Changes in newspaper coverage of cardiovascular health issues in conjunction with a community-based intervention

Numerous community-based prevention projects, with significant media components, have been conducted over the past decade. Multiple evaluation strategies have been used to document the effectiveness of these interventions, including intermediate measures of community impact such as assessment of media coverage. As part of the evaluation of a community-based intervention (the Bootheel Heart Health Project), dissemination of information on cardiovascular disease (CVD) was measured through a media content analysis of newspapers. Data were analyzed from 23 newspapers in six rural counties in southeastern Missouri for the period October 1988 through August 1993. An increase was observed in CVD-related coverage in the pre-intervention period (mean articles per month = 31.5) compared with the post-intervention period (mean articles per month = 50.7) (F = 10.2; P = 0.003). In supporting data from a separate randomized risk factor survey of 1510 residents in the same area, respondents reported hearing of heart health coalitions primarily through local newspapers. The current study documents increasing print media coverage of cardiovascular health issues in a high-risk, rural area and shows that media content analysis can be a useful evaluation tool in community-based interventions.     

Involving people with learning disabilities in research: issues and possibilities

Advances in the social position of people with learning disabilities have led to a situation where research and evaluation studies are increasingly required to include the views and opinions of people with learning disabilities. One key outcome of this shift is that some of the major funding bodies now insist on the inclusion of people with learning disabilities as a condition of research funding. This has produced new possibilities and new challenges for researchers, and it has real consequences for people working in health and social care. The present paper sets out to explore some of the developments and challenges in research with people with learning disabilities. The author provides a selective overview of developments with the aim of demonstrating the richness, ingenuity and potential of research involving people with learning disabilities. The paper is divided into three broad sections that focus on: (1) the ethics and philosophy of participatory research; (2) the methodologies employed at particular points in the research process that are designed to ensure the involvement of participants in research; and (3) building capacity in participatory research as a precondition to the further development of this approach. An investment in capacity would enable this approach to move into the mainstream of research activity involving people with learning disabilities.     

Sampling and ethical issues in a multicenter study on health of people with intellectual disabilities

ObjectivesTo study health inequalities in persons with intellectual disabilities, representative and unbiased samples are needed. Little is known about sample recruitment in this vulnerable group. This study aimed to determine differences in ethical procedures and sample recruitment in a multicenter research on health of persons with intellectual disabilities. Study questions regarded the practical sampling procedure, how ethical consent was obtained in each country, and which person gave informed consent for each study participant.Study Design and SettingExploratory, as part of a multicenter study, in 14 European countries. After developing identical guidelines for all countries, partners collected data on health indicators by orally interviewing 1,269 persons with intellectual disabilities. Subsequently, semistructured interviews were carried out with partners and researchers.ResultsIdentification of sufficient study participants proved feasible. Sampling frames differed from nationally estimated proportions of persons with intellectual disabilities living with families or in residential settings. Sometimes, people with intellectual disabilities were hard to trace. Consent procedures and legal representation varied broadly. Nonresponse data proved unavailable.ConclusionTo build representative unbiased samples of vulnerable groups with limited academic capacities, international consensus on respectful consent procedures and tailored patient information is necessary.     

HIV issues and people with disabilities: A review and agenda for research

The recent AIDS and Disability Partners Forum at the UN General Assembly High Level Meetings on AIDS in New York in June 2011 and the International AIDS Conference in Washington, DC in July 2012 underscores the growing attention to the impact of HIV and AIDS on persons with disabilities. However, research on AIDS and disability, particularly a solid evidence base upon which to build policy and programming remains thin, scattered and difficult to access. In this review paper, we summarise what is currently known about the intersection between HIV and AIDS and disability, paying particular attention to the small but emerging body of epidemiology data on the prevalence of HIV for people with disabilities, as well as the increasing understanding of HIV risk factors for people with disabilities. We find that the number of papers in the peer-reviewed literature remains distressingly small. Over the past 20 years an average of 5 articles on some aspect of disability and HIV and AIDS were published annually in the peer-reviewed literature from 1990 to 2000, increasing slightly to an average of 6 per year from 2000 to 2010. Given the vast amount of research around HIV and AIDS and the thousands of articles on the subject published in the peer-reviewed literature annually, the continuing lack of attention to HIV and AIDS among this at risk population, now estimated to make up 15% of the world's population, is striking. However, the statistics, while too limited at this point to make definitive conclusions, increasingly suggest at least an equal HIV prevalence rate for people with disabilities as for their non-disabled peers.     

Still a burning issue: trends in the volume,content and population reach of newspaper coverage about tobacco issues

Tobacco control advocates expend considerable effort in generating news stories on tobacco issues to assist progress in tobacco control, and the news coverage itself may have important policy and behavioral influences. Yet, studies of trends in such news coverage are uncommon. Between 2001 and 2006, we conducted a content analysis of tobacco-related newspaper articles in the 12 major daily Australian newspapers and coded them for type of article, topic, and tone. Overall, 6483 tobacco-focused articles were published, representing an average of one article every 4 days for each newspaper. There was variability in volume between years but no decline over time. Overall, 67% of articles reported on events that represented progress for tobacco control, 21% on setbacks, and 7% on events that were of mixed impact. Newspaper coverage of tobacco issues was dominated by articles on smoke-free issues (32% of articles), health effects of smoking (12%), education, prevention and cessation programs and services (12%), and the tobacco industry (9%). During the 6-year period, on average, Australian adults were potentially exposed to around one article on tobacco issues every week, or using a more stringent prominence-adjusted measure, one article every 2 to 3 weeks, a level comparable to paid media campaigns in some jurisdictions. Temporal variation in population exposure to news coverage about tobacco issues may reflect variability in newsworthiness of tobacco control issues, media advocacy resources and success, and/or preparedness of editors and journalists to entertain news stories on tobacco.     

Nationwide newspaper coverage of physician-assisted suicide: a community structure approach

Using a community structure approach linking city characteristics and variations in media coverage, the authors examined newspaper coverage of physician-assisted suicide. A nationwide sample of 15 city newspapers yielded 288 articles in a four year period. Content analysis of article "prominence" (placement, headline size, story length, presence of photos) and overall article direction (favorable, unfavorable, or balanced/neutral) yielded a combined and widely varied single score "Media Vector" or measure of issue "projection" for each newspaper. Correlation and factor analysis yielded two significant city characteristic factors: a "stakeholder" factor, age (percent over 75) associated with unfavorable coverage of physician-assisted suicide (r = -.491; p = 000); and an "access" factor--combining media access (newspaper circulation, cable stations, FM or AM stations) and health care access (health care facilities, physicians)--linked to favorable coverage (r = .472; p = .000), combining to account for 46.3 percent of the variance. Western US newspapers and public opinion are most favorable to physician-assisted suicide.     

Inequalities in access to health care for people with disabilities in Chile: the limits of universal health coverage

We analysed cross-sectional data collected as part of the National Socioeconomic Characterisation Survey (2013) in Chile, in order to explore if there are differences in access to health care between adult Chileans with and without disability. The study included 7459 Chilean adults with disability and 68,695 people without disability. Logistic regressions were performed in order to determine the adjusted odds ratios for the associated variables. We found that despite universal health coverage, Chileans with disabilities are more likely to report worse access to health care, even when controlling for socio-economic and demographic variables, including age, gender and income. Specifically, they are more likely to face greater difficulty arriving at a health facility, obtaining a doctor’s appointment, being attended to in a health facility, paying for treatment due to cost, and obtaining necessary medicine. Both people with and without disability are more likely to face difficulties in accessing health services if they are affiliated with the public health provider, an indication of the economic factors at play in accessing health care. This study shows that universal health coverage does not always lead to accessibility of health services and underlines the disadvantaged position of disabled people in Chile in accessing health services. While efforts have been made recently to improve equity in health care access, disability in Chile poses an additional burden on people’s access to health care, emphasising the necessity for policy to address this perpetual cycle of disadvantage for disabled people.     

Securitising health: Australian newspaper coverage of pandemic influenza

This paper analyses contemporary Australian newspaper coverage of the threat of pandemic influenza in humans, specifically in the light of recent transformations in biomedical and public health understandings of infectious disease as continuously emerging. Our analysis suggests that the spectre of pandemic influenza is characterised, in newspaper accounts, as invoking a specific form of nation building. The Australian nation is depicted as successfully securing itself in the face of a threat from Asia (and in the absence of an effective international health body). What is described in newspaper accounts reflects a shift in the public health response to infectious disease. This response does not entail a direct focus on protecting either the population or national territory. Instead, it involves the continuous rehearsal of readiness to react to disasters through the networking of government and private agencies responsible for maintaining critical infrastructure. In this way, coverage of pandemic influenza positions health as central to national security, with little reporting of the reasons for or the potential implications of this alliance. Thus, the imperative to 'be prepared' is presented as self-evident.     

Organizations in community living: Supporting people with disabilities

This article highlights the common characteristics of organizations that promote community integration, compares these organizations on several structural dimensions, discusses emerging practices in community living and argues against the use of the model replication framework underlying many current research, training, dissemination and change strategies in the disability field. Based on an analysis of research field data collected from 31 human service organizations in 21 states, this article contributes to the growing body of literature on alternative approaches to helping people with severe disabilities^2–5 live in their own homes^6–8.     

Deconstructing media coverage of trastuzumab (Herceptin): an analysis of national newspaper coverage

OBJECTIVE: To explore and critically describe the content and main narratives of UK national daily newspaper coverage of trastuzumab (Herceptin). DESIGN: We used the NewsBank database to search eight national daily newspapers, and their Sunday equivalents, retrospectively from 19 February 2006 back to the earliest mention of trastuzumab or Herceptin (19 May 1998). Setting UK national newspapers. MAIN OUTCOME MEASURES: To be eligible for inclusion, articles had to contain at least three sentences about trastuzumab. Articles that focused on the financial performance of companies associated with the drug were excluded from the analysis. For each included article, we extracted bibliographic details and data, and independently rated the reporting slant towards trastuzumab and, where relevant, the reporting slant towards access to treatment. RESULTS: We identified 361 articles that met the study inclusion criteria. The proprietary name of Herceptin was always used, with only eight articles mentioning the generic alternative. 294/361 included articles (81.5%) were rated as being positive towards trastuzumab, the remainder rated as neutral. Access to trastuzumab treatment was the main narrative running across included articles and reports of individual patients seeking treatment featured prominently throughout. In 208/361 of included articles (57%) the reporting slant towards access to trastuzumab treatment was rated as negative. 178/361 of included articles (49.3%) mentioned licensing, but rarely mentioned that licensing processes can only occur when the manufacturer applies for a licence. Only a minority of articles mentioned that the drug had to be licensed before it could be subject to the NICE approval process. CONCLUSIONS: Newspaper coverage of trastuzumab has been characterized by uncritical reporting. Journalists (and consumers) should be more questioning when confronted with information about new drugs and of the motives of those who seek to set the news agenda.     

Long-term care for people with developmental disabilities: a critical analysis

This article explores how the trends toward long-term community care affecting people with developmental disabilities developed. Appropriateness of care and quality of life issues are discussed. The article also reviews the development of long-term care for frail and disabled elderly people and explores the arguments for a continuum of care that have developed in this area. The authors conclude that future policies with respect to meeting long-term care needs for people with developmental disabilities must be addressed flexibly on an individual basis, related to individual needs, and must provide a continuum of care services.     

Age analysis of newspaper coverage of mental illness

In this study, we examine newspaper coverage of mental illness in children and adults taken from 6 weeks during a 1-year period. Articles were coded for (1) type of article; (2) types of disorders named or described; (3) themes related to crime, attributions of the disorder, treatments, and critiques of the mental health system; and (4) "elements of responsible journalism," including inclusion of perspectives from mental health experts, statistics related to mental illness, referrals to additional sources of information, and avoidance of slang terminology. We examine how these variables differ by the age of the group discussed in the article: children/adolescents and adults/older adults. One thousand two hundred fifty-two articles were coded for these four clusters as well as age of group discussed in the article. Inter-rater correlations of two independent judges were satisfactory for 10% of the stories. Age group comparisons revealed that the child articles contained a significantly higher proportion of feature articles; were significantly more likely to discuss behavior and conduct disorders, and alcohol and drug abuse, attention deficit hyperactivity disorder (ADHD), anxiety disorders, and eating disorders, and to contain themes of causation, treatment, and critiques of the mental health system. The adult articles contained a significantly higher proportion of episodic news stories and were significantly more likely to present themes of dangerousness and crime. Our analysis found that child articles were significantly more likely to incorporate elements of responsible journalism, while adult articles were significantly more likely to use stigmatizing terminology. Our report encourages journalists to develop contextually comprehensive and informative presentations of mental illness and issues surrounding the mental health system for all population groups in order to provide readers with accurate information within the context of general social trends and relevant expert opinion.     

Researching needs: young people with physical disabilities

In many places services for the younger physically disabled are unsatisfactory. Often the first need is to discover what services are actually available, what young disabled people and their carers know about them and what use they make of them. Hilary Priestman and Alan Crawshaw describe such an exercise in North Humberside.     

Community use of a hospital pool by people with disabilities

BackgroundIndividuals with disabling conditions are one of the most physically inactive groups within society. Hospital hydrotherapy pools are a potential resource for people with disability living in the community to access aquatic physical activity.ObjectivesThe aim of this qualitative study was to discover why community dwelling individuals with disability choose a hospital pool over other public pools in the area.MethodsThe study site was a hospital pool in New Zealand. Semi-structured interviews were held with 38 individuals from 17 community user groups to determine reasons for choosing the hospital pool. Interviews were audio-taped, transcribed and analyzed inductively for themes.ResultsThe hospital hydrotherapy pool was perceived to be an invaluable facility, providing opportunity for people with disability to be physically active in a way that is pain free, enjoyable and beneficial for mind and body. In contrast public pool facilities within the metropolitan region are experienced and/or perceived as being inaccessible for people with disabilities due to physical, social and emotional barriers.ConclusionsThis hospital pool provides a highly appreciated but oversubscribed resource for the people with disability in the local environs. If pools in the public domain were able to offer warmer water in a user-friendly environment, then this would promote health and well being to individuals with disabling conditions.     

Access to health care for people with learning disabilities in the UK: mapping the issues and reviewing the evidence

OBJECTIVES: People with learning disabilities are more prone to a wide range of additional physical and mental health problems than the general population. Our aim was to map the issues and review the evidence on access to health care for these patients. The review sought to identify theory, evidence and gaps in knowledge relating to the help-seeking behaviour of people with learning disabilities and their carers, barriers and problems they experience accessing the full range of health services, and practical and effective interventions aiming to improve access to health care. METHODS: A three-strand approach was adopted, involving searches of electronic databases, a consultation exercise and a mail shot to researchers and learning disability health professionals. Evidence relevant to our model of 'access' was evaluated for scientific rigour and selected papers synthesized. RESULTS: Overall, a lack of rigorous research in this area was noted and significant gaps in the evidence base were apparent. Evidence was identified on the difficulties in identifying health needs among people with learning disabilities and the potentially empowering or obstructive influence of third parties on access to health care. Barriers to access identified within health services included problems with communication, inadequate facilities, rigid procedures and lack of appropriate interpersonal skills among mainstream health care professionals in caring for these patients. A number of innovations designed to improve access were identified, including a communication aid, a prompt card to support general practitioners, health check programmes and walk-in clinics. CONCLUSION: There are important gaps in the knowledge base on access to health care for this group. While these need to be addressed, developing strategies to overcome identified barriers should be a priority, along with fuller evaluation of existing innovations.