Public Understanding of Childhood Obesity: Qualitative Analysis of News Articles and Comments on Facebook

Figures & data

Table 1. Classification of news outlets into news outlet categories based on political orientation and type

Type	Political Orientation
	Centrist	Left-wing	Right-wing
Broadsheet		The Guardian The Independent	The Times Daily Telegraph
Tabloid	Metro i	Daily Mirror	Daily Mail Daily Star Daily Express The Sun

The news outlet category broadsheet-centrist was not covered by any news outlet selected.

Figure 1. Data screening with number of news articles and comments per news outlet category

Table 2. Number of news articles coded at frames and frame subcomponents

	Frame
Frame subcomponent	Medical (n = 18)	Societal (n = 28)	Behavioral (n = 26)
Problem definition	9	19	6
Causal attribution	8	17	22
Moral evaluation	9	20	14
Treatment suggestion	4	18	16

N = 30. News article fragments were coded into one or more frame subcomponents of the most relevant frame.

Table 3. Content of news article fragments coded at frame subcomponents of different frames

Frame subcomponent	Frame
	Medical	Societal	Behavioral
Problem definition	Associated illnesses such as type 2 diabetes or cardiovascular diseases	Burden to NHS; Health inequalities; Prevalence of childhood obesity	Mental health consequences; Social exclusion; Being outside of the norm
Causal attribution	Modifiable (breastmilk); Non-modifiable (gender, genetics, age); Mixed (epigenetics, body’s reaction to food), Healthcare professionals (HCPs)	Unhealthy environment; Policies; Lack of health services; Modern society; Poverty	Children’s choices; Diet; Physical activity and sedentary behavior; Parenting
Moral evaluation	Evaluating health impacts and HCPs	Childhood obesity as crisis; Evaluating stakeholders and strategies	Evaluating children, parents, weight and weight change
Treatment suggestion	Involving HCPs (for example, weighing at every visit); Bariatric surgery; Primary prevention before birth	Strategic interventions; Funding; Increasing health awareness; Changing the choice environment	Healthy lifestyle promotion (diet and activity), Changing parental capability and involvement

Figure 2. Themes and subthemes generated from comments on news articles

Table A1. Operational definitions of frames (Stefanik-Sidener, 2013) and frame subcomponents (Entman, 1993)

Subcomponent	Frame
	Medical	Societal	Behavioral
	Biological issues such as genetics and issues involving the medical profession such as surgery	Broad, societal level issues such as the food environment, culture or policies	Individual level issues such as diet and physical activity
Problem definition	Why is childhood obesity seen as an important topic?
Causal attribution	Who or what is seen as responsible for childhood obesity?
Treatment suggestion	What should be done to tackle childhood obesity? Is it going to be effective?
Moral evaluation	How are agents evaluated? How is childhood obesity viewed (positive, negative, other evaluations)?

News outlet categories are denoted as follows: broadsheet-left-wing (B-l), broadsheet-right-wing (B-r), tabloid-centrist (T-c), tabloid-left-wing (T-l) and tabloid-right-wing (T-r).

Stefanik-Sidener, K. (2013). Nature, nurture, or that fast food hamburger: Media framing of diabetes in the New York Times from 2000 to 2010. Health Communication, 28(4), 351–358. https://doi.org/10.1080/10410236.2012.688187

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Entman, R. M. (1993). Framing: Toward clarification of a fractured paradigm. Journal of Communication, 43(4), 51–58. https://doi.org/10.1111/j.1460-2466.1993.tb01304.x

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