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- Publication'Fat is your fault': Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesityWe investigated the representation of obesity in the Irish media by conducting an inductive thematic analysis on newspaper articles (n=346) published in 2005, 2007 and 2009 sampled from six major publications. The study analysed the media's construction of gender in discussions of obesity and associated attributions of blame. Three dominant themes are discussed: the caricatured portrayal of gender, women as caregivers for others, and emotive parent-blaming for childhood obesity. Men were portrayed as a homogenous group; unaware and unconcerned about weight and health issues. Dieting and engaging in preventative health behaviours were portrayed as activities exclusively within the female domain and women were depicted as responsible for encouraging men to be healthy. Parents, specifically mothers, attracted much blame for childhood obesity and media messages aimed to shame and disgrace parents of obese children through use of emotive and evocative language. This portrayal was broadly consistent across media types and served to reinforce traditional gender roles by positioning women as primarily responsible for health. This analysis offers the first qualitative investigation into the Irish media discourse on obesity and indicates a rather traditional take on gender roles in diet and nutrition.
958Scopus© Citations 41
- PublicationThe emergence and portrayal of obesity in The Irish Times: Content analysis of obesity coverage, 1997-2009Both global obesity prevalence rates and media attention to obesity have increased significantly in recent years. The current study examined the representation of obesity in The Irish Times, from 1997 to 2009. A quantitative content analysis was conducted on 479 articles to examine how the causes, consequences, and solutions to obesity have been portrayed and how obesity has been described. A frame analysis was also conducted to examine the dominant frames over time. It was found that attention to obesity was positively correlated with time, indicating coverage has increased significantly over the period examined. Regarding reported causes and solutions, the behavioral frame has been dominant, though environmental and mixed-frame stories have become more frequent. The presence of the genetic frame was consistently low. The study provides an overview of how the issue is being represented in Ireland's paper of record and informs health communicators of the dominant and trending messages and the implications for individuals' formation of illness representations.
290Scopus© Citations 21
- PublicationWeight stigma and narrative resistance evident in online discussions of obesityThis study sampled 2872 obesity-relevant comments from three years of interest from a multi-topic online message board. An inductive thematic analysis was conducted and three themes were evident: reactions and responses to obesity and obese bodies, diminished status of overweight/obese persons, and narrative resistance to an overweight/obese identity. Obesity stigma was pervasive and the discussion of the issue revealed it to be highly acceptable. Consistent with previous research, dominant representations of obese persons as lazy and unintelligent with poor self-control were evident. The analysis provided valuable insight into experiences of explicit stigma, the social and psychological repercussions of overt stigma and norms regarding the perception of obese bodies. There was a prevailing notion that the opinions and insights of overweight and obese persons on the issue of weight were not credible and were perceived as biased. Furthermore, individuals sought to distance themselves from the undesirable labels of 'overweight' and 'obese' by enacting narrative resistance to negotiate the social meaning of excess weight and endeavouring to place themselves on the ‘safe’ side of this boundary. These results highlight the pervasive nature of weight stigma and the social acceptability of such attitudes and beliefs. Furthermore, it highlights the richness of data that may be obtained by examining social media interactions as a window into the naturally-occurring discourse on obesity and stigma.
831Scopus© Citations 65
- PublicationEnabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care settingBackground: Although not an inevitable part of ageing, frailty is an increasingly common condition in older people. Frail older patients are particularly vulnerable to the adverse effects of hospitalisation, including deconditioning, immobility and loss of independence (Chong et al, J Am Med Dir Assoc 18:638.e7–638.e11, 2017). The ‘Systematic Approach to improving care for Frail older patients’ (SAFE) study co-designed, with public and patient representatives, quality improvement initiatives aimed at enhancing the delivery of care to frail older patients within an acute hospital setting. This paper describes quality improvement initiatives which resulted from a co-design process aiming to improve service delivery in the acute setting for frail older people. These improvement initiatives were aligned to five priority areas identified by patients and public representatives.Methods: The co-design work was supported by four pillars of effective and meaningful public and patient representative (PPR) involvement in health research (Bombard et al, Implement Sci 13:98, 2018; Black et al, J Health Serv Res Policy 23:158–67, 2018). These pillars were: research environment and receptive contexts; expectations and role clarity; support for participation and inclusive representation and; commitment to the value of co-learning involving institutional leadership.Results: Five priority areas were identified by the co-design team for targeted quality improvement initiatives: Collaboration along the integrated care continuum; continence care; improved mobility; access to food and hydration and improved patient information. These priority areas and the responding quality improvement initiatives are discussed in relation to patient-centred outcomes for enhanced care delivery for frail older people in an acute hospital setting.Conclusions: The co-design approach to quality improvement places patient-centred outcomes such as dignity, identity, respectful communication as well as independence as key drivers for implementation. Enhanced inter-personal communication was consistently emphasised by the co-design team and much of the quality improvement initiatives target more effective, respectful and clear communication between healthcare personnel and patients. Measurement and evaluation of these patient-centred outcomes, while challenging, should be prioritised in the implementation of quality improvement initiatives. Adequate resourcing and administrative commitment pose the greatest challenges to the sustainability of the interventions developed along the SAFE pathways. The inclusion of organisational leadership in the co-design and implementation teams is a critical factor in the success of interventions targeting service delivery and quality improvement.
294Scopus© Citations 29
- PublicationExamining the Media Portrayal of Obesity Through the Lens of the Common Sense Model of Illness RepresentationsThis study examined the Irish media discourse on obesity by employing the Common Sense Model of Illness Representations. A media sample of 368 transcripts was compiled from newspaper articles (n = 346), radio discussions (n = 5), and online news articles (n = 17) on overweight and obesity from the years 2005, 2007, and 2009. Using the Common Sense Model and framing theory to guide the investigation, a thematic analysis was conducted on the media sample. Analysis revealed that the behavioral dimensions of diet and activity levels were the most commonly cited causes of and interventions in obesity. The advertising industry was blamed for obesity, and there were calls for increased government action to tackle the issue. Physical illness and psychological consequences of obesity were prevalent in the sample, and analysis revealed that the economy, regardless of its state, was blamed for obesity. These results are discussed in terms of expectations of audience understandings of the issue and the implications of these dominant portrayals and framings on public support for interventions. The article also outlines the value of a qualitative analytical framework that combines the Common Sense Model and framing theory in the investigation of illness narratives.
496Scopus© Citations 6