The data set consists of images and text from editorial content on skin cancer and tanning. Traditionally, content analysis of mass print media health coverage has been largely text-based; however, images can influence health attitudes, intentions, and behaviours (Houts, Doak, Doak, & Loscalzo, 2006), including those connected to skin cancer and tanning (Mahler, Kulik, Gibbons, & Gerrard, 2003; Dixon, Warne, Scully, Wakefield, & Dobbinson, 2011; McWhirter & Hoffman-Goetz, 2013a; McWhirter &
Hoffman-Goetz, 2013b). The inclusion of both images and text will help to expand the limited knowledge about visual health communication in the mass print media. Given that images can sway a reader’s interpretation of an article’s text content (Gibson &
Zillman, 2000), comparisons will be important to make between what information is conveyed in the text of articles and in the images that accompany them.
Studying how skin cancer and tanning information is visually communicated and comparing this to the text-based content are important areas to study for several reasons.
It is important theoretically because Visual Persuasion and the Pictorial Superiority Effect (PSE) indicate that images are likely to be attended to and remembered by the reader. Research evidence has demonstrated the positive impact images have on understanding health information and health behaviours (Houts et al., 2006). Images also influence the meaning of accompanying text in the mass media (Gibson & Zillman, 2000;
Zillman, Gibson, & Sargent, 1999). Thus, the PSE, Visual Persuasion, and the research evidence showing that photographs influence how mass print media articles are perceived by readers makes visual images accompanying skin cancer and tanning magazine articles appropriate to examine.
Based on previous research about breast cancer in the media, and one study on skin cancer in the media, it was expected that the visual and text content about skin cancer and tanning in the magazines collected for this research would convey contradictory or discordant health messages relative to text. Prior research has indicated that visual images accompanying magazine articles about breast cancer do not accurately portray risk or true severity of the disease, nor do they portray prevention and early detection (Andsager, Hurst, & Powers, 2000; Clarke et al., 1999a; McWhirter, Hoffman-Goetz, & Clarke, 2012). Simultaneously, breast cancer imagery in the media has been found to emphasize an attractive appearance in contrast to some of the physical realities of the disease described in the text (Clarke et al., 1999a; McWhirter et al., 2012; Phillips,
2009). The findings of a previous study on breast cancer coverage in Canadian magazines suggest that images and text convey very different themes (McWhirter et al., 2012). For example, the most common theme in article text about breast cancer was medical issues while the most common theme in the accompanying images was beauty/fashion. Such discordance is important to document because the visual image may “sway” the reader to take away a different message from the article than what the text intends. Much less is known about how skin cancer is visually depicted in mass media content. Cho and colleagues (2010) found that while magazine article text promoted sun protection, the visual imagery accompanying the text did not always convey messages of UV protection.
In fact, the images contained mixed messages about sun protection or even promoted UV exposure. Hence, it was important to investigate potential differences in visual and text coverage of skin cancer and tanning in popular magazines.
2.3.4 Rationale for Women’s vs. Men’s Magazines Comparison
Men’s and women’s attitudes and intentions about tanning are influenced by the mass media (Dixon et al., 2011; Cho & Choi, 2011). Women use magazines as a source of cancer information (Gerlach, Marino, Weed, & Goetz, 1997; Hoffman-Goetz, Gerlach, Marino, & Mills, 1997) and their attitudes and beliefs about skin cancer and tanning are influenced by media content (Dixon et al., 2014). Focusing on women’s magazines is important because women are the primary users of indoor tanning beds (Wehner et al., 2014) and are frequently targeted by their advertising (Team & Markovic, 2006). Moreover, young women have a higher incidence of melanoma compared to men the same age (National Cancer Institute, 2014). Hence, women are at high risk for the
disease, frequently engage in behaviours that put them at risk, and are influenced by related media content.
Prior research has primarily focused on women’s mass print media content related to skin cancer and tanning communication; it has largely ignored men’s mass print media sources (Cho, Hall, Kosmoski, Fox, & Mastin, 2010; Dixon, Dobbinson, Wakefield, Jamsen, & McLeod, 2008; Gamble et al., 2011). The examination of men’s magazines for content related to skin cancer and tanning was important because men are also at increased risk for skin cancer and UV exposure is a risk factor for skin cancer (Canadian Cancer Society, 2012a, 2012b; Skin Cancer Foundation, 2012). Contributing to the increased risk of skin cancer among men is that they less frequently engage in UV protection behaviours than women (Coups, Manne, & Heckman, 2008; Lewis, Mayer, &
Slymen, 2006). Moreover, although only a minority of men use indoor tanning beds (Choi, Lazovich, Southwell, Forster, Rolnick, & Jackson, 2010), men are at increased risk of skin cancer because they are more likely to have occupations where they work outdoors (at least traditionally), which contributes to their greater lifetime solar UV exposure compared to women (Ramirez, Federman, & Kirsner, 2005). Therefore, there may be a role for the mass print media to play regarding informing men of their increased risk of skin cancer and conveying effective skin cancer prevention and early detection practice information. The extent to which men’s magazines provide this information has not been previously studied.
It was also important to compare skin cancer and tanning coverage in magazines with different gender audiences, as there may be important differences in this regard.
There are broad difference in how cancer is portrayed in the mass print media for men
and women (Cartwright, 1998; Clarke, 1999a, 1999b; Clarke & Robinson, 1999; Reagan, 1997; Seale, 2002). Gender has also been a key organizing principle in popular cancer discourse; cancer education has taught women and men different things about the disease (Reagan, 1997). Lung cancer, for example, was historically emphasized in the mass media as a men’s cancer and presented as a disease about which women ought not to be concerned (Reagan, 1997). However, the reason men were affected more by lung cancer was because of their higher smoking rates. No prior research has investigated differences in skin cancer and tanning coverage in mass print media targeted towards women compared to men.