The Truth About Nursing
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Q: I get that the public health community and even Hollywood itself believes that the entertainment media has a big effect on real world health. But is there any actual research showing it affects what people think and do about health issues like nursing?

A: Yes. In recent years respected studies have shown that entertainment television has a clear and powerful effect on viewers' health-related thoughts--and actions. In the wake of this evidence, to argue that shows like Grey's Anatomy and House have no effect on the real world of health care is simply untenable.

Research has documented the role that entertainment TV plays as [a] source of personal health information. But beyond providing specific information about topics such as cancer, heart disease, or HIV, the 'cultivation theory' of media studies suggests that entertainment media are also likely to play a role in shaping viewers' broader conceptions of the health care system. (Turow and Gans, "As Seen on TV: Health Policy Issues in TV's Medical Dramas," Report to the Kaiser Family Foundation, 2002, p. 1 (citations omitted))

In particular,

research suggests that fictional TV shows may also have an impact on viewers' perceptions of issues such as the quality of managed care, the rights of patients under current law, whether insurance companies are providing sufficient coverage, and end-of-life decisions. Related work suggests, too, that TV viewers may well mix what they see on news and entertainment together, thereby creating a composite sense of the world from both types of programming. (Turow and Gans, p. 1 (citing five studies dating from 1996-2001, citations omitted))

Thus, in 2002, Turow and Gans directed a study in which every single prime time U.S. hospital drama episode in the 2000-2001 season was reviewed in order to analyze the discussion of health policy issues (not surprisingly, they found that physicians dominated discussions of such issues, while nurses and other health care team members hardly existed in policy scenes). (Id. at 22-23)

JWT CommunicationsAt least one recent study has suggested a link between public attitudes toward nursing and "ER." In a 2000 JWT Communications focus group study of youngsters in grades 2-10, respondents said they received their main impression of nursing from "ER." (JWT Communications, "Memo to Nurses for a Healthier Tomorrow Coalition Members on a Focus Group Study of 1800 School Children in 10 US Cities," 2000) Consistent with the show's physician-centric approach, the young people also wrongly believed that nursing was a girl's job, that it was a technical job "like shop," and that it was an inappropriate career for private school students, of whom more was expected. (Id.)

In 2000, the U.S. Centers for Disease Control and Prevention surveyed prime time TV viewers and found that most (52%) reported getting information that they trust to be Kaiser Family Foundationaccurate from prime time TV shows. (Kaiser Report, Henry J. Kaiser Family Foundation, "Entertainment Education and Health in the United States," 2004, citing CDC 2000 Healthstyles Survey)

More than a quarter of this survey's respondents said such shows were among their top three sources for health information. (Id.) Nine out of 10 regular viewers said they learned something about diseases or disease prevention from television, with almost half citing prime time or daytime entertainment shows. (Id.)

Moreover, almost half of regular viewers who heard something about a health issue on a prime time show said they took one or more actions, including telling someone about the storyline (42%), telling someone to do something or doing it themselves, such as using a condom or getting more exercise (16%), or visiting a clinic or physician (9%). (Id.)

Some research has focused on the effects of specific shows, particularly the massively popular "ER," which has been on the air since 1994 and is now shown in many nations around the world. During the U.S. television seasons running during 1997-2000, the Kaiser Family Foundation surveyed 3,500 regular "ER" viewers. (Kaiser Report citing Brodie, Foehr, et al., "Communicating Health Information through the Entertainment Media," (pdf), 2001; Henry J. Kaiser Family Foundation, "Survey of ER Viewers: Summary of Results," 2003; "The Impact of TV's Health Content: A Case Study of ER Viewers," 2002) In the Kaiser surveys, more than half (53%) of regular "ER" viewers said they learned about important health issues while watching the show. (Id.) Almost a third said information from the show helped them make choices about their own family's health care; this was especially true of viewers with less formal education (44% with no college vs. 25% with some college). (Id.) As a result of watching "ER," almost a quarter said they had sought further information about a health issue, and 14% had actually contacted a health care provider because of something they saw in an "ER" episode. (Id.) Many viewers showed significantly increased awareness of specific health issues addressed on the show; the surveys focused on episodes dealing with emergency contraception and the human papilloma virus (HPV). (Id.)

Other recent studies have also measured "ER"'s effects on public understanding and actions. A study at the Harvard School of Public Health found that regular "ER" viewers were far more aware (57% vs. 39%) of the need to get a smallpox vaccination immediately after exposure following an episode dealing with the subject. (Kaiser Report citing Harvard SPH, "After ER Smallpox Episode, Fewer ER Viewers Report They Would Go to Emergency Room if They Had Symptoms of the Disease") Another study, presented at the November 2004 annual meeting of the American Public Health Association, found that an "ER" storyline about teen obesity and hypertension affected viewers' self-reported behavior and knowledge. (Valente, Murphy et al., "Evaluating a Minor Storyline on ER about Teen Obesity, Hypertension and 5 a Day," 2004) Moreover, according to a recent Kaiser Foundation National Survey of Physicians, "one in five doctors say they are consulted 'very' or 'somewhat' often about specific diseases or treatments that patients heard about on TV shows such as 'ER.'" (Kaiser Report citing Brodie, Foehr, et. al., "Communicating Health Information through the Entertainment Media," 2001) In early 2004 and again in late 2005, investigators in USC studies that were clearly aimed at measuring the effects of "ER" on viewers' understanding of health care issues sought survey respondents on the show's own NBC web site; respondents could actually complete the survey by clicking through from the "ER" site.

Research on the effects of popular prime time hospital shows on health care knowledge has not been confined to "ER." In May 2006, a questionnaire for yet another study apparently from USC's Annenberg School appeared on the Fox web site for "House." That survey tested viewer knowledge and opinion on the portrayal of organ donation and transplants on "House," "Grey's Anatomy," and other popular shows, and it specifically asked how accurate viewers thought the presentation of health issues on "House" was.

Entertainment media does not have to be primarily about health care, like "ER" or "Strong Medicine," to affect viewers' understanding of health care issues. In 2002, a RAND Corporation survey of regular viewers of the sitcom "Friends" aged 12-17 found that respondents retained important information from a storyline depicting an unplanned pregnancy caused by condom failure, and found that "entertainment television can be most effective as an educator when teens and parents view together and discuss what they watch." (RANd Report citing Collins, Elliott, et al., "Entertainment Television as a Healthy Sex Educator: The Impact of Condom Efficacy Information in an Episode of Friends," 2003)

Research also shows that the effects of health-related entertainment programming are not confined to popular prime time shows. Even soap operas are influential. In 1999, the CDC surveyed viewers of daytime dramas and "found that many daytime viewers also report learning about health issues from TV." (CDC's 1999 "Soap Opera Viewers and Health Information) Almost half of regular daytime drama viewers reported learning something about a disease or how to prevent it from watching soap operas. (Id.) Over one third reported taking some action in their lives after hearing about a health issue or disease on a soap opera. (Id.) "Black women (69%) were most likely to cite soap operas as a source of health information, as well as to report taking action in their own lives about the health issue, followed by Hispanic (56%) and White (48%) women." (Id.) And in a more recent study, researchers found that following an episode of "The Bold and the Beautiful" with an HIV subplot and subsequent display of the CDC's National STD and AIDS hotline, calls to the hotline spiked. (Kennedy, O'Leary, et al., "Increases in Calls to the CDC's National STD and AIDS Hotline Following AIDS-Related Episodes in a Soap Opera," Journal of Communication, June 2004)

Also see the following related FAQ's:

Come on. Even if the mass media does ignore nursing, or present it inaccurately, how can that possibly affect nursing in real life?

OK, fine. I can see that some media probably affects how people think about and act toward nursing, like maybe a respected newspaper or current affairs show on TV. But how can some TV drama, sitcom or commercial affect people that way? People know enough not to take that stuff seriously!

Well, if all that research shows how influential Hollywood is on health care--and Hollywood itself claims credit for improving the world through "medical accuracy"--why won't it admit that its portrayal of nursing is equally influential, and take steps to fix it? Especially since the nursing shortage is now a global public health crisis.

Bibliography

Kaiser Report (pdf) www.kff.org/entmedia/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=34381 p. 4, citing Centers for Disease Control and Prevention, "Prime Time Viewers and Health Information," 2000 Healthstyles Survey Executive Summary, October 24, 2001. Available at: www.cdc.gov/communication/healthsoap.htm

Kaiser Report (pdf) p. 6, citing Centers for Disease Control and Prevention, "Soap Opera Viewers and Health Information," 1999 Porter Novelli Healthstyles Survey Executive Summary, November 15, 2000.

Kaiser Report (pdf) at 4, citing Brodie, Foehr, et al., "Communicating Health Information through the Entertainment Media," Health Affairs (Jan./Feb. 2001), at 192-99;

Kaiser Report (pdf) at 4, citing Henry J. Kaiser Family Foundation, "Survey of ER Viewers: Summary of Results," December 12, 2003. Available at: kff.org/womenshealth/1358-ers.cfm

Kaiser Report (pdf) at 4, citing "The Impact of TV's Health Content: A Case Study of ER Viewers," Survey Snapshot, June 2002. Available at: www.kff.org/entmedia/3230-index.cfm

Kaiser Report (pdf) at 5, citing Harvard School of Public Health, "After ER Smallpox Episode, Fewer ER Viewers Report They Would Go to Emergency Room if They Had Symptoms of the Disease," Press Release, June 13, 2002.

Kaiser Report (pdf) p. 4, citing M. Brodie, U. Foehr, V. Rideout, N. Baer, C. Miller, R. Flournoy, and D. Altman (Jan./Feb. 2001). "Communicating Health Information through the Entertainment Media," (pdf) Health Affairs, pp. 192-99.

Kennedy, O'Leary, et al., "Increases in Calls to the CDC's National STD and AIDS Hotline Following AIDS-Related Episodes in a Soap Opera," Journal of Communication, June 2004.

JWT Communications (2000). Memo to Nurses for a Healthier Tomorrow Coalition Members on a Focus Group Study of 1800 School Children in 10 US Cities. Available at: www.truthaboutnursing.org/research/lit/jwt_memo1.html

Kaiser Report (pdf) p. 5, citing Collins, Elliott, et al. (November 2003). "Entertainment Television as a Healthy Sex Educator: The Impact of Condom Efficacy Information in an Episode of Friends," Pediatrics, 112 , p. 1115-21.

RAND Health "Entertainment TV Can Help Teach Teens Responsible Sex Messages", citing Collins, Rebecca; Elliott, Marc; Berry, Sandra; Kanouse, David & Hunter, Sarah. (2003.) " Entertainment Television as a Healthy Sex Educator: The Impact of Condom Efficacy Information in an Episode of Friends," in Pediatrics, 112 (5) November 2003, pp. 1115-1121.

Joseph Turow and Rachel Gans-Boriskin. (2002). "As Seen on TV: Health Policy Issues in TV's Medical Dramas," Report to the Kaiser Family Foundation. http://www.kff.org/entmedia/3231-index.cfm

University of Southern California, the USC Annenberg School for Communication, Annenberg Norman Lear Center's Hollywood Health & Society. Available at: http://www.learcenter.org/html/projects/?cm=hhs

Valente, Murphy et al., "Evaluating a Minor Storyline on ER about Teen Obesity, Hypertension and 5 a Day," 2004. Available at: http://www.comminit.com/es/node/70268

last updated June 1, 2008.

 

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