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A Mixed Methods Investigation of Health News Sources in Flanders

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A Mixed Methods Investigation of Health News Sources in Flanders Reassembling health news A mixed methods investigation of health news sources in Flanders Joyce Stroobant Submitted to the Faculty of Social Sciences of Ghent University, in fulfilment of the requirements for the Degree of Doctor in Communication Sciences Academic year: 2018-2019 Supervisor: Prof. dr. Karin Raeymaeckers Co-Supervisors: Prof. dr. Geert Jacobs Prof. dr. Stijn Joye Supervisor Prof. dr. Karin Raeymaeckers, Department of Communication Sciences, Ghent University, Belgium Co-supervisors Prof. dr. Geert Jacobs, Department of Linguistics, Ghent University, Belgium Prof. dr. Stijn Joye, Department of Communication Sciences, Ghent University, Belgium Doctoral Exam Committee Prof. dr. Liselot Hudders, Department of Communication Sciences, Ghent University, Belgium Prof. dr. Sarah Van Leuven, Department of Communication Sciences, Ghent University, Belgium Prof. dr. Frederik De Grove, Department of Communication Sciences, Ghent University, Belgium Prof. dr. M.J. (Marcel) Broersma, Faculty of Arts, University of Groningen, the Netherlands Prof. dr. Steve Paulussen, Department of Communication Studies, University of Antwerp, Belgium TABLE OF CONTENTS LIST OF TABLES AND FIGURES ........................................................................................................ i LIST OF ABBREVIATIONS ................................................................................................................ iii ACKNOWLEDGEMENTS .................................................................................................................... v 1 INTRODUCTION ........................................................................................................................... 1 1.1 This is why health news matters .............................................................................................. 1 1.2 This is why sources matter ...................................................................................................... 3 1.3 Research questions and general objective ............................................................................... 4 1.4 Structure of the dissertation ..................................................................................................... 6 2 MEDIA: Sourcing the news .......................................................................................................... 11 2.1 Historical contextualization of news sourcing research ........................................................ 11 2.1.1 The prehistory of journalism research ........................................................................... 13 2.1.2 The empirical turn in journalism research ..................................................................... 14 2.1.3 The sociological turn in journalism research ................................................................. 14 2.2 Contemporary sourcing research: Technology takes centre stage ......................................... 18 2.2.1 Four waves of digital journalism research ..................................................................... 18 2.2.2 The trouble of a discipline trying to define its object of study ...................................... 20 2.2.3 The hybrid turn in journalism research ......................................................................... 21 2.3 The material turn in journalism research ............................................................................... 24 2.3.1 The promise of materiality: deactivating a priori categorizations ................................ 26 2.3.2 The limits of materiality ................................................................................................ 30 2.3.3 The materiality of hyperlinking ..................................................................................... 32 3 HEALTH: Understanding health news ......................................................................................... 40 3.1 (Bio)medicalization: the expansion of health ........................................................................ 40 3.1.1 Media as secondary agents of medicalization ............................................................... 40 3.1.2 From medicalization to biomedicalization .................................................................... 42 3.2 Biomediatization: the expansion of media ............................................................................ 47 3.2.1 Co-production: the hybridity of health news ................................................................. 49 3.2.2 Boundary-work: untangling ‘hybridity’ ........................................................................ 51 3.2.3 The limits of (bio)mediatization .................................................................................... 53 3.3 Biocommunicability: the performativity of health news ....................................................... 54 3.3.1 Biomedical authority model .......................................................................................... 56 3.3.2 Patient-consumer model ................................................................................................ 58 3.3.3 Public sphere model ...................................................................................................... 60 4 METHODOLOGY ........................................................................................................................ 65 4.1 Introduction ........................................................................................................................... 65 4.2 Quantitative content analysis ................................................................................................. 67 4.2.1 Operationalizing ‘health’, ‘health news’ and ‘news source’ ......................................... 68 4.2.2 Best of both worlds: manual versus automated content analysis techniques ................ 72 4.2.3 Validity and reliability ................................................................................................... 74 4.3 Qualitative semi-structured elite interviews .......................................................................... 78 4.3.1 Sampling respondents (health stakeholders and media professionals) .......................... 78 4.4 The added value of a (hybrid) mixed methods research design ............................................ 79 5 TRACING THE SOURCES ......................................................................................................... 83 6 HYPERTEXTUALITY IN NET-NATIVE HEALTH NEWS ................................................... 101 7 FINDING THE NEWS AND MAPPING THE LINKS ............................................................. 117 8 WHEN MEDICINE MEETS MEDIA ........................................................................................ 135 9 GENERAL CONCLUSIONS: Reassembling health news ......................................................... 155 9.1 Reassembling the co-production of health news ................................................................. 155 9.2 Suggestions for further research .......................................................................................... 163 9.3 Reassembling journalism theory: A fruitful dialogue between different academic disciplines? ...................................................................................................................................... 164 References ........................................................................................................................................... 169 ENGLISH SUMMARY ...................................................................................................................... 209 NEDERLANDSE SAMENVATTING ............................................................................................... 213 APPENDICES ..................................................................................................................................... 217 LIST OF TABLES AND FIGURES TABLES Table 4-1. Overview empirical enquiry per chapter .............................................................................. 66 Table 4-2. Overview categories for type/origin of health news sources ............................................... 72 Table 4-3. Overview of intra-coder-reliability scores per chapter ........................................................ 77 Table 5-1. Mean number of sources per media type (N= 1998) ............................................................ 92 Table 5-2. General overview of source origin in % (N=1998) .............................................................. 94 Table 6-1. Sample overview per website ............................................................................................ 107 Table 6-2. Internal, pseudo-external, and internal expressed in % (N=769) ....................................... 110 Table 6-3. Type of source/originator of content on target webpage in % (n=580) ............................. 110 Table 6-4. Multimedia, language and advertisements on landing pages in % (N=769) ...................... 112 Table 7-1. Overview of seed websites, individual external hyperlinks and distinct websites after page grouping .............................................................................................................................................. 123 Table 7-2. Health news websites retrieved via environmental scan .................................................... 127 Table 7-3. Cross-tab for type of external
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