmia). For denosumab, 94.1% (225/239) of the reports mentioned benefits and 39.7% (95/239) mentioned harms. The harms described in the advisories were rarely mentioned: 10.9% (26/239) of the reports mentioned osteonecrosis and ≤5% mentioned any of the other harms (atypical fractures, hypocalcaemia, serious infections and dermatologic reactions).

CONCLUSIONS

We found limited media coverage of the harms highlighted in safety advisories. Almost two-thirds of the media stories on denosumab did not include any information about harms, despite the many advisories during this time frame. Citalopram coverage covered harms more often but rarely mentioned cardiac arrhythmias. These findings raise questions about how to better ensure that regulatory risk communications reach the general public.

Development of mass media resources to improve the ability of parents of primary school children in Uganda to assess the trustworthiness of claims about the effects of treatments: a human-centred design approach

BACKGROUND

Claims about what we need to do to improve our health are everywhere. Most interventions simply tell people what to do, and do not empower them to critically assess health information. Our objective was to design mass media resources to enable the public to critically appraise the trustworthiness of claims about the benefits and harms of treatments and make informed health choices.

METHODS

Research was conducted between 2013 and 2016 across multiple iterative phases. Participants included researchers, journalists, parents, other members of the public. First, we developed a list of 32 key concepts that people need to understand to be able to assess the trustworthiness of claims about treatment effects. Next, we used a human-centred design approach, to generate ideas for resources for teaching the key concepts, and developed and user-tested prototypes through qualitative interviews. We addressed identified problems and repeated this process until we had a product that was deemed relevant and desirable by our target audience, and feasible to implement.

RESULTS

We generated over 160 ideas, mostly radio-based. After prototyping some of these, we found that a podcast produced collaboratively by health researchers and journalists was the most promising approach. We developed eight episodes of the Informed Health Choices podcast, a song on critical thinking about treatments and a reminder checklist. Early versions of the podcast were reportedly too long, boring and confusing. We shortened the episodes, included one key concept per episode, and changed to story-telling with skits. The final version of the podcast was found to be useful, understandable, credible and desirable.

CONCLUSION

We found many problems with various prototypes of mass media resources. Using a human-centred design approach, we overcame those problems. We have developed a guide to help others prepare similar podcasts.

From sweeteners to cell phones-Cancer myths and beliefs among journalism undergraduates

OBJECTIVE

The media are an important source of health information that can help people make their own medical decisions. However, medical news can also transmit biases produced by different factors, such as the previously held beliefs of journalists. This study identifies which cancer myths are more popular among future journalists and whether their beliefs are related to their chosen source of health information.

METHODS

A survey was conducted among journalism undergraduates (N = 249) to determine which cancer myths existed and how widespread they were. The survey included a list with different sources of health information and eight questions regarding cancer-related myths.

RESULTS

The most extensive myths among the undergraduate respondents were that sweeteners (40.2%) and cell phones (48.2%) produce cancer and that a patient's good or bad attitude can determine the outcome of such an illness (52.2%). Respondents who relied on their family and friends as a source of health information were more prone to believe in cancer myths.

CONCLUSION

This research focuses on future journalists as a group of special interest for improving knowledge about cancer. Future campaigns to debunk cancer misconceptions should pay attention to the role played by family and friends as agents of health information transmittance.

Medicine and the media: Medical experts' problems and solutions while working with journalists

Medical experts are one of the main sources used by journalists in reporting on medical science. This study aims to 1) identify problems that medical experts encounter in contacts with the media representatives, 2) elucidate their attitudes about interactions with journalists and 3) reflect on solutions that could improve the quality of medical journalism. By using in-depth interviews, focus groups and a survey directed to 600 medical experts in 21 countries, this cohort study elucidates medical experts' experiences and views on participating in popular media. A strong interest in interacting with the media was identified among the experts, where nearly one fifth of the respondents in the survey claimed that they contacted the media more than 10 times per year. Six obstacles for improving the quality of medical reporting in the media were found: deadlines, headlines, choice of topic or angle, journalist's level of medical knowledge, differences in professional culture and colleagues' opinions. The main concern among experts was that short deadlines and exaggerated headlines could harm journalistic quality. It is possible that this is partly due to ongoing changes in the media landscape with many new platforms and less control functions. Nevertheless, for several reasons many experts have great interest in interacting with the media, something that could contribute to better communication and fewer misunderstandings. Our results highlight factors like expert networks, media training for scientists and regular meetings that may facilitate communication between medical experts and medical reporters.

Pandemic Stories: Rhetorical Motifs in Journalists' Coverage of Biomedical Risk

This paper argues that journalists' discursive actions in an outbreak context manifest in identifiable rhetorical motifs, which in turn influence the delivery of biomedical information by the media in such a context. Via a critical approach grounded in rhetorical theory, I identified three distinct rhetorical motifs influencing the reportage of health information in the early days of the H1N1 outbreak. A public-health motif was exhibited in texts featuring a particular health official and offering the statements of such an official as a mechanism of reassurance. A concealment-of-information motif was exhibited in texts emphasizing the importance of the transparency of health officials, and in texts demonstrating ambivalence about information provided by socially-sanctioned sources. Finally, in texts mythologizing the outbreak to the exclusion of other functions of the text (e.g., conveying who is at risk, protective behaviours, symptoms), I identified a pandemic motif. Each motif differs in the conclusions it offers to audiences seeking to gauge relative levels of risk, and to receive information about protective behaviours. I suggest that one means of interpreting the manifestation of distinct rhetorical motifs in the context of a high-risk health threat is the certainty that this context alters moral responsibilities, consequently influencing the manifestation of narrative role.

De-legitimising complementary medicine: framings of the Friends of Science in Medicine-CAM debate in Australian media reports

Complementary and alternative medicine (CAM) has developed into a complex and formidable commercial, sociocultural and political force in Australia, and given its influence, it is a relevant subject for scholars, health practitioners, health communicators, journalists, policy-makers, and consumers of healthcare products and services. This research will consider a relative newcomer to the claims-making space about CAM in the Australian health media-scape; the Friends of Science in Medicine (FSM), an activist group of medical practitioners, researchers, and scientists, founded in late 2011. Using content analysis supported by NVivo, I searched for articles specifically referring to FSM and measured the patterns and frequencies of media frames, intonation and sources that are featured in Australian mainstream news reports between December 2011 and April 2017. The negative headlining and intonation of reports predominated, along with framing CAM as part of a lucrative, undisciplined and unethical industry as well as an illegitimate healthcare approach, more broadly. The findings offer insight into how journalists respond, replicate or reconstruct the framings that are provided by an influential and elite group of medical practitioners and scientists, and readdresses issues surrounding the need for more critical health reporting in Australia.

Readability of the 100 Most-Cited Neuroimaging Papers Assessed by Common Readability Formulae

Background: From time to time, neuroimaging research findings receive press coverage and attention by the general public. Scientific articles therefore should be written in a readable manner to facilitate knowledge translation and dissemination. However, no published readability report on neuroimaging articles like those published in education, medical and marketing journals is available. As a start, this study therefore aimed to evaluate the readability of the most-cited neuroimaging articles.

Methods: The 100 most-cited articles in neuroimaging identified in a recent study by Kim et al. (2016) were evaluated. Headings, mathematical equations, tables, figures, footnotes, appendices, and reference lists were trimmed from the articles. The rest was processed for number of characters, words and sentences. Five readability indices that indicate the school grade appropriate for that reading difficulty (Automated Readability Index, Coleman-Liau Index, Flesch-Kincaid Grade Level, Gunning Fog index and Simple Measure of Gobbledygook index) were computed. An average reading grade level (AGL) was calculated by taking the mean of these five indices. The Flesch Reading Ease (FRE) score was also computed. The readability of the trimmed abstracts and full texts was evaluated against number of authors, country of corresponding author, total citation count, normalized citation count, article type, publication year, impact factor of the year published and type of journal.

Results: Mean AGL ± standard deviation (SD) of the trimmed abstracts and full texts were 17.15 ± 2.81 (college graduate level) and 14.22 ± 1.66 (college level) respectively. Mean FRE score ± SD of the abstracts and full texts were 15.70 ± 14.11 (college graduate level) and 32.11 ± 8.56 (college level) respectively. Both items indicated that the full texts were significantly more readable than the abstracts (p < 0.001). Abstract readability was not associated with any factors under investigation. ANCOVAs showed that review/meta-analysis (mean AGL ± SD: 16.0 ± 1.4) and higher impact factor significantly associated with lower readability of the trimmed full texts surveyed.

Conclusion: Concerning the 100 most-cited articles in neuroimaging, the full text appears to be more readable than the abstracts. Experimental articles and methodology papers were more readable than reviews/meta-analyses. Articles published in journals with higher impact factors were less readable.

Media reporting of health interventions in New Zealand: a retrospective analysis

AIM

To evaluate New Zealand media articles on their coverage of key issues regarding health interventions and whether it is consistent with available evidence.

METHODS

A retrospective analysis was carried out of all articles published in five New Zealand media sources over a 6-week period between 15 October and 26 November 2014. Articles were included if their primary focus was on health interventions involving medications, devices or in-hospital procedures. Articles were assessed for coverage of key issues using previously validated 10-point criteria. A literature review was performed to compare content with scientific evidence.

RESULTS

We identified 30 articles for review. Only 4 of 30 articles covered indications, benefits and risks, and of these, two were consistent with available evidence (7%, 95% CI 1%-22%). For articles that discussed at least one of indications, benefits or risks, and there was corresponding evidence available, there was a high level of consistency with the evidence (89%, 95% CI 77%-95%). The overall mean value of coverage from the 10-point criteria was 51% (95% CI 45%-58%). Single questions regarding the potential harm, costs associated with the intervention and the availability of alternative options were particularly poorly covered. They were rated as 'satisfactory' in 13%, 23% and 33% of the 30 articles respectively.

CONCLUSION

New Zealand news articles covering medical treatments and interventions are largely consistent with available evidence but are incomplete. Vital information is being consistently missed, especially around the potential harms and costs of medical interventions.

A survey on scientific authenticity of health information in Iranian popular magazines: A case study

BACKGROUND

The content of the mass media is a suitable tool for making changes to the society. One of the most read news in the mass media is nutritional information. The goal of this study is to assess the scientific authenticity of such information published in Iranian popular magazines.

MATERIALS AND METHODS

This study is a qualitative study (content analysis) and uses bibliographic approach. A researcher-designed checklist is used as data gathering tool, and the statistical population included the messages obtained from the printed material in 173 volumes of 8 Iranian popular magazines. 10 most frequent messages were identified, and their scientific authenticity was investigated using Pubmed and IranMedex databases. The SPSS Software version 24 (IBM Corporation, Armonk, New York, USA) was applied in the analysis of this work.

RESULTS

The findings indicated that preventive trends had the highest (86.8%) and the treatments had the lowest (4.2%) frequency. Concerning the type of cancer, more than half (51.2%) of the conclusions were about cancer. Regarding authorship, 68% of articles were author signed, but the profession of 66.4% of the authors was not clear. Regarding references, only 25.4% of the articles had validated references.

CONCLUSION

It is revealed that 70% of the "nutrition information" related to cancer which was published in the popular magazines during 2012, considered to be acceptable according to scientific medical information sources. Although in some cases, the amount of evidence is not sufficient. Finally, it could be deduced that the nutrition information published in the Iranian popular magazines are still credible.

Health Journalism: Health Reporting Status and Challenges

Background:

Media play crucial role in disseminating health information. Due to the importance of accurate health news reports, and the national need to professionalism in health journalism, this study aimed to investigate the characteristics of health journalists, and health reporting status and the challenges involved.

Materials and Methods:

Using consensus sampling, this descriptive cross-sectional study was conducted on all health news reporters in Isfahan (34 journalists) in 2015–2016. Data collection was done via a researcher-made questionnaire. Content validity of the questionnaire was determined by qualitative method and based on the opinions of six experts. The test–retest reliability coefficient was 98.0. Data analysis was done by Statistical Package for the Social Sciences, version 16 and descriptive statistics and content analysis were used for analyzing the responses to two open questions.

Results:

Among 34 journalists, 56% were women and 44% men; the majority of journalists (65%) had no specialized training on health reporting, 35% of journalists were not able to understand the health issues, and the knowledge of medical terminology in 59% of them was moderate to low. The most important required skill for reporters was the ability to interpret medical research reports (88%), 97% were eager to participate in specialized health education.

Conclusions:

Our study showed that health journalists lacked knowledge and specialized training for dissemination of health news. This has brought about serious challenges. Thus, development and implementation of training courses in close collaboration with educational department of the Ministry of Health and news programs professionals at Islamic Republic of Iran Broadcasting is highly recommended.

Promoting the Quality of Health Research-based News: Introduction of a Tool

Introduction:

While disseminating health research findings to the public, it is very important to present appropriate and accurate information to give the target audience a correct understanding of the subject matter. The objective of this study was to design and psychometrically evaluate a checklist for health journalists to help them prepare news of appropriate accuracy and authenticity.

Methods:

The study consisted of two phases, checklist design and psychometrics. Literature review and expert opinion were used to extract the items of the checklist in the first phase. In the second phase, to assess content and face validity, the judgment of 38 persons (epidemiologists with a tool production history, editors-in-chief, and health journalists) was used to check the items’ understandability, nonambiguity, relevancy, and clarity. Reliability was assessed by the test–retest method using intra-cluster correlation (ICC) indices in the two phases. Cronbach's alpha was used to assess internal validity of the checklist.

Results:

Based on the participants’ opinions, the items were reduced from 20 to 14 in number. The items were categorized into the following three domains: (a) items assessing the source of news and its validity, (b) items addressing the presentation of complete and accurate information on research findings, and (c) items which if adhered to lead to the target audiences’ better understanding. The checklist was approved for content and face validity. The reliability of the checklist was assessed in the last stage; the ICC was 1 for 12 items and above 0.8 for the other two. Internal consistency (Cronbach's alpha) was 0.98.

Discussion and Conclusions:

The resultant indices of the study indicate that the checklist has appropriate validity and reliability. Hence, it can be used by health journalists to develop health research-based news.

Effects of the Informed Health Choices podcast on the ability of parents of primary school children in Uganda to assess claims about treatment effects: a randomised controlled trial

BACKGROUND

As part of the Informed Health Choices project, we developed a podcast called The Health Choices Programme to help improve the ability of people to assess claims about the benefits and harms of treatments. We aimed to evaluate the effects of the podcast on the ability of parents of primary school children in Uganda to assess claims about the effects of treatments.

METHODS

We did this randomised controlled trial in central Uganda. We recruited parents of children aged 10-12 years who were in their fifth year of school at 35 schools that were participating in a linked trial of the Informed Health Choices primary school resources. The parents were randomly allocated (1:1), via a web-based random number generator with block sizes of four and six, to listen to either the Informed Health Choices podcast (intervention group) or typical public service announcements about health issues (control group). Randomisation was stratified by parents' highest level of formal education attained (primary school, secondary school, or tertiary education) and the allocation of their children's school in the trial of the primary school resources (intervention vs control). The primary outcome, measured after listening to the entire podcast, was the mean score and the proportion of parents with passing scores on a test with two multiple choice questions for each of nine key concepts essential to assessing claims about treatments (18 questions in total). We did intention-to-treat analyses. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201606001676150.

FINDINGS

We recruited parents between July 21, 2016, and Oct 7, 2016. We randomly assigned 675 parents to the podcast group (n=334) or the public service announcement group (n=341); 561 (83%) participants completed follow-up. The mean score for parents in the podcast group was 67·8% (SD 19·6) compared with 52·4% (17·6) in the control group (adjusted mean difference 15·5%, 95% CI 12·5-18·6; p<0·0001). In the podcast group, 203 (71%) of 288 parents had a predetermined passing score (≥11 of 18 correct answers) compared with 103 (38%) of 273 parents in the control group (adjusted difference 34%, 95% CI 26-41; p<0·0001). No adverse events were reported.

INTERPRETATION

Listening to the Informed Health Choices podcast led to a large improvement in the ability of parents to assess claims about the effects of treatments. Future studies should assess the long-term effects of use of the podcast, the effects on actual health choices and outcomes, and how transferable our findings are to other countries.

FUNDING

Research Council of Norway.

Portrayal of Brain Death in Film and Television

We sought to evaluate whether television and cinematic coverage of brain death is educational or misleading. We identified 24 accessible productions that addressed brain death using the archives of the Paley Center for Media (160 000 titles) and the Internet Movie Database (3.7 million titles). Productions were reviewed by two board-certified neurologists. Although 19 characters were pronounced brain dead, no productions demonstrated a complete examination to assess for brain death (6 included an assessment for coma, 9 included an evaluation of at least 1 brainstem reflex, but none included an assessment of every brainstem reflex, and 2 included an apnea test). Subjectively, both authors believed only a small fraction of productions (13% A.L., 13% J.W.) provided the public a complete and accurate understanding of brain death. Organ donation was addressed in 17 productions (71%), but both reviewers felt that the discussions about organ donation were professional in a paucity of productions (9% for A.L., 27% for J.W.). Because television and movies serve as a key source for public education, the quality of productions that feature brain death must be improved.

Poor replication validity of biomedical association studies reported by newspapers

Objective

To investigate the replication validity of biomedical association studies covered by newspapers.

Methods

We used a database of 4723 primary studies included in 306 meta-analysis articles. These studies associated a risk factor with a disease in three biomedical domains, psychiatry, neurology and four somatic diseases. They were classified into a lifestyle category (e.g. smoking) and a non-lifestyle category (e.g. genetic risk). Using the database Dow Jones Factiva, we investigated the newspaper coverage of each study. Their replication validity was assessed using a comparison with their corresponding meta-analyses.

Results

Among the 5029 articles of our database, 156 primary studies (of which 63 were lifestyle studies) and 5 meta-analysis articles were reported in 1561 newspaper articles. The percentage of covered studies and the number of newspaper articles per study strongly increased with the impact factor of the journal that published each scientific study. Newspapers almost equally covered initial (5/39 12.8%) and subsequent (58/600 9.7%) lifestyle studies. In contrast, initial non-lifestyle studies were covered more often (48/366 13.1%) than subsequent ones (45/3718 1.2%). Newspapers never covered initial studies reporting null findings and rarely reported subsequent null observations. Only 48.7% of the 156 studies reported by newspapers were confirmed by the corresponding meta-analyses. Initial non-lifestyle studies were less often confirmed (16/48) than subsequent ones (29/45) and than lifestyle studies (31/63). Psychiatric studies covered by newspapers were less often confirmed (10/38) than the neurological (26/41) or somatic (40/77) ones. This is correlated to an even larger coverage of initial studies in psychiatry. Whereas 234 newspaper articles covered the 35 initial studies that were later disconfirmed, only four press articles covered a subsequent null finding and mentioned the refutation of an initial claim.

Conclusion

Journalists preferentially cover initial findings although they are often contradicted by meta-analyses and rarely inform the public when they are disconfirmed.

Can an educational podcast improve the ability of parents of primary school children to assess the reliability of claims made about the benefits and harms of treatments: study protocol for a randomised controlled trial

Background

Claims made about the effects of treatments are very common in the media and in the population more generally. The ability of individuals to understand and assess such claims can affect their decisions and health outcomes. Many people in both low- and high-income countries have inadequate aptitude to assess information about the effects of treatments. As part of the Informed Healthcare Choices project, we have prepared a series of podcast episodes to help improve people’s ability to assess claims made about treatment effects. We will evaluate the effect of the Informed Healthcare Choices podcast on people’s ability to assess claims made about the benefits and harms of treatments. Our study population will be parents of primary school children in schools with limited educational and financial resources in Uganda.

Methods

This will be a two-arm, parallel-group, individual-randomised trial. We will randomly allocate consenting participants who meet the inclusion criteria for the trial to either listen to nine episodes of the Informed Healthcare Choices podcast (intervention) or to listen to nine typical public service announcements about health issues (control). Each podcast includes a story about a treatment claim, a message about one key concept that we believe is important for people to be able to understand to assess treatment claims, an explanation of how that concept applies to the claim, and a second example illustrating the concept.

We designed the Claim Evaluation Tools to measure people’s ability to apply key concepts related to assessing claims made about the effects of treatments and making informed health care choices. The Claim Evaluation Tools that we will use include multiple-choice questions addressing each of the nine concepts covered by the podcast. Using the Claim Evaluation Tools, we will measure two primary outcomes: (1) the proportion that ‘pass’, based on an absolute standard and (2) the average score.

Discussion

As far as we are aware this is the first randomised trial to assess the use of mass media to promote understanding of the key concepts needed to judge claims made about the effects of treatments.

Trial registration

Pan African Clinical Trials Registry, PACTR201606001676150. Registered on 12 June 2016. http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?dar=true&tNo=PACTR201606001676150.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-016-1745-y) contains supplementary material, which is available to authorized users.

Public education and misinformation on brain death in mainstream media

INTRODUCTION

We sought to evaluate the caliber of education mainstream media provides the public about brain death.

METHODS

We reviewed articles published prior to July 31, 2015, on the most shared/heavily trafficked mainstream media websites of 2014 using the names of patients from two highly publicized brain death cases, "Jahi McMath" and "Marlise Muñoz."

RESULTS

We reviewed 208 unique articles. The subject was referred to as being "alive" or on "life support" in 72% (149) of the articles, 97% (144) of which also described the subject as being brain dead. A definition of brain death was provided in 4% (9) of the articles. Only 7% (14) of the articles noted that organ support should be discontinued after brain death declaration unless a family has agreed to organ donation. Reference was made to well-known cases of patients in persistent vegetative states in 16% (34) of articles and 47% (16) of these implied both patients were in the same clinical state.

CONCLUSIONS

Mainstream media provides poor education to the public on brain death. Because public understanding of brain death impacts organ and tissue donation, it is important for physicians, organ procurement organizations, and transplant coordinators to improve public education on this topic.

Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

Background

Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting.

Methods

Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted.

Results

Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities.

Conclusion

Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can contribute to redefining the role of media in strengthening health systems.

Priority setting for resources to improve the understanding of information about claims of treatment effects in the mass media

OBJECTIVE

Claims about benefits and harms of treatments are common in the media. We engaged health journalists in prioritizing concepts of evidence-based medicine that we believe the public needs to understand to be able to assess claims about treatment effects; and which could improve how journalists report such information.

METHODS

We conducted a three-day workshop with a group of Ugandan journalists in which we presented and explained the concepts. We asked journalists to prioritize groups of related concepts using four pre-specified criteria i.e. relevance of the concepts to journalists and their audiences; ease of comprehension; feasibility of developing resources for teaching the concepts and, whether such resources would potentially have an impact. Using a modified Delphi technique, participants ranked each group of concepts using these criteria on a scale of one to six (one = lowest; 6 = highest). We analyzed the rankings in real time using STATA statistical software.

RESULTS

All six groups of concepts were considered relevant and comprehensible with scores of five and six on a scale of one to six. Twenty two out of 25 participants reported having understood the concepts well, with subjective scores of above 75 on a scale of one to 100.

CONCLUSION

Journalists in Uganda recognize the importance of evidence-based medicine concepts in assessing claims about benefits and harms of treatments to them and their audiences. They should be empowered to use these and similar concepts in order to improve how information about effects of treatments is relayed in the media.

Science reporting in Accra, Ghana: sources, barriers and motivational factors

In Ghana, as in many other developing countries, most science reporting is done by general reporters. However, few studies have investigated science reporting in such a situation. To understand better the dynamics of science reporting in such context, we surveyed 151 general reporters in Ghana. Respondents' demographic characteristics resembled those found in studies elsewhere. Respondents perceived health professionals and scientists as very important sources of information for reporting science. There was an inverse correlation between journalism experience and the number of science feature stories reported in the past 12 months (p=.017). Most respondents indicated that science journalism training would motivate them to report science more. Likewise, most reported that easier access to research findings would do so. We identify characteristics of reporters, media, scientific, and training institutions that are important influences of Ghanaian reporters' coverage of science. We provide recommendations for advancing science reporting in Ghana.

Examination of the mass media process and personal factors affecting the assessment of mass media-disseminated health information

This study examined the mass media and personal characteristics leading to health communication inequality as well as the role of certain factors in health communication’s mass media process. Using both sociodemographic variables and Maletzke’s model as a basis, we investigated the relationship between selected components of the mass communication process, the receiving of reliable health information as a result of health communication, and the condition of its use. The study involved 1853 people in Turkey and was structured in two parts. The first part dealt with questions regarding sociodemographic characteristics, the use of the mass media and the public’s ability to obtain health information from it, the public’s perception of the trustworthiness of health information, and the state of translating this information into health-promoting behaviours. In the second part, questions related to the mass communication process were posed using a five-point Likert scale. This section tried to establish structural equation modelling using the judgements prepared on the basis of the mass media model. Through this study, it has been observed that sociodemographic factors such as education and age affect individuals’ use of and access to communication channels; individuals’ trust in and selection of health information from the programme content and their changing health behaviours (as a result of the health information) are related to both their perception of the mass communication process and to sociodemographic factors, but are more strongly related to the former.

The Angelina effect: immediate reach, grasp, and impact of going public

BACKGROUND

In May 2013, Angelina Jolie revealed in a New York Times opinion piece that she had undergone a preventive double mastectomy because she had a family history of cancer and carried a rare mutation of the BRCA1 gene. Media coverage has been extensive, but it is not obvious what messages the public took from this personal health story.

METHODS

We conducted a survey with a representative national online panel of 2,572 adults. Participants described their awareness and identified information sources for the Angelina Jolie news story. They also reported their understanding, reactions, perceptions, and subsequent activities related to the story. We asked questions pertaining to personal and societal breast cancer risk and hypothetical questions regarding preventive surgery if the respondent or a family member were in the same position as Ms Jolie. Demographic information was collected, as was family risk for breast and ovarian cancer, and a gauge of numeracy.

RESULTS

While three of four Americans were aware of Angelina Jolie's double mastectomy, fewer than 10% of respondents had the information necessary to accurately interpret Ms Jolie's risk of developing cancer relative to a woman unaffected by the BRCA gene mutation. Awareness of the Angelina Jolie story was not associated with improved understanding.

CONCLUSION

While celebrities can bring heightened awareness to health issues, there is a need for these messages to be accompanied by more purposeful communication efforts to assist the public in understanding and using the complex diagnostic and treatment information that these stories convey.

Understanding factors that impact on public and patient's risk perceptions and responses toward Clostridium difficile and other health care-associated infections: a structured literature review

BACKGROUND

Clostridium difficile is the most common health care-associated infection and a major cause of death and increased morbidity. It is vital that patients and the public are provided with the right information and communication to assist them to understand their role in preventative measures. Successful implementation of communication and management strategies hinges on individuals' risk perceptions.

METHODS

We performed a structured literature review to examine the evidence regarding public and patients' risk perceptions and responses toward Clostridium difficile and other health care-associated infections. Fourteen studies were included.

RESULTS

Only 1 study was specific to Clostridium difficile, and 7 were related to other health care-associated infections. Many reported limited understanding of the technical issues of the infection, concerns of transmission to family and friends, inadequate information available, and distrust. The media were one of the main sources of information. Both emotional and physical responses highlighted the level of confusion, fear, anxiety, and anger.

CONCLUSION

Empirical research of risk perceptions toward Clostridium difficile is limited. Without well-researched studies examining risk perceptions and responses, there is a danger of developing and implementing communication and management strategies that do not meet the needs of our patients or the public.

Opinion editorials: the science and art of combining evidence with opinion

In the policy environment, the news media play a powerful and influential role, determining not only what issues are on the broad policy agenda, but also how the public and politicians perceive these issues. Ensuring that reporters and editors have access to information, that is, credible and evidence-based is critical for stimulating healthy public discourse and constructive political debates. EvidenceNetwork.ca is a non-partisan web-based project that makes the latest evidence on controversial health-policy issues available to the Canadian news media. This article introduces EvidenceNetwork.ca, the benefits it offers to journalists and researchers, and the important niche it occupies in working with the news media to build a more productive dialogue around healthcare.

Quality of health news disseminated in the print media in developing countries: a case study in Iran

Background

Mass media play an important role in keeping people up-to-date with the latest health news. This study aims at investigating the quality of health news disseminated in the print media, its course of production and factors affecting its quality.

Methods

In the quantitative section of the study, 410 health-related news items, published during a six-month span in the Iranian public press, underwent content analysis. In the qualitative section, focus group discussions were held with journalists, editors-in-chief and news gatekeepers.

Results

The quantitative phase showed that 18% of the news articles were not fit for dissemination in public. The qualitative phase illustrated that multiple factors at various levels affect the quality of news, namely poor knowledge, inadequate motivations and context-related barriers.

Conclusions

The quality of health news reporting is not desirable. Educational interventions need to be carried out to raise awareness among researchers and journalists. Also, certain steps should be taken to increase motivations and strengthen infrastructures, including designing guidelines and monitoring news.

Journalists' views about reporting avian influenza and a potential pandemic: a qualitative study

Please cite this paper as: Hooker et al. (20XX) Journalists’ views about reporting avian influenza and a potential pandemic: a qualitative study. Influenza and Other Respiratory Viruses 6(3), 224–229.

Background  The mass media is a key component of any public communication strategy for influenza or other respiratory illnesses, but coverage can be variable. In this study, we explored the factors that influenced journalists’ coverage of avian influenza as a model for coverage of a potential influenza pandemic.

Methods  This study involved semi‐structured interviews with 16 journalists from major Australian print, radio and television media organisations reporting on avian influenza and pandemic planning. Journalists, including reporters, editors and producers, were interviewed between October 2006 and August 2007. Thematic analysis was used to draw out major lessons for health communicators.

Results  Coverage of avian influenza was influenced by a small set of news values: catastrophic potential, cultural and geographical proximity, unfamiliarity and uncertainty. Lack of novelty and the absence of compelling images led to a decline in coverage. Journalists expressed concerns about the accuracy and impacts of reporting, but saw as critically important, their primary role as informants. They hence emphasised the importance of journalistic independence. Journalists all intended to continue working in a pandemic.

Conclusions  Health experts need to adapt their timetables and resources to journalists’ needs to improve their mutual communication. In crisis situations, journalists communicate with the public efficiently and effectively, but expert and journalistic views on the role and content of coverage may diverge in the post‐acute, reflective phase of a crisis.

Does it matter who writes medical news stories?

David Henry and colleagues review Australian news stories over a five-year period to assess whether quality is associated with who wrote the story: a specialist health journalist or a non-specialist.

Media coverage of health issues and how to work more effectively with journalists: a qualitative study

Background

The mass media has enormous potential to influence health-related behaviours and perceptions. Much research has focused on how the media frames health issues. This study sought to explore how journalists in Australia select and shape news on health issues.

Methods

The study involved semi-structured interviews with 16 journalists from major Australian print, radio and television media organisations reporting on avian influenza and pandemic planning. Journalists, including reporters, editors and producers, were interviewed between October 2006 and August 2007. Thematic analysis was used to draw out major lessons for health communicators.

Results

Journalists routinely attempted to balance different, sometimes competing, aims amidst significant operational constraints. They perceived the most trusted sources on health issues to be respected and independent doctors. Specialist health and medical reporters had a more sound technical knowledge, channels to appropriate sources, power within their organisations, and ability to advocate for better quality coverage.

Conclusions

An awareness of how to work with the media is essential for health communicators. This includes understanding journalists' daily routines, being available, providing resources, and building relationships with specialist health reporters.

Mass media barriers to social marketing interventions: the example of sun protection in the UK

The role of the mass media in communicating health-related information to the wider population is the focus of this paper. Using the example of sun protection within the UK, we highlight some of the major challenges to raising awareness of steadily increasing melanoma rates and of effective sun protection strategies. The implications of potential barriers to official sun protection messages via conflicting messages in the media are discussed in terms of editorial on sun protection and in the way in which television programme content portrays the issues. Implications for public policy and future research conclude the paper.

Structural problems of medical news reports in newspapers: a verification of news reports on an incident of mass nosocomial Serratia infection

It is unclear how changes in the content and number of news reports over time affect the impressions made in the minds of newspaper readers. This study targeted news reports in major newspapers regarding an incident of mass nosocomial Serratia infection that occurred at one clinic. The trends in the total number of articles and total number of characters contained in the articles were congruent, with a peak on the day after the incident was disclosed and a rapid decrease thereafter. The numbers of articles and characters that appeared during the first 3 days corresponded to 45 and 51% of those that appeared during the entire study period. On day 9, it was published that Serratia liquefaciens propagated on medical instruments, and both the number of articles and the number of characters increased by approximately 40% in comparison to those published on the day after the initial report of the incident. The individual articles were deemed to be medically accurate; however, the main problem was that only part of the specific medical issue had been emphasized because of a poor balance in the number of news reports on this topic.

SUPPORT Tools for evidence-informed health Policymaking (STP) 15: Engaging the public in evidence-informed policymaking

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. In this article, we address strategies to inform and engage the public in policy development and implementation. The importance of engaging the public (both patients and citizens) at all levels of health systems is widely recognised. They are the ultimate recipients of the desirable and undesirable impacts of public policies, and many governments and organisations have acknowledged the value of engaging them in evidence-informed policy development. The potential benefits of doing this include the establishment of policies that include their ideas and address their concerns, the improved implementation of policies, improved health services, and better health. Public engagement can also be viewed as a goal in itself by encouraging participative democracy, public accountability and transparency. We suggest three questions that can be considered with regard to public participation strategies. These are: 1. What strategies can be used when working with the mass media to inform the public about policy development and implementation? 2. What strategies can be used when working with civil society groups to inform and engage them in policy development and implementation? 3. What methods can be used to involve consumers in policy development and implementation?

Media reporting of health interventions: signs of improvement, but major problems persist

Background

Studies have persistently shown deficiencies in medical reporting by the mainstream media. We have been monitoring the accuracy and comprehensiveness of medical news reporting in Australia since mid 2004. This analysis of more than 1200 stories in the Australian media compares different types of media outlets and examines reporting trends over time.

Methods and Findings

Between March 2004 and June 2008 1230 news stories were rated on a national medical news monitoring web site, Media Doctor Australia. These covered a variety of health interventions ranging from drugs, diagnostic tests and surgery to dietary and complementary therapies. Each story was independently assessed by two reviewers using ten criteria. Scores were expressed as percentages of total assessable items deemed satisfactory according to a coding guide. Analysis of variance was used to compare mean scores and Fishers exact test to compare proportions. Trends over time were analysed using un-weighted linear regression analysis. Broadsheet newspapers had the highest average satisfactory scores: 58% (95% CI 56–60%), compared with tabloid newspapers and online news outlets, 48% (95% CI 44–52) and 48% (95% CI 46–50) respectively. The lowest scores were assigned to stories broadcast by human interest/current affairs television programmes (average score 33% (95% CI 28–38)). While there was a non- significant increase in average scores for all outlets, a significant improvement was seen in the online news media: a rise of 5.1% (95%CI 1.32, 8.97; P 0.009). Statistically significant improvements were seen in coverage of the potential harms of interventions, the availability of treatment or diagnostic options, and accurate quantification of benefits.

Conclusion

Although the overall quality of medical reporting in the general media remains poor, this study showed modest improvements in some areas. However, the most striking finding was the continuing very poor coverage of health news by commercial current affairs television programs.

Constructing health news: possibilities for a civic-oriented journalism

Health is a very prominent news category. However, we know little about the production processes of journalists leading to the health stories we encounter on a daily basis. Such knowledge is crucial for ensuring a vibrant public sphere for health. This article draws on interviews with eight health journalists in New Zealand to document what they consider to constitute a health story, their professional norms and practices, their perceptions of audiences, and the need for increased civic deliberations regarding health. Journalists privilege biomedical stories involving lifestyle and individual responsibility, and have limited frames for presenting stories that involve socio-political concerns. Stories are strongly shaped by journalists' considerations of their target audience, the sources they draw on, their professional norms, and institutional practices. This results in the omission of stories that have relevance for minority and disadvantaged groups and limits the nature of the stories told to ones that reflect the views of the majority. However, journalists are also reflective about these issues and receptive to ways to overcome them. This raises possibilities for health researchers to engage with journalists in order to repoliticise health and promote a more civic-oriented form of health journalism.