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“Less Than a Wife”: a Study of Polycystic Ovary Syndrome Content

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“Less Than a Wife”: a Study of Polycystic Ovary Syndrome Content JOURNAL OF MEDICAL INTERNET RESEARCH Sanchez & Jones Original Paper ªLess Than A Wifeº: A Study of Polycystic Ovary Syndrome Content in Teen and Women's Digital Magazines Ninive Sanchez1, MSW, MS, PhD; Hillary Jones2, MSW, LICASW 1School of Social Work, University of Missouri, Columbia, MO, United States 2Catholic Community Services of Western Washington, Newcastle, WA, United States Corresponding Author: Ninive Sanchez, MSW, MS, PhD School of Social Work University of Missouri 712 Clark Hall Columbia, MO, 65211 United States Phone: 1 573 882 0920 Fax: 1 573 882 8926 Email: [email protected] Abstract Background: Polycystic ovary syndrome (PCOS) is a major public health problem that affects women's physical and mental health. According to the US National Institutes of Health Office of Disease Prevention, there is a need to improve public awareness of the syndrome among health care providers and the public. Women's magazines are a type of ªedutainmentº that publish health content in addition to beauty, fashion, and entertainment content. These media have the potential to expose primarily female readers to content on PCOS and influence readers' beliefs and attitudes about women with PCOS. Objective: The objective of this study was to explore how digital (online) teen and women's magazines portray women with PCOS. Methods: We used data from the Alliance for Audited Media to identify popular digital teen and women's magazines with circulation rates ≥1,000,001. We also included magazines with circulation rates 100,001±1,000,000 directed toward racial and ethnic minority readers. A search of magazine websites over a 1-month period in 2015 yielded 21 magazines (eg, Glamour, Cosmopolitan en Español, Essence, and O, The Oprah Magazine) and 170 articles containing ªPCOSº and ªpolycystic ovary syndrome.º Textual analysis using a grounded theory approach was used to identify themes. Results: Articles depicted PCOS symptoms as a hindrance to women's social roles as wives and mothers and largely placed personal responsibility on women to improve their health. To a lesser extent, women were depicted as using their personal experience with PCOS to advocate for women's health. Experiences of Latina and African American women and adolescents with PCOS were absent from women's magazine articles. Conclusions: The findings can inform health education programs that teach women to be critical consumers of PCOS-related content in digital women's magazines. Future research on PCOS content in digital teen and women's magazines can help researchers, patients, and consumer groups engage with the media to increase public awareness of PCOS. (J Med Internet Res 2016;18(6):e89) doi: 10.2196/jmir.5417 KEYWORDS polycystic ovary syndrome; digital magazines; women©s health; edutainment health-related information [2,3]. Among the people searching Introduction for health-related information online are women typing ªPCOS,º In the United States, 35% of adults, or about 1 in 3 Americans, ªpolycystic ovaries syndrome,º and ªPCOS symptomsº [4]. have used the Internet to find out what medical condition they or someone else might have [1]. Younger age groups and women increasingly use the Internet and social media to access http://www.jmir.org/2016/6/e89/ J Med Internet Res 2016 | vol. 18 | iss. 6 | e89 | p. 1 (page number not for citation purposes) XSL·FO RenderX JOURNAL OF MEDICAL INTERNET RESEARCH Sanchez & Jones Overview of PCOS Websites also tend to omit information on authors, editorial Polycystic ovary syndrome (PCOS) is a complex, chronic review process, publication date, strength of evidence reported condition the US National Institutes of Health (NIH) Office of (eg, use of randomized controlled trials), PCOS treatment based Disease Prevention has described as a major public health on practice guidelines [27], privacy and confidentiality of problem for women in the United States. PCOS is characterized personal data, and sources [4]. by a range of symptoms including irregular or no menstrual Media and Health periods, excess hair growth on the face and body (hirsutism), Media do not just provide consumers with health information, weight gain, acne, ovarian cysts, and alopecia [5]. PCOS can however; they also create social constructions of health, illness, also increase women's risk of type 2 diabetes mellitus [6], and medical care that have implications for how consumers cardiovascular disease [7], infertility [8], anxiety and depression view and manage their health [28]. Teen and women's [9-12], and poor health-related quality of life [13]. magazines have traditionally conflated health and beauty PCOS can begin in adolescence [14] and worsen across the life [29,30]. For instance, an analysis of body-related content course if untreated or poorly managed [15,16]. The prevalence published from 1993 to 2003 in Seventeen, a magazine for of PCOS among adult women (18-45 years of age) in the United adolescent girls, found that content created constructions of States is about 7% [17]. However, research with a community desirable bodies as lean, toned, and free of hair and acne [31]. sample of women (27-34 years of age) in the United Kingdom Equating health with beauty can be problematic for readers with suggests that the prevalence of PCOS may be even higher, from PCOS. For instance, teen magazines publish techniques such 7.8% to 20.6%, depending on which of 3 diagnostic criteria for as hair removal strategies and quick-fix diet and exercise PCOS is used. Additionally, using 2 of these criteria, NIH and routines readers can follow to achieve the desirable body [31]. Rotterdam, about 70% of women with PCOS symptoms are Hair removal techniques that do not address the underlying undiagnosed [18]. See Goodman et al [19] and Rosenfield [20] causes of excessive hair growth can mask the severity of for a review of the diagnosis and treatment of PCOS in PCOS-related hirsutism [32]. Diet and exercise routines to adolescents and adults. achieve the desirable body in a short amount of time can overlook the importance of long-term lifestyle changes in diet The 2012 NIH Evidence-based Methodology Workshop on and physical activity needed to manage PCOS. On the other Polycystic Ovary Syndrome recommended establishing hand, content in women's magazines that encourages consumers ªmultidisciplinary programs to improve public and health care to collaborate with health care providers, be cautious about provider awareness and management for women who currently treatments and medications, and look to friends and family for have the syndromeº [5]. The lack of awareness about PCOS is social support may help consumers manage their health [33]. partly due to the condition's misleading name, which suggests that it is a problem of the ovaries; however, the presence of Edutainment polycystic ovaries alone does not indicate that a woman has Magazines are a type of entertainment-education or PCOS [5]. Additionally, although PCOS is a highly prevalent ªedutainment,º which refers to the placement of educational condition, it does not have the ªcelebrityº status of other content in entertainment messages [34]. Magazines publish well-known conditions [21]. health content in addition to beauty, fashion, and entertainment PCOS Online content. Teen magazines have published health content on topics such as sexually transmitted infections, gynecological visits, Women with PCOS describe the process of searching for and birth control [35], and women's magazines have published answers to their symptoms as emotional, confusing, frustrating, on breast cancer [36], heart disease, osteoporosis, and depression devastating [22], and exhausting [23]. In addition to seeing [33]. Interestingly, there is evidence in the literature that several doctors before receiving a diagnosis, women report magazine readers come across content on PCOS. As an diagnosing themselves by searching for information online [24]. adolescent pointed out, Women may search the Internet for information on PCOS they cannot find or understand in books or other print sources [25], So I'm sitting inside the waiting room and I'm reading and when they do not receive sufficient information and support through and looking through magazines, and I came from health care providers [23]. In addition, the Internet provides across an article in the Seventeen magazine: women with a convenient, private, and accessible way to access polycystic ovary disease. And a light bulb went off in information on symptoms such as obesity and hirsutism my head. I'm like, hey, I gained weight for no reason. (excessive hair) that may be too embarrassing to discuss in I have hair all over my face and it's popping up in person [25]. Women communicate and share experiences with places I don't want the hair to pop up. And so, I took PCOS via chat groups, email lists [25], online support groups it to my gynecologist and she was like, ªThat's what [23], and social networking sites like Facebook and Twitter [4]. you haveº [22]. Research on online information about PCOS has primarily Research also suggests that women with PCOS relate focused on accuracy of this coverage. Information on PCOS information they see in the media to their health, as the appears on social networking sites, government health and following quote illustrates: ªIf you look at how the media professional associations'websites, and nonprofit organizations' portrays what is feminine, lack of body hair, thinness, and a websites [4,26], and websites vary regarding PCOS symptoms, beautiful complexion, you don't have these with PCOS and long-term health effects, and management strategies [4,27]. wish you didº [22]. http://www.jmir.org/2016/6/e89/ J Med Internet Res 2016 | vol. 18 | iss. 6 | e89 | p. 2 (page number not for citation purposes) XSL·FO RenderX JOURNAL OF MEDICAL INTERNET RESEARCH Sanchez & Jones While several health topics have been featured across a range criteria. Magazines were selected for inclusion in this study if of edutainment [34], researchers have not examined content on the publisher's statement described the field served as women PCOS in teen and women's magazines.
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