An uneasy relationship: the tensions between medicine and the media

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.

Sleep, body work and bodily capital: Sleep discourse in the magazines Men's Health and Women's Health

The subject of sleep has been receiving increasing attention in multiple arenas over the past decades, including in the social sciences and the media. However, only a few empirical studies have investigated how sleep is constructed within and by media discourses, and also whether and how these discourses are gendered. The present article explores how two popular lifestyle magazines, Men's Health and Women's Health, construct sleep. The analysis of online articles reveals that both magazines constitute sleep as a form of body work that enhances bodily capital, but they do so in gendered ways that reinforce patriarchal norms and expectations. This study shows that the magazines' discourse supports the neoliberal project, while also highlighting the malleability and adaptability of neoliberal discourses. The conclusion is that the ways in which the magazines' discourse constructs sleep might deepen both gender and class inequalities.

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.

Radiology in the News: A Content Analysis of Radiology-Related Information Retrieved From Google Alerts

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Google Alerts highlighted a diverse set of topics present in online media.

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Most links were directly to non-radiology lay press, but <1% of links over the 6-month period sent the user directly to a primary peer-reviewed medical journal article.

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The most common topics were market trends, promotional, COVID-19, and artificial intelligence.

Introduction

Radiology topics receive substantial online media attention, with prior studies focusing on social media platform coverage. We used Google Alerts, a content change detection and notification service, to prospectively analyze new radiology-related content appearing on the internet.

Materials and Methods

An automated notification was created on Google Alerts for the search term “radiology,” sending the user emails with up to 3 new links daily. All links from November 2019 through April 2020 were assessed by 2 of 3 independent raters using a coding system to classify the content source and primary topic of discussion. The top 5 primary topics were retrospectively evaluated to identify prevalent subcategories. Content viewing restrictions were documented.

Results

526 links were accessed. The majority (68%) of links were created by non-radiology lay press, followed by radiology-related lay press (28%), university-based publications (2%), and professional society websites (2%). The primary topic of these links most frequently related to market trends (28%), promotional material (20%), COVID-19 (13%), artificial intelligence (8%), and new technology or equipment (5%). 15% of links discussed a topic sourced from another article, such as a peer-reviewed journal, though only 2 linked directly to the journal itself. 8% of links had content viewing restrictions.

Conclusion

New radiology content was largely disseminated via non-radiology news sources; radiologists should therefore ensure their research and viewpoints are presented in these outlets. Google Alerts may be a useful tool to stay abreast of the most current public radiology subject matters, especially during these times of social isolation and rapidly evolving clinical practice.

Exploring dentists' professional behaviours reported in United Kingdom newspaper media

Aim Stories of dentists and their professional behaviours can be communicated around the world through news media. This may influence people's perceptions of dentistry and their trust in professionals. The aim of this study was to explore reports of dentists and their professional behaviours in newspaper media.Method All articles which included the term 'dentist' alongside 'professional' or 'misconduct' or 'behaviour' between 1 January 2016 and 31 October 2019 were retrieved from the ten most commonly read newspaper print media in the United Kingdom. Thematic analysis was undertaken following the application of inclusion and exclusion criteria.Results A total of 122 articles were identified. Key themes included poor practice, dishonesty and fraud, the killing of Cecil the lion, sexual misconduct, racism and crime. Many articles focused on a small number of extreme cases, labelling the dentists involved and sensationalising the stories. Reports did not reflect the majority of fitness to practise cases seen by the General Dental Council.Conclusion The sensationalist approach to the reporting of dental professional behaviours in the news may cause patients to have less trust in their dentist, and it is recommended that dentists and journalists work constructively together in the best interests of the public.

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.

Maternal Knowledge, Attitudes, and Behavioral Intention after Exposure to Injury Prevention Recommendations in the News Media

INTRODUCTION

Injury prevention recommendations are frequently presented in the media. Parental understanding and response to these recommendations remain uninvestigated.

METHODS

A nationally representative sample of 1,081 mothers completed a cross-sectional survey measuring knowledge, attitudes, and behavioral intention after watching/reading video news stories and print articles on two child safety topics.

RESULTS

Of the 1,081 respondents, 33% reported hearing little about injury prevention in the media in the past 30 days, and 32% reported never hearing about injury prevention. Nearly one-half (46%) reported the injury prevention studies they had previously read or heard about in the media were confusing to them at least some of the time. The proportion of mothers who recalled the correct key statistic presented in the story varied by safety topic and medium in which the story was presented. A greater proportion of mothers correctly recalled information from the story narrative than the statistics. Mothers also rated the most interesting part of the story differently based on safety topic and medium. A small proportion were not planning to follow the safety recommendations after viewing the news story.

CONCLUSIONS

There are gaps in making injury news stories understandable and memorable for mothers in order to encourage behavioral change.

Framing the failure of medical implants: Media representations of the ASR hip replacements in the UK

BACKGROUND

During the twentieth century, hip replacement became one of the most popular and successful operations. In the 1990s, a new type of hip replacement namely the metal-on-metal hip resurfacing was developed. This paper draws on one of the available implants, namely the DePuy Orthopaedics' Articular Surface Replacement (ASR) hip system which was withdrawn from the market because of higher than expected rates of failure. It examines media representations on the failure of the ASR metal-on-metal hip replacement device and its subsequent withdrawal from the market.

METHODS

Drawing on content analysis this paper explores how systemic failure of the medical implant was framed and performed by press media in the UK.

RESULTS

Two narratives were particularly important in framing press media coverage of the ASR case: the role of patients as passive recipients of care and a distinction between health and disability identities as related to how individuals' narratives about the past shaped their sense of present and future. In all cases, the voice of the orthopaedic surgeons responsible for the selection and implantation of the ASR devices remains silent.

CONCLUSIONS

Press media coverage of medically induced harm in the UK is significantly less common than coverage of any other patient safety issues and public health debates. This study aims to contribute to the evidence base on how public discourse on medically induced harm becomes framed through the reported experiences of individuals in press media and also how this process influences the legitimacy of various solutions to medical errors or unanticipated outcomes.

Ethnographic reflections on communicative inequities, global health relationships, and two decades of HIV in the Bolivian press

This article draws on two decades of media representations of HIV, ethnographic research among people living with HIV, and an analysis of global health programms in Bolivia. In doing so, we chart the evolution of media representations in relation to the global health context and the implications of these representations for people living with HIV. Our overarching argument is that media discourses on HIV in Bolivia have consistently been produced in a context of an unequal balance of power between global health bodies and local actors. This power imbalance has enabled global health bodies operating in Bolivia to maintain authority in producing local narratives about HIV, even when these narratives do not adequately capture the particularities of the Bolivian context. The mismatch between dominant global health narratives that have infiltrated the Bolivian media and ethnographic realities can have deleterious effects on people living with HIV. We draw on the concept communicative inequities to highlight how global health bodies shape dominant media narratives and the ways these dominant narratives at times misrepresent ethnographic realities. Thus, a media analysis informed by ethnographic experiences offers a unique lens for interrogating the implications of global health interventions.

Rheumatoid Arthritis Portrayal by UK National Newspapers 2011-2016: A Service User - Led Thematic Analysis of Language Used

BACKGROUND

An important source of knowledge, beliefs, and attitudes about illness is the mass media. Research has established the often negative and emotive language utilised by journalists to report on physical and mental long-term illnesses. The limited amount of research on rheumatological conditions has largely focused on the extent of, and/or accuracy of media coverage. This is the first published study to examine systematically the language used by the United Kingdom (UK) popular press to specifically describe rheumatoid arthritis (RA).

METHODS

A patient and public involvement (PPI) approach, involving academics and service users with RA, was used to conduct the research. LexisNexis online repository of print media was searched for articles within a defined five year time frame, which included RA in the headline and/or lead paragraph of 15 UK national non-specialist newspapers. Resultant articles were uploaded to NVivo, and a realist perspective aided a thematic analysis of the data set.

RESULTS

A search of LexisNexis produced 413 newspaper articles, of which 147 met the inclusion criteria. Three themes emerged: (1) language used to describe RA; (2) language used to refer to those who live with RA and; (3) language used to report on potential new treatments for RA. Negative and emotive terms such as 'attack', 'painful', 'crippling', and 'agony' were the most frequently used to describe the experience of RA. People diagnosed with RA were often portrayed as 'sufferers' or 'victims', though neutral language was also deployed. 'Hope' and 'breakthrough' were the most reported terms for potential new treatments for RA. Across the three themes, tabloid and middle market newspaper articles applied more sensationalised language with attention grabbing headlines and news stories. By contrast, such emotive terminology was less apparent in broadsheets.

CONCLUSIONS

The media is a source of information about RA for the general population, but the quality of newspaper journalism about the condition requires improvement. The findings may act as a stimulus for a national public awareness initiative and/or social marketing campaign. How the language currently constructed to describe RA in the press is received by people with RA would be an important area for future research.

The Mediated Amplification of a Crisis: Communicating the A/H1N1 Pandemic in Press Releases and Press Coverage in Europe

In the aftermath of the A/H1N1 pandemic, health authorities were criticized for failures in crisis communication efforts, and the media were accused of amplifying the pandemic. Considering these criticisms, A/H1N1 provides a suitable case for examining risk amplification processes that may occur in the transfer of information from press releases to print news media during a health crisis. We integrated the social amplification of risk framework with theories of news decisions (news values, framing) in an attempt to contribute to existing research both theoretically and empirically. We conducted a quantitative content analysis of press releases disseminated by health and governmental authorities, as well as the quality and tabloid press in 10 European countries between March 2009 and March 2011. Altogether 243 press releases, 1,243 quality press articles, and 834 tabloid press articles were coded. Consistent with research on news values and framing the results suggest that quality and tabloid papers alike amplified A/H1N1 risks by emphasizing conflict and damage, presenting information in a more dramatized way, and using risk-amplifying frames to a greater extent and risk-attenuating frames to a lesser extent than press releases. To some extent, the quality and tabloid press differed in how risk information was presented. While tabloid press articles seemed to follow the leading quality press with regards to content and framing of health crisis coverage, they exhibited a stronger emphasis on drama and emotion in the way they presented information.

Drivers of poor medical care

The global ubiquity of overuse and underuse of health-care resources and the gravity of resulting harms necessitate an investigation of drivers to inform potential solutions. We describe the network of influences that contribute to poor care and suggest that it is driven by factors that fall into three domains: money and finance; knowledge, bias, and uncertainty; and power and human relationships. In each domain the drivers operate at the global, national, regional, and individual level, and are modulated by the specific contexts within which they act. We discuss in detail drivers of poor care in each domain.

Geneticizing Ethnicity and Diet: Anti-doping Science and Its Social Impact in the Age of Post-genomics

While gene doping and other technological means of sport enhancement have become a topic of ethical debate, a major outcome from genomic research in sports is often linked to the regulation of doping. In particular, researchers within the field of anti-doping science, a regulatory science that aims to develop scientific solutions for regulating doped athletes, have conducted genomic research on anabolic-androgenic steroids. Genomic knowledge on anabolic-androgenic steroids, a knowledge base that has been produced to improve doping regulation, has caused the ‘geneticization’ of cultural objects such as ethnic identities and dietary habits. Through examining how anti-doping genomic knowledge and its media representation unnecessarily reify cultural objects in terms of genomics, I argue that Ethical, Legal, and Social Implications (ELSI) research programs in human enhancement should include the social impacts of anti-doping science in their discussions. Furthermore, this article will propose that ELSI scholars begin their academic analysis on anti-doping science by engaging with the recent ELSI scholarship on genomics and race and consider the regulatory and political natures of anti-doping research.

UK science press officers, professional vision and the generation of expectations

Science press officers can play an integral role in helping promote expectations and hype about biomedical research. Using this as a starting point, this article draws on interviews with 10 UK-based science press officers, which explored how they view their role as science reporters and as generators of expectations. Using Goodwin's notion of 'professional vision', we argue that science press officers have a specific professional vision that shapes how they produce biomedical press releases, engage in promotion of biomedical research and make sense of hype. We discuss how these insights can contribute to the sociology of expectations, as well as inform responsible science communication.

‘The biggest car crash in NHS history’: the media portrayal of GP pay before and after the introduction of the Health and Social Care Bill 2011

Background

The introduction of the Health and Social Care Bill (2011) changed the role of GPs to include commissioning of health services.

Aim

This study aimed to identify any differences in the media portrayal of GPs before and after the introduction of the Bill.

Methods

We retrospectively searched four British newspapers over the period 2009–2013 using the media database Nexis. In order to directly compare the findings of the study with the work of Tanner et al., articles relating to GP pay were analysed using thematic analysis. Themes were identified and each article was scored to determine whether it portrayed GPs positively or negatively.

Results

GPs were portrayed slightly less negatively after the introduction of the Bill. The theme of ‘high salaries’ persisted despite reference to ‘pay freezes’. References to decreased trust in the patient–doctor relationship appeared after the introduction of the Bill.

Conclusion

Negative portrayal of GP pay has continued and a lack of trust in GPs has started to be portrayed. This trend may exacerbate the low morale amongst the profession and difficulties in recruiting and retaining GPs.

Unrealistic Hope and Unnecessary Fear: Exploring How Sensationalistic News Stories Influence Health Behavior Motivation

In light of the inherent conflict between the nature of science (slow, subject to correction) and the nature of news (immediate, dramatic, novel), this study examines the effect of emotional health news coverage on intentions to engage in protective health behaviors. One hundred seventy-seven students read news stories designed to evoke either fear or hope about human papillomavirus (HPV) followed by different levels of response efficacy information regarding an impending HPV vaccine. Results indicated no main effects for emotion frame or response efficacy, but a significant interaction suggested that emotionally-consistent presentations (fear/low efficacy; hope/high efficacy) boosted intentions to engage in protective actions relative to emotionally-inconsistent, sensationalized presentations (fear/high efficacy, hope/low efficacy). Consistent with the emotion-as-frame perspective, this effect was moderated by perceived knowledge about HPV prevention. Effects of the sensationalized story constructions on trust in health news were also evidenced. Implications for the role of emotional health news coverage in priming prior knowledge about preventative health behaviors, along with future research directions, are discussed.

Lessons from Ebola: Sources of Outbreak Information and the Associated Impact on UC Irvine and Ohio University College Students

Objectives. We examined the role of outbreak information sources through four domains: knowledge, attitudes, beliefs, and stigma related to the 2014 Ebola virus disease (EVD) outbreak. Methods. We conducted an online survey of 797 undergraduates at the University of California, Irvine (UCI) and Ohio University (OU) during the peak of the outbreak. We calculated individual scores for domains and analyzed associations to demographic variables and news sources. Results. Knowledge of EVD was low and misinformation was prevalent. News media (34%) and social media (19%) were the most used sources of EVD information while official government websites (OGW) were among the least used (11%). Students who acquired information through OGW had higher knowledge, more positive attitudes towards those infected, a higher belief in the government, and were less likely to stigmatize Ebola victims. Conclusions. Information sources are likely to influence students' knowledge, attitudes, beliefs, and stigma relating to EVD. This study contains crucial insight for those tasked with risk communication to college students. Emphasis should be given to developing effective strategies to achieve a comprehensive knowledge of EVD and future public health threats.

Scientific Versus Experiential Evidence: Discourse Analysis of the Chronic Cerebrospinal Venous Insufficiency Debate in a Multiple Sclerosis Forum

Background

The vascular hypothesis of multiple sclerosis (MS), called chronic cerebrospinal venous insufficiency (CCSVI), and its treatment (known as liberation therapy) was immediately rejected by experts but enthusiastically gripped by patients who shared their experiences with other patients worldwide by use of social media, such as patient online forums. Contradictions between scientific information and lay experiences may be a source of distress for MS patients, but we do not know how patients perceive and deal with these contradictions.

Objective

We aimed to understand whether scientific and experiential knowledge were experienced as contradictory in MS patient online forums and, if so, how these contradictions were resolved and how patients tried to reconcile the CCSVI debate with their own illness history and experience.

Methods

By using critical discourse analysis, we studied CCSVI-related posts in the patient online forum of the German MS Society in a chronological order from the first post mentioning CCSVI to the time point when saturation was reached. For that time period, a total of 117 CCSVI-related threads containing 1907 posts were identified. We analyzed the interaction and communication practices of and between individuals, looked for the relation between concrete subtopics to identify more abstract discourse strands, and tried to reveal discourse positions explaining how users took part in the CCSVI discussion.

Results

There was an emotionally charged debate about CCSVI which could be generalized to 2 discourse strands: (1) the “downfall of the professional knowledge providers” and (2) the “rise of the nonprofessional treasure trove of experience.” The discourse strands indicated that the discussion moved away from the question whether scientific or experiential knowledge had more evidentiary value. Rather, the question whom to trust (ie, scientists, fellow sufferers, or no one at all) was of fundamental significance. Four discourse positions could be identified by arranging them into the dimensions “trust in evidence-based knowledge,” “trust in experience-based knowledge,” and “subjectivity” (ie, the emotional character of contributions manifested by the use of popular rhetoric that seemed to mask a deep personal involvement).

Conclusions

By critical discourse analysis of the CCSVI discussion in a patient online forum, we reconstruct a lay discourse about the evidentiary value of knowledge. We detected evidence criteria in this lay discourse that are different from those in the expert discourse. But we should be cautious to interpret this dissociation as a sign of an intellectual incapability to understand scientific evidence or a naïve trust in experiential knowledge. Instead, it might be an indication of cognitive dissonance reduction to protect oneself against contradictory information.

Waging war: discourses of HIV/AIDS in South African media

This paper explores a discourse of war against HIV/AIDS evident in the Daily Dispatch, a South African daily newspaper, from 1985 to 2000, and discusses the implications of this in terms of the way in which HIV/AIDS is constructed. The discursive framework of the war depends, fundamentally, on the personification of HIV/AIDS, in which agency is accorded to the virus, and which allows for its construction as the enemy. The war discourse positions different groups of subjects (the diseased body, the commanders, the experts, the ordinary citizens) in relations of power. The diseased body, which is the point of transmission, the polluter or infector, is cast as the 'Other', as a dark and threatening force. This takes on racialised overtones. The government takes on the role of commander, directing the war through policy and intervention strategies. Opposition to government is couched in a struggle discourse that dove-tails with the overall framework of war. Medical and scientific understandings pre-dominate in the investigative practices and expert commentary on the war, with alternative voices (such as those of people living with HIV/AIDS) being silenced. The ordinary citizen is incited to take on prevention and caring roles with a strong gendered overlay.

Improvement of the facial evenness of leave-on skincare products by a modified application method in Chinese women

OBJECTIVE

To understand the habits of Chinese women applying leave-on skincare products (LOSCP) and to improve female facial evenness of anti-ageing cosmetics through modifying facial skincare smear ways.

METHODS

A questionnaire on the method of applying LOSCP was distributed to 60 women with habit of using LOSCP. Their facial images before and after applying LOSCP were taken, and their positioning and grey value were used to analyse the effects of different applying methods on the uniformity of facial LOSCP.

RESULTS

LOSCP including anti-ageing cosmetics have been widely used among Chinese women for a long time. However, some women do not concern how to properly apply LOSCP. In our survey, the main focal points of the face are forehead, malar region, cheek, mouth corners and chin when they looking into the mirror, and mouth corners and inner canthus are often overlooked when applying cosmetic products. The image analysis found that after applying the LOSCP, the greyscale of the forehead, glabella, malar region, upper lip region and jaw changed significantly whereas that of canthus, mouth corners and lateral cheek region was not significantly different. Applying an improved smear method (11-point method)could significantly increase the grey values of various facial areas.

CONCLUSION

The way of Chinese women applying LOSCP may result in facial unevenness of skin products. By improving facial skincare smear method, one can make the products even in all facial areas, thereby ensuring the efficacy of anti-ageing cosmetics. Thus, further improvement and education regarding skincare is required.

Health journalism in the service of power: 'moral complacency' and the Hebrew media in the Gaza-Israel conflict

The power of health news as a vehicle in the production of meaning in the service of power is the core of this article. Tracking the media coverage of a medical service, it shows how a routine practice can be invoked at a time of armed conflict so as to enhance a benevolent state image. The case at hand is the medical treatment of Gaza children in Israeli hospitals. A series of Internet searches revealed a group of publications on the subject in the Hebrew media, during and shortly after Israel's assault on Gaza in the winter of 2008-2009. In the press articles the treatments were invariably constituted as the epitome of Israel's compassion towards the enemy's children. This image relied, however, on a simultaneous silencing of other aspects of these treatments, which would have challenged this image. The monolithic depictions give rise to the notion of reversed moral panic or 'moral complacency', wherein the media amplifies a little-known social phenomenon into an epitome of societal values and charges it with significance on a national scale. The article ends with considering some features that possibly render health news an especially convenient domain for state-supportive media presentations.

[The perils of risk communication and the role of the mass media]

Based on theories and empirical results from communication science, the present paper provides an overview of the role of mass media in risk communication. It is guided by the following questions: How do risk issues find their way into the media and how does the media depict them? How do mass-mediated risk messages affect people's perception of risks, knowledge, attitudes, and behavior? What potential does the media have in disseminating health risk information in campaigns? Hence, the present paper aims to provide a basis for the appropriate use of mass media in health risk communication so as to make use of the potential of mass media without neglecting its limits.

Reporting consciousness in coma: media framing of neuro-scientific research, hope, and the response of families with relatives in vegetative and minimally conscious states

This paper examines the public representation of, and family responses to, scientific studies into consciousness in coma-like states. We examine the publicity surrounding high-profile studies using functional Magnetic Resonance Imaging (fMRI) on 'vegetative' or 'minimally conscious' patients and compare this with family views. Our findings show how, with a few notable exceptions, the research was presented as an amazing breakthrough offering a potential 'voice' and choice for patients and hope and comfort for their families. We argue that such representations ignored key limitations, evoked unrealistic visions of recovery, and promoted very narrow representations of family reactions. The comparison between public representations of the science and responses from families with experience of this issue highlights the complex social/medical world into which neurotechnologies intervene, and points to the absence of a range of patient/family perspectives in public discourse. We conclude with suggestions for how those promoting the research, and the journalists reporting its implications, could act to ensure more responsible coverage and enhance public debate.

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.

Portrayals of professionalism by the media: trends in etiquette and bedside manners as seen on television

BACKGROUND

Critics of current healthcare argue that professionalism, as manifest by etiquette and bedside manners, has been eroding, in part as a consequence of portrayals on television (TV) and in the media.

OBJECTIVE

We sought to identify changing patterns of physicians' behaviors as shown on TV (as these interactions have often served as models for physicians-in-training) over the last 30 years.

METHOD

We selected popular TV shows that portrayed practicing physicians and analyzed doctor-family, doctor-doctor, and doctor-nurse interactions as well as methods of disclosing errors to identify changing behavioral trends.

RESULTS

We found that difficult news was more commonly delivered while standing, and that handshakes were rarely offered to patients. Male physicians were seen raising their voices toward, disclosing errors to, as well as inappropriately touching, peers or subordinates. In comparison, female physicians were identified as raising their voices toward, disclosing errors to, as well as inappropriately touching, their supervisors. Over the past several decades, official salutations between physicians and nurses have become less common; physicians have started to address nurses solely by their first names. More recently, sexual banter and sexual activity have been portrayed as occurring predominantly between male physicians and female nurses.

CONCLUSIONS

While shifts in behavioral patterns (in etiquette, bedside manners, and professionalism) of physicians as seen on television have not been radical, potentially concerning trends were identified. Media portrayals may change patients' perceptions of physicians, hospitals, and the health care profession as well as influence behaviors of medical trainees. Moreover, TV and the media can be used as teaching tools about professionalism in healthcare providers.

The effects of human interest framing in television news coverage of medical advances

The last few decades have witnessed the increasing dissemination of information on medical advances such as new medical treatments and prevention/diagnosis technologies through television news. To engage lay audiences with complex information, medical journalists often personalize news stories about medical advances by exemplifying individual patients and their personal experiences. This study investigates the effects of this journalistic technique, which is referred to as human interest framing, on audiences. The results of an experiment provide empirical evidence that the human interest framing of medical news stories can increase audiences' involvement in those stories and facilitate their positive perception of medical advances.

'Relax and take a deep breath': print media coverage of asthma and air pollution in the United States

The media are an important social actor in the construction of the public's understanding of the complex relationships between the environment and their health. This paper explores the print media's coverage of the relationship between asthma and air pollution, focusing on the portrayal of causal certainty between exposure to various forms of air pollution and the etiology and exacerbation of the disease. By examining twenty years of newspaper articles from the New York Timeş Los Angeles Times, and the Washington Post, this paper presents findings on trends across time, within papers, and across key themes. Although the print media's coverage of asthma and its environmental correlates has increased over time, this paper finds relatively little coherence in whether asthma is portrayed as directly caused by air pollution or triggered by exposures. In terms of coverage, outdoor sources of air pollution are covered more frequently - but with less certainty in the discussion of specific relationships. This lack of coherence and specificity in the portrayal of asthma as an environmental disease may weaken regulators' ability to act in passing air pollution reforms by lowering the public's interest and concern.

Tracking beverage nutrition information in the news: an evaluation of beverage-related health reports on television news

News media are a primary source of nutrition information for the general public. Beverages are a key product category implicated in the obesity epidemic, but it is unclear how recommendations for healthy beverage consumption patterns are communicated by the news media. This study evaluated the health content of beverage-related news reports on national television newscasts from 2000 to 2008. News reports were coded to assess topic, source attribution, and confusion. Analysis revealed that beverage nutrition messages focused primarily on educating consumers or reports of prevalence. Conflicting or confusing nutrition recommendations were discussed in nearly one in three reports (29%). News reports most often discussed beverage consumption in terms of individual health decision-making, indicating a significant lack of emphasis on public health policy. The findings provide important insights into health-related beverage messages being disseminated by television news outlets and suggest avenues for nutrition researchers and practitioners to engage the media regarding nutrition policy issues.

Characteristics and influences of H1N1 communication on college students

PURPOSE

The purpose of this paper is to assess how college students received and responded to H1N1 pandemic emergency preparedness information and to assess college students' knowledge and attitudes towards H1N1 during the height of the H1N1 epidemic and corresponding public health response to the outbreak.

DESIGN/METHODOLOGY/APPROACH

Using a case study approach, the researchers conducted five focus groups at a large Southeastern US university between October 20-29, 2009.

FINDINGS

In order to effectively communicate emergency preparedness information to college students, universities should rely on interpersonal communication and mediated communication from trusted sources. College students need to understand the health-related emergency, the risk of the emergency, basic steps to avoid it, and only pertinent cues to action. Oversaturation of this information can lead college students to lessen their perceived importance of the disaster prevention information.

RESEARCH LIMITATIONS/IMPLICATIONS

Focus groups were conducted during only two consecutive weeks of the H1N1 epidemic, and snowball sampling may have led to sample bias.

ORIGINALITY/VALUE

This research was conducted during the height of the H1N1 pandemic, and is the only study to date that explores college students' knowledge, attitudes, and behaviors towards H1N1.

Reporting on health-related research in two prestigious Brazilian newspapers

OBJECTIVES

The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers.

METHOD

We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009). Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies.

RESULTS

Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization.

CONCLUSION

The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization.

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.

Behavioral consequences of conflict-oriented health news coverage: the 2009 mammography guideline controversy and online information seeking

Building on channel complementarity theory and media-system dependency theory, this study explores the impact of conflict-oriented news coverage of health issues on information seeking online. Using Google search data as a measure of behavior, we demonstrate that controversial news coverage of the U.S. Preventive Services Task Force's November 2009 recommendations for changes in breast cancer screening guidelines strongly predicted the volume of same-day online searches for information about mammograms. We also found that this relationship did not exist 1 year prior to the coverage, during which mammography news coverage did not focus on the guideline controversy, suggesting that the controversy frame may have driven search behavior. We discuss the implications of these results for health communication scholars and practitioners.

Doctors on display: the evolution of television's doctors

Doctors have been portrayed on television for over 50 years. In that time, their character has undergone significant changes, evolving from caring but infallible supermen with smoldering good looks and impeccable bedside manners to drug-addicted, sex-obsessed antiheroes. This article summarizes the major programs of the genre and explains the pattern of the TV doctors' character changes. Articulated over time in the many permutations of the doctor character is a complex, constant conversation between viewer and viewed representing public attitudes towards doctors, medicine, and science.

Chronic fatigue syndrome in the media: a content analysis of newspaper articles

OBJECTIVES

Although cognitive behavioural therapy and graded exercise treatment are recognized evidence-based treatments for chronic fatigue syndrome/myalgic encephalomyelitis (ME), their use is still considered controversial by some patient groups. This debate has been reflected in the media, where many patients gather health information. The aim of this study was to examine how treatment for chronic fatigue syndrome/ME is described in the newspaper media.

DESIGN

Content analysis of newspaper articles.

SETTING

The digitalized media archive Atekst was used to identify Norwegian newspaper articles where chronic fatigue syndrome/ME was mentioned.

PARTICIPANTS

Norwegian newspaper articles published over a 20-month period, from 1 January 2008 to 31 August 2009.

MAIN OUTCOME MEASURES

Statements regarding efficiency of various types of treatment for chronic fatigue syndrome/ME and the related source of the treatment advice. Statements were categorized as being either positive or negative towards evidence-based or alternative treatment.

RESULTS

One hundred and twenty-two statements regarding treatment of chronic fatigue syndrome/ME were identified among 123 newspaper articles. The most frequent statements were positive statements towards alternative treatment Lightning Process (26.2%), negative statements towards evidence-based treatments (22.1%), and positive statements towards other alternative treatment interventions (22.1%). Only 14.8% of the statements were positive towards evidence-based treatment. Case-subjects were the most frequently cited sources, accounting for 35.2% of the statements, followed by physicians and the Norwegian ME association.

CONCLUSIONS

Statements regarding treatment for chronic fatigue syndrome/ME in newspapers are mainly pro-alternative treatment and against evidence-based treatment. The media has great potential to influence individual choices. The unbalanced reporting of treatment options for chronic fatigue syndrome/ME in the media is potentially harmful.

Mass media health information: quantitative and qualitative analysis of daily press coverage and its relation with public perceptions

OBJECTIVE

This paper describes the methods followed by the Pisa University OCS for collecting, storing and analyzing all health-related articles and database contents. Moreover, an example population survey on the topic of food safety based on such analysis is shown.

METHODS

Articles published each day since 1999 in Italy's three most popular newspapers are collected and stored in a Data Base Text; on these articles quantitative and qualitative analyses were conducted. On the basis of these results as well as of epidemiological data, a questionnaire survey was carried out about sources of information, knowledge and risk perception of citizens regarding food safety.

RESULTS

On a total of 24,434 articles on all health topics, 18% regarded food related hazards: their evolution over time showed peaks on BSE, avian flu and dioxin. A large proportion of the people surveyed declared having changed their food habits, at least temporarily, as a consequence of media information. Most get their information on food safety mainly from television. Most respondents remembered having previously heard news on BSE, avian flu and dioxin, but did not recall having heard of listeriosis, brucellosis or typhoid fever.

CONCLUSIONS

Newspapers articles facing food related hazards tend to be alarming thus affecting the citizens risk perception. On the other hand people often ignore how to manage their own food safety in a practical way.

PRACTICE IMPLICATIONS

Analysis of media messages can help to evaluate and correct the negative effects that may result in wrong information.

Health on the Web: An examination of health content and mobilising information on local television Websites

The Internet plays a crucial role in the communication of health news and information. This study is the first to examine the volume and scope of health coverage on local television news Websites. Mobilising information (MI), information found in news that can cue people to act on pre-existing attitudes, was also explored. Specifically, this study analysed the content of 278 health stories on 79 local television news Websites during September and October 2007. Data revealed that health stories were present on 64% of the sites examined. Only 30%, however, took advantage of the interactive nature of the Internet by linking the reader to other health sites or giving an e-mail address to obtain additional information. Thirty-two percent of the stories contained MI. Of those stories, locational MI (24%) was significantly more likely to be present than tactical (17%) or identificational (14%) (p < 0.05). There were also significant differences between large and small media markets regarding specific health content. Television news Websites produced by large market stations (designated market size (DMA) 1-50) were significantly more likely than very small market stations (DMA 151+) to contain health stories and have a separate health-related Web page.

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.

Marvelous medicines and dangerous drugs: the representation of prescription medicine in the UK newsprint media

Using discourse analysis, this study examines the representation of prescription medicines in the UK newsprint media and, specifically, how the meaning and function of medicines are constructed. At the same time, it examines the extent to which the newsprint media represents a resource for health information, and considers how it may encourage or challenge faith in modern medicine and medical authority. As such, it extends analysis around concepts such as the informed patient and examines the representation of patients and doctors and the extent to which patient-doctor identities promoted in the newsprint media reflect a shift away from paternalism to negotiated encounters. Findings show the media constructs a discrete, contradictory, and frequently oversimplified set of characterizations about medicine. Moreover, it discursively constructs realities that justify and sustain medial dominance. Ideological paradigms in discourse assign patients as passive and disempowered while simultaneously privileging "expert" knowledge. This constructs a reality that marginalizes patients' participation in decision-making.

Predictors of perceived ambiguity about cancer prevention recommendations: sociodemographic factors and mass media exposures

Cancer prevention recommendations reaching the public today are often ambiguous-that is, of uncertain reliability, credibility, or adequacy-yet little is known about the factors that influence public perceptions of this ambiguity. We used data from the 2005 Health Information National Trends Survey, conducted by the U.S. National Cancer Institute, to explore how sociodemographic characteristics and self-reported mass media exposures relate to perceptions of ambiguity regarding recommendations for the prevention of colon, skin, and lung cancer. Various sociodemographic characteristics (age, education, race) and mass media exposures (television, radio, Internet, health news) were found to be associated with perceived ambiguity about cancer prevention recommendations, and many of these associations varied by cancer type. These findings have important implications for future health communication research and practice.

Sources and coverage of medical news on front pages of US newspapers

Background

Medical news that appears on newspaper front pages is intended to reach a wide audience, but how this type of medical news is prepared and distributed has not been systematically researched. We thus quantified the level of visibility achieved by front-page medical stories in the United States and analyzed their news sources.

Methodology

Using the online resource Newseum, we investigated front-page newspaper coverage of four prominent medical stories, and a high-profile non-medical news story as a control, reported in the US in 2007. Two characteristics were quantified by two raters: which newspaper titles carried each target front-page story (interrater agreement, >96%; kappa, >0.92) and the news sources of each target story (interrater agreement, >94%; kappa, >0.91). National rankings of the top 200 US newspapers by audited circulation were used to quantify the extent of coverage as the proportion of the total circulation of ranked newspapers in Newseum.

Findings

In total, 1630 front pages were searched. Each medical story appeared on the front pages of 85 to 117 (67.5%–78.7%) ranked newspaper titles that had a cumulative daily circulation of 23.1 to 33.4 million, or 61.8% to 88.4% of all newspapers. In contrast, the non-medical story achieved front-page coverage in 152 (99.3%) newspaper titles with a total circulation of 41.0 million, or 99.8% of all newspapers. Front-page medical stories varied in their sources, but the Washington Post, Los Angeles Times, New York Times and the Associated Press together supplied 61.7% of the total coverage of target front-page medical stories.

Conclusion

Front-page coverage of medical news from different sources is more accurately revealed by analysis of circulation counts rather than of newspaper titles. Journals wishing to widen knowledge of research news and organizations with important health announcements should target at least the four dominant media organizations identified in this study.

Local media influence on opting out from an exception from informed consent trial

STUDY OBJECTIVE

News media are used for community education and notification in exception from informed consent clinical trials, yet their effectiveness as an added safeguard in such research remains unknown. We assessed the number of callers requesting opt-out bracelets after each local media report and described the errors and content within each media report.

METHODS

We undertook a descriptive analysis of local media trial coverage (newspaper, television, radio, and Web log) and opt-out requests during a 41-month period at a single site participating in an exception from informed consent out-of-hospital trial. Two nontrial investigators independently assessed 41 content-based media variables (including background, trial information, graphics, errors, publication information, and assessment) with a standardized, semiqualitative data collection tool. Major errors were considered serious misrepresentation of the trial purpose or protocol, whereas minor errors included misinformation unlikely to mislead the lay reader about the trial. We plotted the temporal relationship between opt-out bracelet requests and media reports. Descriptive information about the news sources and the trial coverage are presented.

RESULTS

We collected 39 trial-related media reports (33 newspaper, 1 television, 1 radio, and 4 blogs). There were 13 errors in 9 (23%) publications, 7 of which were major and 6 minor. Of 384 requests for 710 bracelets, 310 requests (80%) occurred within 4 days after trial media coverage. Graphic timeline representation of the data suggested a close association between media reports about the trial and requests for opt-out bracelets.

CONCLUSION

According to results from a single site, local media coverage for an exception from informed consent clinical trial had a substantial portion of errors and appeared closely associated with opt-out requests.

Common sources of skin care education: a cross-sectional study

BACKGROUND

The resources used by the public to locate health information are important.

AIM

To expose the sources from which the public gains a knowledge of dermatology.

METHODS

An anonymous, multiple-choice questionnaire was distributed to adults in college campuses, shopping malls, and community parks over a 4-month period.

RESULTS

Sixty-six percent of individuals stated that they felt physicians had the most authority for making recommendations regarding the skin. When questioned about the sources of skin care advice, however, there was a discrepancy, with only 35% stating that they actually consulted professionals. Indeed, 37% admitted to using family and friends as their primary source of information, and 28% used the media first.

CONCLUSIONS

In our opinion, the best method to ensure healthy skin habits and early diagnosis of disease would be to combine the efforts of healthcare and the media. These public resources should make people aware of skin diseases and preventative measures, whilst encouraging regular check-ups with dermatologists and persuading patients to employ open conversation with their physicians regarding care of their skin.

Interaction between academic radiology and the news media: a potentially powerful and unpredictable process--five stories

OBJECTIVE

Although articles have been published describing the relationship between news reports and the general medical literature, to our knowledge little has been published describing the relationship between radiology publications and news coverage. We present five instances of news stories centered on radiology publications or abstracts of presentations at national meetings and the effect of the media coverage within the medical community.

CONCLUSION

The five examples show that news coverage can have a dramatic effect on advancing research findings and public health information published in radiology journals. Even when news coverage is inaccurate or sensationalized, the attention of the general public can drive change not only generally in medicine but also specifically in radiology.

The development and use of mass media interventions for health-care messages about back pain: What do members of the public think?

The study sought to identify and explore the opinions, beliefs and views of members of the public regarding the use of media interventions for the delivery of health-care messages. It used a draft back pain campaign looking at the level of credibility, acceptability and trust in the authority of these messages. Sixty-eight members of the public participated in the study. A qualitative study design was used with semi-structured focus groups and a sampling frame including gender, age, socio-economic group, and experience of back pain. Three main themes were identified. 1. Media consumption. 2. Credibility. 3. Specific issues surrounding the proposed sample media campaign. The use of media to provide health-care information was viewed positively, with the NHS perceived as the most trustworthy source, and Government bodies viewed with scepticism. Issues surrounding the language, terminology and tone of campaigns were raised. A closer collaboration between health-care professionals and the public is advocated to achieve valuable and effective media campaigns.

News coverage of diet-related health disparities experienced by black Americans: a steady diet of misinformation

Compared to their white counterparts, black Americans experience greater morbidity and mortality across a range of diet-related diseases and conditions, including heart disease, type II diabetes, cancer, stroke, and obesity. Many factors influence dietary behaviors among blacks, including those associated with socioeconomics, culture, racism, psychology, and health care quality and access. However, when reporting about the health status and dietary behavior of black Americans, the mainstream print media pursues a largely one-dimensional focus on behavioral and cultural factors. This approach tends to disregard or minimize other factors that influence health behaviors. Health scientists and journalists must be careful to include discussion of the other factors if they want to become a part of the solution to minimize diet-related disparities.

An update on cancer cluster activities at the Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) continues to be aware of the need for response to public concern as well as to state and local agency concern about cancer clusters. In 1990 the CDC published the "Guidelines for Investigating Clusters of Health Events," in which a four-stage process was presented. This document has provided a framework that most state health departments have adopted, with modifications pertaining to their specific situations, available resources, and philosophy concerning disease clusters. The purpose of this present article is not to revise the CDC guidelines; they retain their original usefulness and validity. However, in the past 15 years, multiple cluster studies as well as scientific and technologic developments have affected duster science and response (improvements in cancer registries, a federal initiative in environmental public health tracking, refinement of biomarker technology, cluster identification using geographic information systems software, and the emergence of the Internet). Thus, we offer an addendum for use with the original document. Currently, to address both the needs of state health departments as well as public concern, the CDC now a) provides a centralized, coordinated response system for cancer cluster inquiries, b) supports an electronic cancer cluster listserver, c) maintains an informative web page, and d) provides support to states, ranging from laboratory analysis to epidemiologic assistance and expertise. Response to cancer clusters is appropriate public health action, and the CDC will continue to provide assistance, facilitate communication among states, and foster the development of new approaches in duster science.

Beliefs about the etiology of homosexuality and about the ramifications of discovering its possible genetic origin

Homosexuality is viewed by many as a social problem. As such, there is a keen interest in elucidating the origins of homosexuality among many scholars, from anthropologists to zoologists, from psychologists to theologians. Research has shown that those who believe sexual orientation is inborn are more likely to have tolerant attitudes toward gay men and lesbians, whereas those who believe it is a choice have less tolerant attitudes. The current qualitative study used in-depth, open-ended telephone interviews with 42 White and 44 Black Americans to gain insight into the public's beliefs about the possible genetic origins of homosexuality. Along with etiological beliefs (and the sources of information used to develop these beliefs), we asked respondents to describe the benefits and dangers of scientists discovering the possible genetic basis for homosexuality. We found that although limited understanding and biased perspectives likely led to simplistic reasoning concerning the origins and genetic basis of homosexuality, many individuals appreciated the complex and interactive etiological perspectives. These interactive perspectives often included recognition of some type of inherent aspect, such as a genetic factor(s), that served as an underlying predisposition that would be manifested after being influenced by other factors such as choice or environmental exposures. We also found that beliefs in a genetic basis for homosexuality could be used to support very diverse opinions including those in accordance with negative eugenic agendas.