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AGENDA-BUILDING, SOURCE SELECTION AND HEALTH NEWS AT LOCAL TELEVISION STATIONS: THE FIRST NATIONWIDE SURVEY OF LOCAL TELEVISION HEALTH REPORTERS
By
Andrea H. Tanner Assistant Professor School of Journalism and Mass Communications University of South Carolina Carolina Coliseum Columbia, SC 29208 Phone: (803) 743-9066 e-mail: [log in to unmask]
Paper submitted to the Science Communications Interest Group
AEJMC 2003 Convention Kansas City, Missouri July 30 – August 2
AV needs: hook-up and projector for laptop computer
Abstract
This study was the first nationwide examination of local television news health reporters looking at health and medical newsgathering from the reporters' perspective. Data from this study revealed significant insight into how these health reporters receive ideas for their health stories and what influences a health reporter to cover a particular topic. The findings suggest a theoretical link between agenda-building and health reporting, suggesting a health reporter's reliance on sources is exacerbated by the technical nature of health and medical news.
Introduction Television stations across the country promote it as "news you can use." Critics call it "news lite." But whatever the label, health, medical and consumer news stories are almost impossible to miss. In fact, since the September 11, 2001 terrorist attacks on the World Trade Center and Pentagon and the subsequent anthrax scare, health news seems to have become a national obsession to both journalists and news consumers. Instead of news dealing with unscrupulous politicians, natural disasters and social security, the lead news stories on both the national and local level are focusing on anthrax cures, smallpox vaccinations and keeping yourself safe from bioterrorism. But the popularity of health news stories certainly precedes the anthrax scare in the United States. Before September 11, 2001 a television news viewer could tune in to almost any local, network or cable news channel and be bombarded with stories dealing with dieting, male menopause, flu, drinking and driving, and the dangers of using a car phone – just to name a few. The dissemination of health news was a booming industry in the 1990s and the trend seems to be continuing as the new millennium progresses.[1] According to Sandy Socolow, a former executive producer for Walter Cronkite at CBS, "all three [network] broadcasts are mesmerized by anything that involves the human body – and I'm not talking about sex."[2] Though there's no mistaking that health care issues receive a great deal of media attention nationwide,[3] news that may help viewers lose weight or find a family doctor is not only flourishing at the network level. Much of the attention given to health news is at the local level, where in recent years local television news has taken on an increasing importance in informing citizens about their world.[4] In fact, local news is watched more than its network counterpart.[5] Whereas Americans are watching more local news, research indicates that many local news viewers would like to see more health stories on the news. A 1993 Gallup poll asked whether the media gave enough attention to health issues.[6] Thirty-five percent said they would like to see "a lot more." Only 6 percent said they would like to see "a little" or "a lot less" health news. Local television news organizations appear to be giving their viewers more of what they want to watch. A 1997 study of local television news content gave hard data confirming the trend: health, crime, weather and natural disaster news is pushing out coverage of government and politics -- what used to be the primary coverage of local television news.[7] The study found that seven percent of all stories at the local news level dealt with health and medicine. To keep up with viewers' demand for health-related news, many local television news stations now employ their own health reporter who is showcased daily in his or her own health segment of the newscast.[8] In addition, local news managers, primarily in the larger media markets, are employing physicians to relate this information to the public. According to Gary Switzer, the number of physician-broadcasters employed at local stations increased during the 1990s.[9] But more health content on local television news does not necessarily lead to an increase of in-depth, non-biased health and medical television news stories put together by well-trained and knowledgeable medical and science reporters. Many medical reporters have no medical training and cannot distinguish the difference between relevant, unbiased information and marketing releases from pharmaceutical and medical manufacturers.[10] This perhaps suggests that a health reporter's lack of medical expertise and training, coupled with the daily deadline pressure, may encourage a health reporter to air a story simply because the story is convenient and accessible. Therefore, it's not necessarily the best or most accurate health information that is released by the media to the public, but sometimes the information that is packaged and marketed in the best manner. This study examines the health reporting practices of local network affiliate television news health reporters in the United States. Specifically, the researcher seeks to determine what influences these television news health reporters to cover a specific health topic from all potential health stories. The researcher will also examine why a health reporter chooses to use a particular source when covering a health-related story. In addition, this study will also examine how these sources of information influence a health reporter's decision-making process as he or she decides what will ultimately be broadcast to the public. Theoretically, this study will be based upon the fourth and latest phase of agenda-setting research. In the past, many communication researchers assumed that the media alone set the agenda for what issues media consumers think about. Such assumptions were examined during the first phase of agenda-setting research, begun in the early 1970s by Maxwell McCombs and Donald Shaw.[11] The current research expands such traditional agenda-setting research and explores the theory of agenda-building – a term for the fourth and most recent phase of agenda-setting research that suggests organizations in society, media-savvy experts and officials, and newsroom decision-makers together set the agenda as to what will be broadcast or printed in the media.[12] This was the first nationwide quantitative analysis of local television news health reporters, thus giving a unique look at health and medical newsgathering from the reporters' perspective. Previous studies have primarily focused on medical and health news as covered by the national media outlets (such as network news and newspapers and magazines such as The New York Times, USA Today and Time magazine). Furthermore, most of these studies have consisted of a content analysis of media coverage. By examining health newsgathering from the reporters' perspective, the researcher was able to determine why certain topics were or were not covered and what sources health reporters used when covering stories and finding possible story ideas. In addition, this research examined whether these journalists' reported that they relied on certain health practitioners to aid them in finding story ideas and, if so, did this suggest that the medical community was setting the agenda for what could and should be covered by local television stations.
Review of the Literature Many factors influence what is included in media content. There is no denying that reporters, producers and news managers at local television stations ultimately decide what news is broadcast.[13] The multiple daily deadlines in television news coupled with the size of the "news hole" also are deciding factors as to what makes air. The lack of resources and reporters at local television stations also have an effect on what is broadcast. According to Phyllis Kaniss of the American Journalism Review, in today's newsroom the "bottomline" seems to be more important than covering relevant news stories. Kaniss said, "local television news content is decided by what is easy to do rather than what needs to be done."[14] Although it can be argued that there are many influences that play a role in shaping what information is broadcast to the public, for at least the past twenty years, researchers examining the media's agenda have been focusing on the sources of the raw material on which journalists rely.[15] According to researcher Herbert Gans it's the source who leads the journalist to a particular news story.[16] Oscar Gandy, one of the first researchers to go beyond agenda-setting to attempt to determine who sets the media agenda as well as how and for what purpose it is set, believes the journalist/source relationship can be interpreted as basic economics.[17] Because reporters must meet deadlines and television news producers must fill the news hole, these journalists must decide whether to invest time pursuing one source rather than another, all based on the return the journalist expects to receive from his source. In other words, a source who has quickly provided truthful information that was easily transferable into a news story is much more likely to be chosen over a source who has misled or ignored the journalist in the past. This regular contact between a journalist and his sources may also result in hesitancy on the journalist's part to reveal information that might harm the relationship with the source.[18] This is especially the case in science and health reporting where reporters depend on sources from the health and science community to explain the technical nature of a certain finding or to tell them why a certain story is of particular importance. According to Gandy, journalists may choose sources for a story for other reasons as well. For instance, journalists seem to identify bureaucratic sources as the most reliable source, thus these bureaucrats are the ones most often giving a soundbite on a television broadcast or quoted in the newspaper.[19] This tendency is exacerbated by the willingness of reporters to accept information from these routine sources without questioning the information.[20] Judy VanSlyke Turk studied the influence public information officers for six state agencies in Louisiana had on the agenda of news reported about their agencies in daily newspapers in the state.[21] She found that newspapers were more likely to use public relations information in published stories than to dispose of it. In fact, the study found that almost half of the information provided was used in news stories. Again, this reiterates the source/journalist relationship and how this relationship could have a profound effect on what news is disseminated. Deciding What News Makes it to Air In a 1990 study exploring how local television learns what is news, John McManus examined how medium-sized, large and very large local television news organizations learn what in their environments is newsworthy.[22] McManus found that all the stations examined were essentially passive in their news discovery, meaning that events and information were learned from individuals promoting an event or an issue or from other news organizations. This type of passive news discovery can be done without ever leaving or even phoning outside the newsroom and includes monitoring press releases, newspapers, television competitors and wire services. Passive news discovery suggests that public relations and promotions from government and big corporations may help set the public agenda by giving news professionals the information needed to cover a story with minimal costs to the news organizations. A 1974 study by John Dimmick found that deciding on stories for a television newscast can be broken down into two distinctive activities: sensing and valuation.[23] According to Dimmick, sensing occurs in a television newsroom when decision makers evaluate numerous story ideas against news selection criteria in order to select potential news stories for a television newscast. Once potential news stories have been selected, valuation then occurs. Valuation happens when decision makers take the potential news stories and decide which stories will become actual news stories for broadcast. Gant and Dimmick reexamined sensing, valuation and news criteria in their 2000 study.[24] After conducting a seven-week field study at a mid-30th market network affiliate, they found that 42 percent of news story ideas survived sensing and valuation to ultimately make air. This meant that nearly half of all news story ideas entering the newsroom in some manner eventually went on the air. Gant and Dimmick also found that information subsidies did not prove to be critical during sensing or valuation, but resource constraints and visual potential were good predictors of which potential news stories would become actual stories on the news. Most importantly, Gant and Dimmick's study suggests that during valuation, decision-makers inside the newsroom, not information subsidies, are the most influential sources.
How Health Information Becomes News Unlike general news reporters, science and health reporters rely on scientists and doctors as a primary source of information about complex issues dealing with health, energy, environmental and economic affairs.[25] But these scientists also rely on the media. Without the media, groundbreaking research would never reach the public. This reliance on one another shapes how science becomes news and is ultimately relayed to the public.[26] But this mutual relationship between scientists and the media is often uncomfortable one.[27] Researchers are hesitant to talk to the media because they perceive science reporters as irresponsible and prone to sensational reporting.[28] The media blame doctors and scientists for being secretive, unemotional, and unable to explain complicated research in laymen's terms.[29] A 1999 study by Julia Corbett and Motomi Mori found that medical and health reporting was different from general news reporting in that the media were dependent on medical institutions for information concerning scientific material and to explain the importance of this material.[30] Corbett and Mori found that because of the technical and specialized nature of science and medical information, the medical community acted as a gatekeeper, deciding what information would be released and explained to the media. The idea of the science and medical communities as gatekeepers is reiterated in a study of four major British newspapers. Vikki Entwistle found that 86% of all medical stories began as press releases issued by two prominent British medical journals.[31] Entwistle found that the journalists often scanned medical journals looking for story ideas, but rarely had enough time to seek additional information from other sources. Agenda-Building and the Media
In the past 20 years, more mass communications researchers seem to be focusing on the theory of agenda-building, rather than solely investigating the agenda-setting function of the press first examined by McCombs and Shaw. Agenda-building theory posits that the media, government and society reciprocally influence one another. For example, research by David Weaver and Swanzy Elliot revealed that assuming the press is setting the public's agenda is inaccurate.[32] In fact, they found that, in many instances, the press is simply passing on the ideas and priorities set by institutions in society. This study suggests a source-media relationship in which the press interacts with other institutions to create the public agenda. Whereas Weaver and Elliott looked at newspaper coverage and agenda-building, a 1987 study by Dan Berkowitz examined agenda-building as related to both television and newspapers on a national and local level.[33] Berkowitz investigated the channels and sources from which published news stories evolved to determine if television news used different sources than did newspapers. One interesting finding from this study was that television journalists relied heavily on routine news events, such as press conferences and experts and officials for their news sources, even more so than their newspaper counterparts. This suggests that officials and executives dominate the agenda-building process, especially in television news. These findings indeed support the agenda-building theory in that journalists don't necessarily set the agenda, instead the news agenda is set by the sources used to shape the information reaching the mass audience. Corbett and Mori's 1999 study examined the relationship between public events, medical activities and press coverage of breast cancer over a thirty-six year period.[34] This study revealed how societal institutions (in this case the medical community) impact and influence the reporting of medical problems and if any other factors (public events regarding breast cancer) also influence media coverage of public health issues. The findings of the Corbett and Mori study do suggest a distinct media-health link. There was a strong correlation between TV coverage and breast cancer incidence, which the researchers say indicates that media attention to breast cancer sent women to their doctors for mammograms. In addition, there was evidence of a reciprocal relationship between the medical community and the mass media. The researchers found a strong association between breast cancer funding and print and TV coverage of breast cancer in the same year. Furthermore, public events concerning breast cancer also seemed to boost media and medical attention of the disease. Research Questions The overall objectives of this exploratory study were: a) to examine the health reporting practices of local network affiliate television news health reporters in the United States; b) determine how these health reporters decide to cover a specific health topic from all potential health stories; c) examine the health reporter/source relationship from the journalist's perspective; and d) assess how these sources of information influence a health reporter's decision-making process as he or she decides what will ultimately be broadcast to the public. Specifically, this study was designed to address the following research questions: R1: What influences a local television news health reporter to cover a particular health topic?
R2: How do sources in the community influence the coverage of health news?
R3: According to the health reporter, what strategies or tools does a source of health information proactively use in order to set the agenda as to what health stories make air?
Data Collection Method To answer these questions, the researcher conducted a survey of television health reporters at network television affiliates in the United States. From the 2000 NAPTE Station Listing Guide 190 television stations were selected from the 809 commercial broadcast stations listed as having news departments. These stations were either independent local television stations or stations affiliated with a national network including NBC, ABC, CBS, FOX, WB, UPN and PAX. Stations affiliated with the Public Broadcast Station (PBS) were excluded from the population. Journalism undergraduate student volunteers at the University of XXXXXXXXXXXXXX contacted these stations in order to obtain the name of the health reporter at each station and find out if the reporter would rather receive the questionnaire by mail or e-mail. In this particular study, a local news health reporter was considered any reporter designated to cover health and medical topics at their local
network affiliate in which they are employed. A health reporter may specialize and only cover health news, or a health reporter may have to cover general news as well as focus on health-related issues, but should be generally considered the health or medical reporter at his or her television station. Of the 190 stations contacted, 72 of these stations were eliminated from the original sample for one of the following reasons: the station did not air regularly scheduled news programming, the station did not employ a health reporter or the television station's phone number had been disconnected or the station refused to participate in the study. In an effort to increase the sample size, the researcher randomly selected another 50 television stations. Each of these television stations was contacted in the same manner as those in the original sample. After resampling, the final sample size for this study was 139. In order to increase the response rate, the questionnaire was designed to be distributed via three different media, mail, on-line and fax. The on-line version of the questionnaire was located on the University of XXXXXXXXXXXXXXX College of Journalism and Mass Communications web site at www.jour.wc.edu/PEOPLE/tansurvey.html.[35] The content was the same in all versions of the questionnaire and contained both open- and close-ended questions. Section 1 of the questionnaire asked respondents questions about their journalism career and the overall health reporting practices at their current television station. Section 2 focused on the factors that might influence the reporter to cover a particular health topic. The purpose of Section 3 was to assess the effectiveness of sources of health information as these sources work to get a particular message to air on a newscast. Section 4 sought biographical and professional information.
Findings
Of the 139 health reporters who were selected from a random sample of television news stations in the United States a total of 53 responded, for a response rate of 38 percent. Of the health reporters who responded, 13 subjects (25%) were from television stations in large media markets (ADI 1-30), 21 (40%) were from medium markets (ADI 31-100) and 18 (35%) were from stations in small media markets (ADI 101+). The hours per weekday of local news programming at these television stations ranged from one hour to nine hours with a median of four hours of local news programming. More than three-fourths (87%, n=45) of the respondents were female. As pertaining to race, eight of ten (81%, n=42) respondents were Caucasian, eight percent (n=4) were Hispanic and four percent (n=2) were African American. Six percent (n=3) indicated that their race was something other than the choices listed. One respondent was of Asian descent. The age of the respondents ranged from 24 to 60 years of age with a median age of 33. Almost three-fourths had completed a bachelor's degree (71%, n=37) with 12 percent (n=6) indicating they had obtained a masters degree. Only one respondent indicated he had received another type of advanced degree. Eight respondents (15%) indicated that their highest level of education was either high school, some college or an associate degree. When describing the type of degree received, seven of ten (n=37) indicated their degree was in broadcast, telecommunications, mass communications or journalism. Other degrees received included political science (8%, n=4), English, history or language (8%, n=4), and communications or speech communications (8%, n=4). Only five percent of respondents (n=3) indicated that they had a degree in a science-related field of study. When asked if they had any other type of specialized training in the field of health almost one-third (28%, n=15) answered yes, while more than two-thirds (72%, n=38) said they had no special health training. Of those indicating they had prior training in the field of health, six of ten (64%, n=9) indicated that their training had consisted of either a seminar or college courses on health and/or health issues, and nearly 30 percent (n=4) indicated they had received some other type of health training. Only one respondent had received a college degree in the health or medical field. Regarding a respondent's entire journalism career, the number of years that the respondents had been covering health issues ranged from six months to 22 years with a mean of seven years. At the respondents' current television station, most had been covering the health beat for an average of four years. More than half of the respondents (58%, n=30) said that their health stories are included in a broadcast on a daily basis. Twenty percent (n=11) indicated their health stories aired 2-3 times a week, and 15 percent (n=8) indicated their stories aired weekly. Three respondents (6%) said their health stories air more than once a day. As pertaining to the format of these health stories, more than half (55%, n=29) of the health reporters indicated that their stories usually aired as a reporter package (a story voiced by the reporter lasting approximately 1 minute to 1 minute, 30 seconds). Another quarter of respondents had to fill even more airtime. Twenty-four percent (n=13) said their health report consists of a live shot, or a live shot and a package, usually lasting between two and three minutes in length. Almost 20 percent (17%, n=9) said their health stories are run as either a voice-over (a story approximately 20-30 seconds in length that the anchor reads on set with video accompanying the copy) or a voice-over/sound-on-tape (vo-sot) which is also read by the anchor with video appearing on the screen, but includes a taped interview or soundbite usually lasting about 15 seconds. Interestingly, only one-third (34%, n=18) of the health reporters responding said they concentrate solely on health reporting. The remainder (66%, n=35) are required to cover other stories in addition to their health reporting duties. However, more than 80 percent (83%, n=15) of reporters in small media markets were required to cover other stories in addition to health, whereas less than half (46%, n=6) of large market reporters had to cover other stories. Of those who are required to cover both general news and health news, 12 percent (n=4) said that covering both types of stories helps them when it comes to covering health news. However, 20 percent said it interfered with their health reporting, and 68 percent (n=24) said that it had no effect on their health reporting. When asked about the support staff available to help with the research, writing, shooting, editing and/or reporting of health stories, respondents were given numerous choices and asked to check all that apply. More than a quarter (27%, n=14) said they received no help with their health reporting. Of the 53 health reporters who did receive assistance, almost three-fourths (70%, n=36) said they received help from a photographer on a regular basis, one-fourth (25%, n=13) received help from an editor, 14 percent (n=7) received help from a producer, six percent (n=3) received help from an intern, and six percent (n=3) received regular help from "other" sources, including an anchor at one station and an entire health reporting staff at another station.[36] It is interesting to note that none of the health reporters had either a researcher or a writer to help with health reporting. RQ #1: What influences a local television news health reporter to cover a particular health topic?
Section II of the survey looked at how a local television news health reporter is influenced to cover a particular health topic. The respondents were first asked where they receive the majority of the ideas for their health stories. They were given a list of eleven items from which to choose and asked to identify the top three from which they usually receive their story ideas. Of these choices, just more than half (51%, n=27) of all respondents said they receive a most of their story ideas from a public relations spokesperson (for example, a hospital public relations practitioner or a spokesperson from the American Cancer Society) who personally contacts them with a story idea. Press releases were the second most popular manner in which to receive ideas for a health story with forty-four percent (n=23) of respondents indicating they receive most of their story ideas from press releases, followed by an e-mail or a phone call from a viewer (31% of all respondents, n=16). One-fourth (n=13) of all respondents indicated they receive a majority of their ideas for stories from newspaper articles or advertisements, another quarter (25%, n=13) receive the majority from wire services. Twenty-five percent (n=13) said they receive their ideas from syndicated prepackaged health stories, and twenty-five percent (n=13) from topics that personally interest or affect them in some manner. Just more than 20 percent (21%, n=11) of respondents said they receive a majority of their story ideas from medical journals. Eight percent (n=4) of all respondents indicated they receive story ideas from a video news release and eight percent (n=4) from their network affiliate.[37] Figure 5. Where health reporters receive most of their story ideas
Because having an idea for a health story and actually covering a particular health topic are two different entities, the health reporters were given several items in which they were asked to determine how influential each was on his or her decision to cover a health topic. Each item was followed by a five-point Likert scale where 1 = no influence and 5 = highly influential. When asked what influenced them to cover a health topic, more respondents said the audience was more influential than any other factor. Six of ten respondents (64%, n=34) said the audience and the audience's interest in a health topic was highly influential and nearly one-third (30%, n=16) indicated it was influential on their decision-making. Six percent (n=3) said the audience was sometimes influential, had little influence or had no influence on their decision to cover a health topic. The ability to humanize a story also has a tremendous influence on a reporter's decision to cover a story. Almost two-thirds (62%, n=33) of respondents said the ability to humanize a story was highly influential on their decision to cover a health topic, while almost another third (30%, n=16) of respondents said it was influential. Only four respondents (8%) said that humanization was sometimes influential, or had little or no influence on their decision to cover a story. Available resources (such as time or support staff) are also highly influential. Half (49%, n=26) of respondents said available resources were highly influential and one-fourth (26%, n=14) said they were influential. Seventeen percent (n=9) indicated that available resources were sometimes influential, and eight percent (n=4) said resources had little or no effect. As pertaining to a reporter being able to shoot video on a certain health topic, just more than 40 percent (41%, n=22) said the ability to shoot video on a topic was highly influential in their decision to cover a health topic, 36 percent (n=19) said it was influential and 17 percent said it was sometimes influential. Six percent (n=3) indicated that ability to shoot video had little or no influence. Interestingly, while reporters said the ability to shoot their own video on a health topic was highly influential, access to a video news release on a health topic seemed to have very little influence when it came to deciding whether to cover a health topic. One-third (34%, n=18) of respondents indicated it had no influence, one-fourth (25%, n=13) said video news releases had little influence and 30 percent (n=16) said video news releases sometimes were influential, sometimes not when deciding whether to cover a topic. Only 11 percent (n=6) of respondents said video news releases were influential or highly influential in their decision to cover a topic. When asked if management was influential in their decision to cover a particular health topic, one-fourth (24%, n=13) indicated that management was highly influential, just more than one-fourth (28%, n=15) said management was influential, and almost one-third (32%, n=17) said management was sometimes influential, sometimes not. Eight percent (n=4) said management had little influence and another eight percent (n=4) said management had no influence on their decision to cover a health topic. When asked if a health issue that had personally affected the reporter had influenced his or her decision to cover a health story, one in ten (9%, n=5) said it was highly influential and nearly one-fourth (23%, n=12) said personal health issues were influential. More than half (57%, n=30) said issues affecting them personally were sometimes influential, sometimes not. Eleven percent (n=6) said personal issues had little or no influence. Regarding station sponsors and how this sponsorship influences a health reporter to cover a topic, more than half of respondents (51%, n=27) said it had no influence, almost one-fourth (23%, n=12) said it had little influence and 13 percent (n=7) said a station sponsor was sometimes influential, sometimes not. Another 13 percent (n=7) said a station sponsor was influential or highly influential on their decision to cover a health topic. When asked how influential a station-sponsored event (such as a blood drive) is on their decision to cover a health topic, less than ten percent (9%, n=5) said it was highly influential, whereas 32 percent (n=17) said it was influential. Just more than one-fourth ( 26%, n=14) of respondents said a station-sponsored event was sometimes influential, sometimes not, another 21 percent (n=11) said it had little influence and eleven percent (n=6) said it had no influence on their decision-making. In a separate question, respondents were asked how story selection was most often determined at their station. More than one half of respondents (59%, n=31) indicated that values and interests of the people in the community decide story selection and just more than 20 percent (21%, n=11) said health sources in the community decide story selection. Nine percent (n=5) said events in the community decide story selection and another nine percent answered "other." Only one respondent said that technology of the medium most often decides story selection at his or her television station. When cross-tabulating how story selection is determined with market size there was no statistical significance indicating a relationship between how story selection is determined and market size (chi square = 10.602, p=.101). As pertaining to health reports and sponsorship, just more than half (57%, n=30) said the health reports at their station were sponsored. Forty-three percent (n=23) did not have sponsored health reporters. When cross-tabulating this with market size there was no statistical significance when trying to establish a relationship between market size and whether or not the health report was sponsored (chi-square = 1.432, p = .489). Of the respondent's whose health reports are sponsored, several answered an open-ended question asking how they believe sponsorship affects how they cover health issues. These answers are as follows: • Affects it very little to not at all. • I never think about this. • Our sponsors are local hospitals. We work with them on a regular basis to promote new treatments and health care advancements in our stories. They are also extremely helpful finding experts on certain medical subjects and patients who have undergone treatments. • It does not affect coverage at all. • We have two different franchises that are sponsored by different hospitals. • We do have a weekly taped interview segment on our 5pm newscast with a local doctor affiliated with a hospital on various health topics. He is not promoting going to their facility, but it is sponsored by his hospital group. • I have several different health segments. One that runs at 5pm, another on Monday morning, then two on the weekend. Only some are sponsored. It doesn't affect my coverage at all. • Some reports are sponsored by a local hospital. They determine what topics we cover in the sponsored reports and provide resources. They do not influence other independantly produced pieces, and their sponsorship of one report does not influence coverage in another report. • It does not affect coverage at all. • Must use doctors from a certain medical center for our expert on each topic. • It does not. I am free to cover any story I like. • It has no effect. • I have great resources to use, patients and faces to include in my stories. But sponsor also has an agenda of issues they want covered. • They are not all sponsored, and frankly, I don't know who sponsors them, so it doesn't influence coverage. • It doesn't. My station is great about not allowing sponsors to interfere with how we cover a story. • An area hospital sponsors one health segment. Because of that if I need a doctor for a soundbite, I feel obligated to check there first. • It doesn't.
RQ #2: How do sources in the community influence the coverage of health news? In Section III of the questionnaire, respondents were asked to indicate whether they agreed with a series of statements dealing with health sources and the interaction between health reporters and their sources. A five-point Likert scale was utilized where 1 = strongly disagree and 5 = strongly agree. More than half of respondents strongly agreed or agreed that health sources often influenced the health news content making air. Breaking down these numbers, almost 20 percent (17%, n=9) strongly agreed and more than 40 percent (42%, n=22) somewhat agreed with the statement. Just more than one-fourth of respondents (26%, n=14) said they neither agreed or disagreed, four percent (n=2) said they somewhat disagreed and ten percent (n=5) strongly disagreed. When cross-tabulating the responses to the statement "health sources often influence the health news content making air" with a reporter's years of health reporting experience there was no statistical significance indicating a relationship (Cramer's V =.158, chi-square = 2.607, p = .625). However, 69 percent (n=11) of those reporter's with less than three years of experience and 65 percent of those with three to eight years of experience indicated that health sources often influenced the content making air, whereas only forty-four percent (n=7) of health reporters with more than eight years of experience said that health sources influenced the health content airing at their station.
Table 7. Crosstabulation – health sources influence content by reporting experience (Cramer's V =.158, chi-square = 2.607, p = .625 )
A similar situation occurred when cross tabulating the responses to the statement "health sources often influence the health news content making air" with market size. Though there was no statistical significance (Cramer's V = .301, chi-square = 9.451, p = .051), only 39% (n=5) of health reporter's in large market strongly or somewhat agreed with the statement, whereas 68% of reporters in both medium markets (n=14) and small markets (n=12) strongly or somewhat agreed with the statement.
Table 9. Crosstabulation – health sources influence content by market size (Cramer's V = .301, chi-square = 9.451, p = .051),
Next, the reporters were asked if they must frequently find a health expert to explain information due to the technical nature of health and medical news. Just more than one-fourth of respondents (27%, n=14) said they strongly agreed with the statement and 31 percent (n=16) said they agreed. Almost one-fourth (23%, n=12) neither agreed nor disagreed, 12 percent (n=6) somewhat disagreed and seven percent (n=4) strongly disagreed when asked if they must frequently find a health expert to explain health information. When cross-tabulating whether a reporter must frequently find a health expert to explain information with market size, there was no statistically significant relationship (Cramer's V = .235, chi-square = 5.75, p = .218). However, this cross-tabulation still has an interesting finding. As shown in the table below, in the large media markets (ADI 1-30) less than half (46%, n=6) of respondents strongly or somewhat agreed with the statement, but almost 60 percent (n=12) in medium markets (ADI 31-100) and two-thirds (67%, n=12) of those in small markets (ADI 101+) strongly or somewhat agreed that they needed a health expert to explain information to them.
Table 11. Crosstabulation – health experts must explain information by market size (Cramer's V = .235, chi-square = 5.75, p = .218).
When cross-tabulating whether a reporter must frequently find a health expert to explain information with a health reporter's experience, again there was no statistically significant relationship (Cramer's V = .153, p = .658). This absence of a relationship is quite interesting because more than 60 percent (63%, n=10) of respondents with less than 3 years of experience and more than 60 percent (63%, n=10) of respondents with more than eight years of experience said that they must frequently find an expert to explain health information. Half (50%, n=10) of those with three to eight years of experience also strongly or somewhat agreed with the statement.
Table 13. Crosstabulation – health experts must explain information by reporting experience
RQ #3: According to the health reporter, what strategies or tools does a source of information proactively use in order to set the agenda as to what health stories make air?
When asked if health sources in the community understand what stories are best for the reporter's needs and the medium of television, 12 percent (n=6) strongly agreed with the statement and half (50%, n=26) somewhat agreed. Just less than one-fourth of respondents (23%, n=12) neither agreed nor disagreed, ten percent (n=5) somewhat disagreed and five percent (n=3) strongly disagreed. Next, the respondents were given a list of strategies and/or tools health sources sometimes use when trying to get a particular story covered by a television news station. The respondents were asked to mark the three top methods that these sources successfully use. Nine of every ten reporters (90%, n=46) indicated that when a health source provides personal examples for a particular story for the reporter to use, the story idea has a good chance of making it to air. The next most likely to be used methods were giving a reporter access to video opportunities (57%, n=29), personally contacting a health reporter with a story idea (45%, n=23), giving interesting and concise soundbites (35%, n=18) and explaining technical information (31%, n=29). Other techniques that health sources use that seem to be less effective include understanding deadline pressure (22%, n=11), sending press releases (14%, n=7) and sending video news releases (6%, n=3).
Figure 6. PR strategies/tools used successfully to facilitate a story making air
Next, the respondents were asked if they were generally satisfied with what sources are doing to help them get health stories on the air. More than eight of ten respondents (85%, n=44) said "yes" they are generally satisfied. Of the 15 percent (n=8) who were not satisfied with their health sources, these respondents were asked to explain what they would like these health sources to do that would help their story make air. These open-ended responses are as follows: • Many sources write releases in a very technical, non-visual way that our viewers can't relate to. Often, they want us to cover a story but will not let us shoot video! They do not understand that we are a VISUAL medium and can't tell the story without pictures. • Don't even pitch a story that doesn't have a person involved. Remember that deadlines are my business... a phone call returned tomorrow is too late and I already got what I needed from another source. • Make more video opportunities available, and make more personal examples available. I sometimes won't commit to a story until my source can e-mail, fax, or phone me with relevant studies or literature on the subject. Also, docs too often don't understand that we need the interview today... tomorrow, it won't be news. • I am, however, very wary of p.r. people who try to push products/new surgical techniques, etc on behalf of their client...in order just to increase business for a particular drug company or foot traffic into a doctor's office. My concern is getting objective, accurate information to the viewer without hidden agendas attached to the story. • I'd like them to find patients so our viewers can relate.
Conclusion To find out about the latest health scare or medical miracle, most Americans simply flip on the television. But as more and more viewers use the medium of television as their primary means of learning about health and medical issues, it becomes increasingly important to understand why these health issues are being publicized in the media and what entities are building the public's health agenda. This study, the first nationwide quantitative examination of local television news health reporters, was designed to explore the health reporting practices of these reporters from their own perspective. Data from this study revealed significant insight into how these health reporters receive ideas for their health stories and what influences a health reporter to cover a particular topic. Theoretically, the data from this study support the agenda-building process. The results of the data suggest a reciprocal effect among the viewing audience, the media and media sources as related to the media's health agenda. Whereas agenda-setting assumes the media alone sets the public's agenda, agenda-building, in effect, takes the process a step further by suggesting many different entities influence and build the agenda the media presents to the viewing audience. Overall, this study revealed that the health reporters responding to the questionnaire were uneducated in the health and medical field, meaning very few had received a college degree in a health or science related field or taken college courses or seminars on the topic of health. This lack of formal training in health and/or medicine, coupled with the large amount of airtime these reporters must fill with health-related information on a daily basis, seemed to contribute to an extreme reliance on health sources in the community. For example, more than half of respondents receive ideas for their health reports directly from a public relations spokesperson who personally contacts them. Other popular manners in which the health reporters said they receive story ideas included a phone call or e-mail from a viewer or information from other media outlets, such as the newspaper or wire services. This suggests the reporters are learning of story ideas through a "passive news discovery process" in which reporters find story ideas without ever leaving the newsroom. Though the literature revealed that passive news discovery may take place in all facets of television news reporting, the findings of this study perhaps suggest it may be more prevalent in television health reporting because of the lack of training in the field of health, lack of resources to cover stories and the large amounts of airtime these reporters are expected to fill with health information on a daily basis. Data from this study not only revealed where the respondents were receiving their story ideas, but also examined the factors influencing a health reporter to actually cover the story after receiving the idea. Interestingly, the findings revealed several factors that were most influential, but the data also suggested that numerous factors work together to influence a health reporter to cover a particular story. The health reporters in this study said the audience's interest in a topic and a reporter's ability to humanize the topic by using personal examples in the story were the most influential factors when deciding whether to cover a story. Other highly influential factors included having available resources to cover the story and being able to shoot video on a certain topic. These findings are alarming in that they suggest a reporter may decide not to cover a newsworthy story due to lack of video or humanization opportunities. Other data also suggest, in some instances, a bias in health news coverage in reports that are sponsored. While only 13 percent of respondents said their health sponsor influences their decision to cover a story, qualitative research from this study suggests some health reporters feel obligated to use story ideas pitched by their sponsor or use sources only from the sponsor. Though it is important to note that this is not an objective description of the majority of health reports at television stations across the country, it does send up a red flag, suggesting that some of these sponsors are using their influence to promote stories they want covered. When asked about overall story selection, the respondents indicated that values and interest of the people in the community and health sources most often determine story selection. Theoretically, this data suggests agenda-building is occurring when pertaining to health reporting because it appears the media are not setting the public agenda, but instead the public itself, along with health sources in the community, are determining what stories make air. In addition, 60 percent of respondents said they must frequently find a health expert to explain technical information and 60 percent also agreed that health sources often influence the health content making air. Again, this suggests a theoretical link between agenda-building and health reporting in that it is not solely the reporter who determines what story is broadcast to the public. The data suggests a health reporter's reliance on sources is exacerbated by the technical nature of health and medical news and a health reporter's lack of training. Public relations practitioners trying to find the best manner in which to pitch a story idea can gain great insight from this study. Time and again, the reporters responding to this questionnaire stressed the importance of personal contact. Not only did these reporters receive many of their ideas from public relations practitioners who personally contacted them, but the data revealed that this personal contact was the number one tactic public relations practitioners can use to facilitate their story making air. In an increasingly technological era, it was interesting to find that this personal touch still has a significant impact. A majority of respondents said they were generally satisfied with what their sources were doing to help them get stories on the air. However, this satisfaction could be attributed to the special journalist/source relationship that is many times evident when a reporter is assigned to cover a "beat" such as health. The literature revealed that a beat reporter may return to the same source again and again simply because the source has been reliable in the past. This relationship between the health reporter and her sources suggests the source should work to develop his or her relationship with the reporter. As the literature and the current study revealed, once this relationship is established, it more than likely will continue. This suggests that once the source has "proven himself," the reporter will continue to cover the source's story ideas because the source and the reporter have had a successful working relationship in the past. But personal contact alone does not necessarily guarantee a particular health story will make air. In order to have a good source/journalist relationship, the source must know the intricacies of the medium of television. The findings of this study revealed that a health reporter is less likely to pursue a story with little humanization or video potential. Despite the newsworthiness of the story, if a health issue can not be presented in a visual manner that viewers can relate to through humanization of topic, a reporter may decide not to cover the story. This study has laid the groundwork for a number of future research possibilities. This study collected data from health reporters, thus the information gathered was entirely from the reporter's perspective. The next phase of research should consist of an examination of the health sources. Because there are so many health sources contributing to a television reporter's health agenda, it would not be feasible to conduct an empirical content analysis of the information these sources are releasing to the health reporter. However, a qualitative study, consisting of one-on-one interviews with several prominent health sources would be applicable and would allow the researcher to determine how and why these sources release certain health information to reporters of all media outlets. An ethnographic study of several different news organizations and the organization's health reporter would also be beneficial. Not only would this type of study allow for richer data to be collected as to the different factors influencing a reporter to cover a particular health topic, it would also eliminate the need for the self-reporting of an individual's practices and behaviors. Self-reporting can sometimes be problematic because respondents may answer how they think they should answer instead of how they truly behave. An ethnographic study would allow the researcher to examine an reporter's actual newsgathering practices, learn more about the behaviors of the health reporters and explore the environment in which the reporter works on a day-to-day basis. Finally, the respondents for this study were obtained by randomly selecting a sample of local television stations, then contacting the health reporters at these stations. However, many of these stations did not employ a health reporter, therefore the number of cases for analysis was small. In future examinations of local television health reporters, a census of the population should be obtained in an effort to increase the overall number of respondents.
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[33] Dan Berkowitz, "TV News Sources and News Channels: A study in Agenda-Building," Journalism Quarterly (Summer/Autumn 1987), vol. 64, 508-513. [34] Julia B. Corbett and Motomi Mori, "Medicine, Media and Celebrities: News Coverage of Breast Cancer, 1960-1995," Journalism and Mass Communication Quarterly (Summer1999), vol. 76 (2), 229-249.
[35] The on-line version of the questionnaire was designed by Patty Kornegay at the College of Journalism and Mass Communications at the University of XXXXXXXXXXXXXXXX. [36] It is important to realize that these percents do not add up to 100 percent because each respondent disclosed all of the help they received, with some respondents receiving help from more than one person. For example, some health reporters worked with a photographer and a producer on a regular basis. In order to calculate this, frequency and percents were calculated separately for each job description. [37] These percents do not add up to 100 percent because each respondent was asked to disclose the top three ways they receive ideas for health stories. The frequencies and percents for each item were tabulated individually.
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