Download A mixed-method approach to mass media content about skin cancer

A mixed-method approach to mass media
content about skin cancer and recreational
tanning in teen girls’ magazines
(2000-2012)
Jennifer McWhirter PhD Candidate
Laurie Hoffman-Goetz PhD, MPH
Skin Cancer, Tanning, and Mass Media
in
Skin Cancer, Tanning, and Mass Media
IARC & WHO Reports
2006 IARC Report
2009 WHO Report
Objective & Methods
Evaluate volume & nature of skin cancer and
tanning coverage in teen girls’ magazines
(2000-2012)
 risk factors
 UV attitudes/behaviours
 early detection
time frame
content type
Methods
Directed content analysis:
47 articles, 170 images
Two magazines: Seventeen,
Teen Vogue
Results: Time frame comparisons
2006 IARC Report:
– increase in volume of
coverage
– mostly no change in skin
cancer content
2009 WHO Report:
– no change in volume of
coverage
– no change in skin
cancer content
Results: Content type comparisons
Text (vs images) more often:
• conveyed risk factors
• promoted UV
protection/avoidance
• encouraged early
detection
Both text and images:
• promoted tanned look
“Jamie wanted a ‘killer’ tan,
and that’s what she got. She
died when she was just 20.”
Teen Vogue, 2010
Conclusions & Implications
• Minimal impact of landmark skin cancer & UV
exposure reports
• Discordant messages between text and
images
• Teen girls receiving mixed messages about
skin cancer and tanning
Funding Sources:
A mixed-method approach to mass media content about skin cancer and
recreational tanning in teen girls’ magazines (2000-2012)
Jennifer McWhirter, PhD Candidate & Laurie Hoffman-Goetz, PhD, MPH
If you have chronic,
unprotected sun
exposure, your risk of
developing skin cancer
increases.
School of Public Health and Health Systems, University of Waterloo (Waterloo ON, Canada)
Background
Methods
• Melanoma is the most common cancer among 15-34 year olds in Canada; the incidence of
skin cancer is increasing among young women.
• Skin cancer is largely preventable, with a high likelihood of survival when caught early.
• Mass media is an important and influential source of information about skin cancer and
tanning.
• Indoor tanning is common among teen girls; primary reasons related to appearance.
• Two major international reports link skin cancer and recreational tanning (Group 1
carcinogen): 2006 International Agency for Research on Cancer (IARC) report and 2009
World Health Organization (WHO) report.
Research Orientation: Directed content analysis. Codes developed based on American
Academy of Dermatology/Canadian Cancer Society risk factors, prevention behaviours, and
early detection information for skin cancer, and prior research by authors.
Data Collection: Highest-circulating North American female youth magazines – Teen Vogue
(2,025,299), Seventeen (1,018,242) – identified; article text and images obtained for 20002012
Coding Reliability: Inter-coder kappa scores were high ranging from 0.85 (e.g., protective
clothing) to 1.00 (e.g., UV exposure).
Teen Vogue, 2008
With skin cancer on the
rise among teen girls,
there’s no excuse for
skipping sunscreen.
Seventeen, 2012
Objective
To evaluate the volume and nature of skin cancer and tanning coverage in teen girls’ magazines
(2000-2012) with regards to risk factors, UV attitudes and behaviours, and early detection
information. The presence of these variables was compared by: 1) content type (text vs images);
and 2) time frame (before vs after 2006 IARC and 2009 WHO reports).
Statistical Analyses: Chi-square (2) and Fisher’s exact test using SPSS v21; p<0.05
considered significant
Data: 47 articles about skin cancer or tanning published between 2000 and 2012; 170 images
within these articles (range=1-17 images per article; mean=4, SD=3)
You don’t have to stop
lying out altogether, but
protection is a must.
Results
Comparison of Skin Cancer Risk Factors Between Text & Images
Comparison of Screening Variables Between Text & Images
Variable
Variable
Text
Images
Test and Significance
Text
Images
Test and Significance
UV exposure
46% (21)
4% (7)
2
Light skin/hair/eyes
13% (6)
14% (23)
2 =0.01, df=1, n.s.
ABCD criteria
Skin self-examination
9% (4)
13% (6)
1% (2)
5% (8)
2
Moles (>50 or abnormal)
15% (7)
3% (5)
2-sided Fisher’s, p=0.00
Physician skin examination
20% (9)
0% (0)
2-sided Fisher’s, p=0.00
Personal/family history
Sunburns
9% (4)
9% (4)
0% (0)
0% (0)
2-sided Fisher’s, p=0.00
2-sided Fisher’s, p=0.00
n.s. = not significant
n.s. = not significant
=55.36, df=1, p=0.00
For cells with n < 5 expected cell count, Fisher’s exact test was used in place of the Chisquare test.
Comparison of UV Attitudes & Behaviours Between Text & Images
Variable
Text
Images
Test and Significance
Promotes tanned look
Promotes self-tanners
74% (34)
63% (29)
54% (92)
30% (51)
2 =5.84, df=1, p=0.02
2 =16.95, df=1, p=0.00
Promotes UV sun avoidance
17% (8)
15% (26)
2 =0.12, df=1, n.s.
Discourages indoor tanning
44% (20)
0% (0)
2-sided Fisher’s, p=0.00
Promotes shade
9% (4)
3.5% (6)
2-sided Fisher’s, n.s.
Promotes protective clothes
15% (7)
14% (23)
2-sided Fisher’s, n.s.
Promotes sunscreen
65% (30)
18% (31)
2 =39.43, df=1, p=0.00
n.s. = not significant
For cells with n < 5 expected cell count, Fisher’s exact test was used in place of the Chisquare test.
Seventeen, 2004
=7.29, df=1, p=0.01
2-sided Fisher’s, n.s.
For cells with n < 5 expected cell count, Fisher’s exact test was used in place of the Chisquare test.
Before and After 2006 IARC Report
• Significantly more articles on skin cancer and tanning appeared after (65%) compared to
before (35%) 2006 IARC Report (2=3.93, df=1, p=0.05)
• Only 3 articles mentioned the 2006 IARC report
• No significant differences for risk factors, UV attitudes & behaviours, or early detection
variables in text or images before vs after this report, except for encouraging sunscreen use in
text, which increased after 2006 (2=4.20, df=1, p=0.04)
Summertime means
showing off a glowing
complexion, but you don’t
need to hit the beach to
achieve it.
Teen Vogue, 2009
Before and After 2009 WHO Report
Jamie wanted a “killer”
tan, and that’s what she
got. She died when she
was just 20.
• No significant difference in volume of articles appearing after (54%) compared to before
(46%) 2009 WHO Report (2=0.14, df=1, not significant)
• No significant differences for risk factors, UV attitudes & behaviours, or early detection
variables in text or images before vs after this report
Teen Vogue, 2010
Conclusions and Implications
Text and Image Comparisons:
• Risk factors, except for UV exposure, were mentioned/depicted infrequently; conveyed more
through text than images
• Text discouraged indoor tanning and promoted sunscreen use more frequently than images;
other ways of protecting oneself from UV exposure were mentioned/depicted infrequently
• Little emphasis on screening (early detection) of skin cancer, but more so in text than images
• Both text and images promoted tanned look as cosmetically desirable
Time Frame Comparisons:
• IARC report, but not WHO report, had a small but significant impact on frequency of media
coverage of skin cancer and tanning geared toward teenage girls, but the content of that
coverage (risk factors, attitudes and behaviours, screening) generally did not improve
Implications:
• Teen girls receiving mixed messages from popular magazines: UV exposure is dangerous,
but a tan is attractive
• Public health professionals should consider ways to work effectively with media and develop
health communication and social marketing campaigns to counteract these mixed messages
Funding Sources: