Ethnicity, genetics, and breast cancer: media portrayal of disease identities

Cancer-related stigma in the USA and Israeli mass media: an exploratory study of structural stigma

PURPOSE

Cancer is considered a stigmatized condition in many cultures. One key cultural site that produces illness-related structural stigma is mass media. This study explored the social construction of cancer-related stigma in mass media during the time of COVID-19. Specifically, we compared how cancer-related stigma is constructed in two contexts: American and Israeli mass media.

METHODS

Two samples were drawn: all articles that mentioned cancer and published in a 4-month period in USA Today (N = 117) and Israel Today (N = 108). Inductive Thematic Analysis was used to analyze the articles.

RESULTS

Three similar themes were identified in the samples: "the trivialization of cancer," "cancer as metaphor," and the "the war against cancer." In both samples, people with cancer were depicted as heroic. Despite the similarities in themes, how each theme was constructed reflected sociocultural differences between the two samples.

CONCLUSIONS

There appear to be presented universal mechanisms of cancer-related stigma in the media, alongside cultural differences in how they are employed and constructed.

IMPLICATIONS FOR CANCER SURVIVORS

The results stress the importance of debunking cancer-related stigma in the media and elsewhere. Cancer survivors and their families, reporters, researchers, and other stakeholders in the two studied countries should collaborate to devise culturally informed guidelines for reporting and writing about cancer.

Early Perceptions of COVID-19 Contact Tracing Apps in German-Speaking Countries: Comparative Mixed Methods Study

Background

The main German-speaking countries (Germany, Austria, and Switzerland) have implemented digital contact tracing apps to assist the authorities with COVID-19 containment strategies. Low user rates for these apps can affect contact tracing and, thus, its usefulness in controlling the spread of the novel coronavirus.

Objective

This study aimed to assess the early perceptions of people living in the German-speaking countries and compare them with the frames portrayed in the newspapers during the first wave of the COVID-19 pandemic.

Methods

We conducted qualitative interviews with 159 participants of the SolPan project. Of those, 110 participants discussed contact tracing apps and were included in this study. We analyzed articles regarding contact tracing apps from 12 newspapers in the German-speaking countries.

Results

Study participants perceived and newspaper coverage in all German-speaking countries framed contact tracing apps as governmental surveillance tools and embedded them in a broader context of technological surveillance. Participants identified trust in authorities, respect of individual privacy, voluntariness, and temporary use of contact tracing apps as prerequisites for democratic compatibility. Newspapers commonly referenced the use of such apps in Asian countries, emphasizing the differences in privacy regulation among these countries.

Conclusions

The uptake of digital contact tracing apps in German-speaking countries may be undermined due to privacy risks that are not compensated by potential benefits and are rooted in a deeper skepticism towards digital tools. When authorities plan to implement new digital tools and practices in the future, they should be very transparent and proactive in communicating their objectives and the role of the technology—and how it differs from other, possibly similar, tools. It is also important to publicly address ethical, legal, and social issues related to such technologies prior to their launch.

Applying Natural Language Processing to Evaluate News Media Coverage of Bullying and Cyberbullying

Bullying events have frequently been the focus of coverage by news media, including news stories about teens whose death from suicide was attributed to cyberbullying. Previous work has shown that news media coverage is influential to readers in areas such as suicide, infectious disease outbreaks, and tobacco use. News media may be an untapped resource to promote bullying prevention messages, though current news media approaches to describing bullying and cyberbullying remain unexplored. The purpose of this study was to evaluate the current state of news media coverage of bullying and cyberbullying. A sample of newspaper articles covering bullying or cyberbullying across regional and national US newspapers from 6 recent years was identified. A content analysis using natural language processing was conducted with the Linguistic Inquiry and Word Count (LIWC) software program for key variables including affective, social, and cognitive processes. Evaluation included the percentage of words that represented Fear-based reporting such as alarmist words (e.g., epidemic, tragic), as well as words that represent Public Health-oriented messages such as prevention. A total of 463 newspaper articles met inclusion criteria, including 140 cyberbullying articles and 323 bullying articles. Findings indicated that cyberbullying articles scored higher on affective processes such as measures of anxiety (Mdn = 0.34) compared to bullying articles (Mdn = 0.22). A greater number of cyberbullying articles were Fear-based (41.4%) than were bullying articles (19.5%). An equivalent number of cyberbullying articles (50.0%) and bullying articles (49.8%) were Public Health-oriented. Findings may be used to collaborate with journalists toward optimizing prevention-oriented reporting.

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.

Mental representations of HPV in Appalachia: gender, semantic network analysis, and knowledge gaps

Media coverage has emphasized human papillomavirus (HPV) as a vaccine-preventable, sexually transmitted virus causing cervical cancer. Appalachian undergraduate students (N = 309, 50% female) were surveyed on their knowledge of HPV; analyses of mental representations were similar to content analyses of media coverage of HPV, suggesting media cultivation. Semantic network analysis revealed linkages between vaccine, disease causation and prevention, women's centrality in the representations, and structural differences that varied between vaccinated women, unvaccinated women, and men. The findings provided insights into gaps in the public's understanding of HPV, potential stigmatization of those testing HPV+, and future challenges in vaccinating men.

"No respecter of youth": over-representation of young women in Australian television coverage of breast cancer

Ninety four percent of new breast cancer cases in Australian women occur in those aged over 40. Mammographic breast screening programs target women over 40, especially those aged 50-69, but participation rates in this age group have recently declined. To test the hypothesis that young women, at low risk for breast cancer, are overrepresented in television news, we analyzed all televised news reports on age and breast cancer shown on five free-to-air Sydney television stations, from 3 May 2005 to 28 February 2007, to determine the age of women shown with, or at risk for, the disease. Over half (55%) of statements about age and breast cancer referred to young women stated or known to be aged under 40. Sixty seven percent of images of women in breast cancer reports were known or judged to be women aged under 40. Three cases in young celebrity women accounted for 53% of all statements and 24% of all images about young women and breast cancer. Overrepresentation of young women with breast cancer in television news coverage does not reflect the epidemiology of the disease. This imbalance may contribute to public uncertainty regarding screening policy.

Topics and sources of memorable breast cancer messages and their impact on prevention and detection behaviors

Often, people are able to recall a message on a particular topic for a long period of time. These memorable messages have the ability to influence behavior when they are recalled from memory long after initial exposure. Knowing the topics and sources of the messages that are remembered about breast cancer can improve the efficacy of future breast cancer outreach. To this end, 359 women completed an online survey about memorable breast cancer messages. Most women (60%) recalled a memorable message, described it, identified its source, and noted whether it had resulted in prevention or detection behaviors. Four categories of message topics emerged: early detection (37.3%), awareness (30.9%), treatment (25.8%), and prevention (6%). Furthermore, five categories of sources of these memorable messages were found: media (35.5%), friends (22.2%), family (21.6%), medical professionals (15.2%), and others (5.5%). The media were a major source of all four topics of messages, although family members, friends, and the medical community were major sources for particular message topics as well. Memorable messages originating from medical professionals were substantially more likely to motivate detection behaviors than prevention behaviors. This research demonstrates that message topic and source both play roles in determining message recall as well as in determining how memorable messages impacted behavior.

News coverage of cancer in the United States: a national sample of newspapers, television, and magazines

A content analysis of cancer news coverage in a sample of local and national newspapers, television, and magazines was conducted for the years 2002 and 2003. Analyses compared proportions of mentions of cancer sites with proportional contribution to cancer incidence and mortality based on available epidemiological estimates. Analyses also examined relative attention provided to prevention, detection, treatment, causes, and outcomes of various cancers. Results indicated that coverage reflected incidence rates more closely than they did mortality rates, but in both cases coverage under-represented the contribution of lung cancer to morbidity and mortality and over-represented the contribution of breast cancer. Of greater public health concern was the limited coverage of prevention and detection even for highly preventable or relatively easily detected cancers. Implications of findings are discussed.

Media influence on Herceptin subsidization in Australia: application of the rule of rescue?

BACKGROUND

In August 2006, the Australian government announced that Herceptin (Trastuzumab) would be added to the national Pharmaceutical Benefits Scheme (PBS) of government-subsidized drugs, for treatment with adjuvant chemotherapy of HER2 breast cancer. Following initial reticence, the health minister responded to a campaign by patients and patient advocacy groups by announcing PBS subsidization which lowered the cost of a weekly dose from A$1000 to A$30. The cost to the government would be A$470 million over three years for treatment of an estimated 2100 women annually.

DESIGN

We analysed the news frames used in all direct and attributed statements (n=239) in television news coverage of the discourse preceding the Herceptin decision by the Australian government.

SETTING

Five Sydney free-to-air channels between October 2005 and August 2006.

MAIN OUTCOME MEASURES

News frames or themes.

RESULTS

Of five news frames identified, one ('desperate, sick women in double jeopardy because of callous government/incompetent bureaucracy') accounted for 54% of all reported statements. Government financial parsimony was framed as responsible for the women's plight, with drug industry pricing never mentioned. Claimed benefits of Herceptin often conflated cancer non-recurrence and survival and favoured quantification rhetoric which emphasized percentage increases in improvement rather than the more modest increases in absolute survival.

CONCLUSIONS

News frames invoking key tenets of the 'rule of rescue' dominated television discourse on Herceptin. Clinicians, patients, their families and patient advocacy groups invoking the rule of rescue can increase the likelihood of achieving their objective of gaining access to expensive healthcare such as pharmaceuticals. Rational, criteria-based public health policy will find it hard to resist the rule of rescue imperative.

Cancer coverage in a mainstream and Korean American online newspaper: lessons for community intervention

OBJECTIVE

Korean Americans have higher incidence of stomach, liver, and cervical cancer than most groups in CA, USA, and generally lower rates of cancer screening. To better target community interventions, we evaluated the cancer content in a leading Korean American newspaper, the Korea Daily, compared to a mainstream newspaper from the same metropolitan area, the Los Angeles (LA) Times.

METHODS

Using the online versions of each newspaper for the year 2006, we counted articles mentioning cancer and evaluated the content in a random sample of 300 articles from each newspaper. Articles were categorized by relevance of cancer content and topic(s) covered.

RESULTS

Although the LA Times had a higher proportion of articles mentioning cancer, the Korea Daily had more articles that primarily focused on cancer and addressed specific types of cancer. Articles in the Korea Daily were more likely to discuss prevention, while those in the LA Times more often focused on people, politics, or research.

CONCLUSIONS

Smaller, ethnic newspapers may be more amenable to messages about prevention and appropriate places to target community-focused interventions.

PRACTICE IMPLICATIONS

Health practitioners should consider submitting articles to ethnic newspapers and forming partnerships with journalists to cultivate this potential.

An exploratory study of canadian aboriginal online health care forums

Internet-based discussion forums provide access to health information and social support, and serve as a resource for others. This investigation analyzed health-oriented Aboriginal Internet discussion forum (Forum A; Forum B) conversations. The findings were framed with Nutbeam's model of health literacy. Discussions within Forum B were centralized around issues of political activism and advocacy regarding Aboriginal health care. Activity in Forum A encouraged the development of "virtual" social capital, with health care discussions providing a "just-in-time" model for health education. Members of Forum A functioned as a smoking cessation self-help group and as health educators. The Internet provided a venue for the dissemination of health information and also served as a virtual voice for lifestyle coaching, political action, community building, and advocacy.

Chat Room Computer-Mediated Support on Health Issues for Aboriginal Women

Within contemporary health care, increases in chronic disease have necessitated a disease management focus. Given that chronic disease is managed, more so than cured, there are increased demands for greater participation by health care consumers and they are expectated to take on increased responsibility for self-care. The emphasis on consumer responsibility has increased the significance of health-promoting behavior change in contending with contemporary health care concerns. In Canada, the reported inequity in health status between Aboriginal and non-Aboriginal Canadians further emphasizes the need for innovative health strategies. For Aboriginal women isolated by geography, changing societal norms (e.g., women working outside of the home, single parent families), and cultural distinction, online chat participation serves as a novel medium for the provision of health knowledge, support, and motivation within a virtual "neighborhood." Recognizing the significance of social support in the promotion of positive health behavior change, we investigated the theme of social support within health conversations among Aboriginal women participating in an online chat room. Content analysis was the primary methodological focus within a mixed methods approach. Of 101 health-based online conversations, the majority reflected one of three forms of social support: (1) emotional support, (2) informational support, or (3) instrumental support. The value of social support and social cohesion within health has been well documented. The current investigation suggests that "community" need not be physically constructed; virtual communities offer great potential for social cohesion around the issues of health and health care.

Genomics-based labeling and attribution: a case for integrating social sciences into personalized medicine research

As the field of genomics uncovers the etiology and pathophysiological mechanisms of disease, we will gain a greater understanding of the causes of disease, leading to preventive interventions, early diagnoses and new and improved treatments. Although understanding the specific roles of environment and genetics in disease onset and development will most likely improve health outcomes, the impact of this information for the individual and public remains to be seen. Understanding what factors influence individual and public perceptions and behavioral consequences related to genome-based disease labels and attributions will be critical to a successful transition for personalized medicine. To better understand the impact of genomic-based disease labeling and attribution, social scientists need to be involved in clinical genomics studies to assess the consequences of the use of and response to new personalized diagnoses and treatments.