Skip to main content

Advertisement

Log in

Reach and Impact of a Mass Media Event Among Vulnerable Patients: The Terri Schiavo Story

  • Brief Report
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Background

It is unknown whether health-related media stories reach diverse older adults and influence advance care planning (ACP).

Objective

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.

Measurements

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.

Main Results

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%).

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1

References

  1. Grilli R, Ramsay C, Minozzi S. Mass media interventions: effects on health services utilisation. Cochrane Database Syst Rev. 2002(1):CD000389.

  2. Kravitz RL, Epstein RM, Feldman MD, et al. Influence of patients’ requests for direct-to-consumer advertised antidepressants: a randomized controlled trial. JAMA. 2005;293(16):1995–2002. Apr 27.

    Article  PubMed  CAS  Google Scholar 

  3. Mosca L, Mochari H, Christian A, et al. National study of women’s awareness, preventive action, and barriers to cardiovascular health. Circulation. 2006;113:525–34. Jan 31.

    Article  PubMed  Google Scholar 

  4. Frates J, Bohrer GG, Thomas D. Promoting organ donation to Hispanics: the role of the media and medicine. J Health Commun. 2006;11(7):683–98. Oct-Nov.

    Article  PubMed  Google Scholar 

  5. Moynihan R, Bero L, Ross-Degnan D, et al. Coverage by the news media of the benefits and risks of medications. N Engl J Med. 2000;342(22):1645–50. Jun 1.

    Article  PubMed  CAS  Google Scholar 

  6. Schwartz LM, Woloshin S. News media coverage of screening mammography for women in their 40s and tamoxifen for primary prevention of breast cancer. JAMA. 2002;287(23):3136–42. Jun 19.

    Article  PubMed  Google Scholar 

  7. Cram P, Fendrick AM, Inadomi J, Cowen ME, Carpenter D, Vijan S. The impact of a celebrity promotional campaign on the use of colon cancer screening: the Katie Couric effect. Arch Intern Med. 2003;163(13):1601–5. Jul 14.

    Article  PubMed  Google Scholar 

  8. Annas GJ. “Culture of life” politics at the bedside-the case of Terri Schiavo. N Engl J Med. 2005;352(16):1710–15. Apr 21.

    Article  PubMed  CAS  Google Scholar 

  9. Sudore RL, Landefeld CS, Barnes DE, et al. An advance directive redesigned to meet the literacy level of most adults: a randomized trial. Patient Educ Couns. 2007;69(1–3):165–95. Dec.

    Article  PubMed  Google Scholar 

  10. 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.

    Google Scholar 

  11. Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33–42. Sep.

    Article  PubMed  CAS  Google Scholar 

  12. 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.

  13. 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.

  14. Eisemann M, Richter J. Relationships between various attitudes towards self-determination in health care with special reference to an advance directive. J Med Ethics. 1999;25(1):37–41. Feb.

    Article  PubMed  CAS  Google Scholar 

  15. Hofmann JC, Wenger NS, Davis RB, et al. 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. 1997;127(1):1–12. Jul 1.

    PubMed  CAS  Google Scholar 

  16. Hanson LC, Rodgman E. The use of living wills at the end of life. A national study. Arch Intern Med. 1996;156(9):1018–22. May 13.

    Article  PubMed  CAS  Google Scholar 

  17. Weiss BD, Reed RL, Kligman EW. Literacy skills and communication methods of low-income older persons. Patient Educ Couns. 1995;25(2):109–19. May.

    Article  PubMed  CAS  Google Scholar 

  18. Volandes AE, Paasche-Orlow MK. Health literacy, health inequality and a just healthcare system. Am J Bioeth. 2007;7(11):5–10. Nov.

    PubMed  Google Scholar 

  19. Stacy M. More living wills is lasting legacy of Schiavo drama. The Associated Press State and Local Wire, March 20, 2006.

  20. Smith WR, Betancourt JR, Wynia MK, et al. Recommendations for teaching about racial and ethnic disparities in health and health care. Ann Intern Med. 2007;147(9):654–65. Nov 6.

    PubMed  Google Scholar 

Download references

Acknowledgements

Dr. Sudore and this study were supported by the American Medical Association Foundation; the National Institutes of Health/National Institute on Aging K07 AG000912; the National Institutes of Health Research Training in Geriatric Medicine Grant: AG000212; the Pfizer Fellowship in Clear Health Communication; the NIH Diversity Investigator Supplement 5R01AG023626–02; and an NIA Mentored Clinical Scientist Award K-23 AG030344–01. Dr. Schillinger was supported by an NIH Clinical and Translational Science Award UL1 RR024131.

The abstract of this paper was presented at the Society of General Internal Medicine conference in April 2007.

Conflict of Interest Statement

Dr. Sudore is funded in part by the Pfizer Foundation through the Clear Health Communication Fellowship. The Pfizer foundation was not involved in the design, acquisition of data, analysis, interpretation of the results, or the writing of this manuscript. No other authors report a conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rebecca L. Sudore MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sudore, R.L., Landefeld, C.S., Pantilat, S.Z. et al. Reach and Impact of a Mass Media Event Among Vulnerable Patients: The Terri Schiavo Story. J GEN INTERN MED 23, 1854–1857 (2008). https://doi.org/10.1007/s11606-008-0733-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-008-0733-7

KEY WORDS

Navigation