BLACK NEWSPAPERS AS A TOOL FOR CANCER EDUCATION IN AFRICAN AMERICAN COMMUNITIES
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BLACK NEWSPAPERS AS A TOOL FOR CANCER EDUCATION
IN AFRICAN AMERICAN COMMUNITIES
Background. Despite the long history, wide Charlene A. Caburnay, PhD, MPH; Matthew W. Kreuter, PhD, MPH;
reach and unique influence of Black newspa- Glen Cameron, PhD; Douglas A. Luke, PhD; Elisia L. Cohen, PhD;
pers in many African American communities,
no national studies have examined how these Lillie McDaniels, MPH; Monica Wohlberg, MHA; Paul Atkins, MHA
newspapers cover health and cancer issues, or
reader perceptions of their coverage.
INTRODUCTION
Design and Participants. A two-year national
sample of Black newspapers (n524) and This paper examines how
community-matched general audience news-
Cancer is the second leading cause
papers (n512) was reviewed, and 8,690 of death among African Americans, Black newspapers report
health and cancer stories were identified and accounting for 21.5% of all deaths.1
content analyzed. A survey of 783 Black Although racial disparities have de-
cancer information and how
newspaper readers in the same 24 communi-
ties assessed reading frequency and percep-
creased from 1997–2007, African readers of these newspapers
Americans continue to suffer from
tions of reporting for both types of newspapers,
cancer at a higher rate relative to other perceive the coverage.
as well as readers’ health concerns and cancer
screening behaviors. groups.1 This paper examines how
Black newspapers report cancer infor-
Results. As a proportion of total health mation and how readers of these local Black communities.5–7 Because
coverage, Black newspapers published more
newspapers perceive the coverage. Our Black newspapers are especially attentive
cancer stories than general audience newspa-
pers, and their stories were more likely to study’s aims were to: 1) summarize what and responsive to local issues,8 they are
contain localized information, address dispar- is known about Black newspapers’ often viewed as a voice of the local Black
ities, focus on prevention, include calls to influence and reach; 2) describe and community9,10 and accorded the same
action for readers and refer readers to cancer compare the amount and nature of status as other social institutions like
information resources (all P,.001). Black
newspaper readers identified cancer as the
cancer coverage in Black and general schools and churches.11,12
health issue that concerned them most, yet
audience newspapers from 24 US cities; Although Black newspapers cannot
rated it the fourth most important health and 3) describe and compare percep- match the reach of general audience
problem affecting African Americans. tions of cancer coverage in both types of newspapers, they serve a large proportion
newspapers and health concerns in a of the US Black population. The National
Conclusions. Black newspapers hold promise sample of Black newspaper readers from Newspaper Publishers Association (the
for helping to eliminate cancer disparities by
increasing cancer awareness, prevention, and
the same 24 cities. ‘‘Black Press of America’’) and others
screening among African Americans. (Ethn Dis. report there are over 200 Black weekly
2008;18:488–495) Social significance, reach and use newspapers across the United States, with
of Black newspapers a combined circulation of 6 to 15 million
Key Words: Black Newspaper, African
Black newspapers were originally readers.13,14 From 1965–2000, such
Americans, Cancer Disparities, News
established to enhance the quality of community newspapers saw a threefold
life of American Blacks by providing a increase in circulation —a direct contrast
mechanism for public dialogue within to the stagnation of daily newspapers’
Black communities, a counterpoint to circulation15,16 as verified by recent data
negative representations of Blacks, and from the Audit Bureau of Circulations17
From Health Communication Research an outlet for stories of unique interest or and other studies.18,19 A 2005 survey of
Laboratory, George Warren Brown School concern to Black communities.2,3 As media use among ethnic American adults
of Social Work, Washington University in St. stated in an editorial in the 1827 found that Black newspapers reach at least
Louis, St. Louis, MO (CAC, MWK, DAL, LM,
opening issue of Freedom’s Journal, the 25% of all African Americans.20 Because
MW, PA); Department of Communication,
University of Kentucky (EC), and Missouri nation’s first Black newspaper: ‘‘We most Black newspapers are free and
School of Journalism, University of Missouri- wish to plead our own cause. Too long widely accessible in Black communities,
Columbia, Columbia, MO (GC). have others spoken for us.’’4 Black they are often passed on to be reread by
newspapers still serve certain functions others,21 suggesting that reach may be
Address correspondence and reprint
that general audience newspapers do higher than circulation numbers indicate.
requests to Charlene A. Caburnay, PhD,
MPH; 700 Rosedale Ave, Campus Box not, including addressing health and In an age of increasing use of the Internet
1009; St. Louis, MO 63112; 314-935-3703; other issues that are especially important for news and declining readership of
314-935-3757; ccaburnay@wustl.edu and relevant to African Americans and traditional newspapers, the success of
488 Ethnicity & Disease, Volume 18, Autumn 2008BLACK NEWSPAPERS FOR CANCER EDUCATION - Caburnay et al
community papers has been attributed to deciding what issues to report on and papers and randomly selected 12 of the
their ability to target selected audiences, how those issues will be presented to the same communities to include their
focus on local news, and provide different public, the press influences what people largest circulation general audience
kinds of information than found in think about and how they think about newspapers. Details of the sampling
general audience daily newspapers.16,19,22 it.31–33 According to agenda setting frames have been previously reported.36
theory, if cancer prevention and control Analyses were conducted with SPSS
Studies of health and cancer issues were consistently and prominent- v.13.0.37
coverage in Black and general ly covered in the news media, those
audience media exposed to the coverage would be more Identifying Health and Cancer Stories
Empirical studies of health and likely to perceive cancer prevention and Each Black newspaper issue
cancer coverage in Black media have control as an important issue.34 When (N52,190) was read in its entirety to
been relatively rare. Many African Amer- cancer-related issues are perceived by identify health- and cancer-related sto-
icans perceive that general audience media the public as important, we would ries. Health-related stories were those
present an unbalanced portrayal of their generally expect greater individual, pertaining to health promotion, well-
racial group. Studies of news coverage community, and political support for ness, disease prevention, well-being,
provide empirical support for this be- cancer prevention and control activi- lifestyle, and any mental, physical or
lief.23–25 Studies have also shown that ties,35 potentially reducing cancer dis- spiritual aspects of health. Cancer-relat-
Black media sources are trusted, valued, parities. ed stories contained within the headline
and preferred by African Americans.20,26 In summary, a relatively limited or first 2 paragraphs cancer key words
A 2002 study examined HIV/AIDS research literature suggests news cover- (eg, cancer, tumor, lump). Inter-coder
coverage in five African American age in general audience media is reliability for story identification was
newspapers from 1991 to 1996.27 Of perceived by many African Americans high (mean kappa50.87).
the 201 stories that framed HIV/AIDS as racially biased and not adequately For general audience newspapers,
as a health issue, one-third (33%) addressing health issues important to we used a ‘‘constructed week’’ sam-
contained mobilizing information, African Americans. In contrast, Black pling approach in order to minimize
50% discussed any type of prevention. newspapers reach large numbers of the costs (ie, time, personnel) of
Hoffman-Goetz et al (1997) tracked the African Americans with coverage that analyzing daily newspapers.38 Using this
number and type of cancer-related is community- and race-specific. De- method, sample dates are stratified by
stories in three Black magazines – spite the apparent promise of Black day of the week to account for system-
Ebony, Essence, and Jet – from 1987– newspapers as a channel for cancer atic variation. Each month, a construct-
1994. In 596 total issues, only 84 stories information to reduce disparities, sur- ed week was selected for each of the 12
focused on cancer (13% of health prisingly little is known about their general audience newspapers. Each
articles).28 In a study of 25 ethnic actual coverage of health and cancer newspaper issue comprising the con-
minority newspapers in Canada pub- issues, and about their readers’ knowl- structed week was read for health and
lished in 2000, a total of 27 cancer edge, awareness and perceived impor- cancer stories using the definitions
articles were printed.29 Of these, only 3 tance of cancer. This study helps fill above.
articles were published in Black/Carib- these gaps by reporting findings from
bean newspapers from 1,549 total pages the first national study of cancer Coding Health and Cancer Stories
searched. In a study of 565 cancer coverage in Black newspapers. Cancer-related stories were coded
stories from a sample of 283 English- for journalistic and public health vari-
language newspapers in the Ethnic ables; non-cancer health-related stories
NewsWatch database, cancer stories in METHODS were coded for journalistic variables
ethnic newspapers were written at lower only. Inter-coder reliability measured
literacy levels and were more likely to Sample of Black newspapers as intraclass correlation coefficient
discuss cancer prevention, awareness, All health and cancer-related stories (ICC) or kappa follows each variable.
and education compared to stories in published in 24 Black weekly newspa-
general audience newspapers.30 pers and 12 community-matched gen- Journalistic Variables. Total area
eral audience daily newspapers for two was measured by summing the square
Theoretical basis for media full years (Jan. 2004–Dec. 2005) were inches of text in a story, not including
effects through newspapers identified and content analyzed. We headlines or graphics (ICC50.89).
News media are an important part selected for inclusion in the study 24 Location of the story was classified as
of the information environment. By communities with weekly Black news- above or below the fold (kappa50.90).
Ethnicity & Disease, Volume 18, Autumn 2008 489BLACK NEWSPAPERS FOR CANCER EDUCATION - Caburnay et al
Visual elements (yes/no) included pho- criteria (1,085 ineligible due to not sonally. First they were asked to indicate
tographs or other graphics (ICC50.62). reading the local Black newspaper; 546 which three health problems – from a
Local angle (yes/no) was defined as were , 21 years old; 2,470 did not list that included HIV/STDs, high
information specific to the newspaper’s identify as African American; 1,200 blood pressure, heart disease, stroke,
local audience (kappa50.83). were not household members). Of the violence, cancer, and diabetes – they
remaining eligible individuals, 1,585 felt most affected Blacks. Respondents
Public Health Variables. Disparity (4.7%) initially agreed to participate were then asked an open-ended ques-
information in a story (yes/no) required and provided contact information for tion about what health issue had
reporting differences in the incidence, another phone call to complete the concerned them the most in the last
prevalence, mortality, or burden of survey. Of these, a total of 783 12 months.
diseases (kappa50.93). Mobilization (49.4% of all eligible contacts) com-
(yes/no) was measured separately for pleted the reader survey and received a Cancer Screening Behaviours. Based
individuals (‘‘personal mobilization’’; $15 gift card or check. on respondents’ age and sex and in
kappa50.72) and the community accord with US Preventive Services Task
(‘‘community mobilization’’; kap- Measures Force guidelines,40 respondents were
pa50.56) and identified explicit recom- The 20-minute survey included the asked if they had ever had specific
mendations to improve one’s own following items: screening tests and if so, when (in
health or that of the community, months) they last had the test. For
respectively. Prevention focus was mea- Use of Newspapers. Use of both each screening type, interviewers
sured as the highest level of prevention Black and general audience newspapers first presented respondents with a lay
(highest: primary, lowest: tertiary) dis- was measured by the number of times description of the test followed by
cussed in the story (kappa50.62). per month the respondent read the local specific questions (eg, A sigmoidoscopy
Cancer site was defined as the primary Black/general audience newspaper. is an exam of the lower colon and the
cancer location (kappa50.88). Referral rectum using a thin, lighted tube called a
to resources (yes/no) included detailed Perceptions of Reporting in Black sigmoidoscope. Have you ever had a
contact information for obtaining can- Newspapers. In four separate items, sigmoidoscopy?)
cer-related resources (kappa50.89). respondents indicated how strongly
they agreed or disagreed (5-point scale) Cancer History. Respondents were
Reader Survey with statements about the reporting asked in a single item if they or any of
The primary objective of the reader and influence of the local Black news- their brothers, sisters, parents, children,
survey was to better understand Black paper. or other close family members ever had
newspaper readers’ use and perceptions cancer.
of Black and general audience newspa- Comparisons of Black and General
pers as well as their knowledge, atti- Audience Newspaper Coverage. Respon- Demographics. Respondents’ age,
tudes, beliefs and behaviors related to dents indicated how strongly they years of education, household income,
cancer. The survey was conducted from agreed or disagreed (5-point scale) with employment and marital status were
September 2005 through April 2006, the fairness and balance of the reporting recorded.
in the same 24 communities whose in the local Black newspaper/general
Black newspapers were selected for the audience newspaper and the coverage of
study. We obtained sets of random certain issues and events in both types of RESULTS
telephone numbers from census tracts newspapers. We also used items from
with .60% African American popula- the National Cancer Institute’s Health Content Analysis
tion, stratified into lower, middle, and Information National Trends Survey A total of 2,190 weekly Black
higher median income. Eligible re- (HINTS).39 In separate items, respon- newspaper issues and 4,364 daily gen-
spondents were those 21 years of age dents were asked how much they would eral audience newspaper issues were
or older, living at the location of the trust (4-point scale: a lot to a little) reviewed. Of these, 1,391 Black news-
dialed number, having read the local information about cancer from six paper issues (63.5%) and 1,302 general
Black newspaper at least once in the different sources. audience newspaper issues (29.8%)
past four weeks, and self-identifying as contained at least one health story.
African American. Health Concerns. Respondents were Black newspapers contained a total of
Of 39,016 individuals reached, asked about their health concern for 4,158 health stories, and general audi-
5,301 (13.6%) did not meet inclusion Blacks generally, and themselves, per- ence newspapers contained 4,352 health
490 Ethnicity & Disease, Volume 18, Autumn 2008BLACK NEWSPAPERS FOR CANCER EDUCATION - Caburnay et al
and averaged 50 years old (SD5 Black newspaper does a good job
Of these health stories, 14.4% 15 years). Because the sampling frame reporting on issues relevant to the Black
was stratified by household income, this community and covers issues and events
of those in Black newspapers variable is normally distributed. Most not covered in the general audience
were cancer-related (n5598), respondents were either currently em- newspaper, (93% and 92%, respective-
ployed (46%) or retired (23%). Using ly). After doctors or other healthcare
compared to 10.4% of stories guidelines for cancer screening and professionals, Black newspapers were
(n5472) in general audience respondents’ self-reported time of last the most frequently cited media source
screening, 86% of women ages 40 respondents reported turning to for
newspapers (P,.001). and older (n5436) were up-to-date health or medical information.
on use of mammography; 89% of all
women (n5595) were up-to-date on Health Concerns
Pap testing; and of all respondents The health problems most likely to
stories, or an average of 1.9 and 1.0
.50 years of age and older (n5398), be listed by respondents as among the
health stories per issue, respectively. Of
51% were up-to-date on fecal occult ‘‘top three’’ health problems affecting
these health stories, 14.4% of those in
blood testing, and 45% were up-to-date African Americans were high blood
Black newspapers were cancer-related
on use of sigmoidoscopy. A majority of pressure (chosen by 65% of respon-
(n5598), compared to 10.4% of stories
respondents (72%) had personal or dents), diabetes (61%), HIV/STDs
(n5472) in general audience newspa-
family history of cancer. (56%), cancer (39%), and heart disease
pers (P,.001).
(31%). When stratified by respondent
Journalistic Variables Use of Black and General age in decades (ie, ,30, 30–39, …,
Cancer stories in Black newspapers
Audience Newspapers $70 years), HIV/STDs was the most
were significantly larger than those in Table 2 describes survey respon- commonly identified health problem
general audience newspapers and more dents’ use and perceptions of Black affecting African Americans by those
likely to have a local angle. There were and general audience newspapers as well ,60 years, whereas high blood pressure
no differences by newspaper type in as their health concerns. On average, is the top problem for those §60 years.
story location or presence of a visual. respondents reported reading the local Respondents who have had a personal/
Table 1 summarizes cancer coverage by Black newspaper 2.7 times per month family history of cancer identified the
type of newspaper. (out of 4–5 weekly issues per month), same health problems in the same order
and the local daily general audience and roughly the same proportions:
Public Health Variables newspaper 14.5 times per month (out of high blood pressure (66% of respon-
Cancer stories in Black newspapers 30–31 daily issues per month). Fre- dents), diabetes (60%), HIV/STDs
were more likely than those in general quency of reading Black newspapers did (53%), cancer (43%), and heart disease
audience newspapers to include infor- not vary significantly by sex, age, (29%).
mation on racial disparities, personal education, or income. In contrast, When asked an open-ended question
mobilization and community mobiliza- frequency of reading general audience for the health issue that had concerned the
tion. They were also more likely to newspapers increased with higher levels respondent the most in the last
address prevention in general, secondary of education (P5.001) and income 12 months, cancer was named most
prevention (ie, screening and early (P5.01), and was positively correlated frequently (32%), followed by diabetes
detection) specifically, and to refer with age (P5.001). (15%), high blood pressure (10%), HIV/
readers to topic-related resources. Breast STDs (9%), and heart disease (8%). For
and prostate cancers were the leading Perceptions of Black and General all age categories, cancer was the health
cancer sites covered in both types of Audience Newspaper Coverage issue that concerned respondents most,
newspapers, although prostate cancer At least 84% of respondents strongly followed by HIV/STDs for those
accounted for a larger proportion of all agreed or agreed that the local Black ,50 years, and diabetes for those
cancer stories in Black newspapers. newspaper: 1) has a lot of influence in $50 years. Respondents who have had a
the Black community; 2) shows how personal/family history of cancer named
Reader Survey national news affects the local commu- the same health issues in the same order
nity; 3) does a good job reporting on and roughly the same proportions: cancer
Respondent Characteristics local issues; and 4) is fair and balanced (36%), diabetes (14%), high blood
Respondents were mostly women in its reporting. Many respondents also pressure (9%), HIV/STDs (9%), and
(76%), completed high school (86%), strongly agreed or agreed that the local heart disease (7%).
Ethnicity & Disease, Volume 18, Autumn 2008 491BLACK NEWSPAPERS FOR CANCER EDUCATION - Caburnay et al
HIV/AIDS, a leading cause of death for
Table 1. Characteristics of cancer stories in Black and general population
newspapers African Americans in their 20s and 30s,
was rated lower as a personal health
Black newspapers General population concern than as a problem affecting
(n=598 stories) newspapers (n=472 stories) P
Blacks. However, this would not explain
Journalistic variables why diabetes and high blood pressure
Average size in square inches 28.6 24.4 ,.001
Percent with local angle 36.3 25.5 .001 were rated lower as personal health
Percent with a visual 43.1 43.0 .965 concerns than as population threats. A
Percent above fold 74.9 74.1 .772 follow-up analysis that controlled for
Public health variables
frequency of reading Black and general
Percent with disparity information 29.8 10.4 ,.001
Percent with personal mobilization 42.4 15.0 ,.001 audience newspapers, age, education,
Percent with community mobilization 16.4 4.9 ,.001 and personal or family history of cancer
Percent with any prevention focus 79.7 69.7 ,.001 did not change these results. Though
Percent with primary prevention 30.0 25.4 .096
not asked in the current study, future
focus
Percent with secondary prevention 36.3 20.3 ,.001 research may explore how personal or
focus family history of these specific health
Percent with referral to resources 42.5 23.3 ,.001 issues (other than cancer) could help
Percent with primary cancer site ,.001
Breast 31.3 22.5
explain these discrepancies.
Prostate 19.2 9.1 Third, the study found that frequen-
Colon and rectum 7.5 6.4 cy of reading general audience newspa-
Leukemia 3.5 1.7 pers varied by education, income, and
Lung and bronchus 1.7 7.6
Uterus 1.5 1.1 age, but was constant for readers of
Ovary 1.0 2.5 Black newspapers. To the extent that
socioeconomic status is an indicator of
disparity, general audience newspapers
DISCUSSION media sources. Black and general are read less by the most disadvantaged
audience newspapers both appear to African Americans. This finding high-
Exploring underutilized channels for serve important functions in Black lights and supports one unique feature
cancer communication is necessary to communities. The unique aspects of of Black newspapers – that their use is
help eliminate cancer disparities. Re- Black newspapers – including covering more universal and not limited to
search using these channels can help issues and events specific for their local members of the population with higher
inform future health communications African American readership – might levels of education or income. As a
and have implications for cancer-relat- lend themselves to covering cancer or result, use of the Black newspaper as a
ed policies. This national-level study of other health topics in a similar, com- channel for cancer communication
health and cancer coverage in Black munity-focused way. should reach a broader cross section of
newspapers expands the limited exist- Second, respondents to the reader African Americans than would general
ing literature with three main findings. survey thought that health issues other audience newspapers.
First, Black newspapers publish pro- than cancer were more serious for Although cancer coverage in Black
portionately more stories about cancer Blacks, yet cancer was the most impor- newspapers is more likely to have a local
than general audience newspapers, and tant health issue for them personally. angle, disparity information, personal
this coverage contains more desirable This discrepancy is interesting given mobilization, any prevention focus, and
attributes for public health advocates, that cancer is the second leading cause referral to resources than general audi-
such as being locally relevant and of death among Blacks in the United ence newspapers, these attributes are
containing mobilization information, States 1 – and that incidence and still found in less than half of all cancer
referrals to resources, and prevention mortality rates for a wide range of stories. Both Black and general audience
information. Findings from both the cancers are higher among African newspapers still have room to improve
content analysis and reader survey also Americans than any other racial or on their current quality of cancer
support claims that Black newspapers ethnic group.1,39 Given that certain coverage.
are community-focused. Black news- diseases are more likely to affect younger
papers are also a trusted source of or older adults, the age of the survey Limitations
cancer information, trusted more than sample (mean550 years) might explain Three limitations of the study
general audience newspapers or other part of these findings. For example, must be recognized. First, although the
492 Ethnicity & Disease, Volume 18, Autumn 2008BLACK NEWSPAPERS FOR CANCER EDUCATION - Caburnay et al
Table 2. Respondents’ newspaper use, perceptions of coverage and health concerns (N=783)
Newspaper use
Average times/month (SD) has read the local (weekly) Black newspaper 2.7 (3.2)
Average times/month (SD) has read the local (daily) general population newspaper 14.5(12.2)
Perceptions of Black newspapers
The local Black newspaper has a lot of influence in the Black community.* 85.7%
The local Black newspaper shows how national news affects my community.* 84.0%
The local Black newspaper does a good job reporting local issues.* 90.4%
The local Black newspaper does a good job reporting on issues relevant to Black community.* 92.9%
Comparing Black and general population newspapers
The local Black newspaper is fair and balanced in its reporting.* 84.3%
The general population newspaper is fair and balanced in its reporting.* 53.4%
In the Black newspaper I can read about issues and events not covered in the general population newspaper.* 91.8%
How much would you trust the information about cancer from:3
A doctor or other health care professional 71.4%
Black newspapers 51.2%
The Internet 46.7%
Television 37.5%
Magazines 36.0%
General population newspapers 33.1%
Family or friends 24.4%
The radio 21.7%
Health concerns
Top health problems affecting Blacks4
High blood pressure 65.1%
Diabetes 61.2%
HIV/STDs 55.6%
Cancer 39.0%
Heart disease 31.2%
Violence 25.0%
Stroke 21.6%
Health issue of most concern to you in last 12 months (n5731)
Cancer 31.7%
Diabetes 14.6%
High blood pressure 9.6%
AIDS/HIV/STDs 9.3%
Heart disease, heart attacks 8.3%
Other topics 26.4%
* Percent ‘‘strongly agree’’ or ‘‘agree.’’
3 Percent stating ‘‘a lot.’’
4 Because respondents could mention any three health problems, percentages do not total 100%.
study reports on a national sample of local Black newspaper on a more cases, because these characteristics are
Black newspapers, it was not intended sporadic basis and may have inflated more likely to be ‘‘absent’’ from articles
to be a nationally representative sample. estimates of reading frequency, though in Black and/or general audience news-
Findings may not be generalizable to it is not clear whether or how it might papers and thus more difficult to assess
other weekly Black newspapers, or to affect observed differences between use reliability for their identification, the
daily or monthly Black newspapers in and perceptions of Black vs general calculated kappa yields a more conser-
the United States. audience newspapers. However, if the vative estimate of reliability. For exam-
Second, respondents in the reader purpose of media intervention is to ple, reliability for personal mobilization
survey were those who had read the target those who regularly read Black in terms of percent agreement is
local Black newspaper in our study at newspapers, these results are particularly relatively higher (87%) than kappa
least once in the past month. This relevant. (.72); a similar difference for commu-
selection bias may have resulted in a Third, a few of the content analysis nity mobilization is also found (75% vs
sample of Black newspaper readers who variables had relatively low (ie, ,0.75) .56), For these reasons, results from
are different than others who read the inter-coder reliability. In some of these these variables with lower reliability
Ethnicity & Disease, Volume 18, Autumn 2008 493BLACK NEWSPAPERS FOR CANCER EDUCATION - Caburnay et al
should be viewed with caution until source. The Howard Journal of Communica- 25. Swain K, Walsh-Childers K, Chance J.
replicated in other studies of cancer tions. 1999;10(3):147–167. Minorities in health stories: How newspapers
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ACKNOWLEDGMENTS 15. Hatcher J. Passion for the ‘minor leagues’: mass print media. Ethn Dis. 2005;15(2):
This study was supported by the National Nurturing devotion in an increasingly corpo- 332–340.
Cancer Institute’s Centers of Excellence in rate community press. Columbia Journalism 30. Stryker J, Emmons K, Viswanath K. Uncov-
Cancer Communication Research program Review. May/June 2003. ering differences across the cancer control
(CA-P50-95815). 16. Davis N. Ring around the metros. Presstime. continuum: A comparison of ethnic and
September 1999. mainstream cancer newspaper stories. Preven-
The authors thank Stephanie McClure,
17. Thomasch P. Small towns are bright spots for tive Medicine. 2007;44(1):20–25.
Anthony Hurst, and I-Huei Cheng for
US newspapers. Reuters. June 12, 2006. 31. Wallack L, Dorfman L, Jernigan D, Themba
assistance with literature reviews that led to
18. Sheppard J. The strength of weeklies. Am M. Media Advocacy and Public Health:
this paper; Jon Stemmle and research
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assistants for coding newspapers; and to the
19. Lauterer J. Hold that obit! The report of our Sage; 1993.
HCRL Call Center for conducting the 32. McCombs M, Shaw D. The agenda setting
death has been greatly exaggerated. Paper
reader survey. function of mass media. Public Opinion
presented at: Newspapers and Community-
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2002. Wohlberg, Atkins Luke, Cohen
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