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1、Communicating uncertainty - how Australian television reported H1N1 risk in 2009:a content analysis【Andrea S Fogarty1 , Kate Holland2, Michelle Imison1 , R Warwick Blood 2, Simon Chapman1* and Simon Holding1】Abstract1.Background: Health officials face particular challenges in communicating with the

2、public about emerging infectious diseases of unknown severity such as the 2009 H1N1（swine flu） pandemic （pH1N1）. Statements intended to create awareness and convey the seriousness of infectious disease threats can draw accusations of scaremongering, while officials can be accused of complacency if s

3、uch statements are not made. In these communication contexts, news journalists, often reliant on official sources to understand issues are pivotal in selecting and emphasising aspects of official discourse deemed sufficiently newsworthy to present to the public. This paper presents a case-study of n

4、ews communication regarding the emergence of pH1N1. 2.Methods: We conducted a content analysis of all television news items about pH1N1. We examined news and current affairs items broadcast on 5 free-to-air Sydney television channels between April 25 2009 （the first report） and October 9 （prior to t

5、he vaccine release） for statements about the seriousness of the disease how the public could minimise contagion government responses to emerging information. 3.Results: pH1N1 was the leading health story for eight of 24 weeks and was in the top 5 for 20 weeks. 353 news items were identified, yieldin

6、g 3086 statements for analysis, with 63.4% related to the seriousness of the situation, 12.9% providing advice for viewers and 23.6% involving assurances from government. Coverage focused on infection/mortality rates, the spread of the virus, the need for public calm, the vulnerability of particular

7、 groups, direct and indirect advice for viewers, and government reassurances about effective management. 4.Conclusions: Overall, the reporting of 2009 pH1N1 in Sydney, Australia was generally non-alarmist, while conveying that pH1N1 was potentially serious. Daily infection rate tallies and commentar

8、y on changes in the pandemic alert level were seldom contextualised to assist viewers in understanding personal relevance. Suggestions are made about how future reporting of emerging infectious diseases could be enhanced.BackgroundIn recent years , Australians have been exposed to a range of large s

9、cale news coverage and health promotion campaigns about communicable disease. These have included seasonal influenza advisories; campaigns promoting immunisation for vaccine-preventable diseases; traveller vaccination messages; sexually transmitted disease prevention campaigns, including human papil

10、loma virus vaccine to prevent cervical cancer ; HIV/AIDS and hepatitis B and C prevention. With the exception of HIV/AIDS and sexually-transmitted diseases, each of these has a vaccine and clear directives about how to avoid infection, forming the central communicative focus of such campaigns. The W

11、HO-declared global pH1N1 （swine flu） pandemic of 2009 has attracted research attention from virologists and infectious disease specialists, but less from communication scholars. From the first reports of Mexican cases in late April 2009, what would become sustained Australian reportage rapidly turne

12、d to the likelihood of Australian cases involving perhaps epidemic and high mortality numbers. Australians were exposed to daily news featuring the countrys senior health officials and an array of infectious disease experts, who unavoidably, had to deal with the uncertain and complex trajectories an

13、d virulence of the disease in the context of news production cultures characterized by seven second sound-bites and an appetite for unambiguous , easily understood information.MethodsSince May 2005, the Australian Health News Research Collaboration has recorded and categorised all news, current affa

14、irs and infotainment programmes related to health and medicine on Sydney free-to-air television stations . We searched the AHNRC database and included all items tagged with H1N1 or swine flu in the period April 25, 2009 （the first mention） until October 9 2009. All stories were video clips which wer

15、e used for the content analysis reported here. Using a list of content categories that emerged progressively from the content as the pH1N1 story evolved, two authors （AF and MI） compared coding on a set of 15 random clips that each watched and coded individually. After resolving any coding differenc

16、es and agreeing upon how particular items should be handled, they coded the remainder of the items. These categories related to statements made regarding 1 the seriousness of H1N1, 2 recommended actions viewers were advised to take about avoiding contracting or spreading pH1N1, and 3 reassurances th

17、at the government was handling the situation. A statement was any direct （X said “Y”） or attributed （X said that.”） quote by the journalists or news actors featured in each item. A test of inter-coder reliability produced a Kappa statistic of 0.63, indicating a good level of agreement.The role of th

18、e Internet as a platform for delivering public health interventions to specific patient groups and to the general public is constantly increasing, due in particular to its disseminating potential: the worldwide penetration of the Internet is increasing and the use of this medium for seeking health i

19、nformation is frequent . Moreover, the Internet potential for individual tailoring and interactivity is superior to that of other high reach-delivery channels .ResultsA total of 353 news stories were identified, containing 3,086 statements related to the three key areas of inquiry. During the 24 wee

20、ks reported here, pH1N1 was the leading health story for eight weeks and for 20weeks remained in the top five most frequently reported health stories. We also note that the virus was rarely referred to by the name pH1N1 during the coverage and instead, was routinely termed swine flu . When reporting

21、 exact quotes we have therefore retained the term swine flu.（1）Seriousness Of pH1N1Of all statements , 63. 4% （n = 1, 958 /3 ,0 86 ） related to the seriousness of pH1N1 . This was communicated via four recurring stories : （i） daily tallies of infection and mortality ; （ ii ） des- criptions of spread

22、 of the virus; （iii） the need for calm responses; and （iv） the vulnerability of particular groups. We briefly summarise other statements which did not comprise significant proportions of the coverage, but may have been important to those who incidentally saw some news stories. This included similari

23、ties between pH1N1 and other viruses, government management plans, and the need for systems covering diagnosis and the anticipated vaccine roll out.（2）Advice And Recommended Actions For ViewersIn more than one third of stories （n = 131/353 - 37%） direct or indirect advice was given on what viewers c

24、ould do to prevent spreading infection . However, these statements accounted for just 12.9% （n =399/3,086） of all statements. Just over a quarter （27.8%,n = 111/399） focused on basic personal hygiene, another quarter related to preventing infection by being mindful of issues of proximity （27.8%, n =

25、 111/399） and a fifth advised seeing a doctor and seeking further information （20.6%, n = 82/399）.（3）Reassurance That Government Was Handling The SituationOf all statements recorded , 23.6 % （ n = 7 2 9 / 3 , 0 8 6 ）assured viewers that the government was handling the situation by elaborating on its

26、 current and proposed actions.About a third of these statements （ 2 9 . 8 % , n = 2 1 7 /7 2 9 ） referred to the immediate need for the Government to develop, test and then distribute a vaccine starting with priority groups. A quarter of these statements （ 2 5 . 9 % , n = 1 8 9 / 7 2 9 ）reassured th

27、e public that the government was putting significant effort into border control measures designed to prevent pH1N1 entering Australia, and following up and containing detected infection. These statements generally concerned quarantine measures , the use of thermal imaging at airports or statements a

28、bout new measures and ongoing monitoring of the situation。 ConclusionsThe Australian government and media acted responsibly by providing regular, high profile and highly transparent information on the emerging intelligence about the pandemic. Uncertainty about the trajectory of the disease was openl

29、y acknowledged and reassurances given about government preparedness. Potentially dissonance generating news coverage that might have engendered panic, complacency or cynicism about “yet another epidemic” was uncommon. The Internet is a rich and efficient source of information about infectious diseas

30、es and their prevention. Its role in social marketing can be crucial. Integrating its potentials with those of other media can guarantee a broad spread of information. Moreover, public health interventions transmitted through this medium could target groups with peculiar characteristics. In conclusi

31、on, in order to guarantee an adequate use of this instrument by the public, health professionals, who are still one of the main sources of information regarding health matters, should guide patients to other reliable sources （information prescription） at the same time, deeper attention should be pai

32、d by Public Health Agencies towards quality of information and search engine optimization; studies like the one presented in this article should be used more often to improve delivery of public health information to the general public. Further research should explore how various publics decoded and received the information and advice provided and how journalists approached the challenges of making this on-going story maximally newsworthy. Triangulated with content analysis of what was broadcast, such as this paper, these studies could provide valuable informati