Framing Obesity: How News Frames Shape Attributions and Behavioral Responses

The Effect of Parent-Targeted Obesity Messaging on Parental Weight Talk Intention: A Randomized Controlled Experiment

It is unknown if parent-targeted health messages about childhood obesity affect parental weight communication with children (e.g., encouraging a child to diet). This randomized, controlled, online experiment assessed the effects of exposure to different message frames on parental intentions to 1) engage in weight communication with their child and, 2) follow the health advice in the message. A diverse sample of U.S. parents (N = 452) were randomly assigned to one of three conditions: 1) a mock news article emphasizing childhood obesity (weight-framed message) with health behavior advice for parents; 2) an article with identical health behavior advice for parents, but framed within the context of improving children's school performance (school-framed message); and 3) a no-treatment control group. Following message exposure, parents completed online surveys assessing their intention to engage in weight communication and the recommended health behaviors. Hierarchical linear regression was used to assess the relationship between experimental condition and the outcome variables. Parents in the weight-frame condition were significantly more likely to report intention to engage in weight communication with their child than parents in the control group, while there was no difference between the school-frame condition and the control group. Parents in both message conditions were equally likely to report intention to adopt the health advice, but parental weight-based self-stigma moderated the relationships. Parent-targeted health advice that features childhood obesity may encourage parents to engage in weight communication with their children. Our findings can inform the development of health messages targeting parents about children's weight-related health.

Understanding Blame in the Context of Childhood Obesity

This paper explicates blame as a psychological construct in communication processes, with a focus on its underlying structure and its mediating role between message characteristics and the public's issue engagement. Data were collected from Amazon Mechanical Turk (N = 373) via a Web-based experiment, where we manipulated a news story about a child suffering an obesity-related health risk (asthma attack vs. heart attack) with different levels of preventability (high vs. low) and severity (high vs. low). Findings showed that blame should best be conceptualized and operationalized as a latent construct comprising both cognitive and affective components. Blame mediated message effects on social responses related to obesity prevention, including punitive attitudes, policy support, and intentions toward interpersonal communication and civic participatory behaviors.

Assigning Responsibility for Depression and Diabetes: Frame Building Factors in Health Coverage

Although frame building is a crucial part of framing in health communication, it is much less understood than media frames or their effects on audiences (i.e. frame setting). To address this research gap, we analyzed the individual, organizational, and external factors of influence contributing to the media's portrayal of responsibility for two major health issues: depression and diabetes. To identify relevant factors, we conducted 23 semi-structured interviews with German journalists who regularly report on these health issues. Our findings indicate that the way in which media coverage portrays responsibilities in depression and diabetes is affected by a variety of factors. These include individual (journalist role perception, journalistic routines, academic background and personal experiences with depression, diabetes-related knowledge, and personal values and beliefs), organizational (editorial lines, space limits, time limitations and payment, and newsroom structures), and external (health news sources, audience interest, newsworthiness, and social norms) factors. Notably, there are differences between depression and diabetes coverage - especially regarding individual factors - confirming that frame building, similar to framing in general, should be examined with regard to specific issues. Nevertheless, some factors that seem important across different topics could be identified.

Media Framing of Causes, Risks, and Policy Solutions for Cannabis-Impaired Driving: Does Medical vs. Non-Medical Cannabis Context Matter?

Driving under the influence of cannabis (DUIC) is a major cause of preventable death and a growing public health concern. News media coverage of DUIC may influence public perceptions of causal factors for DUIC, risks of DUIC, and potential policy solutions. This study examines Israeli news media coverage of DUIC, and contrasts media coverage according to whether news items refer to cannabis use for medical vs. non-medical purposes. We conducted a quantitative content analysis of news articles related to driving accidents and cannabis use (N = 299) from eleven of the highest circulation newspapers in Israel between 2008 and 2020. We apply attribution theory to analyze media coverage of accidents that were linked to medical cannabis, use compared with non-medical use. News items describing DUIC in the context of non-medical (vs. medical) cannabis use were more likely to: (a) emphasize individual causes (vs. social and political); (b) describe drivers in negative terms (vs. neutral or positive); (c) refer to an increased accident risk due to cannabis use (vs. inconclusive or low risk); and (d) call for increased enforcement rather than education. Results show that Israeli news media coverage of cannabis-impaired driving varied significantly depending on whether it referred to cannabis use for medical purposes, or non-medical purposes. News media coverage may influence public perceptions of the risks of DUIC, the factors that are associated with this issue, and potential policy solutions that may reduce the prevalence of DUIC in Israel.

Effects of Health Responsibility Frames on Attributions, Emotions, and Social Support Intentions in the Context of Dementias

When news stories cover health and diseases, they often address issues of responsibility. These responsibility frames can affect recipients' responsibility beliefs (i.e., attributions) and thereby affect emotions and motivations to support people affected by health problems. To date, it is not fully understood how responsibility frames affect these attributions, emotions, and social support intentions in the context of dementia. In an online experiment with N = 1,059 German participants, we tested the effects of different responsibility frames (individual vs. contextual) on social support intentions through responsibility attributions and emotional reactions in the context of dementia. Results show that responsibility frames affect responsibility attributions and social support intentions. Mediation analysis shows that the effect of contextual responsibility frames on social support intention is partially mediated by responsibility attribution and emotions (sympathy and anger). We discuss these findings considering framing effects research and media coverage.

(De)Stigmatizing Depression on Social Media: The Role of Responsibility Frames

Responsibility frames on social media could shape recipients' responses toward people with depression, which is crucial for the public (de)stigmatization of the mental disorder. Thus, the present study examines the effects of different responsibility frames (individual, social, combination) in Instagram-posts about depression on respondents' related attributions as well as their emotional and behavioral reactions toward people suffering from the illness. Our online-experiment (N = 1,015) revealed that frames emphasizing the responsibility of one's social network (e.g. family, friends and professionals) for depression, i.e. social frames, strengthened participants' attributions to the social network, i.e. social attributions, most effectively. Individual frames, however, primarily intensified individual attributions to those affected by depression. Contrary to previous findings, a combination frame did not prove to increase recipients' social attributions more than a one-sided social frame. For emotional and behavioral responses, we did not find any effects of responsibility frames compared to the control group-possibly due to buffering effects of the narrative structure of the Instagram posts.

Effects of Health Responsibility Frames: Testing a Mediation Model of Attributions, Emotions, and Social Support Intentions

When news stories cover health and illness, they often address issues of responsibility. These responsibility frames can affect recipients' responsibility beliefs (i.e. attributions) and thereby indirectly affect emotions and motivation to support people affected by health problems. To date, it is not fully understood how responsibility frames affect social support intentions, and if attributions and emotions mediate this effect. In an online experiment with N = 1,088 German participants, we tested the effects of responsibility frames (individually controllable vs. non-controllable) for type 2 diabetes and depression on social support intentions through responsibility attributions and emotional reactions. Mediation analyses show that responsibility frames indirectly affect social support intentions through social-societal attributions and sympathy. This mediation effect was observed in both depression and type 2 diabetes, despite issue-specific differences in attributions, emotions, and social support intentions. We discuss these findings considering framing effects research and health reporting.

Multilevel causal attributions on transboundary risk: Effects on attributions of responsibility, psychological distance, and policy support

This study used two randomized experiments in a prospective design (Study 1 N = 297, Study 2 N = 296) to examine how multilevel causal attribution dimensions (internal vs. external to an individual or a country) shape domestic and foreign policy support to counter transboundary risk. Results from Study 1 and 2 showed that external-country (vs. internal-country) causal attribution reduced perceptions of internal-country attributions of responsibility, which had a cross-lagged effect on support for domestic-industry policies to mitigate the risk. In contrast, perceptions of external-country attributions of responsibility increased support for foreign policies in a 2-week follow up. This study offers theoretical insights into the demarcation of multilevel causal attribution dimensions in studying media framing effects. It also highlights some important causal mechanisms of how media frames shape public support for policies aimed at transboundary risk mitigation.

Addressing stigma within the dissemination of research products to improve quality of care for pregnant and parenting people affected by substance use disorder

Substance use disorders are a common and treatable condition among pregnant and parenting people. Social, self, and structural stigma experienced by this group represent a barrier to harm reduction, treatment utilization, and quality of care. We examine features of research dissemination that may generate or uphold stigmatization at every level for pregnant and parenting individuals affected by substance use disorder and their children. We explore stigma reduction practices within the research community that can increase uptake of evidence-based treatment programs and prevent potential harm related to substance use in pregnant and parenting people. The strategies we propose include: (1) address researcher stereotypes, prejudice, and misconceptions about pregnant and parenting people with substance use disorder; (2) engage in interdisciplinary and transdisciplinary collaborations that engage with researchers who have lived experience in substance use; (3) use community-based approaches and engage community partners, (4) address stigmatizing language in science communication; (5) provide contextualizing information about the social and environmental factors that influence substance use among pregnant and parenting people; and (6) advocate for stigma-reducing policies in research articles and other scholarly products.

Public Understanding of Childhood Obesity: Qualitative Analysis of News Articles and Comments on Facebook

Childhood obesity has become a major focus of public health and subject to increased news coverage. News can shape public understanding of childhood obesity by selective reporting (framing) which can affect policy support and weight stigma. As news is consumed on social media, comments on articles present a novel method to explore public understanding. This study examined how childhood obesity is framed by news articles on Facebook and how individuals commenting understand and react to these articles. This study used a qualitative research design. Facebook pages of 11 national UK news outlets were searched for news articles on childhood obesity published between May 2015 and May 2020. Of those, 30 articles were randomly selected. Framing analysis was used to determine whether childhood obesity was portrayed as a behavioral, societal or medical issue. Responding comments (N = 1,104) were grouped according to the dominant frame of the corresponding article and analyzed using qualitative content analysis. Of the 30 articles, 28 mentioned societal, 26 behavioral and 18 medical aspects of childhood obesity, highlighting that most articles included more than one frame. Three themes were generated from responding comments: Culprits and Remedies, Appraising Childhood Obesity and Making Sense of the News Article. Findings showed that comments related to Appraising Childhood Obesity differed between differently framed articles, while the other themes did not. This study highlights the need for improved communication on childhood obesity to address weight stigma and improve understanding of news articles.

Effects of Communicating Prevalence Information about Two Common Health Conditions

Obesity and diabetes are widespread health conditions with rising prevalence rates in the United States. News stories and health campaign messages frequently feature prevalence rates of obesity and diabetes, at times under the expectation that such messages will increase readers' disease awareness, health behaviors, and policy support. At the same time, American adults overestimate the prevalence of obesity and diabetes in the absence of prevalence information, raising important questions about the implications of communicating accurate prevalence information that may be lower than baseline estimates. The current study examines the effects of communicating information about the prevalence of obesity and diabetes, varying the format of this information (using qualitative terms, raw frequencies, or percentages). Results from two pre-registered, web-based randomized experiments suggest that only prevalence statistics in percentage formats shift readers' prevalence estimates, though in some percentage formats these estimates were lower than observed in a no-message control group. Prevalence estimates, in turn, were positively associated with perceived social causes of obesity/diabetes, intensions for healthy behaviors, and support for policy-level solutions. These findings offer guidance for health communication campaigns that seek to increase healthy behavior and support for policies to address health conditions.

PTSD Coverage in the New York Times: Implications for the State of Mental Health in the U.S

Post-Traumatic Stress Disorder (PTSD) has been portrayed in media in a skewed way such that the coverage overrepresents combat-precipitated trauma and neglects to communicate treatment options, which has direct implications for people with PTSD. Given the traumatic nature of contemporary events such as the COVID-19 pandemic and the emergence of social movements concerning traumatic violence such as #MeToo and Black Lives Matter, this study examines if media coverage of PTSD has evolved to account for these changes. We specifically examined sourcing and framing in PTSD news coverage published by The New York Times from 1999 to 2020 using quantitative content analysis. The findings indicate that the coverage overrepresents combat trauma and neglects to communicate treatment options; favors men over women in sourcing of the news stories; and uses more thematic, compared to episodic framing. The theoretical and practical implications of the findings are discussed.

A Systematic Review of Responsibility Frames and Their Effects in the Health Context

Responsibility frames potentially shape the public perception of health issues such as obesity, diabetes, or mental illness, specifically regarding responsibility attributions for their causes and treatment. Which responsibility frames prevail in the health context, and the responses they may elicit from audiences, has not been studied systematically. This systematic review includes studies with different methodological approaches published between 2004 and 2019 (N = 68). Content analyses (n = 56) show that different media attribute health responsibility most frequently, but not exclusively to individuals. Individual responsibility was especially emphasized for obesity, which was also the most studied health issue. Tendencies toward societal attributions of responsibility emerged over time, particularly regarding health risks for which the frames describe a specific cause (e.g., sugar, trans-fat). Experimental studies (n = 12) indicate that individual responsibility frames reduce policy support. The effects of responsibility frames were, however, not as clear-cut as expected with research gaps regarding behavioral and affective outcomes. Overall, there is a clear emphasis on noncommunicable diseases in this field. Finally, the conceptual focus on individual vs. societal health responsibility distracts from social network influences as another relevant health determinant. The implications for health communication are discussed.

Behavioral Responses of Pregnant Women to the Early Stage of COVID-19 Pandemic in the Network Era in China: Online Questionnaire Study

Purpose

The aim of this study was to examine the behavioral responses of pregnant women during the early stage of Coronavirus Disease 2019 (COVID-19) outbreak.

Methods

We recruited 1,099 women to complete an online questionnaire survey from February 10 to February 25, 2020. The subjects were divided into two groups (the pregnant women group and the control group).

Results

Concerns about infection: most of the participants watched the COVID-19 news at least once a day. Protective behaviors: the utilization rate of pregnant women (often using various measures) was higher than that of nonpregnant women. Exercise: 30.6% of the pregnant women continued to exercise at home, whereas in the control group, this percentage was 8.4%. Spouse relationship: 38.8% of the subjects’ relationship improved, whereas only 2.3% thought the relationship was getting worse.

Conclusion

Pregnant women had some unique behavioral responses different from that of nonpregnant women. It is important to understand the behavioral responses of pregnant women in this network era.

Who or what is to blame? Examining sociodemographic relationships to beliefs about causes, control, and responsibility for cancer and chronic disease prevention in Alberta, Canada

BACKGROUND

Beliefs about causes and responsibility for chronic diseases can affect personal behaviour and support for healthy policies. In this research we examined relationships between socio-demographics (sex, age, education, employment, political alignment, perceived health, household income, household size) and perceptions of causes and responsibility for health behaviour, chronic disease correlates, and attitudes about cancer prevention and causes.

METHODS

Using data from the 2016 Chronic Disease Prevention survey in which participants (N = 1200) from Alberta, Canada responded to items regarding how much they believed personal health behaviours, prevention beliefs, and environmental factors (i.e., healthy eating, physical activity, alcohol, smoking, and where a person lives or works) are linked to getting cancer. Participants also responded to questions about causes and responsibility for obesity, alcohol, and tobacco (i.e., individual or societal). Relationships were examined using multinomial logistic regression on socio-demographics and survey items of interest.

RESULTS

Men (compared to women) were less likely to link regular exercise, or drinking excessive alcohol, to reducing or increasing cancer risk. Similarly, men were less likely to link environmental factors to cancer risk, and more likely to agree that cancer was not preventable, and that treatment is more important than prevention. Finally, men were more likely to believe that alcohol problems are an individual's fault. Left and central voters were more likely to believe that society was responsible for addressing alcohol, tobacco, and obesity problems compared to right voters. Those with less than post-secondary education were less likely to believe that regular exercise, maintaining a healthy body weight, or eating sufficient fruits and vegetables were linked to cancer - or that society should address obesity - compared to those with more education. Households making above the median income (versus below) were more likely to link a balanced diet with cancer and were less likely to think that tobacco problems were caused by external circumstances.

CONCLUSIONS

These results provide insight into the importance of health literacy, message framing, and how socio-demographic factors may impact healthy policy. Men, those with less education, and those with less income are important target groups when promoting health literacy and chronic disease prevention initiatives.

Mut zur Lücke. Verantwortungszuschreibungen auf der Ebene sozialer Beziehungen als neuer Bereich der Framing-Forschung zu Gesundheitsthemen

Frames der Verantwortungszuschreibung (Responsibility Frames) in der Medienberichterstattung betonen sowohl spezifische Ursachen als auch spezifische Lösungen für ein Thema. Die Forschung zum Responsibility Framing von Medieninhalten und deren Wirkungen untersucht diese Betonung bislang zumeist auf zwei verschiedenen Ebenen: der Individualebene und der gesellschaftlichen Ebene. Diese Betrachtungsweise vernachlässigt allerdings die wichtige mittlere Ebene des sozialen Umfelds der Menschen. Hier befinden sich zentrale Akteur*innen (wie Familie, Freund*innen oder Kolleg*innen), die als Ursache oder Lösung zu einem Problem beitragen können, was insbesondere bei Gesundheitsproblemen deutlich wird. Das Ziel des Beitrags ist es daher, die Ebene sozialer Beziehungen in das Konzept des Responsibility Framings zu integrieren. Dafür verknüpfen wir zentrale Elemente der sozialen Netzwerktheorie (Akteur*innen und ihre Funktionen für das Individuum) und der Attributionstheorie mit den Framing-Konzepten. Darauf aufbauend werden Konsequenzen für die zukünftige Forschung der Kommunikationswissenschaft abgeleitet.

Icing on the Cake: "Amplification Effect" of Innovative Information Form in News Reports About COVID-19

In the information era, the instant and diversified broadcasting of the COVID-19 pandemic has played an important role in stabilizing the societal mental state and avoiding inter-group conflicts. The presentation of visual graphics was considered as an innovative information form and broadly utilized in news reports. However, its effects on the audiences' cognition and behaviors have received little empirical attention. The current study applied real-time and retrospective priming paradigms to examine the impacts of information framing (positive vs. negative) and form (plain text vs. pie chart) on individuals' risk perception (cognition), positive emotion (emotion), and willingness to help others (behavioral intention) during the outbreak and post-pandemic period in China. The results indicated the "amplification effect" of the innovative form of information in the real-time priming condition, which increased the effect of the information framing on cognition, emotion, and behavioral intention. However, in the retrospective priming condition, the amplification effect on cognition and emotion were weakened, while its effect on behavioral intention disappeared. In conclusion, the study found the "amplification effect" of innovative information forms. Further, the difference in the results in the real-time and retrospective priming paradigms suggested the constraint of the context of the "amplification effect," and indicated the possible deviation of the retrospective paradigm in studies about disaster-related news. This study provides empirical support for how subtle changes in information presentation influence public mental and behavioral responses during a pandemic and has important implications for media psychology and social governance.

[Media coverage of prevention and treatment options using the examples of diabetes mellitus and depression]

BACKGROUND

Diabetes mellitus and depression are diseases with a rising prevalence in Germany. Journalistic media coverage offers the opportunity to inform the public about options for prevention and therapy. Research shows that media portrayals of different prevention and treatment options might influence health behavior as well as policy support and eventually structural healthcare.

OBJECTIVES

To date, little is known about the media coverage of the prevention and treatment of diabetes mellitus and depression. This study aims at demonstrating how diabetes mellitus and depression are portrayed in the German news media, focusing on options for prevention and therapy.

MATERIALS AND METHODS

A quantitative content analysis of German print and online media from 2012 to 2018 was conducted. In sum, N = 645 articles on diabetes mellitus (n = 219) and depression (n = 426) were analyzed.

RESULTS AND DISCUSSION

Diabetes mellitus and depression are rarely the main subject in German news coverage despite their high prevalence. Depression is reported more frequently than diabetes mellitus - often, however, in the context of suicide or celebrities. Regarding diabetes mellitus, reports differentiated insufficiently between the various types. For both conditions, pharmacotherapy was mentioned more frequently than low-threshold measures and structural prevention opportunities, which might have adverse consequences for those seeking help. Overall, to establish prevention and low-threshold forms of therapy as treatment options in the public, strategic communicators should focus more on them.

Reducing Health-Related Stigma Through Narrative Messages

Public stigma characterizes three leading health issues: prescription opioid addiction, obesity, and cigarette smoking. Attributions of individual responsibility are often embedded in negative public attitudes around these issues and can be important to stigma's development and reduction. Research suggests that narrative messages may hold promise for influencing attributions and stigma in these health contexts. Using a national sample of American adults from an online panel (N = 5,007), we conducted a survey-embedded randomized experiment, assigning participants to read one of six messages about one of three health issues. All participants read a statement detailing the magnitude of their assigned health problem, after which some respondents received a short inoculation message (serving as a comparison group) or a narrative message emphasizing external factors while acknowledging personal responsibility for the issue. Some participants also read a counter message emphasizing personal responsibility for the health issue to replicate competitive messaging environments surrounding these issues. Relative to those who received only the magnitude of problem message (comparison group 1) or the magnitude of problem and inoculation messages (comparison group 2), the narrative message reduced prescription opioid addiction stigma and increased attributions of responsibility to groups beyond the individual. Narrative effects were mixed for obesity, had no effect on attributions or stigma around cigarette smoking, and were generally consistent whether or not respondents received a counter message. Narrative messages may be a promising approach for shifting responsibility attributions and reducing public stigma around prescription opioid addiction, and may have some relevance for obesity stigma-reduction efforts.

30+ years of media analysis of relevance to chronic disease: a scoping review

BACKGROUND

Chronic, non-communicable diseases are a significant public health priority, requiring action at individual, community and population levels, and public and political will for such action. Exposure to media, including news, entertainment, and advertising media, is likely to influence both individual behaviours, and attitudes towards preventive actions at the population level. In recent years there has been a proliferation of research exploring how chronic diseases and their risk factors are portrayed across various forms of media. This scoping review aims to map the literature in this area to identify key themes, gaps, and opportunities for future research in this area.

METHODS

We searched three databases (Medline, PsycINFO and Global Health) in July 2016 and identified 499 original research articles meeting inclusion criteria: original research article, published in English, focusing on media representations of chronic disease (including how issues are framed in media, impact or effect of media representations, and factors that influence media representations). We extracted key data from included articles and examined the health topics, media channels and methods of included studies, and synthesised key themes across studies.

RESULTS

Our findings show that research on media portrayals of chronic disease increased substantially between 1985 and 2016. Smoking and nutrition were the most frequent health topics, and television and print were the most common forms of media examined, although, as expected, research on online and social media channels has increased in recent years. The majority of studies focused on the amount and type of media coverage, including how issues are framed, typically using content analysis approaches. In comparison, there was much less research on the influences on and consequences of media coverage related to chronic disease, suggesting an important direction for future work.

CONCLUSIONS

The results highlight key themes across media research of relevance to chronic disease. More in-depth syntheses of studies within the identified themes will allow us to draw out the key patterns and learnings across the literature.

Health in the United States: Are Appeals to Choice and Personal Responsibility Making Americans Sick?

The United States suffers high rates of preventable lifestyle disease despite widespread calls for people to take responsibility for their health. The United States also stands out in its rejection of government action to guide industry practices and consumer choices. Why? We examine how deeply rooted cultural narratives about “free choice” and “personal responsibility” infuse policymaking, advertising, media, social norms, and individual attitudes about health in the United States. We argue that these narratives contribute to ill health in the United States: They encourage stress and worry over health, blame and stigmatization of the unhealthy, widened health disparities, and the failure to adopt policies that could save lives. Psychologists can play a major role in expanding narratives about health so that they include the role of personal choice and responsibility but also reflect current science about the physical, social, and cultural drivers of health. These broader narratives can be used to promote a more comprehensive understanding of health and to better inform the design, communication, and implementation of effective health-supportive policies.

Beyond Personal Responsibility: Examining the Effects of Narrative Engagement on Communicative and Civic Actions

Moving beyond personal responsibility-taking behaviors, this paper examines communicative (interpersonal talk and online message sharing) and civic (public policy support and intention to donate) behavioral outcomes in the context of narrative persuasion. A web-based experiment was conducted to test the mediating effects of two narrative engagement constructs, transportation and empathy, on these behavioral outcomes. Participants recruited via Amazon Mechanical Turk (n = 467) participated in an experiment conducted on Qualtrics, where they were randomized to read either a narrative or a nonnarrative message about factors contributing to obesity. The narrative message, compared to the nonnarrative message, generated greater transportation and affective empathy but had no overall advantage regarding behavioral outcomes. Path analyses showed consistent, significant indirect effects via transportation and affective empathy on all the outcome variables: online message sharing, interpersonal talk, public policy support, and intention to donate to a non-profit obesity organization. Our study contributes to the extant narrative research by shedding light on how narrative messages, via engaging the audience, could shape social responses beyond personal responsibility-taking. Implications and limitations of findings were discussed.

Is the news making us unhappy? The influence of daily news exposure on emotional states

There is evidence that exposure to negative news is making people feel bad, but not much is known about why this only affects some people or whether this also applies to everyday news exposure. This study examined the direct and indirect effects of daily news exposure on people's affective states. Using ecological momentary assessment (EMA), 63 respondents (24 men and 39 women) reported their news exposure and affective states five times a day for 10 days. In addition, personal relevance of the news and personality characteristics, neuroticism and extraversion, were assessed. Results showed that negative news perceptions were related to more negative affect and less positive affect, and these effects were moderated by personal relevance, but not personality characteristics. The implications of these outcomes are discussed.

The Cultural Competence of Health Journalists: Obesity Coverage in Four Urban News Organizations

This study sought to identify indicators of cultural competence in 670 news stories covering obesity by four urban news organizations: two mainstream newspapers and two ethnic newspapers serving the African-American and Hispanic communities. Through semantic network analysis, the research found that the news organizations converged on five themes: unhealthy lifestyle, food access and education, healthy lifestyle, public policy, and research. Public policy solutions were favored by the mainstream newspapers, while self-efficacy was emphasized in the ethnic papers. In all four newspapers, indicators of cultural competence were mixed. Ethnic newspapers showed particular competence in certain areas, such as community-based sourcing, direct mention of groups at risk for obesity, and lack of medical jargon. Chi-square tests showed, however, that the African-American newspaper discussed obesity less than expected, while the metropolitan daily directly mentioned ethnic groups at risk for obesity less than expected.

Healthcare Providers' Responses to Narrative Communication About Racial Healthcare Disparities

We used qualitative methods (semi-structured interviews with healthcare providers) to explore: 1) the role of narratives as a vehicle for raising awareness and engaging providers about the issue of healthcare disparities and 2) the extent to which different ways of framing issues of race within narratives might lead to message acceptance for providers' whose preexisting beliefs about causal attributions might predispose them to resist communication about racial healthcare disparities. Individual interviews were conducted with 53 providers who had completed a prior survey assessing beliefs about disparities. Participants were stratified by the degree to which they believed providers contributed to healthcare inequality: low provider attribution (LPA) versus high provider attribution (HPA). Each participant read and discussed two differently framed narratives about race in healthcare. All participants accepted the "Provider Success" narratives, in which interpersonal barriers involving a patient of color were successfully resolved by the provider narrator, through patient-centered communication. By contrast, "Persistent Racism" narratives, in which problems faced by the patient of color were more explicitly linked to racism and remained unresolved, were very polarizing, eliciting acceptance from HPA participants and resistance from LPA participants. This study provides a foundation for and raises questions about how to develop effective narrative communication strategies to engage providers in efforts to reduce healthcare disparities.

Combining Two Outcome Frames to Promote Support for Obesity-Related Policies

Guided by construal level theory (CLT), this study investigates the interplay between two framing approaches that address outcomes of obesity-related policies. A randomized experiment (N = 299) was conducted with a 2 (gain- vs. loss-frame) X 2 (societal- vs. individual-frame) between-participants design. Consistent with CLT, frame combinations with consistent construal levels were more persuasive. Compared to a societal-loss frame, a societal-gain frame was perceived as a stronger argument, which in turn increased policy support. Participants were also more likely to engage in healthier diets and physical activity when messages highlighted societal-gain rather than societal-loss. This study offers important insights for combining multiple framing approaches in a persuasive message to improve policy support as well as individual health decisions.

Media and Its Influence on Obesity

PURPOSE OF REVIEW

To review how the media frames obesity and the effect it has upon on public perceptions.

RECENT FINDINGS

The scientific and public health understanding of obesity increasingly points away from individual behaviors and toward medical and community factors, but diffusion of this knowledge is slow. Growing awareness of the importance of body positivity is driving attention to the harms of weight bias and fat shaming. Health science reporting related to obesity, nutrition, and physical activity tends to perpetuate myths and misunderstandings. Moving forward, greater attention to accurate messages about obesity and evidence-based interventions will be essential for progress to reduce suffering and the impact on public health from this chronic disease.

Promoting healthy home environments and lifestyles in families with preschool children: HomeStyles, a randomized controlled trial

The purpose of the HomeStyles randomized controlled trial was to determine the effect of participation in the HomeStyles intervention vs an attention control condition on the weight-related aspects of the home environment and lifestyle behavioral practices of families with preschool children. Parents of preschool children (n=489) were systematically randomized to experimental or attention control group after completing the baseline survey. Baseline and post surveys comprehensively assessed study outcomes using a socio-ecological approach incorporating valid, reliable intrapersonal (e.g., diet, activity), interpersonal (e.g., family meal frequency), and environmental measures (e.g., home media environment), and self-reported parent and child measured heights and weights. For all outcome measures, paired t-tests compared within group differences over time and ANCOVA, controlling for baseline scores and prognostic variables (e.g., parent sex), determined differences in post survey scores between groups. The final analytical sample (N=172; age 32.34±5.71SD; 58% White; 93% female) completed baseline and post surveys. The experimental group families had improved family meal and diet-related behaviors, and self-efficacy for food-related childhood obesity-protective practices. Household food supplies changed little, except for less availability of salty/fatty snacks. Within group effects indicated the control group also experienced some improvements, however these were few in number. ANCOVA revealed the experimental group parents had greater physical activity, reduced screentime, improved family mealtime behaviors, and increased self-efficacy for childhood obesity-protective behaviors and cognitions compared to the control group at post survey, though effect sizes were small. The HomeStyles program for families with preschool children promoted improvements in an array of obesity-preventive behaviors.