People with diabetes overestimate their risk for long-term complications and experience significant anxiety from distorted perceptions. Diabetes-specific media is a significant source of information about complications for people with diabetes, however, no research has evaluated the quality of these media messages. This study aimed to evaluate the characteristics of risk and prevalence communication about complications presented in high-circulation print publications that target people with diabetes.
Issues of the 3 publications were screened for references to major complications of diabetes within articles, advice columns, advertisements, letters and images. References were analyzed for (1) the use of gain- and loss-framing of messages about complications risk, (2) communication of information about complications prevalence and (3) the language used to describe general and specific complications. References to psychological issues associated with developing or living with diabetes complications were also coded. The definition of major long-term complications was limited to nephropathy, retinopathy, neuropathy and cardiovascular disease. Prospect theory guided the coding framework, based on the differential effects on a person’s choices depending on whether health information is presented either as a gain- or loss-framed message.1
Almost all issues of publications included references to complications with an average of 2.4 references per issue. The majority of risk (70%) and prevalence messages (80%) were communicated with loss framing (negative outcomes). Most commonly cited risk factors for complications were “high BGLs” or simply “having diabetes”. Inconsistent and sometimes highly emotive language was used to refer to the general and specific complications of diabetes. Psychological issues associated with the development of complications were identified in only one reference.
Diabetes health professionals may need to take into consideration the messages their patients have absorbed from media exposure when having conversations about complications risk.
1. Tversky A, Kahneman D, The framing of decisions and the rationality of choice. Science. 1981;221:453-458.