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Mass Communication and Policy Gatekeeping  

Richard T. Craig

Who filters through information and determines what information is shared with media audiences? Who filters through information and determines what information will not be shared with media audiences? Ultimately, who controls the flow of information in the media? At times commentary pertaining to media content references media as an omnipotent individual entity selecting the content transmitted to the public, reminiscent of a Wizard of Oz manner of the all-powerful being behind the curtain. Overlooked in this perception is the reality that in mass media, there are various individuals in positions of power making decisions about the information accessed by audiences of various forms of media. These individuals are considered gatekeepers: wherein the media functions as a gate permitting some matters to be publicized and included into the public discourse while restricting other matters from making it to the public conscience. Media gatekeepers (i.e., journalists, editors) possess the power to control the gate by determining the content delivered to audiences, opening and closing the gate of information. Gatekeepers wield power over those on the other side of the gate, those seeking to be informed (audiences), as well as those seeking to inform (politics, activists, academics, etc.). The earliest intellectual explanation of gatekeeping is traced to Kurt Lewin, describing gatekeeping as a means to analyze real-world problems and observing the effects of cultural values and subjective attitudes on those problems like the distribution of food in Lewins’s seminal study, and later modified by David Manning White to examine the dissemination of information via media. In an ideal situation, the gatekeepers would be taking on the challenge of weighing the evidence of importance in social problems when selecting among the options of content and information to exhibit. Yet, decisions concerning content selection are not void of subjective viewpoints and encompass values, beliefs, and ideals of gatekeepers. The subjective attitudes of gatekeepers influence their perspective of what qualifies as newsworthy information. Hence, those in the position to determine the content transmitted through media exercise the power to shape social reality for media audiences. In the evolution of media gatekeeping theory three models have resulted from the scholarship: (1) examination of the one-way flow of information passing through a series of gates before reaching audiences, (2) the process of newsroom personnel interacting with people outside of the newsroom, and (3) the direct communication of private citizens and public officials. In traditional media and newer forms of social media, gatekeeping examination revolves around analysis of these media organizations’ news routines and narratives. Gatekeeping analysis observes human behavior and motives in order to make conceptualizations about the social world.

Article

Cultural Fusion in Physician–Patient Communication and Decision Making in Japan  

Miho Iwakuma and Daisuke Son

The term “cinemeducation” was coined by Matthew Alexander in 2002, and according to P. Ravi Shankar, it refers to the use of clips from movies and videos to educate medical students and residents on the psychosocial aspects of medicine. As a counterbalance to the biomedicine-centric medical curricula, cinemeducation deals with the psychosocial aspects of medicine and sensitive topics in healthcare, including but not limited to depression, family and marital counseling, doctor–patient relationships, family systems, addiction, mental illness, cultural competency, and foreign patients and their healthcare beliefs. Cinemeducation is particularly useful when the viewing is followed by a discussion, which engages students in active learning of clinically relevant concepts such as informed consent (IC), palliative care, and patient-centeredness. In other words, cinemeducation provides students in the healthcare fields with opportunities to learn about the humanistic aspects of medicine by watching movies or clips that provide insight into human experiences and challenges in medicine. A famous Japanese medical TV series, Shiroi Kyoto (The Great White Tower) will be examined to discuss the cultural fusion that has occurred in Japan, specifically with regard to clinical communication. Based on a novel authored by Toyoko Yamazaki in the 1960s, this series is of interest because the novel was made into a drama twice, first in the 1970s and again in 2003. Accordingly, several significant changes in health communication are noticeable between the first and second versions. Social changes in paternalism in medicine, palliative care, and IC that were adapted from the West and localized in Japan, as cultural fusion are evident in several noteworthy scenes.

Article

Using Quotations in Health and Risk Message Design  

Rhonda Gibson

Quotations, something that a person says or writes that is then used by someone else in another setting, have long been a staple of news stories. Reporters use quotations—both direct and paraphrased—to document facts, opinions, and emotions from human and institutional sources. From a journalistic standpoint, quotations are beneficial because they add credibility to a news report and allow readers/viewers to consider the source of information when evaluating its usefulness. Quotations are also valued because they are seen as adding a “human” element to a news report by allowing sources to present information in their own words—thus providing an unfiltered first-person perspective that audiences may find more compelling and believable than a detached third-person summary. Research into the effects of news report quotations has documented what journalists long assumed: Quotations, especially direct quotes using the exact words of a speaker, draw the attention of news consumers and are often attended to in news stories more than statistical information. Studies show that the first-person perspective is considered both more vivid and more credible, a phenomenon that newspaper and website designers often capitalize on through the use of graphic elements such as the extracted quote. Quotations in news stories have also been found to serve as a powerful persuasive tool with the ability to influence perception of an issue even in the face of contradictory statistical information. This is especially true when the topic under consideration involves potential risk. Direct quotations from individuals who perceive high levels of risk in a situation can sway audience perceptions, regardless of whether the quoted risk assessments are supported by reality. The power of quotations remains strong in other forms of communication involving risk, such as public service, health-related, or promotional messages. The vivid, first-person nature of quotes draws the attention of audiences and makes the quoted information more likely to be remembered and to influence future judgments regarding the issue in question. This presents the message creator, whether it be a journalist or other type of communicator, with a powerful tool that should be constructed and deployed purposefully in an effort to leave audiences with an accurate perception of the topic under consideration.

Article

Popular Media and Exposure to Health and Risk Messages  

Kimberly N. Kline

Popular media are a source of information, a powerful socializing agent, and generate sociopolitical and sociocultural meanings that impinge on health promotion and/or disease prevention efforts and individual lived experiences. Thus, motivated by the goal of improving individual and social health, multidisciplinary scholars attend to the implications of entertainment and news media with regard to a range of topics such as individual health threats related to prevention, health conditions and illnesses, patient–provider interactions and expectations, public health issues related to crisis management and health recommendations, and public policy. Scholarship in this line of research may approach the study of popular media guided by the social scientific tradition of media effects theory to explain and predict response or by critical theory to consider ideological implications and employ different methodologies to describe and evaluate the images of health and health-related matters to which people are being exposed or that focus on media representations or audience (both individual and societal) response.