Jo Ellen Stryker

The HPV vaccine: a content analysis of online news stories.

PURPOSE Approximately 73 million adults in the United States report using the Internet as a source for health information. This study examines the quality, content, and scope of human papillomavirus (HPV) vaccine Internet news coverage starting on the day of its licensure. Information about the HPV vaccine in the media may influence personal attitudes and vaccine uptake. METHODS Using four search engines and six search terms, a sample of 250 Internet articles on the HPV vaccine were identified between June 8, 2006, and September 26, 2006. The coding instrument captured how the headline was depicted and how the vaccine was labeled in addition to information about HPV, cervical cancer, the HPV vaccine, and current social issues and concerns about the vaccine. RESULTS Analysis revealed balanced Internet news coverage; 52.4% of Internet news stories were coded as neutral toward the vaccine. Eighty-eight percent of articles labeled the vaccine as a cervical cancer vaccine; 73.5% explained the link between HPV and cervical cancer, although without providing background information on HPV or cervical cancer. Vaccine affordability was the most cited social concern (49.2%). Information about vaccine safety and side effects, duration of vaccine protection, and availability of the catchup vaccine for females aged 13-26 was repeatedly missing. CONCLUSIONS The HPV vaccine is being marketed as a vaccine to prevent cervical cancer. Comprehensive information on the vaccine, HPV, and cervical cancer continues to be missing from media coverage. Public health educators should monitor online media in an effort to respond to inaccurate information. Barriers to vaccine cost and funding mechanisms need to be addressed more effectively by states. Knowledge of particular media messages could provide a starting point for tackling opposition and uptake issues for future sexually transmitted infection (STI) vaccines.

News media coverage of human papillomavirus.

Now that human papillomavirus (HPV) DNA testing is being incorporated into cervical cancer screening programs, salient and accurate media information about HPV will be crucial to inform womens screening choices and to manage psychosocial responses to HPV DNA test results.

Social Influences, Social Context, and Health Behaviors Among Working-Class, Multi-Ethnic Adults

Little research has explored the relationship between social influences (e.g., social networks, social support, social norms) and health as related to modifying factors that may contribute to health disparities. This is a cross-sectional analysis of fruit and vegetable intake and physical activity, using baseline data from two cancer prevention studies with working-class, multi-ethnic adults. Several social influence and social contextual variables were associated with fruit and vegetable intake and physical activity in both samples. Fruit and vegetable consumption was associated with social norms and social networks, although different contextual variables also were related to intake across the two samples. Physical activity was associated with social networks, social norms, and competing demands. By examining how key social influence and contextual mediating variables relate to health behaviors, we can learn more about the types of interventions that might be needed to promote sustained health behavior change in this population.

Effects of newspaper coverage on public knowledge about modifiable cancer risks.

This study explores the relationship between cancer newspaper coverage and public knowledge about cancer prevention, confirming self-reported associations between news exposure and cancer prevention knowledge with descriptions of newspaper coverage of modifiable cancer risks. Content analyses (N = 954) revealed that newspapers pay relatively little attention to cancer prevention. However, there is greater newspaper attention to tobacco and diet than to exercise, sun, and alcohol. Survey analysis (the National Cancer Institutes Health Information National Trends Survey) revealed that after controlling for differences based on gender, race, age, income, and education, attention to health news was significantly associated with knowledge about cancer risks associated with food and smoking but not for knowledge about exercise, sun, or alcohol. These findings conform to the findings of the content analysis data and provide a validation of a self-reported measure of media exposure, as well as evidence suggesting a threshold below which news coverage may not generate public knowledge about cancer prevention.

Validation of Database Search Terms for Content Analysis: The Case of Cancer News Coverage:

While databases are increasingly used for content analyses in mass communication and journalism research, concerns about sampling error have been largely ignored. We introduce a method to measure the quality of a search phrase according to two criteria: recall (its ability to accurately call up items of interest) and precision (ability to avoid extraneous ones). We present a detailed description of the evaluation procedure, offer an example of its use assessing an online search for news reports about cancer, and discuss limitations of the procedure and further potential uses.

Making Sense of Cancer News Coverage Trends: A Comparison of Three Comprehensive Content Analyses

Cancer stories (N = 5,327) in the top 50 U.S. newspapers were analyzed by a team of four coders and the results were compared with the earliest analyses of this type (from 1977 and 1980). Using cancer incidence rates as a comparison, three cancers were found to be consistently underreported (male reproductive, lymphatic/Hodgkins, and thyroid) and four cancers were found to be consistently overreported (breast, blood/Leukemia, pancreatic, and bone/muscle). In addition, cancer news coverage consistently has focused on treatment rather than on other aspects of the cancer continuum (e.g., prevention), portrayed lifestyle choices (e.g., diet, smoking) as the most common cancer risk factor, and rarely reported incidence or mortality data. Finally, the data were compatible with the idea that personalization bias (e.g., celebrity profiles, event coverage) may explain some news coverage distortions.

An exploratory study of factors influencing glaucoma treatment adherence.

PurposeTo understand the factors that influence glaucoma treatment adherence with medication taking, prescription refills, and appointment keeping to develop an intervention for a specific population. Patients and MethodsIn-depth interviews were conducted with 80 individuals diagnosed with open-angle glaucoma, glaucoma suspect, or ocular hypertension. Additional eligibility requirements were that all participants were: between the ages of 18 to 80; white or African American; spoke and understood English; and were taking daily doses of topical glaucoma treatments for at least the past year. Cross-tabulations and χ2 tests were conducted to compare adherent and nonadherent individuals, classified as such based on self-report and medical chart/pharmacy data. ResultsCompared with adherent participants, nonadherent participants were less likely to: believe their eye doctors spent sufficient time with them; ask their eye doctor if they had any questions; know of benefits to taking their glaucoma medication regularly; and have someone help them take their glaucoma medications or drive them to eye appointments. Conversely, compared with adherent individuals, nonadherent participants were more likely to have difficulty remembering to take their medications and to believe their glaucoma would affect their eye sight in the future. ConclusionsNonadherent glaucoma patients struggle with a variety of issues related to consistent use of glaucoma medicine and routine eye care. Interventions are needed to address these modifiable factors related to glaucoma treatment adherence.

Measuring Nonsolar Tanning Behavior : Indoor and Sunless Tanning

OBJECTIVE To develop items to measure indoor tanning and sunless tanning that can be used to monitor trends in population surveys or to assess changes in behavior in intervention studies. DESIGN A group of experts on indoor tanning convened in December 2005, as part of a national workshop to review the state of the evidence, define measurement issues, and develop items for ever tanned indoors, lifetime frequency, and past-year frequency for both indoor tanning and sunless tanning. Each item was subsequently assessed via in-person interviews for clarity, specificity, recall, and appropriateness of wording. SETTING Universities in Tennessee and Virginia, a medical center in Massachusetts, and a high school in New Hampshire. PARTICIPANTS The study population comprised 24 adults and 7 adolescents. RESULTS Participants understood indoor tanning to represent tanning from beds, booths, and lamps that emit artificial UV radiation, rather than sunless tanning, even though both can be obtained from a booth. Two items were required to distinguish manually applied from booth-applied sunless tanning products. Frequency of use was easier for participants to recall in the past year than for a lifetime. CONCLUSIONS While indoor tanning items may be recommended with confidence for clarity, sunless tanning items require additional testing. Memory aids may be necessary to facilitate recall of lifetime use of nonsolar tanning. In addition, studies that assess reliability and validity of these measures are needed. Since study participants were primarily young and female, testing in other populations should also be considered.

PrEP Awareness and Attitudes in a National Survey of Primary Care Clinicians in the United States, 2009-2015.

Objectives As trials were assessing the safety and efficacy of daily oral antiretroviral preexposure prophylaxis (PrEP) for the prevention of HIV infection, there was a clear need to understand the evolution of knowledge of, and attitudes toward, PrEP among primary care clinicians. Methods Physicians and nurse practitioners were surveyed in 2009 (n = 1500), 2010 (n = 1504), 2012 (n = 1503), 2013 (n = 1507), 2014 (n = 1508) and 2015 (n = 1501) to assess their awareness of PrEP, willingness to prescribe PrEP, and whether they support use of public funds to pay for PrEP. Pharmacists (n = 251) were surveyed about PrEP in 2012 only. Descriptive statistics were computed for physician demographics and PrEP-related questions. Prevalence ratios for willingness to prescribe PrEP were computed using Poisson regression analysis. Results Awareness of PrEP was low among clinicians (2009: 24%, 2010: 29%) but increased after trials reported effectiveness (2012: 49%, 2013: 51%, 2014: 61%, 2015: 66%). Following a description of PrEP with an estimated effectiveness of 75%, across 6 of the study years 91% of clinicians indicated a willingness to prescribe PrEP to at least one group at high risk of HIV acquisition. A smaller majority of clinicians indicated support for public funding of PrEP in 2009: 59%, 2010: 53%, and 2013: 63%. Conclusions In surveys conducted before and after the release of PrEP trial results, primary care clinicians were largely unaware of PrEP. They indicated high levels of willingness to prescribe it for patients at high risk of HIV acquisition and expressed interest in education about how to deliver this new clinical HIV prevention method. It will be important to continue monitoring clinician knowledge, attitudes, and practices as the use of PrEP increases in the US.

Measuring Aggregate Media Exposure: A Construct Validity Test of Indicators of the National News Environment

This study seeks to determine a parsimonious set of media indicators to represent the national media news environment at the daily, weekly, and monthly levels. It provides evidence of the convergent validity of these indicators using cancer and drunk driving news coverage for 1981–2006, and of criterion validity using cancer news coverage for 2003–2006. Validated search terms were used to retrieve stories about cancer and drunk driving from the Lexis-Nexis database. Results revealed that, of the indicators selected, the best aggregate measure of the national news environment is a combined measure of Associated Press, Washington Post, and New York Times. Together, these three sources consistently predicted national newspaper, broadcast, and combined news environment at the daily, weekly, and monthly levels. Since the convergent validity test revealed that the relationship between AP, WPOST, and NYT varies across health topics and time, use of a single indicator is not recommended.