A content analysis of pediatric information in widely circulated newspapers in Iran.

BACKGROUND: Newspapers play an important role in improving public health literacy. This study analysis the content of pediatric information in widely circulated Iranian newspapers in 2014.
MATERIALS AND METHODS: This is an applied survey performed using content analysis method. The data gathering tool was a checklist designed by the researcher. The sample size was determined using nonprobability sampling to be 426 articles with pediatric-related topics of five Iranian newspapers.
RESULTS: The results showed that the most popular topics included "psychological disorders" (19.6%) and "nutrition" (19.27%). The null areas include "physiopathology of body fluids and fluid therapy" and "gynecological problems in childhood" (0%).
CONCLUSION: The messages identified were more in line with needs of Iranian society which shows a need to pay more attention to international standards by both journalists and pediatricians.

Introduction

Todays, no one can deny the importance of information and its role in the development of societies. One of the important and noteworthy aspects of society that can also be considered to be one of the criteria for social development is the development of health literacy. General populace receives its health-related information from mass media.[1] Using these media, outlets play an important role in transfer of information and improving society's knowledge and attitude and can also play an important role in controlling the prevalence of diseases in society.[2] Today's society that despite increased importance of electronic media have managed to stay as strong as ever in printed press role in informing the populace.[3]

Due to their ease of access and transportation, cheap price and possibility of use at any time and place, longer history, and function as historical documents, these printed newspapers have retained their place among general populace.[4] One of the topics that from time to time appears on the pages of newspapers and is popular among people, especially with mothers, is pediatric information. Pediatric information concentrates on medical and health care and information for infants, children, and teenagers from birth to 18 years of age.[5] Economic, social, and cultural development of every society depends on its human development which depends on physical, mental, and social health of member of the society. In this regard, childhood is the most important and influential period in providing, maintaining, and improving health situation in societies that can ensure future social development.[6]

Various studies in Iran and other countries concentrate on the content analysis of health information in mass media. In Iran, the most important studies in this area are the studies by Taghdisi et al. on health-related articles of the most widely circulated newspapers in Iran,[7] Amini et al. on influence of TV food commercials on children,[8] Mohammadpour Ahranjani et al. on nutritional messages in Iranian press,[9] Malek Afzali et al. on publication of health research results in Iranian newspapers,[10] Nasrollahzadeh and Shahbaztabar on scientific medical information in Iranian newspapers,[11] and Hovsepyan et al. on content analysis of cancer-related nutritional messages in Iranian popular magazines.[12] Important studies in other countries include studies by Prabhu et al. on prime-time pediatric television medical news,[13] Pruitt and Mullen on inaccurate descriptions of emergency contraception in newspaper articles,[14] Salzman on content analysis of nutrition coverage on the today show program,[15] Mahshawar and Rao on nutrition science coverage by popular Indian daily newspapers,[16] and Ashorkhani et al. on quality of health news disseminated in the print media in developing countries.[1]

Investigating the previous literature showed that various studies have been conducted on content analysis of medical and health-related information on electronic and printed media in Iran and other countries, and among various media, newspapers have been one of the favorite forms of media in these studies.[17910111416] However, there are no content analysis studies on pediatric health information in Iran. Given the fact that most people use public publications, mass media, and internet to obtain their health-related information[1718] and given the importance of health information, especially pediatric health information, this study aims to perform a content analysis on the pediatric health information published in widely circulated Iranian newspapers, the most important published massages, the topic trends of the message have been published and empty topic areas. The results of this study can help identify the strengths and weaknesses of pediatric health information in Iranian newspapers and therefore can be used to improve the quality of published pediatric information.

Materials and Methods

This applied type study was carried out using content analysis method. The statistical population consisted of all messages in 694 issues of five Iranian widely circulated newspapers between March and September 2014 which were selected after applying the inclusion criteria of having national coverage, having a general focus, having an electronic format, and having medical and pediatric information. Exclusion criteria included lack of access to the newspaper during the study. These selected newspapers were Ettelaat, Iran, Jam-e-Jam, Resalat, and Kayhan newspapers. The sample size was determined using nonrandom purposeful sampling, and 426 pediatric-related articles were extracted from these newspapers. It is worth mentioning that it was possible to extract more than one message from an article.

Data gathering tool was a checklist designed by the researcher whose components were selected based on research goals and included (a) newspaper characteristics, (b) message content, and (c) topic orientation of the message passed on pediatrics curriculum.[6] During the study, messages related to pediatric health were extracted from newspapers using content analysis, and there were coded and entered into the checklist. Then, the data were entered into MS Excel software, and descriptive statistics such as frequency and percentage were used to analyze the data.

Results

From a total of 694 issues of investigated newspapers, 426 articles (3019 messages) related to pediatrics were extracted. Each newspaper contribution to this total includes Jam-e-Jam: 216 articles (50.7%), Ettelaat: 113 articles (26.5%), Iran: 77 articles (18%), Kayhan: 15 articles (3.5%), and Resalat: 5 articles (1.17%).

Table 1 shows the topics of pediatric-related messages in the newspapers. The 31 clusters of this table and their order are based on “curriculum and criteria of pediatrics.”[6] As can be seen in the table, “psychological disorder” cluster with frequency of 19.60% and “nutrition” cluster with frequency of 19.27% have the highest number of messages.

Table 1

The topic orientation of pediatric-related information in the investigated newspapers

Figure 1 shows the results of Table 1 with more clarity and from highest to the lowest frequency. As mentioned before, the topics with most attention in the newspapers were “psychological disorders” and “nutrition,” followed by “growth, development, and behavior” and some topics such as “physiopathology of body fluid and fluid therapy” and “gynecological problems in childhood” have not been mentioned and topics such as “human genetics,” “metabolic diseases,” and “special-needs children” had received very limited attention.

Figure 1

Frequency of pediatrics-related messages in newspapers based on topic

To identify the most important messages in the investigated newspapers, a data refinement stage was conducted. In the first stage, the subject clusters with a frequency of 200 or higher were selected from among 31 total clusters. These clusters include (1) psychological disorders, (2) nutrition, (3) growth, development, and behavior, (4) general health in children, and (5) fetus and infants and in the next stage, messages with the most frequency were determined in each cluster. Table 2 shows that in each important cluster, only three messages had a frequency higher than the threshold. For example, in the first cluster (psychological disorders), messages related to “anxiety disorder,” “extensive development disorders,” and “attention deficit hyperactivity disorder” were the first three frequent topics.

Table 2

Messages with most frequency in most frequent clusters

Finally, in the third stage, the most prominent topic in each cluster was investigated [Table 2], and the most important messages highlighted in the Iranian newspapers were identified [Table 3].

Table 3

Most important topics in pediatrics in widely circulated Iranian newspapers

Discussion

The results of the current study showed that among the investigated newspapers, Jam-e-Jam newspaper had published more than half of all articles related to pediatrics. These findings are similar to the results reported by Nasrollahzadeh and Shahbaztabar[11] that showed Jam-e-Jam newspaper having the highest amount of medical information.

The results show that the investigated newspapers had published several articles about pediatrics and one can say that this topic if popular among newspapers. These results are different from results of the study by Taghdisi et al.[7] who reported a lack of interest in medical information in Iranian newspapers but are similar to the results reported by Malek Afzali et al.[10] who reported that wieldy circulated newspapers publish medical information in more than 50% of situations.

In the current study, the most frequent messages were about “psychological disorders,” “nutrition,” “growth, development, and behavior,” “general health in children,” and “fetus and infants” which is similar to the results by Nasrollahzadeh and Shahbaztabar[11] who reported nutrition and psychology to be among the most frequent topics in newspapers. The results are also similar to that of the study by Amini et al.[8] who reported that components of food products have the most frequency in TV advertisements. Findings by Prabhu et al.[13] and Salzman[15] also showed that medical information in television was mostly focused on nutritional messages.

The results showed that the least frequent topics were “physiopathology of body fluid and fluid therapy,” “gynecological problems in childhood,” “human genetics,” and “metabolic diseases” which is different from the results reported by Mohammadpour Ahranjani et al.[9] that showed nutritional-related messages having the least amount of frequency. However, these results are similar to the results reported by Vedadhir et al.[19] that showed a lack of attention to women's health in magazines. Investigating the scientific articles indexed in “PubMed” database which is the most credible database in the medical fields[20] showed that between 2011 and 2016, there has been 437 articles on “human genetics”[21] and 23,554 articles on “metabolic diseases”[22] which show that despite a great amount of scientific production worldwide in these fields, these two topics have been neglected in Iranian newspapers. On the other hand, topic of “physiopathology of body fluid and fluid therapy” had no indexed articles between 2011 and 2016 in “PubMed” database[23] which shows a general lack of attention to this topic among researchers, perhaps due to the novelty of the field.

Five highlighted messages in Iranian newspapers were “anxiety in children-family (as the cause),” “not using milk-developmental disorder in children,” “anger management-teaching it to children,” “diarrhea-lack of relation with teething,” and “using junk food-premature birth” which should be investigated with regard to their accuracy and citation.

Topics such as psychological health, proper nutritional behavior, growth and development problems in children, and general health of fetus, infant, and children are among the important topics for societies and many parents use mass media to gain information on these topics. In this regard, newspapers as one of the most influential forms of media can play an important role in improving the knowledge, attitude, and health in families and society, especially when it comes to children. By publishing accurate scientific facts on pediatrics, newspapers can improve the knowledge of parents and families which leads to improving the health status of the society. Investigating the performance of newspapers in this regard showed that Iranian newspapers had paid adequate attention to pediatrics, but this attention suffers from an asymmetry in topic distribution. In other words, some topics such as “psychological disorders” and “nutrition” were mentioned with high frequency while topics such as “physiopathology of body fluid and fluid therapy” and “gynecological problems in childhood” were not mentioned at all. This shows that the information in Iranian newspapers is more in line with needs of Iranian society than the international needs because the most frequent topics in the results of the current study [Table 2] also appear among the research priorities of Iranian medical science universities and research centers,[24252627] whereas studies on child mortality show that topics such as congenital disorders, trauma (road accidents, burning,…), noncommunicable diseases (chronic respiratory disorders and acquired heart diseases) and cancers in childhood, diabetes, and obesity were the research priorities in pediatric health at an international level.[28]

Finally, this study aimed to provide an overview of articles on pediatrics published in Iranian newspapers to gain the attention of journalists and physicians alike. Due to the asymmetry in topics covered by newspapers on pediatrics, it can be suggested that pediatricians should cooperate with journalists in widely circulated newspapers, especially in neglected topic areas, to improve the knowledge of parents and society on these topics.

Financial support and sponsorship

Isfahan University of Medical Sciences, Deputy of Research and Technology.

Conflicts of interest

There are no conflicts of interest.