Reach and Impact of a Mass Media Event Among Vulnerable Patients: The Terri Schiavo Story
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It is unknown whether health-related media stories reach diverse older adults and influence advance care planning (ACP).
To determine exposure to media coverage of Terri Schiavo (TS) and its impact on ACP.
Design and Participants
Descriptive study of 117 English/Spanish-speakers, aged ≥50 years (mean 61 years) from a county hospital, interviewed six months after enrollment into an advance directive study.
We assessed whether participants had heard of TS and subject characteristics associated with exposure. We also asked whether, because of TS, subjects engaged in ACP.
Ninety-two percent reported hearing of TS. Participants with adequate literacy were more likely than those with limited literacy to report hearing of TS (100% vs. 79%, P < .001), as were participants with ≥ a high school vs. < high school education (97% vs. 82%, P = .004), and English vs. Spanish-speakers (96% vs. 85%, P = .04). Because of TS, many reported clarifying their own goals of care (61%), talking to their family/friends about ACP (66%), and wanting to complete an advance directive (37%).
Most diverse older adults had heard of TS and reported that her story activated them to engage in ACP. Media stories may provide a powerful opportunity to engage patients in ACP and develop public health campaigns.
- Grilli R, Ramsay C, Minozzi S. Mass media interventions: effects on health services utilisation. Cochrane Database Syst Rev. 2002(1):CD000389.
- Kravitz, RL, Epstein, RM, Feldman, MD (2005) Influence of patients’ requests for direct-to-consumer advertised antidepressants: a randomized controlled trial. JAMA 293: pp. 1995-2002 CrossRef
- Mosca, L, Mochari, H, Christian, A (2006) National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation 113: pp. 525-534 CrossRef
- Frates, J, Bohrer, GG, Thomas, D (2006) Promoting organ donation to Hispanics: the role of the media and medicine. J Health Commun 11: pp. 683-698 CrossRef
- Moynihan, R, Bero, L, Ross-Degnan, D (2000) Coverage by the news media of the benefits and risks of medications. N Engl J Med 342: pp. 1645-1650 CrossRef
- Schwartz, LM, Woloshin, S (2002) News media coverage of screening mammography for women in their 40s and tamoxifen for primary prevention of breast cancer. JAMA 287: pp. 3136-3142 CrossRef
- Cram, P, Fendrick, AM, Inadomi, J, Cowen, ME, Carpenter, D, Vijan, S (2003) The impact of a celebrity promotional campaign on the use of colon cancer screening: the Katie Couric effect. Arch Intern Med 163: pp. 1601-1605 CrossRef
- Annas, GJ (2005) “Culture of life” politics at the bedside-the case of Terri Schiavo. N Engl J Med 352: pp. 1710-1715 CrossRef
- Sudore, RL, Landefeld, CS, Barnes, DE (2007) An advance directive redesigned to meet the literacy level of most adults: a randomized trial. Patient Educ Couns 69: pp. 165-195 CrossRef
- Sudore RL, Schickedanz AD, Landefeld CS, et al. Engagement in multiple steps of the advance care planning process: a descriptive study of diverse older adults. J Am Geriatr Soc. 2008;56(6):1006–13, Apr 10.
- Baker, DW, Williams, MV, Parker, RM, Gazmararian, JA, Nurss, J (1999) Development of a brief test to measure functional health literacy. Patient Educ Couns 38: pp. 33-42 CrossRef
- Lexisnexis Academic Database. Search terms: “Terri Schiavo” for all English, full-text articles within the Major U.S. and World Publications search category and all non-English full-text publications within the major world publications search category. http://academic.lexisnexis.com. Accessed June 27, 2008.
- Vanderbilt Television News Archives. Search Terms: “Terri Schiavo” for all evening news coverage for ABC, CBS, NBC, CNN, PBS, FOX, MSNBC,CSPAN, and CNBC. http://tvnews.vanderbilt.edu. Accessed June 27, 2008.
- Eisemann, M, Richter, J (1999) Relationships between various attitudes towards self-determination in health care with special reference to an advance directive. J Med Ethics 25: pp. 37-41 CrossRef
- Hofmann, JC, Wenger, NS, Davis, RB (1997) Patient preferences for communication with physicians about end-of-life decisions. SUPPORT investigators. Study to understand prognoses and preference for outcomes and risks of treatment. Ann Intern Med 127: pp. 1-12
- Hanson, LC, Rodgman, E (1996) The use of living wills at the end of life. A national study. Arch Intern Med 156: pp. 1018-1022 CrossRef
- Weiss, BD, Reed, RL, Kligman, EW (1995) Literacy skills and communication methods of low-income older persons. Patient Educ Couns 25: pp. 109-119 CrossRef
- Volandes, AE, Paasche-Orlow, MK (2007) Health literacy, health inequality and a just healthcare system. Am J Bioeth 7: pp. 5-10
- Stacy M. More living wills is lasting legacy of Schiavo drama. The Associated Press State and Local Wire, March 20, 2006.
- Smith, WR, Betancourt, JR, Wynia, MK (2007) Recommendations for teaching about racial and ethnic disparities in health and health care. Ann Intern Med 147: pp. 654-665
- Reach and Impact of a Mass Media Event Among Vulnerable Patients: The Terri Schiavo Story
Journal of General Internal Medicine
Volume 23, Issue 11 , pp 1854-1857
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- mass media
- public health
- advance care planning
- health literacy
- vulnerable populations
- Industry Sectors
- Author Affiliations
- 1. Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
- 2. San Francisco VA Medical Center, San Francisco, CA, USA
- 3. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- 4. UCSF Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, CA, USA