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The Woodhull Study Revisited: Twenty Years of Nurses in Health News A Study of Nurses' Representation in Health News Media

Mason, left, Glickstein, right

Diana J. Mason, PhD, RN, FAAN, principal investigator, Barbara Glickstein, MPH, MS, RN, co-investigator

At 4 million strong, nurses make up the largest segment of the health care workforce and are consistently considered the most trustworthy profession, according to Gallup polls. Yet their voices and images have been woefully underrepresented in health news stories, despite their relevance to almost any health issue.

In 1998, Sigma Theta Tau, the nursing honorary society, published "The Woodhull Study on Nursing and the Media: Health Care's Invisible Partner," documenting that nurses were used as sources in only 4 percent of health news stories in leading newspapers, and only 1 percent in weeklies and industry publications. The study also found nurses were seldom identified in photos accompanying stories.

The media landscape has changed a lot in 20 years. So has nursing. We launched the Woodhull Study Revisited to see what's different now.

The new study had two phases. The first replicated the original Woodhull study. Partnering with Berkeley Media Studies Group, we collected healthcare stories from the same sources used in 1998 -- nearly 550 articles from eight newspapers, four magazines and three healthcare industry publications, published in September 2017.

Mason, D.J., Nixon, L., Glickstein, B. Han, S., Westphaln, K. & Carter, L. (2018). The Woodhull Study Revisited: Nurses' Representation in Health News Media 20 Years later. Journal of Nursing Scholarship, 50(6), 695-704.

The results were disappointing -- for nurses, whose work on the front lines gives them unique insight; for the media, whose job includes seeking out a diversity of knowledgeable voices; and for the public, who should have more access to nurses' perspectives and knowledge.

Top line: Nurses are missing from health news stories.

Among the most startling numbers:

Cartoon credit: MK Czerwiec, RN, MA

Nurses were most likely to be mentioned in articles about labor (57 percent), profession (44 percent), quality (32 percent), and education (25 percent). They were less likely to be mentioned in articles about research (9 percent), policy (4 percent), the Affordable Care Act (4 percent), and business (3 percent). They were more likely to be mentioned in industry press (14 percent) or newspapers (14 percent) compared to news magazines (6 percent), according to the study.

The study identified numerous instances of stories where nurses were absent, even though their perspectives were highly relevant to the topic being discussed. Nurses were never sourced in stories about health policy.

Men were quoted roughly twice as often as women (65 percent and 34 percent, respectively), the study found.

Nurses were identified in 4 percent of the photos analyzed. Women were in 25 percent of the photos; and men in 49 percent, according to the study.

The second phase of the study looked at health journalists' experiences with using nurses as sources. We interviewed 10 health journalists about their experiences with finding and reaching nurses as sources in their stories, as well as their perspectives on related barriers.

Mason, D.J., Glickstein, B., & Westphaln, K. (2018). Journalists’ experiences with using nurses as sources in health news stories. American Journal of Nursing, 118(10), 42-50.

The study found journalists are uncertain about what nurses do and how to find them for interviews on specific health topics. They are not sure when and how to use them if the story is not about nurses or nursing.

When they do use nurses as sources, the journalists may have to justify doing so to their editor, particularly if a physician is not also a source in the story, the study found.

Nurses can provide important perspectives to stories but are often slow to respond to journalists’ requests for interviews and may be reluctant to be interviewed, the study found.

Cartoon credit: MK Czerwiec

Journalists rarely get press releases from nursing journals on new research, the study found.

Public relations/communications staff at healthcare organizations and universities do not offer nurses for interviews unless the journalist requests to interview a nurse, the study found.

Now what?

The good news is there are steps that nurses, journalists and institutions like nursing schools and hospitals can take to bring nurses' voices into the media.

The time is now to change the health narrative to reflect more diverse voices in health news.

What will you do to help achieve this?

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