The Future of the Public's Health in the 21st Century (2003) / Chapter Skim
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7. Media
7. Media
Pages 307-357
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From page 307... ...
In this chapter, the committee examines the potential role of the media as an actor in the public health system, that is, how it can use its presence and power to lead to the mobilization of societal action that creates the conditions for health. The chapter specifically discusses how the news media can place health issues on the national public agenda and can catalyze action at the national and local levels.
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During this time, news media coverage of the illnesses that appeared to be affecting homosexual men was limited. According to an analysis conducted by the Kaiser Family Foundation (1996)
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Subsequent coverage of AIDS included several newsmaker and public interest stories that further increased the public's concern about AIDS. News media coverage during the mid- to late 1980s may have contributed to improved public awareness and knowledge of AIDS.
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Advocacy groups and celebrities used news media coverage to bring attention to the case of Ryan White, an Indiana teenager who acquired AIDS through blood products used to treat his hemophilia, and to AIDS issues in general (AIDS Project Los Angeles, 2001~. In August 1990, the Ryan White Comprehensive AIDS Resources (CARE)
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families" living across the street from Disneyland in Orange County, California, demonstrates the power of the news media to highlight social issues and stimulate action by local government and community members. Over a period of 6 months in 1998, Laura Saari, a writer for the Orange County Register, brought to light the sharp social and economic contrast that exists in one of California's more affluent counties, where one in five children lives in poverty.
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NEWS MEDIA COVERAGE AND HEALTH INFORMATION Although news media coverage can help place a specific health issue on the national agenda, tensions exist among news reporters, scientists, and public health professionals as they seek to convey health news and information to the public, especially during a crisis. It is important to understand these tensions if the news media is to be involved in the public health system.
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Journalists' Agreement (%) Few members of the news media understand the nature of science News media reporters are ignorant of the process of science News media reporters cannot interpret results News media reporters overblow risks News media reporters rarely get details right Member of the media seek the sensational Members of the news media focus on the trendy News media reporters focus on personalities, not on findings News media reporters want instant answers 91 69 66 61 56 76 79 49 75 77 46 48 45 62 69 67 70 52 SOURCE: Hartz and Chappell (1997)
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Scientific journals may also contribute to the distortion of research findings. Scientific journals often prepare press releases for the news media to assist them in getting the story right.
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From page 316... ...
Both the Kaiser Family Foundation and the CDC-Knight fellowships, as well as others, facilitate a healthy dialogue between health officials and reporters and contribute to the development of a well-trained cadre of health journalists. Journalist associations also have begun to take a lead in providing opportunities for journalists to improve the quality of information they provide to the public.
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From page 317... ...
During such times, the news media play an important role in amplifying or attenuating the public's perception of risk and serve as a key link in the risk communication process. The media played a key role in reporting the anthrax attacks following the terrorist attacks on September 11, 2001.
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In response to Department of Health and Human Services plans to reorganize communication, legislative, and public affairs offices, the Association of Health Care Journalists and the National Association of Science Writers warned that tight control of information by top department managers may be efficient, but it can also increase the risk of communication bottlenecks that can deprive the public of timely and vital health information, and raises questions about how the public's access to objective information will be protected (AHCT, 2002a)
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The section concludes with an examination of social marketing and media advocacy, strategies that use media as part of a broader approach to changing individual behavior or promoting social change. Advertising Media: Public Service Announcements Broadcasters can help create conditions for improved population health by choosing to donate time for PSAs that convey health-promoting messages.
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From page 320... ...
The study also found that health issues are the top priority of PSAs at some networks: 52 percent of all donated airtime on MTV, 35 percent of all donated airtime on Fox, and 33 percent on CBS are devoted to health issues (Kaiser Family Foundation, 2002a)
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The $1 million investment in media messages reduced per capita cigarette sales by 7.7 packs. Part of the success of this campaign was that the paid nature of the PSAs allowed greater freedom in their design, which was considered controversial and attracted news media attention (Doriman and Wallack, 1993~.
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The campaign capitalizes on Viacom's global brand power and strong audience relationships to reach the public at large and those most affected by the disease. The Kaiser Family Foundation brings to the partnership its expertise in HIV/AIDS and public education.
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The FCC should review the regulations governing broadcast and broadband media with an eye toward finding ways in which media institutions can serve the public's interest in accurate health information without being unfairly burdened in the process. Better placement of PSAs would benefit the public as well as the media, which will be seen as fully contributing to the public good.
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However, concerted efforts to develop strong partnerships between the entertainment media and health communicators are increasingly contributing to more accurate and timely health information in entertainment programming. American television producers have a history of working with health promotion experts to address public health issues.
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Some alcohol control advocates argued that they may have done more harm than good by encouraging excessive drinking by passengers and deflecting attention away from the social determinants that influence alcohol consumption (DeTong and Wallack, 1992~. In a more recent partnership, researchers at the Kaiser Family Foundation, together with a writer and producer of ER, NBC's medical drama, collaborated to test the effect of health information communicated through an ongoing television drama.
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The use of entertainment media as a strategy for providing health information is well founded. In 1999, the case for presenting health information through entertainment was strengthened by a CDC study of the Healthstyles Survey Database.
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Consequently, the committee recommends that public health officials and local and national entertainment media work together to facilitate the communication of accurate information about disease and about medical and health issues in the entertainment media. Recognizing the powerful impact of the entertainment media in conveying health information and messages, a number of health agencies and other groups are working to acknowledge the efforts of the Hollywood community.
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The committee applauds efforts to recognize and highlight the contributions of the entertainment media in conveying accurate health information and messages as part of their programming .
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In the health arena, interactive health communication, or the interaction of an individual consumer, patient, caregiver, or professionalwith an electronic device or communication technology to access or transmit health information or receive guidance and support on a health-related issue, is growing at a rapid pace (Robinson et al., 1998~. Consumer health in particular is one area that is being reshaped by interactive health communication.
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the privacy and confidentiality of personal health information. A recent National Research Council (NRC)
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Protection of the privacy and confidentiality of personal health information is a challenge for Internet health communication activities. According to consumer surveys, individuals fee!
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Two of the most prominent of these strategies are social marketing and media advocacy. Social Marketing Social marketing is an approach that attempts to apply advertising and marketing principles to "sell" positive health behaviors (Kotler and Zaltman, 1971; Kotler and Roberto, 1989; Kotler et al., 2002~.
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In social marketing for improved health outcomes, these marketing variables (the "four P's") take on the following definitions: · "Product" might be defined as the behavior that the program is trying to change within the target audience; more specifically, it could be safer sex or nonsmoking.
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· "Policy" recognizes the need for social and environmental changes to support individual behavioral change. Without supportive policies, social marketing campaigns cannot be sustained.
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cities, the ABC Immunization Calendar program was developed to raise immunization rates among children from families in lower socioeconomic groups the targeted audience (Zell et al., 1994~. Based on evidence that more patient-oriented approaches by providers have been recommended and that computer-generated educational materials that are tailored to individuals are more likely to be read, remembered, saved, and discussed and to lead to changes in behavior, especially among poor and underserved populations, the program provides computer-made immunization promotion calendars tailored to each child (National Vaccine Advisory Committee, 1992; Skinner et al., 1994; Brug et al., 1996; Bull et al., 1999~.
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Coupled with these two components, the ABC Immunization Calendar program uses the focus and strategies of social marketing to more effectively engage parents and ensure higher rates of childhood immunization among low-income and underserved families. The national Turning Point Initiatives understood the potential impact that social marketing initiatives can have on improving population health and formed a collaborative of partners to review and widely disseminate social marketing information to improve community health.
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The primary focus is on the role of the news media, with secondary attention to the use of paid advertising (DHHS, 1989; Wallack and Sciandra, 1990, 1991; Wallack et al., 1993; Chapman, 1994; Wallack, 1994; Wallack and Doriman, 1996; Winett and Wallack, 1996~. Media advocacy seeks to create a loud voice for social change and shape the message so that it resonates with social justice values that are the presumed basis of public health (Beauchamp, 1976; Mann, 1977~.
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Media advocacy involves understanding how journalism works to increase access to the news media. This includes maintaining a media list, monitoring the news media, understanding the elements of newsworthiness, pitching stories and holding news events, and developing editorial strategies for reaching key opinion leaders.
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The coalition used media tools to educate community members about the ordinance, demonstrate unity of opinion to policy makers, and
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HEALTH COMMUNICATION CAMPAIGNS: THEORY, EVALUATION, AND RESEARCH NEEDS In the twentieth century, large-scale health communication campaigns focused on the promotion of hygiene behaviors, safety and accident prevention, substance abuse prevention, adoption of healthy lifestyles and eating habits, family planning and contraceptive use, and many other topics (Valente and Schuster, 2002~. Through mass media campaigns, health promoters try to accelerate behavioral change by informing the public (increasing knowledge)
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The health belief mode! is one of the oldest models developed to understand health-related behavioral change (Becker, 1974~.
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Theory According to the social learning (cognitive) theory model, four components are critical if behavioral change is to occur.
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For communication strategies, this means that highly emotional messages would be more readily accepted by audience members and would more likely lead to behavioral change than messages that are low in emotional content. Stages-of-Change Theory The stages-of-change theory posits that several psychological stages can be observed in individuals who are making a behavioral change (Prochaska et al., 1992~.
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, and most of them acknowIedge that the media can play some role in influencing human behavior. These theories can be used to understand how health information in the media affects the public's health, whether the information is received from deliberate media programming or from day-to-day behavior (IOM, 2002~.
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In conclusion, CDC researchers learned that it is important to obtain input from the target audience throughout the creative process and that more research is needed to better execute messages to target audiences. Naturally, many other challenges face evaluators as they try to determine what works in the deliberate and not-so-deliberate communication of health information to the public (Valente, 2002~.
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These studies have shown that the media can be used to increase knowledge about appropriate behaviors, create more positive attitudes toward the health behaviors, and lead to behavioral change among audience members. This triad of outcomes, knowledge (K)
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Print and broadcast news media outlets, entertainment television, and the Internet constitute immensely influential channels through which people gather their information, accurate or not, about health. Given the speed and diversity of media outlets, they cannot be considered mere commentators in dialogues on popular culture about health, health risk, and health behaviors.
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Communicating health information through the entertainment media: a study of the television drama ER lends support to the notion that Americans pick up information while being entertained. Health Affairs 20(1)
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2000. 1999 Healthstyles Survey: soap opera viewers and health information.
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2002. Strategies to Improve Consumer Health Information Services.
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1991. Social marketing and communication in health promotion.
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2002. Mass communication, and social marketing theories, models, and practices.
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1989. Community health behavior change through computer network health promotion: preliminary findings from Stanford Health-Net.
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Social Marketing Resource Guide. Seattle, WA: Turning Point National Program Office, University of Washington.
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From page 356... ...
1990. Improving health promotion: media advocacy and social marketing approaches, pp.
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1996. Advancing public health goals through mass media.
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