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

  • Rebecca L. Sudore
  • C. Seth Landefeld
  • Steven Z. Pantilat
  • Kathryn M. Noyes
  • Dean Schillinger
Brief Report



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.

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%).


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.


mass media public health advance care planning health literacy vulnerable populations 



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.


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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Rebecca L. Sudore
    • 1
    • 2
    • 3
  • C. Seth Landefeld
    • 1
    • 2
    • 3
  • Steven Z. Pantilat
    • 3
  • Kathryn M. Noyes
    • 1
    • 2
  • Dean Schillinger
    • 3
    • 4
  1. 1.Division of GeriatricsUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.San Francisco VA Medical CenterSan FranciscoUSA
  3. 3.Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  4. 4.UCSF Center for Vulnerable PopulationsSan Francisco General HospitalSan FranciscoUSA

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