Differences in Antenatal Care Policies in England, Finland, and the Netherlands: A Framing analysis

BACKGROUND AND PURPOSE

The World Health Organization (WHO) states that good quality antenatal care should strive for both mother and child achieving their best possible health. On a policy level, in Europe these goals are reached with varying approaches. This research offers a fresh look on the underlying assumptions embedded in the ANC policies in three European countries.

METHODS

A framing analysis was conducted to publicly available ANC policies on uncomplicated pregnancies in Finland, England, and the Netherlands. Analysis was guided by van Hulst and Yanowa and included the following phases: a) Sense-making, b) Selecting, naming, and categorizing and c) Storytelling.

MAIN FINDINGS

Findings of this study demonstrate how ANC is organized with distinct frames. The Finnish ANC policies emphasized equity in care and instead of focusing on women, the ANC focused on the family. In England the pregnant woman was central, and it is seen as her responsibility to understand the ANC protocols. The ANC in the Netherlands focused on the pregnant woman's pregnancy experience and freedom.

CONCLUSION

The three studied countries had individual priorities and values guiding ANC provision. Despite each country being in line with the WHO ANC recommendations, areas requiring improvement should not be overlooked.

The Nine Cancer Frames: A Tool to Facilitate Critical Reading of Cancer-Related Information

People's ability to critically assess cancer-related information is essential from a preventional and therapeutic, as well as a general democratic perspective. Such cancer literacy is not just about acquiring factual knowledge. It also involves the ability to analyze how the information is contextualized-how cancer is framed. Previous research concerning the framing of cancer in public discourse is voluminous and penetrating but also fragmented and inaccessible to non-experts. In this study, we have developed an integrated and applicable tool for analyzing cancer discourse by systematically classifying distinctive ways of framing of the concept of cancer. Building on previous research and an inductive framing analysis of a broad range of public cancer discourse, systematically selected from British and Norwegian newspapers, we have characterized nine cancer frames: the biomedical, the environmental, the epidemiological, the personal, the sociopolitical, the economic, the antagonistic, the alternative, and the symbolic frame. This framing scheme may be applied to analyze cancer-related discourse across a plurality of themes and contexts. We also show how different frames combine to produce more complex messages, thereby revealing underlying patterns, strategies, and conflicts in cancer communication. In conclusion, this analytical tool enables critical reading of cancer-related information and may be especially useful in educational initiatives to advance health communication and public understanding of cancer.

The Framing of "Alzheimer's Disease": Differences Between Scientific and Lay Literature and Their Ethical Implications

Background and Objectives

The meaning of Alzheimer’s disease (AD) is changing in research. It now refers to a pathophysiological process, regardless of whether clinical symptoms are present. In the lay literature, on the other hand, AD is understood as a form of dementia. This raises the question of whether researchers and the lay audience are still talking about the same thing. If not, how will these different understandings of AD shape perspectives on (societal) needs for people with AD?

Research Design and Methods

We use framing analysis to retrieve the understandings of the term AD that are upheld in the research literature and in national Dutch newspaper articles. We make explicit how the framings of AD steer our normative attitudes toward the disease.

Results

In the analyzed research articles, AD is framed as a pathological cascade, reflected by biomarkers, starting in cognitively healthy people and ending, inevitably, in dementia. In the lay literature, AD is used as a synonym for dementia, and an AD diagnosis is understood as an incentive to enjoy “the time that is left.”

Discussion and Implications

The two different uses of the term AD in research and in the lay literature may result in misunderstandings, especially those research framings that falsely imply that people with AD biomarkers will inevitably develop dementia. Adoption of the research understanding of AD in clinical practice will have normative implications for our view on priority setting in health care. For example, it legitimizes biomarker testing in people without dementia as improving “diagnostic” certainty.

Framing global discourses on non-communicable diseases: a scoping review

Background

The choices that policymakers make are shaped by how their problems are framed. At last, non-communicable diseases (NCDs) have risen high on the global policy agenda, but there are many disputed issues. First, what are they? Their name refers not to what they are but what they are not. Second, where do their boundaries lie? What diseases are included? Third, should we view their causes as mainly biomedical, behavioural, or social, or a combination? Our failure to resolve these issues has been invoked as a reason for our limited progress in developing and implementing effective remedies. In this scoping review, we ask “What is known from the existing literature about how NCDs are framed in the global policy discourses?” We answer it by reviewing the frames employed in policy and academic discourses.

Methods

We searched nine electronic databases for articles published since inception to 31 May 2019. We also reviewed websites of eight international organisations to identify global NCDs policies. We extracted data and synthesised findings to identify key thematic frames.

Results

We included 36 articles and nine policy documents on global NCDs policies. We identified five discursive domains that have been used and where there are differing perspectives. These are: “Expanding the NCDs frame to include mental health and air pollution”; “NCDs and their determinants”; “A rights-based approach to NCDs”; “Approaches to achieving policy coherence in NCDs globally”; and “NCDs as part of Sustainable Socio-economic Development”. We further identified 12 frames within the five discursive domains.

Conclusions

This scoping review identifies issues that remain unresolved and points to a need for alignment of perspectives among global health policy actors, as well as synergies with those working on mental health, maternal health, and child health. The current COVID-19 pandemic warrants greater consideration of its impact on global NCDs policies. Future global strategies for NCDs need to consider explicitly how NCDs are framed in a changing global health discourse and ensure adequate alignment with implementation and global health issues. There is a need for global strategies to recognise the pertinent role of actors in shaping policy discourses.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-020-05958-0.

Frequency, Context and Characteristics of Smile Used in Advertising

OBJECTIVE

The images of smiling people are omnipresent in marketing. Frequency, smile characteristics, context of the smile and target audience in newspaper advertisements were points of interest of this study.

MATERIAL AND METHODS

Four examiners analyzed 600 advertisements from 46 European magazines and newspapers by using content and framing analysis. Twenty items of the analysis form the presence of people, smile characteristics, context of smile use, impression of success and health, and targeted audience. The chi-square test was used in statistical analysis.

RESULTS

People were present in over 70% of the newspapers advertisements, and almost 80% of them were smiling, relating the product or service with positive context more often than with neutral or negative context (p<0.001). The advertisements with smile targeted the adults more frequently (70.6%) and adolescents (33.6%), and less often the elderly (22.2%) and children (4.2%); women (45.9%) or both genders (29.2%) were targeted more often than solely men (2.6%). Smile mostly filled out one quarter of the size of the entire advertisement (97%), equally spontaneous and posed smiles were used. In 82% of cases teeth were visible during smile, and buccal corridors were present in 39% of them.

CONCLUSIONS

Smile is often used in newspaper advertisements, mostly targeting adult women, and providing the context of positive emotions. Most people will show teeth when they smile. Parameters of micro smile esthetics are not in the focus of an advertisement.

Bed bugs bite the hospitality industry? A framing analysis of bed bug news coverage

News coverage plays an important role in determining individuals' travel decisions and influencing the general tourism market. Bed bug infestation, as a growing crisis in the hospitality and tourism industry, has been featured in news coverage. This study conducted a framing analysis of news coverage that is pertinent to the bed bug crisis and to the hospitality and travel industry. Selected news articles, representing three different destinations, were retrieved from five national newspapers. Results showed that bed bug infestation has been framed as a typical health crisis, with aspects of consequence and seriousness featured. Findings further confirmed the hospitality and travel industry as frequently cited in the bed bug news coverage. A positive correlation existed between the mention of the hospitality and travel industry, and the use of either a thematic frame or the news frame consequence. Based on the findings, implications for tourism crisis management were discussed.

A frame-critical policy analysis of Canada's response to the World Food Summit 1998-2008

BACKGROUND

The 2012 visit to Canada of Olivier De Schutter, the United Nations Special Rapporteur on the Right to Food, led to a public rebuff by Canadian governmental officials. This paper adapts the frame-critical policy analysis of Schön and Rein (1994), to explore the rhetorical basis for this conflict. This examination is offered as an illustrative example of how food insecurity is framed as a public policy problem in a high-income nation and how this framing has changed over time.

METHODS

We analyze Canada's decade of sequential responses to the 1996 World Food Summit, spanning 1998-2008, in the form of Canada's Action Plan on Food Security, and its subsequent Progress Reports. We conducted a qualitative policy analysis, adapting the frame-critical approach first delineated by Schön and Rein (1994). This analysis uses a social constructionist approach to map out the relationships between tacit understanding of policy by particular actors, explicit rhetoric in the public domain, and action in this policy area over time.

RESULTS

We identify three key ways in which competing rhetorical frames arise over time: frame shifts (e.g., a shift away from language highlighting the right to food and health); frame blending (e.g., discussion about poverty becomes obscured by complexity discourse); and within-frame incongruence (e.g., monitoring for health indicators that are unrelated to policy solutions). Together, these frames illustrate how the conflict embodied in the UN Special Rapporteur's visit has been deeply woven into the policy discourse on food insecurity in Canada over time.

CONCLUSION

Frame-critical analysis is instructive for exposing and also predicting tensions that impede forward progress on difficult policy issues. Accordingly, such analyses may be helpful in not only dissecting how policy can become 'stuck' in the process of change but in active reframing towards new policy solutions.