(De)Stigmatizing Depression on Social Media: The Role of Responsibility Frames.

Responsibility frames on social media could shape recipients' responses toward people with depression, which is crucial for the public (de)stigmatization of the mental disorder. Thus, the present study examines the effects of different responsibility frames (individual, social, combination) in Instagram-posts about depression on respondents' related attributions as well as their emotional and behavioral reactions toward people suffering from the illness. Our online-experiment (N = 1,015) revealed that frames emphasizing the responsibility of one's social network (e.g. family, friends and professionals) for depression, i.e. social frames, strengthened participants' attributions to the social network, i.e. social attributions, most effectively. Individual frames, however, primarily intensified individual attributions to those affected by depression. Contrary to previous findings, a combination frame did not prove to increase recipients' social attributions more than a one-sided social frame. For emotional and behavioral responses, we did not find any effects of responsibility frames compared to the control group-possibly due to buffering effects of the narrative structure of the Instagram posts.

Effects of Health Responsibility Frames: Testing a Mediation Model of Attributions, Emotions, and Social Support Intentions.

When news stories cover health and illness, they often address issues of responsibility. These responsibility frames can affect recipients' responsibility beliefs (i.e. attributions) and thereby indirectly affect emotions and motivation to support people affected by health problems. To date, it is not fully understood how responsibility frames affect social support intentions, and if attributions and emotions mediate this effect. In an online experiment with N = 1,088 German participants, we tested the effects of responsibility frames (individually controllable vs. non-controllable) for type 2 diabetes and depression on social support intentions through responsibility attributions and emotional reactions. Mediation analyses show that responsibility frames indirectly affect social support intentions through social-societal attributions and sympathy. This mediation effect was observed in both depression and type 2 diabetes, despite issue-specific differences in attributions, emotions, and social support intentions. We discuss these findings considering framing effects research and health reporting.

The media's coverage and framing of hospital reforms: The case of Denmark.

The Danish hospital landscape has been continuously restructured since the early 2000s. A structural reform reorganized the public sector, and a hospital reform restructured the hospital landscape, closing hospitals and concentrating specialized treatment in so-called super-hospitals. Reforms can generate considerable debate, including in the media, especially regarding sensitive topics like healthcare. The present study explores the media's coverage of the hospital reform, the antecedent structural reform, and three events related to differences in treatment outcomes, whose importance was pointed out in expert interviews. The coverage is analyzed regarding quantity and main theme (agenda-setting): tone and whether the focus was on single events (episodic framing) or broader context (thematic framing). We used a systematic keyword search to identify relevant news stories and analyzed the headlines and lead paragraphs of 1192 news stories. The three events generated a large amount of coverage, but some events varied in terms of context and tone of coverage. Further, the media covered hospital closures in connection with the two reforms differently in context and tone, although the first difference is not statistically different. Overall, the coverage of the events might have helped raise the public's awareness of challenges in the healthcare system, which could have contributed to opening a window of opportunity for a hospital reform.

Assigning Responsibility for Depression and Diabetes: Frame Building Factors in Health Coverage.

Although frame building is a crucial part of framing in health communication, it is much less understood than media frames or their effects on audiences (i.e. frame setting). To address this research gap, we analyzed the individual, organizational, and external factors of influence contributing to the media's portrayal of responsibility for two major health issues: depression and diabetes. To identify relevant factors, we conducted 23 semi-structured interviews with German journalists who regularly report on these health issues. Our findings indicate that the way in which media coverage portrays responsibilities in depression and diabetes is affected by a variety of factors. These include individual (journalist role perception, journalistic routines, academic background and personal experiences with depression, diabetes-related knowledge, and personal values and beliefs), organizational (editorial lines, space limits, time limitations and payment, and newsroom structures), and external (health news sources, audience interest, newsworthiness, and social norms) factors. Notably, there are differences between depression and diabetes coverage - especially regarding individual factors - confirming that frame building, similar to framing in general, should be examined with regard to specific issues. Nevertheless, some factors that seem important across different topics could be identified.

A Systematic Review of Responsibility Frames and Their Effects in the Health Context.

Responsibility frames potentially shape the public perception of health issues such as obesity, diabetes, or mental illness, specifically regarding responsibility attributions for their causes and treatment. Which responsibility frames prevail in the health context, and the responses they may elicit from audiences, has not been studied systematically. This systematic review includes studies with different methodological approaches published between 2004 and 2019 (N = 68). Content analyses (n = 56) show that different media attribute health responsibility most frequently, but not exclusively to individuals. Individual responsibility was especially emphasized for obesity, which was also the most studied health issue. Tendencies toward societal attributions of responsibility emerged over time, particularly regarding health risks for which the frames describe a specific cause (e.g., sugar, trans-fat). Experimental studies (n = 12) indicate that individual responsibility frames reduce policy support. The effects of responsibility frames were, however, not as clear-cut as expected with research gaps regarding behavioral and affective outcomes. Overall, there is a clear emphasis on noncommunicable diseases in this field. Finally, the conceptual focus on individual vs. societal health responsibility distracts from social network influences as another relevant health determinant. The implications for health communication are discussed.

[Media coverage of prevention and treatment options using the examples of diabetes mellitus and depression]. / Medienberichterstattung zu Präventions- und Therapiemöglichkeiten an den Beispielen Diabetes mellitus und Depression.

BACKGROUND: Diabetes mellitus and depression are diseases with a rising prevalence in Germany. Journalistic media coverage offers the opportunity to inform the public about options for prevention and therapy. Research shows that media portrayals of different prevention and treatment options might influence health behavior as well as policy support and eventually structural healthcare. OBJECTIVES: To date, little is known about the media coverage of the prevention and treatment of diabetes mellitus and depression. This study aims at demonstrating how diabetes mellitus and depression are portrayed in the German news media, focusing on options for prevention and therapy. MATERIALS AND METHODS: A quantitative content analysis of German print and online media from 2012 to 2018 was conducted. In sum, N = 645 articles on diabetes mellitus (n = 219) and depression (n = 426) were analyzed. RESULTS AND DISCUSSION: Diabetes mellitus and depression are rarely the main subject in German news coverage despite their high prevalence. Depression is reported more frequently than diabetes mellitus - often, however, in the context of suicide or celebrities. Regarding diabetes mellitus, reports differentiated insufficiently between the various types. For both conditions, pharmacotherapy was mentioned more frequently than low-threshold measures and structural prevention opportunities, which might have adverse consequences for those seeking help. Overall, to establish prevention and low-threshold forms of therapy as treatment options in the public, strategic communicators should focus more on them.