The association between alcohol and breast cancer: popular press coverage of research

Is Coffee the Cause or the Cure? Conflicting Nutrition Messages in Two Decades of Online New York Times' Nutrition News Coverage

Two-thirds of US adults report hearing news stories about diet and health relationships daily or a few times a week. These stories have often been labeled as conflicting. While public opinion suggests conflicting nutrition messages are widespread, there has been limited empirical research to support this belief. This study examined the prevalence of conflicting information in online New York Times' news articles discussing published nutrition research between 1996-2016. It also examined the contextual differences that existed between conflicting studies. The final sample included 375 news articles discussing 416 diet and health relationships (228 distinct relationships). The most popular dietary items discussed were alcoholic beverages (n = 51), vitamin D (n = 26), and B vitamins (n = 23). Over the 20-year study period, 12.7% of the 228 diet and health relationships had conflicting reports. Just under three-fourths of the conflicting reports involved changes in study design, 79% involved changes in study population, and 31% involved changes in industry funding. Conflicting nutrition messages can have negative cognitive and behavioral consequences for individuals. To help effectively address conflicting nutrition news coverage, a multi-pronged approach involving journalists, researchers, and news audiences is needed.

Effects of Prior Exposure to Conflicting Health Information on Responses to Subsequent Unrelated Health Messages: Results from a Population-Based Longitudinal Experiment

BACKGROUND

Accumulating evidence suggests that exposure to conflicting health information can adversely affect public understanding of and trust in health recommendations. What is not known is whether prior exposure to such information renders people less receptive to subsequent unrelated health messages about behaviors for which the evidence is clear and consistent.

PURPOSE

This study tests this "carryover" effects hypothesis, positing that prior exposure to conflict will reduce receptivity to subsequent unrelated health messages, and examines potential affective and cognitive pathways through which such effects might occur.

METHODS

A three-wave, online, population-based survey experiment (N = 2,716) assessed whether participants who were randomly assigned to view a series of health news stories and social media posts featuring conflict at Times 1 and 2 were ultimately less receptive at Time 3 to ads from existing health campaigns about behaviors for which there is scientific consensus, compared to those who saw the same series of stories and posts that did not feature conflict.

RESULTS

Structural equation modeling revealed evidence of carryover effects of exposure to conflict on two dimensions of message receptivity: greater resistance to the unrelated ads and lower perceptions of the health behaviors featured in the ads. Modeling indicated that carryover effects were a function of generalized backlash toward health recommendations and research elicited by prior exposure to conflicting information.

CONCLUSIONS

Findings suggest that the broader public information environment, which is increasingly characterized by messages of conflict and controversy, could undermine the success of large-scale public health messaging strategies.

How Are the Links between Alcohol Consumption and Breast Cancer Portrayed in Australian Newspapers?: A Paired Thematic and Framing Media Analysis

A dose-dependent relationship between alcohol consumption and increased breast cancer risk is well established, even at low levels of consumption. Australian women in midlife (45–64 years) are at highest lifetime risk for developing breast cancer but demonstrate low awareness of this link. We explore women’s exposure to messages about alcohol and breast cancer in Australian print media in the period 2002–2018. Methods: Paired thematic and framing analyses were undertaken of Australian print media from three time-defined subsamples: 2002–2004, 2009–2011, and 2016–2018. Results: Five key themes arose from the thematic framing analysis: Ascribing Blame, Individual Responsibility, Cultural Entrenchment, False Equilibrium, and Recognition of Population Impact. The framing analysis showed that the alcohol–breast cancer link was predominantly framed as a behavioural concern, neglecting medical and societal frames. Discussion: We explore the representations of the alcohol and breast cancer risk relationship. We found their portrayal to be conflicting and unbalanced at times and tended to emphasise individual choice and responsibility in modifying health behaviours. We argue that key stakeholders including government, public health, and media should accept shared responsibility for increasing awareness of the alcohol–breast cancer link and invite media advocates to assist with brokering correct public health information.

Confusion and nutritional backlash from news media exposure to contradictory information about carbohydrates and dietary fats

OBJECTIVE

To test the effect of news media exposure to contradictory information about carbohydrates and dietary fats on levels of confusion, nutritional backlash and dietary intentions.

DESIGN

We conducted an online survey experiment between 11 and 28 February 2018, randomizing participants to one of six experimental conditions. Two 'contradictory information' conditions asked participants to read one news article on the risks of a low-carbohydrate diet and one article on the risks of a low-fat diet. Two 'convergent information' conditions asked participants to read two articles with similar information on the risks of one of these two diets. A fifth 'established health recommendations' control condition asked participants to read two articles on the harms of smoking and sun exposure. A sixth 'no information' condition served as a second control group. We used general linear models to test hypotheses on the effects of exposure on confusion, nutritional backlash and dietary intentions.

SETTING

USA.

PARTICIPANTS

Adults (n 901) registered with Amazon's Mechanical Turk (M-Turk).

RESULTS

Exposure to contradictory information about carbohydrates and dietary fats increased confusion and nutritional backlash compared with exposure to established health recommendations for non-dietary behaviours and a no-exposure control. Exposure to contradictory information also increased confusion compared with exposure to consistent nutrition information regarding carbohydrates and dietary fats.

CONCLUSIONS

Contradictory nutrition information in the news media can negatively affect consumers' attitudes, beliefs and behavioural intentions. Dietary debates that play out in the media may adversely influence both short-term dietary decisions and future efforts to communicate about unrelated nutrition issues.

Source-specific Exposure to Contradictory Nutrition Information: Documenting Prevalence and Effects on Adverse Cognitive and Behavioral Outcomes

Communication scholars have raised concerns that the media present contradictory or conflicting information on health, science, and political issues, speculating that such information may have adverse effects on public cognitions, affect, and behaviors. However, the evidence base for the effects of contradictory messages remains thin. Using nutrition as a case example, this study builds upon this nascent literature by employing a three-wave panel dataset from a survey with a nationally representative sample of American adults. We found that exposure to contradictory nutrition messages from television increases nutrition confusion, whereas exposure from print media decreases confusion. Moreover, nutrition confusion was positively associated with nutrition backlash, and nutrition backlash decreased engagement in fruit and vegetable consumption. Implications for campaigns and other communication interventions are discussed.

Adverse outcomes associated with media exposure to contradictory nutrition messages

There is increasing concern that the media present conflicting health information on topics including cancer screening and nutrition. Although scholars have speculated that exposure to this information leads to increased public confusion, less trust in health recommendations, and less engagement in health behaviors, there is a lack of empirical research that directly addresses the role of media exposure to conflicting information. Using data from the Annenberg National Health Communication Survey, this study finds that exposure to conflicting information on the health benefits and risks of, for example, wine, fish, and coffee consumption is associated with confusion about what foods are best to eat and the belief that nutrition scientists keep changing their minds. There is evidence that these beliefs, in turn, may lead people to doubt nutrition and health recommendations more generally-including those that are not rife with contradictory information (e.g., fruit/vegetable consumption, exercise). The implications of these findings for healthy eating campaigns and interventions are discussed.

Measuring Media Exposure to Contradictory Health Information: A Comparative Analysis of Four Potential Measures

There is increasing concern that the news media present conflicting health information on topics including cancer screening and nutrition, yet little is known about whether people notice such content. This study proposes four potential measures of media exposure to contradictory health information, using nutrition as an example (Measures I-IV). The measures varied on two dimensions: (1) content specificity, or whether specific nutrition topics and health consequences were mentioned in the question scripting, and (2) obtrusiveness, or whether "contradictory or conflicting information" was mentioned. Using data from the Annenberg National Health Communication Survey (ANHCS), we evaluated the performance of each measure against a set of validity criteria including nomological, convergent, and face validity. Overall, measure IV, which was moderately content-specific and obtrusive, performed consistently well and may prove most useful to researchers studying media effects of contradictory health information. Future directions and applications are discussed.

A comprehensive analysis of breast cancer news coverage in leading media outlets focusing on environmental risks and prevention

Breast cancer has a high profile in the news media, which are a major source of information for cancer patients and the general public. To determine the nature of breast cancer news coverage available to audiences, particularly on the topics of environmental risks and prevention, this content analysis measured a broad array of dimensions in 231 stories appearing in nine leading newspapers, newsmagazines, and television networks in 2003 and 2004. One fourth of all stories reported on various risks such as hormone replacement therapy (HRT) use. Very few items specifically addressed risks related to controllable lifestyle practices such as prepubertal obesity or chemical contaminants in the environment. About one third of the stories included prevention content, primarily focusing narrowly on use of pharmaceutical products. Little information described risk reduction via other individual preventive behaviors (e.g., diet, exercise, and smoking), parental protective measures, or collective actions to combat contamination sites. The more traditional categories of prevalence, detection, and treatment were featured in one third, one quarter, and two fifths of the news items, respectively. There were twice as many stories featuring personal narratives as statistical figures, and two thirds of all the news items cited expert medical professionals, researchers, or organizations. Implications of these findings and directions for future research are addressed.

Coverage and quality of oral cancer information in selected popular press: May 1998 to July 2003

OBJECTIVES

A 1998 study demonstrated a lack of coverage about oral cancer in the popular press between April 1987 and April 1997. Since that study, several oral cancer-related activities took place, many of which could have increased the media's attention to oral cancer. Therefore, this study analyzed coverage and quality of oral cancer information in selected popular press between May 1998 and July 2003.

METHODS

Articles from magazines and newspapers were retrieved from three databases and were analyzed by specific topics and subtopics for adequacy of content and accuracy of information. Articles were categorized as either "primarily oral cancer-related" or "primarily tobacco-related."

RESULTS

Sixty articles were identified, 39 of which were included in the analysis (14 magazines; 25 newspapers). Seventeen articles were "primarily oral cancer-related," and 22 were "primarily tobacco-related." Seventy-two percent of the articles mentioned at least one risk factor for oral cancer, the most common being tobacco use (69%). Far fewer articles noted alcohol (10%) or the combined use of tobacco and alcohol (5%) as risk factors. Only 8 percent of the articles recommended an oral cancer examination.

CONCLUSION

Despite local and limited national efforts and activities aimed at increasing public awareness of oral cancer, the popular press coverage of those activities was minimal or nonexistent.

Reporting medical information: effects of press releases and newsworthiness on medical journal articles' visibility in the news media

BACKGROUND

Characteristics defining newsworthiness of journal articles appearing in JAMA and NEJM were examined to determine if they affect visibility in the news media. It was also hypothesized that press releases affected the amount of news coverage of a journal article due to the fact that the most newsworthy journal articles are selected for press releases.

METHODS

Journal articles (N = 95) were coded for characteristics believed to describe the "newsworthiness" of journal articles. Quantity of news coverage of the journal articles was estimated using the LEXIS-NEXIS database. Bivariate associations were examined using one-way analysis of variance, and multivariate analyses utilized OLS regression.

RESULTS

Characteristics of the newsworthiness of medical journal articles predicted their visibility in newspapers. The issuing of press releases also predicted newspaper coverage. However, press releases predicted newspaper coverage largely because more newsworthy journal articles had accompanying press releases rather than because the press release itself was influential.

CONCLUSIONS

Journalists report on medical information that is topical, stratifies risk based on demographic and lifestyle variables, and has lifestyle rather than medical implications. Medical journals issue press releases for articles that possess the characteristics journalists are looking for, thereby further highlighting their importance.

Science writers' reactions to a medical "breakthrough" story

In numerous incidences, the news coverage of medical research has incited unjustified optimism or fear. The medical literature provides an archive of the scientific community's condemnation of these misleading reports, but little is known about how they are judged by newsmakers. This study explored science writers' reactions to a controversial New York Times story that inflated the hopes of thousands of cancer patients. More than 60 science writers in the US, Canada, and Great Britain participated in a 12-day email discussion triggered by the Times article. We analyzed 255 of these email postings and coded (1) positive and negative critiques of the Times story, (2) references to the article's repercussions including the creation of false hope, (3) attributions of responsibility for the resulting public misunderstanding, and (4) suggestions to improve the public's comprehension of medical research news. The participating science writers generally responded negatively to the controversial article: 83% of the critiques were unfavorable. In addition, the science writers in the sample were cognizant and concerned about the impact of their work on the public, and accepted the largest share of the responsibility for the false hope created by the news coverage of medical research. Finally, the suggestions offered by respondents to improve the public's understanding of medical research news were similar to those proposed by the scientific community. Thus, some commonality exists between how scientists and science writers believe the news coverage of medical research could be improved.

Media coverage of women's health issues: is there a bias in the reporting of an association between hormone replacement therapy and breast cancer?

Media coverage of scientific research plays a major role in shaping public opinion and influencing medical practice. When an association is controversial, such as with hormone replacement therapy (HRT) and breast cancer, it is important that a balanced picture of the scientific literature be reported. The objective of this study was to assess whether scientific publications that do and do not support an HRT/breast cancer association were cited in the media in proportions similar to those with which they appear in the scientific literature. Scientific publications reporting on the HRT/breast cancer association published from January 1, 1995, to June 30, 2000, were identified through a systematic Medline search. Media reports from newspapers, magazines, television, and radio that reported on HRT and breast cancer were retrieved from an online database. Investigators independently recorded characteristics of the scientific publications and media reports. A total of 32 scientific publications were identified: 20 (62.5%) concluded there was an increased risk of breast cancer associated with HRT (positive publications), and 12 (37.5%) concluded there was no evidence for an association (null publications). Nearly half (47%) of the scientific publications were not cited by the media. There were 203 media citations of scientific publications: 82% were of positive publications and 18% were of null publications, representing a significant excess of citations of positive publications (p < 0.01). Media coverage of this controversial issue is based on a limited sample of the scientific publications. Moreover, the excess of media citations for positive scientific publications suggests a bias against null scientific publications.

Coverage of beverage alcohol issues in the print media in the United States, 1985-1991

OBJECTIVES

This study assessed the portrayal of alcohol-related issues in the print media in the United States during the 7-year period bracketing implementation of the US alcohol warning label act in November 1988.

METHODS

All articles that appeared from 1985 to 1991 in 5 national newspapers and that were indexed as dealing with beverage alcohol were identified. Content analysis of a 15% sample of these articles allowed an in-depth assessment of the conceptualization of alcohol in the US print media.

RESULTS

A slight decrease in articles related to alcoholism was offset by an increase in articles about the more general health-related effects of alcohol. The warning label act received little attention. Most articles portrayed alcohol neutrally or negatively, using information from government sources.

CONCLUSIONS

Portrayal of alcohol in the US print media has changed in recent decades. A general shift noted as early as the 1960s has increasingly emphasized public health issues and deemphasized clinical aspects of alcoholism. This has been accompanied by a continuing shift away from a biopsychological definition of alcohol-related behavior to a definition stressing external environmental factors.

[Health and social aspects in the investigation of cancer clusters]

This paper analyzes the main problems in the research on cancer clusters, with a specific emphasis on the population perception and risk communication. Population information needs and the approach to give information to the population regarding environmental risks are reviewed, as well as the relationship with mass media. Finally, the implications of risk perception for epidemiologic research on clusters and for public health are discussed.