Stroke Information Reported on Local Television News
A National Perspective
Background and Purpose— Local television news commonly reports on health. This study aimed to characterize local TV news stroke reporting in America.
Methods— Content analysis of stroke stories reported on 122 US local television stations. All stroke stories were coded for main focus and discussion of risk factors, stroke signs and symptoms, recombinant tissue plasminogen activator, treatment within 3 hours, or recommendation to call 911.
Results— Of the 1799 health stories, only 13 stroke stories aired, and the median story length was 24 seconds (interquartile range 21 to 48). Stroke was the 22nd most common health topic. Few stroke stories discussed useful information about prevention or treatment of stroke.
Conclusion— Stroke stories were nearly nonexistent in our sample, and those reported failed to discuss important messages needed to improve stroke prevention and treatment.
Most Americans do not know the signs, symptoms, or risk factors for stroke.1 Improving stroke-related knowledge may advance stroke prevention and treatment and has been declared a health priority.2–4 Local television news is the No. 1 source of information in America,5 and news media health reporting may be an opportunity to disseminate important public health information. This study examined the quantity of stroke stories reported on local television news stations throughout the United States and assessed whether useful information about stroke was conveyed.
This study evaluated the late evening (typically 11 pm), 30-minute local television news broadcasts; 122 stations were randomly sampled from the top 200 local television stations within the top 50 media markets (covering 67% of the US population)6 during October 2002. A media market is an exclusive geographic area of counties in which the home market television stations hold a dominance of total hours viewed. Detailed methods of broadcast-capture and health story identification are detailed previously.7
All health stories were coded into one of the International Classification of Disease (ICD-9) main subject headings by 2 independent health professionals (HPs). All HP coders were blinded to the main outcome of this study to avoid introducing bias from the inclusion or exclusion of stroke stories.
All health stories coded under the ICD-9 category of “circulatory disorders” were independently viewed by 2 HPs to extract all ischemic stroke stories. Agreement between these 2 HPs was 100%.
All stroke stories were re-viewed independently by 2 HPs to assess whether the main message of the stroke story was about prevention, treatment, diagnosis, or epidemiology. They also coded whether any of the stroke stories discussed stroke risk factors, symptoms and signs, recombinant tissue plasminogen activator (rt-PA), the need for treatment to be within 3 hours of symptoms onset, or gave recommendations to call 911. Coding agreement between the 2 HPs was 100%.
Of the 1799 health stories identified, there were only 9 unique stroke stories airing a total of 13 times during our study, comprising 0.7% (95% CI, 0.4% to 1%) of all health stories reported. Despite stroke being a major public health problem, stroke was the 22nd most common health topic reported on local television news (Table). Six of the 13 stroke stories were about epidemiology, with 3 focused on treatment and 4 focused on prevention. The median stroke story length was 24 seconds (interquartile range 21 to 48).
Of the 3 stroke stories that mentioned symptoms, only 1 listed all the common symptoms of acute stroke. Two stories discussed risk factors. Stroke treatment of any type was discussed in 4 stories. However, only 1 discussed rt-PA, whereas 2 others discussed antioxidants, and 1 discussed Citocoline treatment of stroke. Despite the antioxidant story being based on an animal study, the local television stations reported that it decreases brain damage by 40% when injected into the brain within 7 hours after a stroke. Moreover, the stations reported that if Citocoline was taken within 14 hours of symptom onset, patients are more likely to fully recover from stroke. Of all the stroke stories reported, only 2 stories recommended that stroke patients present to the hospital within 3 hours of symptom onset, and none recommended calling 911.
Despite stroke being the third leading cause of death and the No. 1 cause of adult disability in the United States,8 remarkably few health stories were reported about stroke. In fact, only 13 (<1% of all health stories) covered stroke.
Television is the most frequently cited source for stroke information for the public.9 Our study demonstrated that very few stroke stories discussed risk factors, warning signs and symptoms, and approved treatment options, and none recommended that the public call 911 for acute stroke treatment. Moreover, experimental treatment of stroke was discussed 3× more often than approved treatment for stroke with rt-PA. The news media may prefer to report on new drugs and treatments, but this information would be most useful if put into context of currently available and approved drugs and treatments. Because the news media plays a significant role in the health literacy of the public,10 messages need to improve stroke awareness and should not confound the issue. Not conveying useful stroke information through local television news is a missed opportunity to disseminate important stroke information to the public. Researchers should use the media both to share research and improve public health.
The main limitation of this study is selection bias. Major news events such as natural disasters, outbreaks of emerging infections, or health awareness months could affect our findings. However, despite the Washington, DC, sniper happening during our study, many health stories were reported. It is unclear whether the quantity of stroke reporting may differ in various times of the year such as stroke awareness month (May) or immediately after the annual International Stroke Conference (February). A larger sampling duration, such as over a year, would help account for variability in reporting associated with month-dependent events. However, this limitation should not affect how stroke information was reported. Another limitation is that the study included only late local news; broadcasts aired during other parts of the day may differ. However, the late local news broadcasts are typically the highest-rated newscasts, reaching the greatest number of viewers.
These results are disappointing and alarming. Future studies need to assess the longitudinal exposure of the public to stroke messages reported on local television news, the usefulness of stroke messages to the public, and methods to facilitate conveying these stroke messages through the television news media so that public health messages can be disseminated along with stroke research to improve the prevention and treatment of stroke.
- Received March 14, 2006.
- Accepted March 29, 2006.
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