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ОглавлениеIntroduction: This Is a Health Communication Book?
Geoffrey Rose advised epidemiologists that “(s)ociety is not merely a collection of individuals but also a collectivity, and the behavior and health of its members are profoundly influenced by its collective characteristics and social norms” (2, p. 62).
Hundreds of health news stories are read and viewed daily across the globe. While individuals may turn to multiple outlets for health information, news remains one of the most important providers of health knowledge. All health news stories use some combination of episodic and thematic framing. Reporters tell stories about an individual’s health problem or provide details about a single event involving health (episodic coverage) and/or discuss a health problem more broadly offering context by focusing on prevalence, societal causes, and treatments including health policy (thematic coverage). These are the frames journalists use in the real world. Understanding how journalists construct these frames, and how these frames influence audience members, is critical for anyone involved in health communication, including health reporters.
Shanto Iyengar introduced thematic and episodic news frames in his 1991 book, Is Anyone Responsible? How Television Frames Political Issues. These news frames provide the audience with critical information about the causes of problems and who or what is responsible for solving problems. This attribution of responsibility influences how individuals think about social problems including health—who or what is causing the problem and who or what is responsible for solving it. ←1 | 2→Attributions of responsibility are critical elements of all social knowledge (Iyengar, 1991). Iyengar found news stories using an episodic frame led audience members to blame problems on the person in the story, while a thematic-framed story did the opposite. Thematic news coverage led audience members to think about problems in a broader context. In turn, audience members would consider societal conditions as problems requiring societal solutions like public health policies.
We began this research project thinking we would analyze all the academic research on thematic and episodic frames in news coverage of social problems for the past 25 years. This time period covered the 25 years since the 1991 publication of Iyengar’s seminal work. After collecting the sample for our study, we realized that seventy percent of the research was on health news. While we had expected to find more studies on thematic and episodic frames in news coverage, we were not surprised that health communication dominated this research area. We adapted and focused our research on thematic and episodic frames in health news.
This book is not an examination of the arguments for how to define framing research, how to operationalize frames, or how to measure frames in terms of the entire field of framing research. While we appreciate the academic conversations taking place in our field, our work focuses on episodic and thematic frames in health news specifically. We provide analyses of research on these frames spanning 25 years. In doing this, we bring to the table our experiences as working journalists and academics who study framing in health news.
Both of us worked as journalists before moving to academia. We understood episodic and thematic framing in practice long before we studied framing effects or media content. We do not expect what we say here to rewrite the framing paradigm but we offer a new perspective for organizing the existing research on these frames in health news followed by a framework for moving forward.
We think our approach will help researchers, journalists, and practitioners make changes beneficial to individuals as well as overall societal health. Our fellow framing scholars’ work is indispensable in our efforts.
In Chapter 2, we provide a brief overview of Iyengar’s (1991) book, Is Anyone Responsible? How Television Frames Political Issues. The academic research on thematic and episodic frames is dominated by studies on health news. In Chapter 3, we discuss three primary reasons for this occurrence. First, framing research has become increasingly popular in communication research (Ardèvol-Abreu, 2015). Because it is a multidisciplinary paradigm, it allows for the holistic study of media and its four elements of the communication process: the sender, the receiver, the message, and culture (Berlo, 1960). The connection among these four elements and thematic and episodic frames is key in terms of their linkage to audiences and attribution of responsibility for health issues and persuasion of public opinion support ←2 | 3→and action. Second, news coverage of health issues has increased dramatically during the past fifty years. Despite significant changes in the media landscape that allow people immediate access to health-related information online, news remains influential in shaping how we think about and discuss health (Walsh-Childers, Braddock, Rabaza & Schwitzer, 2018; Major, 2018). Third, health communication research in academia has developed as an important field over the last thirty-five years. Scholars in this area investigate the roles performed by human and mediated communication in health care delivery, health promotion, and journalism while benefiting from ample funding opportunities not readily available to other areas of communication research. We posit these trends along with Iyengar’s (1991) introduction of thematic and episodic frames as a way to categorize news frames and study their effects accounts for the prevalence of scholarly research on thematic and episodic frames in health news. We discuss this premise in Chapter 3.
We collected and analyzed academic research on thematic and episodic frames in health news published in peer-reviewed journals since 1991. The studies we included in our analysis fall into two categories: ones using thematic and episodic framing definitions in the literature review only, and ones operationalizing thematic and episodic frames for measurement or testing. In Chapter 4, we present the findings in two stages. We cover the results from an analysis of all the studies included in our sample, followed by a separate look at the research articles that tested/measured thematic and episodic frames—actual operationalization. Our findings show which health topics have been investigated, how much research has been conducted on specific health issues, which journals have published this research, when research was conducted, and countries where most of this research has been conducted before moving to more in-depth analysis of how thematic and episodic frames have been studied, both conceptually and operationally.
Using our findings from a content analysis of the research on thematic and episodic frames in health news, in Chapter 5 we introduce the integrated process of framing approach as a way to organize and evaluate existing research on these frames. Also, we use this model to create a framework for developing research in this area. By applying the integrated process of framing to existing research we ascertained the strengths and weaknesses of the current literature on thematic and episodic frames. Finally, we propose several areas that need to be developed.
Using the integrated process model of framing, Chapter 6 examined the 45 studies that operationalized thematic and episodic. Using a qualitative analysis, this chapter discusses the ways these articles tackle the issues of journalists, policy, and recommendations for future studies. Although none of the 45 studies interviewed journalists, many of the studies talk about the roles and responsibilities of journalists as they consider the ways these attributes may or may not influence ←3 | 4→framing. Considering the factors proposed in Chapter 5, this chapter also analyzes the ways current research has used elements of stigma, psychological reactance, emotions, civic behavior, and interaction effects.
Chapters 7 and 8 involve a discussion of the most used health issues in the studies that operationalized thematic and episodic frames: obesity and mental health. In Chapter 7, we examine the studies that involve obesity. In Chapter 8, we found mental illness to be one of the most used health issues in the studies that operationalized thematic and episodic frames. More specifically, several of these studies examined depression. In both chapters, we use the findings of these studies as a primer for our own work on thematic and episodic frames in depression studies. These chapters present the findings of five experiments, three on obesity and two on depression. These experiments examine the ways framing impacts or interacts with civic engagement, emotions, psychological reactance, and stigma.
While we are interested in the effects of episodic and thematic news frames on behavior change to improve individual health, our larger mission in this study is examining how these frames influence support for health policy benefiting population health.
In this book, we present a way to organize and evaluate existing research on these frames as a whole process—beginning with the journalists who develop and create the health news stories to the framing effects leading to public action and everything in between. We combine an existing process model of framing with our original work to achieve this goal. As we will explain, this is the first step in our process. We present significant findings and offer insight into what we know so far about thematic and episodic frames and how they influence support for policy. We conclude with our ideas on the direction of future research based on what we have learned and some initial findings of investigations following that direction.
We appreciate and understand the time and effort scholars put forth to conduct the research we analyzed for this project. Both of us know the challenges involved in developing and undertaking scholarly research. By examining the whole, research on thematic and episodic frames in health news, we offer a clear view of what might be missing in the framing process of increasing public support for health policy. We understand how lack of resources and certain aspects university tenure and promotion might prohibit what we are suggesting researchers could pursue to move research on episodic and thematic frames forward. We realize as thorough as we tried to be in collecting scholarly research articles for this project, we are bound to have missed some journal articles.
Also, having worked as reporters at the local level, both of us know what it is like to have deadlines to meet when covering stories. We understand being a one-man-band when reporting, the idea that sometimes the source you get is the source ←4 | 5→available due to time constraints. Journalists face incredible obstacles in terms of labor force cuts and hostile working environments in the U.S. and more so around the world. A 2017 survey Gallup and the Knight Foundation found Americans strongly believe news media have an important role in democracy—providing the public with information they need and holding the powerful accountable. As we write this text, the need for accurate reporting has never been more dire.
In the midst of these turbulent times, gaining a better understanding of how to effectively communicate information about health policy may not seem as important as other topics. We believe the appetite for this information exists. Around the globe, we all face significant challenges to our health and well-being, and there has never been a more important time for scholars from multiple disciplines, journalists, and the public to join together to deal with these serious threats. We hope the work we present in this text will be used to address risks to our public health like gun violence and climate change along with other significant health issues that require policy solutions.
References
Ardèvol-Abreu, A. (2015). Framing theory in communication research in Spain. Origins, development and current situation. Revista Latina de Comunicación Social, 70, 423–450. http://www.revistalatinacs.org/070/paper/1053/23en.html doi:10.4185/RLCS-2015-1053 accessed May 20 2019.
Fletcher, P. (2018, January). Americans see news media as vital, but failing to live up to the role. Forbes at https://www.forbes.com/sites/paulfletcher/2018/01/16/report-americans-see-news-media-as-vital-but-failing-to-live-up-to-role/#cdd768ef8354 accessed on March 25, 2018.
Iyengar, S. (1991). Is Anyone Responsible: How Television Frames Political Issues. Chicago, IL: The University of Chicago Press. doi:10.7208/Chicago/9780226388533.001.000.
Major, L.H. (2018). Health news coverage and policy: The effects of combining news frames. In P. D’Angelo (Ed.), Doing News Framing Analysis 2: Empirical and Theoretical Perspectives. New York: Routledge.
Rose, G. (1992). The Strategy of Preventive Medicine. Oxford University Press.
Walsh-Childers, K., Braddock, J., Rabaza, C., & Schwitzer, G. (2018). One step forward, one step back: Changes in news coverage of medical interventions. Health Communication, 33(2), 174–187. https://doi-org.proxyiub.uits.iu.edu/10.1080/10410236.2016.1250706
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