Physical activity in the mass media: an audience perspective

Abstract

Physical activity’s role in promoting health is highlighted in public health campaigns, news and current affairs, reality television and other programs. An investigation of audience exposure, beliefs and reactions to media portrayals of physical activity offers insights into the salience and influence of this communication. An audience reception study was conducted involving in-depth interviews with 46 adults in New South Wales, Australia. The sample was stratified by gender, age group, area of residence and body mass index. Most respondents could only recall media coverage of physical activity with prompting. Television was the primary channel of exposure, with reality television the dominant source, followed by news programs and sports coverage. The messages most readily recalled were the health risks of inactivity, especially obesity, and the necessity of keeping active. Physical activity was regarded as a matter of personal volition, or for children, parental responsibility. Respondents believed that the media had given physical activity inadequate attention, focused too heavily on risks and not provided practical advice. In Australia, there is a need to counter the framing of physical activity by reality television, and engage the media to generate understanding of the socioecological determinants of inactivity. Physical activity campaigns should deliver positive and practical messages.

Introduction

The population reach and influence of the mass media has given it a high level of importance in strategies to address the public health priority of physical inactivity. Stand-alone physical activity campaigns using traditional media such as television, radio and billboard advertising have led to increases in awareness and knowledge about this issue, although evidence of their impact on behaviours is inconclusive [1, 2]. Community-wide physical activity programs, which have incorporated mass media strategies alongside community mobilization, settings-based education and environmental improvements, have been more consistently reported to generate behaviour change [3, 4]. Evidence is also emerging about the potential of online platforms, including interactive websites and social media, as channels for physical activity interventions with wide population reach [5, 6].

Although behaviour change has been the dominant purpose behind the use of the mass media in physical activity programs, it has been recognized that the media is also a vital arena for advocacy for policy change and public investments in infrastructure that support active living. The importance of the media, particularly news and current affairs programs, in advocacy stems from its agenda setting power [7] and role in framing public understandings about the primary causes of health problems, the possible solutions to these and the agents responsible for instigating action [8, 9]. To monitor and guide media advocacy for physical activity, a growing body of research is investigating the extent and nature of media coverage on this topic. Studies in several countries have found that physical activity appears not to be high on the news agenda, with low levels of coverage and significantly fewer items presented on this topic than on obesity, diet or smoking [10–12]. Fewer studies have examined the way that physical activity is framed in news stories, and so far these have revealed that this issue is presented as the responsibility of individuals, with very little attention to environmental and policy drivers of inactivity [13].

There is a need for on-going reflection on the kinds of research that will enable the most strategic and effective use of the mass media in physical activity promotion. Several reviews of evaluations of physical activity campaigns have drawn attention to study designs, impact measures and analytical techniques that will improve the quality of evidence that these provide [2, 3, 14]. Others have argued for a critical reflection on the assumptions underpinning social marketing and advocacy research related to physical activity, and for adoption of a media analysis approach that better matches the complex processes inherent in mass media communication [15]. This process entails the creation and encoding of messages by media producers, and their decoding, consumption and negotiation by audiences [15]. Research that is consistent with this social constructionist [16] approach includes studies of the meaning that media producers attempt to instil in messages, the beliefs and interests that shape this production activity, the range of messages that audiences receive, their interpretations and reactions to these and the various factors that influence their responses.

Media analysis research undertaken with audiences recognizes that a direct effects, or ‘hypodermic’, model of communication incorrectly regards audiences as passive and neutral recipients of the messages conveyed to them [17]. On the contrary, it is argued that audiences actively engage in the construction of meaning in response to images, messages and the medium through which these are delivered, by drawing on their own understandings, values and experiences [18, 19]. Consequently, they may vary widely in their interpretation of messages, and derive meanings that differ significantly from what was intended by the initiators of the communication [20].

For health communication researchers, audience reception studies can provide valuable insights into the salience of messages and the elements affecting this, the information received, the meanings produced by exposure and the personal and contextual factors affecting reactions to the messages. In one example of an audience study in Scotland, focus groups were conducted with members of the general public and past users of psychiatric services, finding that media portrayals of mental illness were having a stigmatizing effect by framing affected people as presenting a higher risk of violence [21]. In another example, in-depth interviews explored obese persons’ beliefs and reactions to messages conveyed by public health agencies about obesity [22], finding that audience members considered these to be overly simplistic, made them feel blamed for their weight status and offered few realistic solutions. Studies of this type offer a deeper understanding of the effects of health communication initiatives, and may be used to improve the design of these and the benefits they produce.

There has not yet been an in-depth audience study to examine the beliefs and reactions generated by mass media coverage of physical activity. Since the release of the US Surgeon General’s Report on Physical Activity and Health in 1996, a number of mass media campaigns have been conducted in Australia to promote understanding and adoption of the recommendations for regular moderate-intensity physical activity. Researchers and advocates have also sought to engage the news media to increase attention to the public health significance of inactivity, and the environmental and policy developments required to support a more active population. Mass media coverage of the problem of obesity has grown dramatically over this period [11], which has stimulated public discussion of diet and physical activity, and generated the popular reality entertainment program ‘The Biggest Loser’. The audience study reported here was designed to explore the exposure, understandings, beliefs and reactions of Australians to mass media coverage of physical activity. Its purpose was to gain insights to inform more strategic and effective communication about this public health priority.

Methods

Study design

A qualitative study, using a semi-structured interview design, was conducted. This approach was considered suitable for discovering the range of beliefs and understandings about physical activity and responses to media coverage of this topic. Ethical approval for the study was granted by the University of Technology, Sydney Human Research Ethics Committee (number 2010-033A).

Sampling and recruitment

Participants were aged 18 years and over, resided in New South Wales, Australia and able to converse in English. Because data were collected as part of a larger study concerning media portrayals of obesity and health, participants were also required to have been exposed to presentation of content about these topics. The purposive sampling strategy was designed to recruit 50 participants, including people aged 18–39, 40–64 and 65 years and over; living in urban, suburban, and rural locations; and of diverse weight status, with 46 participants successfully recruited and interviewed.

Data collection

Face-to-face interviews were conducted by an experienced research officer. These were held at the University of Technology Sydney campus, or a private room at a local club (for those living in rural locations), or in the participants’ home if they were not able to travel. Interview questions explored the nature of exposure to the media’s coverage of physical activity and physical inactivity, personal influences resulting from this exposure, perceived causes of and solutions to the issues presented in media coverage, and, general opinions and evaluations of media coverage. During interviews, respondents were prompted to gain further responses concerning child physical activity and inactivity. Interviews were 40–70 min in duration and all were audio recorded, then transcribed and sent for checking to those participants who requested them.

Analysis

Transcripts were formatted for NVivo 9 (QSR International Pty Ltd) and coded for analysis using this software program. Themes (nodes) were reviewed by two researchers and rationalized. Node trees, themes and coded participant data referring to physical activity and inactivity were extracted for analysis using queries tailored to elicit data related to this study. Respondent quotes were used to illustrate themes observed in the data. Generic labels were assigned to the quotes to preserve anonymity, with gender (‘M’ for male and ‘F’ for Female) and weight status denoted (‘He’ for healthy weight, ‘Ow’ for overweight, ‘Ob’ for obese) to show the range of persons who made the statements.

Results

There were 24 men and 22 women interviewed. Eighteen participants were aged 18–39 years, 21 were aged 40–64 years and 7 were aged 65 years or older. Persons from a range of weight categories were included, with 16 reporting to be underweight or healthy weight, 12 overweight and 18 obese or morbidly obese. Most participants were in paid employment (24 full time and 7 part time).

Exposure to content concerning physical activity

Fewer than half of the respondents could readily recall media coverage of physical activity, but with further prompting the majority was able to do so. The dominant channel of exposure was television, which was more often mentioned than newspapers or online sources. The most commonly cited coverage was reality television programs (especially ‘The Biggest Loser’), news and current affairs coverage of child obesity and inactivity, and sports programs.

“Yes, you see it all the time on TV, and the reality shows, Biggest Loser, you see the amount of physical work they have to do.” (M-Ob)

“Yes one of the current affairs or one of the stories – they do have things about like that. I have heard stories like that lately but just pinpointing one is a bit … they were trying to get the kids to walk from school to home which I thought was a good idea instead of catching buses.” (F-He)

To a lesser extent, respondents mentioned being exposed to coverage of physical activity through the advertising of exercise equipment and government-sponsored physical activity campaigns. A number of respondents were not confident that the information they could recall came from news media coverage or from other sources.

“Twelve months ago they ran a government campaign on exercise similar to the Life Be In It idea – to do half an hour’s exercise every day and you will feel a lot better. I can’t remember exactly when that was.” (M-Ob)

“Not that I can recall recently. Probably have in the dim dark past, about some new revolutionary exercise that will fix your backside or fix your abs or whatever.” (M-Ow)

When probed about exposure to coverage of the problem of inactivity, most did not recall information they had seen or read about this topic. Others were able to recall it being presented, but did not elaborate on where or in what way; just a few said there was a significant amount of coverage. The most common stories that were recalled were focused on the issue of obesity, with some noting that these appeared to concentrate mostly on this problem among children.

“Certainly about inactivity and how it contributes to obesity and being overweight … generally speaking can’t think of anything specific.” (M-He)

Several of those who were overweight or obese noted that this is not a topic that holds interest for them, so they did not attend closely to stories in which it was covered.

“If you’re not interested it goes over the top of your head and I’m sure a lot more people like me think ‘oh yeah let it go’.” (F-Ow)

Messages and understandings taken from media exposure

There were two dominant physical activity promotion messages that respondents recalled from media coverage of this topic, which were both general exhortations to become more active: physical activity is ‘good for you’ because it improves health, and individuals should make an effort ‘to get out there’ and become regularly active. The need for children to have regular physical activity was a physical activity promotion theme also identified by a number of respondents. Examples of comments about these messages are shown in Table I. A selection of other less common messages were referred to, namely: short bouts of activity are good for health; simple choices can create opportunities for more daily activity; walking is beneficial; people should go to the gym and a personal trainer is valuable for becoming active (Table I).

Table II presents the major themes that emerged concerning discussion of the problem of inactivity and its causes. The broad theme of physical inactivity causing health problems, such as obesity, heart disease, stroke and cancer, was referred to as a major topic. The single problem that was most often recalled in this coverage was obesity. Another aspect of this media coverage observed by a number of interviewees was discussion of lack of activity among children, and its relationship with sedentary leisure pursuits.

The comments by respondents about the portrayal of the causes of inactivity generated a broad selection of themes, with no single cause observed to be dominant. The themes concerning causality were the following: the impact of office-based work; the effect of busyness and lack of time; modernization and technological change reducing opportunities for activity; laziness and the use of motorized rather than active transport. Table II shows example of comments corresponding to each of these themes.

The vast majority of respondents expressed the view that the responsibility for becoming physically active rested with the individual. The quotes below are illustrative of the many comments made about the primacy of individual motivation and determination.

“Once you make people aware of the benefits of it, it’s ultimately up to them. You can’t go and drag them out. Encouragement from other people, but, other than that, it’s really your own responsibility. You have to be somehow motivated to do it.” (M-He)

It is the individual. You can take a horse to water, but can’t make it drink … I believe it all boils down to the individual and how do you get through to the individual?’ (F-Ob)

Other people and organizations referred to as having responsibility for promoting physical activity were parents, in relation to their children, the government, mass media and, to a lesser extent, schools and peers. The references to government usually mentioned its role in instigating community education and awareness campaigns. The responsibility of the media to influence community attitudes was raised in several ways by respondents.

“Well I do actually think the media has a big responsibility in it because the media is the thread that ties everyone together, especially in Sydney – people hardly ever talk to each other but they read the same articles, or hears or reads or watches the same news programs. So it’s sort of their responsibility to create that zeitgeist for what we should be doing or where we should be.” (M-Ow)

Perceived impact of media exposure

Although many respondents expressed the view that media coverage of physical activity had not affected their beliefs and attitudes, a number reported being at least somewhat influenced. The dominant ways in which they believed their exposure to media had an influence on their attitudes and intentions were: reminding them of the importance of regular activity; exemplifying the harmful effects of inactivity through narratives about obese individuals and providing examples of actions that can be taken to adopt a more active lifestyle.

“You see The Biggest Loser or something and think I don’t want to get like that.” (F-Ob)

“I think it’s made me more aware that I have to get my children out every day … I have to say both my children are fairly active anyway but it’s always – come on let’s go for a bike ride, let’s do this – always want to get them out of the house. It’s more from watching programs like The Biggest Loser or the media, I want to make sure when they grow up they have healthy habits.” (F-Ow)

Assessments of media coverage

When asked their opinions about the coverage of physical activity in the media, the most common view expressed by respondents was that there was not enough attention paid to the issue, and that the media could do more. Examples of statements about the extent and nature of media coverage are shown in Table III. Consistent with the view that the media holds some responsibility for promoting physical activity, several people stated that there should be more education provided about this topic, especially through television. A number of people observed that there was a lack of practical advice given in the media that would assist audiences to adopt more active lifestyles. In addition to this, several commented that media stories tended to be negative, and often used extreme examples rather than presenting content relevant to the circumstances and abilities of people in the general community.

Discussion

Mass media communication has strategic value in physical activity promotion to influence beliefs, socials norms and personal behaviours, and to advocate for policy change to create supportive environments for active living. To date, the success of these efforts has been largely viewed in terms of their reach and impact as measured by a prescribed set of psychosocial and behavioural indicators. A media analysis perspective argues that a deeper understanding of what mass communication efforts are achieving can be obtained by listening to audiences, using qualitative approaches that can record the breadth and complexity of message exposure and the meaning that is being derived from this [15, 23]. This study is the first to explore audience reception, interpretation and evaluation of mass media coverage of physical activity. The findings challenge assumptions that may be held by physical activity policy makers and advocates about the salience and impact of the communication initiatives by health agencies, and indicate directions for future communication strategies.

A fundamental concern for those communicating public health messages is the exposure and understanding achieved among audiences in a crowded, information-rich media environment [24]. This study has found that physical activity content was not easily recalled by the audience members interviewed. Television was the dominant source of content that was recalled, and this came from a diverse mix of program types. Unprompted recall of government-initiated media campaigns about physical activity was low, which indicates that these modestly funded initiatives are likely to be having little impact beyond the short-term time frames within which they are evaluated [3]. High ratings reality television, notably ‘The Biggest Loser’, was the most frequently identified source of physical activity information. Apart from the extensive audience reach that this program achieves, its impact is likely to be increased through a number of entertainment features that have been reported to increase audience engagement and influence health understandings. These include the presentation of personal narratives [25], showing actual events that have consequences for real people and incorporating health information (i.e. physical activity, dietary intake) that fits the context of the program [26]. The impact of this program format has been shown in experimental research, where presentation of a Biggest Loser segment depicting a demanding personal training session was found to promote a negative affective attitude to exercise among viewers [27].

News and current affairs programs, while also known to have high audience ratings, did not feature as strongly as reality entertainment as a source of content about physical activity. This supports previous news analysis studies which have found that physical activity has received a modest level of coverage, and far less than obesity [10, 11, 13]. The presentation of sports and sporting news held a similar level of prominence to news and current affairs reporting. An unexpected finding was the frequency that commercial advertising of exercise equipment was cited as a source of information about physical activity. This is a reminder of the enormous scale of the exercise products and services industry, which has unknown impacts on physical activity knowledge and attitudes, and has been largely neglected by policy makers and practitioners [28]. It has been suggested that the higher frequency of advertising of exercise-related products, compared with those within public service campaigns about physical activity, may result in commercial messages having a powerful influence on the framing of this topic by media consumers [29].

The dominant messages about physical activity and physical inactivity that were recalled concerned their health impacts, and the prevalence of sedentariness among children. Obesity was the health outcome that was most strongly associated with inactivity, which is consistent with the finding that ‘The Biggest Loser’ was a major source of information, and with previous research that obesity has received extensive news coverage in Australia in recent years [30, 31]. Although there was some evidence of recall of key public health messages about physical activity, including the benefits of walking and short bouts of activity, there were also beliefs expressed that going to the gym and getting help from a personal trainer were necessary steps towards becoming active. This highlights the diverse and competing messages that are shaping public understandings about physical activity.

The widely expressed perception of respondents was that the influence of exposure to content about physical activity in the media had been low, and had mostly been as a reminder of the consequences of inactivity and a prompt to get out and be more active. The nature of this, albeit limited, influence was therefore consistent with the dominant messages that they could recall. The acknowledgement made by several participants that what they had observed in programs such as ‘The Biggest Loser’ was a deterrent to inactivity, by illustrating the harmful effects that this can have, shows the potential impact of role modelling in entertainment programs on health beliefs and actions [19]. It has been argued that a harmful consequence of this individual role modelling may be a tendency towards victim blaming and a lack of recognition of the social and environmental factors that influence public health issues [32].

An important concern for physical activity advocates is the nature of audience framing of physical activity, because of the implications that this has for public support for policy action to address this issue. The comments from respondents about the causes of inactivity revealed that a diverse range of factors were seen to be contributing to this, ranging from the prevalence of sedentary occupations to the pervasiveness of personal laziness, with no clearly dominant explanation. It has been argued that this kind of fragmentation of beliefs about an issue is the result of exposure to brief, episodic information in the media [33], and can dispose audiences to adopt the default position in which individuals are considered personally responsible for the problems they experience [34]. Indeed, when probed about perceived responsibility for addressing inactivity, respondents overwhelmingly assigned this to individuals, or in the case of children, to parents. This indicates the need for advocates to engage more successfully with the news and entertainment media about topics such as transport planning, the characteristics of workplaces and urban design, which are significant determinants of physical activity requiring environmental and policy solutions. Generating public debate about the strong individualistic emphasis in popular weight loss programs like ‘The Biggest Loser’ may assist in raising awareness of the range of social and environmental factors contributing to inactivity in the population.

The view expressed quite strongly among respondents was that they had been under-served by media coverage of physical activity, and that this issue should be given more attention, with less focus on negative health outcomes and more on clear, practical advice to assist regular activity. This supports the findings of a review of the impact of different approaches to physical activity message design, which reported that ‘gain-framed’ messages focusing on the benefits of activity, rather than the harms of inactivity, were more likely to generate positive intentions in message recipients [35]. This also highlights that health topics are viewed by audiences as experiential in nature and that there is some expectation that coverage will include ‘news you can use’. The abovementioned review of approaches to message design noted that the presentation of achievable physical activity recommendations with clear instructions tended to be more effective in improving self-efficacy [35].

The in-depth interview methodology adopted in this study offered insights into the perceptions of audience members. The themes identified from the interviews of this purposive sample can be regarded as a schema, or chart, of beliefs and responses concerning the coverage of physical activity in the mass media [23], and the generalizability of these will need to be investigated through larger, representative surveys of audience members. Inclusion of participants of diverse weight status improved the breadth of perspectives that were included in the analysis and contributed to people of size having a voice in research concerning their well-being. The inclusion criteria that participants needed to have some recall of the coverage of obesity in the media may have inflated the importance given to this as a health consequence of physical inactivity, although the extensive reporting on obesity means that these criteria are unlikely to have resulted in a significant selection effect. Data were not available for the educational attainment or household income of all respondents, hence it was not possible to consider how these factors may have influenced exposure and reactions to media coverage of physical activity.

This study has found that renewed and concerted effort is required to engage more effectively with the Australian mass media to raise awareness and understanding of the public health importance of physical activity and the negative impacts of sedentary behaviours. The media and reality entertainment framing of physical activity as important because of obesity calls for counter frames focusing on physical activity as vital at all weights. Given their audience reach and extensive coverage of obesity and other health issues, the news media have a vital role to play in this debate, as a channel for evidence about the broader determinants of inactivity and the personal, organizational, community and policy actions that are required to tackle these. Physical activity researchers and advocates will need to take account of journalistic preferences for novelty, personal narratives and visual interest when engaging with news outlets [36], and in doing so should give heed to the strong preference of the audience for presentation of practical solutions. The burgeoning range of social media channels provide opportunities for direct communication between health agencies and the public [37], and the potential to harness these for physical activity education and advocacy deserves future attention. Public health campaigns using traditional channels are likely to constitute only a small share of media content about physical activity, and to optimize their levels of audience engagement these should emphasize positive and realistic messages about ways to become regularly active.

Funding

This work was supported by the Australian Research Council (DP1096251).

Conflict of interest statement

None declared.

References