In the quantitative section, as mentioned earlier, the news items were classified into two groups: the first group consisted of news items that had referred to a research article, and the second one included news items that had ‘not’ referred to a research article. In the second group the most frequent topic, i.e. nutrition news was chosen to be examined as the representative.
In the first group, the study design of each article was studied. Two of them were systematic reviews, 10 were interventional, 12 were observational and 5 were basic science studies. Eighteen (62.1%) were of appropriate scientific quality level and 11 (37.9%) were weak. The news was also checked for its consistency with the research articles results. Four (13.8%) were completely consistent with the research articles results, 11 (37.9%) were highly consistent, 6 (20.7%) were somewhat consistent, and 8 (27.6%) were not consistent with the research findings. In the second group, 71 nutrition news items were examined by experts in this field. News that qualified for options 4 or 5 (mentioned in the methodology section: “there are controversial results in this field” and “there is no evidence available for this topic”) for supporting evidence, and qualified for options 3 or 4 of scientific accuracy (“it is a matter of debate”, it “is scientifically incorrect”) were considered to be unfit for dissemination. These cases comprised 10 out of 71 cases of nutrition news.
A summary of the study’s quantitative findings is presented in Table . On the whole, if we consider the 29 news items of the first group as representative of this group, and the 71 nutrition news items as representative of the second group, we may conclude that 18% of the news was not fit for public dissemination.
Examination of news for its quality to be publicly announced
The results of the qualitative phase revealed two primary categories: ‘description of the process of production, selection and dissemination of news’ and ‘factors affecting the quality of news’. Below each category is described, and verbatim quotes from FGDs are included in italics to exemplify participants' comments.
1) Description of the process of production, selection and dissemination of news
Journalists have recognized a specific set of criteria and values for the production and selection of news content. From their perspective, news values include: bizarreness or rarity of news, the novelty and appeal, significance, proximity, and universality of news, and reputation and standing of the person announcing the news. Apart from the above general principles, in some units certain guidelines are observed by journalists in the news production process. The news prepared by journalists are checked and selected by the editor-in-chief or gatekeeper in the editorial section. It may be merged with other news or some material may be added or removed which may compromise the accuracy or content of the news. In addition to news criteria and values exercised by journalists, there are other criteria affecting the selection of news by editors, editors-in-chief and gatekeepers in the media, such as national archives, health priorities, daily events, emergencies etc. However, according to some of the participant editors, in Iran there are no standard or specific guidelines for news selection by editors, explaining why news is sometimes selected on the basis of personal taste.
2) Factors affecting the scientific quality of news
"“Having a guideline of whatsoever quality is better than not having one at all.” (Member of the ‘Health Media Policy-Making Council’- 1)"
"“If we have 5 news items of equal weight, we will give priority to the news that is more eye-catching because more target audiences are absorbed.”(Editor-2)"
In effect all participants believed that not all health news produced and published are qualified and accurate enough for public announcement. Different factors at various levels affect the accuracy of news. These factors can be classified into inadequate knowledge, inadequate motivations and context-related barriers.
a) Inadequate Knowledge
Some journalists believed that journalists do not have enough information in the field of health knowledge, and the dearth of specialized health journalists hinders the production of quality health news. In the same context, lack of required knowledge, concentration and accuracy in translation skills often leads to certain changes in the news content.
"“Being familiar with health knowledge seems a requisite for people in this field, but this mechanism hasn’t been designed in our country yet.” (Journalist-5)"
"“At times foreign news is translated badly because of the translator’s lack of knowledge in the health domain.”(Journalist-2)"
Gatekeepers’ knowledge has been mentioned as another important factor in monitoring the quality of news. Some editors recognized having adequate knowledge on the general principles of research as helpful, while many editors do not have sufficient knowledge in this field.
"“Perhaps our biggest problem arises when we don’t have sufficient knowledge [on research]. The news editor doesn’t have a good grip over the topic.”(Editor- 4)"
"“The number of individuals with a grip over the study components like design, methodology etc., and quality appraisal skills is small.”(Editor-2)"
Researchers who pass on health research results to journalists and news agencies are also unaware of reporting criteria and techniques, which is considered another common problem. Hence, researchers’ styles of writing is inappropriate for dissemination in the media, and journalists create certain changes in the news content to make them more appealing, but this might not exactly be in line with the concept the researcher has in mind. At this stage the content of the news may lose its original intent and accuracy.
b) Inadequate motivation
Time, circulation and sales matter to newspapers. Producing appealing news in a limited time period is of paramount importance to newsmen. With little alteration journalists familiar with news principles and journalistic techniques can turn unimportant news topics into headlines. Such changes often result in changing the original content of the news that greatly affects its quality.
""Some people and organizations have special ties with certain journalists or news agencies. Because of journalistic favoritism, news related to a certain person or group is covered differently, or differs even in content."(Journalist- 1)"
A similar phenomenon happens in the domain of researchers cooperating with the press. Journalists and editors believed researchers played an influential role as one of the sources of news. According to them, sometimes competition among researchers leads to the early release of news or even its unreal and incorrect dissemination.
"“Studies that are being conducted on animals should not be announced to the public. However, because of competition among researchers or institutes….the early announcement of news leads to its renouncement afterward. This way people lose trust in the media.”(Journalist-2)"
On the other hand, researchers do not have adequate motivations toward collaborating with the media.
"“For certain reasons, such as lacking a media perspective and financial issues etc., academics are not interested in cooperating with the media and acting as consultants for checking the authenticity of the health news.”(Journalist- 6)"
Further, economic issues were among media's significant challenges. Currently, many research centers and companies use media consultants. The latter is done for marketing. Financial ties between pharmaceutical companies and researchers pave the way for advertising pharmaceutical products. These ties, in turn, lead to the concealment of adverse effects of drugs and to an exaggeration of their benefits.
c) Context-related barriers
""At times pharmaceuticals arrange meetings with physicians and researchers beforehand and convince them to announce news that would approve and promote their products."(Journalist-5)"
""Potentially, 12% of the world drug market is in the Middle East… and our country is a potential target."(Editor-3)"
Mass media organizational policies influence the quality of news. These policies demand that the health news be delivered to the society. They also demand that the country's scientific research achievements be announced to the public:
""Big projects are a source of pride for the nation, and people expect to be given good coverage."(Editor-3)"
However, Journalists and editors-in-chief believed this exploitation of health news could be harmful, and lead to omission of results or exaggeration of the news. At times they are compelled to publish these kinds of news stories, the quality of which they themselves doubt.
According to these participants, the reputation of the person reporting the news and his/her socio-political position also influences them to publish the news.
""At times the reputation of the person announcing the news is even bigger than that of the gatekeeper's. When the health minister announces certain news the gatekeeper cannot prevent its dissemination."(Member of the ‘Health Media Policy-Making Council’-2)"
"“Politicizing scientific news exaggerates some topics.” (Journalist-6)"
"“At times the limits prevent the editors and editors-in-chief from improving or criticizing the news.” (Editor-3)"