Presenter:
Title of Lecture:
Chapman, Simon (Prof.)
Health Communication & Advocacy
COMMONWEALTH OF AUSTRALIA
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Health Communication &
Advocacy
Simon Chapman
Three arms
• Australian Health News Research
Collaboration (NHMRC Capacity Building 5
years 2009-13 + H1N1 grant 2009 + NSW
Cancer Council 2007-09)
• What characterises influential public health
research & researchers? (NHMRC Project
grant 2009-10)
• Web2.0 and tobacco control (NHMRC project
grant 2009-2011)
Team so far ...
•
•
•
•
•
•
•
•
AHNRC
A/Prof Jane Pirkis, UMelb
Prof Warwick Blood, UCanb
Dr Fiona Giles, Media & Comm, USyd
Dr Mark Ragg
Melissa Sweet
Dr Norman Swan
Team investigators: Andrea Fogarty, Michelle
Imison, Simon Holding + 2 others
Team so far ...
• What characterises influential public
health research & researchers
• Profs Wayne Hall (UQ), Steve Leeder,
Sally Redman; Jim Gillespie
• Abby Haynes & Gjemma Derrick
(USyd), Heidi Sturk (UQ)
• Web2.0 and tobacco control
• Becky Freeman
Today…
• Summarise why health news research is an important
focus of research
• Describe the ANHRC & our TV database
• Quickly describe 6 study types
• Illustrate with some recent papers
• Consider role of research in changing PH policy
• Scope research challenge of new media
• Promote collaboration
Why do we all work in public
health?
• For most, ultimately to improve health outcomes by
….
• Influencing policy (laws, regulations, funding)
• Providing evidence to reform health care practice
• Influencing public agenda – what’s important &
what’s not
• Influencing personal health practices
• Counteracting actions of those whose interests are
inimical to public health
Two views of research
dissemination
“they should stick to what
they’re good at and not
become actual players in the
policy process”.
• Researchers were said to
have become ‘advocates’
rather than unbiased
analysts ‘keeping to the
science’.
• going “outside their scientific
brief”
• “the political process is
influenced by what
politicians think the
electorate wants and that’s
influenced strongly by what
the media says... so the
media does tend to marshall
arguments which have an
influence on the way that
things are discussed by the
public and the way that
they’re discussed by
politicians”.
Citations
Number of papers
% papers
0
1114
20.55
1
624
11.51
78.3%
2- 10
2509
46.27
11-20
674
12.43
21-50
407
7.51
51-100
76
1.40
100 +
18
0.33
total
5422
100
Citations per paper 1997-2008, Australian based researchers in
“Public, Environmental & Occupational Health journals”
In our society public media
are irreplaceable as a
mechanism for moving a
problem to a solution'
`
George Lundberg
Editor JAMA
Sheer volume of exposure
• National TV News
Audience Sun 1 May
2009
• 7:
1.7m
• 9:
1.548m
• ABC
0.97m
• 10
0.718m
• SBS
0.21m
• Total
5.146m
Large evidence base that news
coverage influences health policy
and personal behaviour
• 3 illustrations
• (Sceptics: reflect on why health would
be any different to consumer behaviour,
fashion, popular culture, voting &c &c)
Source: Scollo, M. VicHealth Centre for Tobacco Control
Kylie’s breast cancer
• 101% increase in
unscreened (target
age) women
booking for screens
• But also .. Increase
in low-risk young
women being
screened
Examples of personal impact: HRT & Womens Health
Initiative (WHI) Study 2002
• WHI publication associated HRT decline of 18% per
quarter.
•
Haas JS et al Changes in the use of postmenopausal hormone therapy after the
publication of clinical trial results. . Ann Intern Med. 2004 3;140:184-8.
• Greater average household exposure to newspaper
coverage about the harms associated with HRT was
associated with a large population-based decline in
HT use.
•
Haas JS et al. Average household exposure to newspaper coverage about the harmful
effects of hormone therapy & population-based declines in hormone therapy use. J
Gen Intern Med. 2007 Jan;22(1):68-73.
AHNRC database
• Since May 2005 .. All health news,
current affairs, infotainment,
documentaries recorded on 5 free-to-air
Sydney channels
• 19,300 items building at around
120/week
Top 21 “broad content” areas
in first 13,702 items (%)
1.
2.
3.
Injury (26)
Health care system (17)
Medical & surgical
advances (15.1)
4. Stages/life (14.7)
5. Cancer (10.5)
6. Inf.Disease (7.5)
7. Food,nutrit & obesity (6.7)
8. Substance abuse (6.5)
9. Mental health (3.6)
10. CVD (3.2)
11. Environ.Hlth (2.5)
11. Resp/Sleep (2.5)
13. Disability (2.4)
14. Neurol. (1.9)
15. Indigenous (1.7)
16. Endocrine (1.4)
17. Misc (1.2)
18. Muscoskel. (0.8)
19. Comp. Med (0.9)
20. Dermatol. (0.7)
21. Dental (0.6)
Top 10 specific news &
current affairs items in 13,702
• NEWS
1. Road injury 1577 (13.8)
2. Hospital crises 915 (8.0)
3. Celeb. Illness 741 (6.5)
4. “Breakthroughs” 656 (5.8)
5. Kids’ health 590 (5.2)
6. Med misconduct 537 (4.7)
7. Health funding 480 (4.2)
8. Med ethics 458 (4.0)
9. Polit statements 454 (4.0)
10.Recreat.injury 451 (4.0)
• CURRENT AFFAIRS
1. Obesity 281 (12.2)
2. Food/nutrit 209 (9.1)
3. Kids’ health 186 (8.1)
4. Cosmetic surg 144 (6.2)
5. Celeb illness 129 (5.6)
6. Hosp crises 125 (5.4)
7. Prescrip.drugs 91 (3.9)
8. Health funding 90 (3.9)
9. Med ethics 89 (3.9)
10.Road injury 88 (3.8)
Length of items (mins/secs)
(n=11,809)
•
•
•
•
•
•
News
ABC
9
7
10
SBS
1.43
1.33
1.32
1.36
2.08
•
•
•
•
•
•
•
Current Affairs
7.30 Rep
7.16
ACA
4.22
Today Tonight 4.19
60 Mins
13.43
4 Corners
44.44
Lateline
3.02
News actors (sampled)
•
•
•
•
•
•
•
•
Patients/victims: 174 in 117 items
Experts: 137/98
Gvt politicians: 95/74
Civil servants (incl. emerg): 71/53
Patient support /NGOs: 38/31
Opposition/indep. Pollies: 25/22
“Everyperson”: 23/23
Business/villians: 20/16
Median soundbite length/secs
(sampled)
•
•
•
•
•
•
•
•
•
Patients/victims: 6.6
Experts: 7.9
Gvt politicians: 7.3
Civil servants (incl. emerg): 8.1
Patient support /NGOs: 8.0
Opposition/indep. Pollies: 25/22
Everyperson: 4.2
Business/villians: 7.2
ALL TYPES: 7.2 seconds
6 Study types
1. Textual analysis: content, thematic, discourse & dramaturgical
analysis, including study of expert, interest group and patient
“news actor” roles;
2. Audience studies: focus group & experimental studies of how
general or particular audiences “consume” or deconstruct
meaning in media coverage (eg: risk perception, the nature of
disease, the credibility of public health and medical advocates &
of those opposing public health initiatives).
3 . News production studies: interview & observational studies of
news gathering/reporting; source selection & operational notions
of newsworthiness; what factors operate to ‘play up’ or ‘play
down’ or ignore health issues?
6 Study Types
4. Accuracy and quality studies: reportage measured against a
priori standards of accuracy, comprehensiveness or quality of
evidence (particularly re drugs, diagnostics, “breakthroughs”,
preventive advice).
5. Studies of relationship between reportage and changes in
consumer demand for health care (eg: studies of patient
requests for particular drugs, testing or procedures; studies
examining the attribution of influence of the media in consumer
decisions about health-related behaviour)
6. Studies of interest group efforts to influence news (eg:
pharmaceutical, tobacco and medical equipment manufacturer
industries, advocacy groups)
Belief/faith in testing
• 87% of US adults believe routine cancer
screening is almost always a good idea
& that finding cancer early can save
lives.
• 77% of men would try to keep having a
PSA test even if a physician
recommended they stopped or had less
frequent testing
Schwartz et al. Enthusiasm for cancer screening in the United States. JAMA
2004;291:71-8.
NSW: new cancers diagnosed in 2005
Top 4 cancers in NSW males
Prostate
Bowel
Melanoma
Lung
31%
13%
10%
9%
Together
63% of total
http://www.cancerinstitute.com.au/cancer_inst/publications/pdfs/cancer-incidence-mortality-prevalence-2005.pdf
2 papers
What did news emphasise?
• Pro-screening • Caution and
concern
• 86% of all quotes
about PSA
were explicitly or
testing. 14%
implicitly
supportive of
testing/screening
Under/over-reporting of
cancer
• Are some cancers over or under-represented
in television news?
• Specifically, are the incidence, mortality rates
and Disability Adjusted Life Year (DALY)
rankings of different cancers reflected in the
volume of news coverage given to various
types of the disease?
Results
• 24 cancers received some reportage
• 5 (cervix, breast, ovarian, melanoma,
brain) received more reportage than n
predicted by the null hypothesis
• All others under-reported
• Many not reported at all
13% in under 40 yrs; 49% in >60 years
Age & breast cancer study
• 55% of statements about age & breast cancer
referred to young women (ie stated or known
to be aged under 40).
• 67% of images of women in breast cancer
reports were known or judged to be women
aged under 40.
• 3 cases of breast cancer in celebrity women
aged less than 40, accounted for 53% of all
statements & 24% of all images about young
women and breast cancer.
What characterises influential public
health research & researchers?
•
•
•
•
•
•
Tobacco control
Illicit drugs
Alcohol
Obesity
Injury
Skin cancer
Step 1: Identify researchers whom
other researchers consider influential
• From ISI: all those with 10> relevant
publications in last 10 years identified
• Asked to nominate 5 “most influential”
researchers + their own 5 most
influential papers
• Top 5 then interviewed
Step 2: Interviews with health
policy makers
• Ex-health ministers
• Current senior policy officers (health,
road safety)
Australian Internet Use
• 2008: average Australian spends 90 mins (29%) of
leisure time online each day
• 2008: one in two Australians use social networking sites,
such as Facebook or MySpace
• 15,300,000 Australian Internet users as of Dec. 2007,
74.3% of the population
• During 2007-08, 72% of people aged 15 years or over
accessed the Internet from any location in the previous
12 months
1. source: http://www.simplenet.com.au/about-us/website-design-melbourne-news.aspx?NewsId=66
2. Source: http://www.itu.int/en/pages/default.aspx
3. Source: http://www.abs.gov.au/ausstats/abs@.nsf/lookupMF/ACC2D18CC958BC7BCA2568A9001393AE
Source: 2008. http://www.tnsglobal.com/_assets/files/TNS_Market_Research_Digital_World_Digital_Life.pdf
*combined data for all countries in the the survey
Source: 2008. http://www.tnsglobal.com/_assets/files/TNS_Market_Research_Digital_World_Digital_Life.pdf
12, 059
fans
Source: http://www.facebook.com/s.php?q=lucky+strike&init=quick#/pages/Lucky-Strike/36385940657?v=wall&viewas=657821256&ref=search
• BAT employees are active on Facebook
• Joining and starting groups
• Posting images, comments, new products
to fan groups
• Possible violation of advertising bans
1,162
member
s
Fundraising dance
for National
Network for Older
Persons of Uganda
(NNOPU)
Taking a break from their
unacclaimed world tour, the
legendary Faux Pas will be
playing a benefit gig at
Petersham Bowling Club,
Brighton St Petersham (3 mins
from Petersham station)
Sunday August 16, 6pm-9.30pm.
$5 at door.
Drinks at bar prices. Good bar
food on sale.
NNOPU supports more than 30
different small NGOs in Uganda.
There are 1.5 million people aged
60 years and older in Uganda.
They are the poorest of the poor
and are largely neglected by the
government and the international
aid community. Older people
provide much of the care for the
tens of thousands of children
orphaned by HIV/AIDS in
Uganda.
L-R Mitchell Ward, Strat Mairs, Dave Petroni,
Simon Chapman, Bob Cumming + Rob Heard
on keyboards (debuting this gig)
Trish (the Dish) Kirby, Julie Leask
Setlist includes shameless cove
Rolling Stones, Ramones, Door
Coldplay, Travelling Wilburys ,K
Animals, Paul Kelly, REM, Ian D