Interpreting mass media: Implications for health education

Background.  Patients access health education from a variety of sources:  healthcare providers, family, friends, and media.  As we have seen with pharmaceutical advertising, what patients learn outside the clinical encounter can impact their perceived need for services, their conversations with healthcare providers, and ultimately even their courses of treatment.

Purpose.  We explore how newspapers frame cell-free fetal DNA testing, a newly available technology for prenatal genetic diagnosis.

Methods.  LexisNexis Academic database searched 3 national and 3 regional newspapers to surface potential variation based on location and identified nearly 350 articles.  Two independent coders reviewed these for relevance, and discrepancies were reconciled through consensus.  A qualitative analysis was performed on the included articles (n=22).

Findings.  Most articles include expert discussion, translating scientific literature, clinical practice guidelines or expert opinions.  Rarely are the opinions of patients included as experts.  Most of the articles allude to a connection between prenatal diagnosis and pregnancy termination.  Several articles also discuss the commercial underpinnings of such testing, drawing upon larger conversations about cost-effective healthcare services.

Significance.  This circulating health information suggests: facts about this testing are purely scientific and objective, earlier testing may shape pregnancy decisions, and that cost is the primary barrier to testing.  This framing may cause misunderstanding for prospective parents who are trying to make the best decisions they can for themselves and their families, and thus, primary care providers need to pay extra attention when providing these procedures.  Broader efforts addressing public health genetics education may help facilitate informed consent.