Public health framing and attribution: Analysis of the first lady’s remarks and news coverage on childhood obesity

Figures & data

Table 1. Operational definitions of variables for public health framing

Context
Overall wellbeing of children	Reducing childhood obesity affects the overall well-being of the nation’s children (e.g. ability to join military, school performance, healthcare costs)
Risk factors
Unhealthy eating or drinking	Unhealthy eating or drinking habits by the child at home
Lack of physical activity	A lack of physical activity by child at home
Busy Parents	Working and/or busy parents (e.g. reliance on fast food, inactive)
Parents not teaching or modeling healthy behavior	Parents not teaching children healthy habits (e.g. supplying healthy dinners, lack of physical activity with child) or parents setting a bad example (e.g. overeating, lack of physical activity)
Unhealthy foods and drinks in schools	Unhealthy foods available in school (e.g. vending machines, snacks and soda available for purchase at lunch)
Lack of physical activity at school	Lack of physical activity at school
Television shows and ads	Television shows and ads that promote poor eating habits
Outdoor activity unsafe in neighborhood	Outdoor physical activity unsafe in disadvantaged areas
Poverty and food deserts	Poverty conditions (e.g. availability of healthy food, families unable to afford activities for children)
Larger portions and high calorie foods	Unhealthy food in restaurants (e.g. higher calorie food, larger portion sizes)
Other diet-related factors	Other diet-related causes not listed
Other physical activity-related factors	Other exercise-related causes not listed
Solutions
Diet changes at home	Diet changes made in the home or areas controlled by parents
Physical activity changes at home	Exercise changes made in the home or areas controlled by parents
Healthy diet education	Providing general education to children and parents regarding healthy diets
Physical activity education	Providing general education to children and parents regarding exercise
Diet-related policies at schools	Diet changes mandated in schools (e.g. reduced calorie school lunches)
Physical activity education at schools	Exercise changes mandated in schools (e.g. increase recess time, physical education)
Diet-related policy (general)	Public policy changes affecting diet (e.g. public vending machines)
Physical activity-related policies (general)	Public policy changes affecting exercise (e.g. city weight-loss programs)

Note: Based on those outlined by Hawkins and Linvill (2010).

Table 2. Operational definitions of variables for attributions of responsibility

Individual risk factors

Unhealthy eating or drinking

Lack of physical activity

Busy parents

Parents not teaching or modeling healthy behavior

Environmental risk factors

Unhealthy foods and drinks in schools

Lack of physical activity at school

Television shows and ads

Outdoor activity unsafe in neighborhood

Poverty and food deserts

Larger portions and high calorie foods

Other diet-related factors

Other physical activity-related factors

Individual solutions

Diet changes at home

Physical activity changes at home

Healthy diet education

Physical activity education

Environmental solutions

Diet-related policies at schools

Physical activity education at schools

Diet-related policy (general)

Physical activity-related policies (general)

Table 3. Public health framing

	Remarks (n = 103)		Articles (n = 260)
	Number	% of total	Number	% of total
Three components	36	35.0	51	19.6
Two components	28	27.2	72	27.7
Risk/cause and solution	13	12.6	32	12.3
Risk/cause and context	2	1.9	4	1.5
Solution and context	13	12.6	36	13.8
One component	29	28.2	100	38.5
Risk/cause	1	0.1	7	2.7
Solution	24	23.3	93	35.8
Context	4	3.9	0	0.0
No components	10	9.7	37	14.2

Table 4. Frequency of risk factors

	Frequency
	Remarks (n = 103)	Articles (n = 260)
Individual risk factors
Unhealthy eating or drinking	16	51
Lack of physical activity	17	34
Busy parents	25	11
Parents teaching or modeling healthy habits	13	9
Environmental risk factors
Unhealthy foods or drinks in schools	11	19
Lack of physical activity in schools	12	12
Television shows and ads	10	19
Outdoor activity unsafe in neighborhood	6	3
Poverty and food deserts	25	25
Larger portions and high calorie foods	4	6
Other diet-related factors	0	9
Other physical activity-related factors	0	4
Total	139	202

Table 5. Frequency of solutions

	Frequency
	Remarks (n = 103)	Articles (n = 260)
Individual solutions
Diet changes in the home	27	77
Physical activity changes in home	12	32
Healthy diet education	58	97
Physical activity education	24	64
Environmental solutions
Diet-related policies at schools	46	95
Physical activity-related policies at schools	19	47
Diet-related policies (general)	38	86
Physical activity-related policies (general)	7	43
Total	231	541

Note: The total number exceeds the total sample because although some remarks and media articles had no mentions others included multiple solutions.

Table 6. Attributions of responsibility for risk factors and solutions

	Remarks (n = 103)		Articles (n = 260)
	Number	% of total	Number	% of total
Risk factors
Both environmental and individual	27	26.2	27	29.0
Environmental	16	15.5	37	41.0
Individual	9	8.7	30	28.0
No mention	51	49.5	166	63.8
Solutions
Both environmental and individual	30	29.1	78	36.8
Environmental	54	52.4	129	60.8
Individual	2	1.9	5	2.4
No mention	17	16.5	48	18.5

Hawkins, K. W., & Linvill, D. L. (2010). Public health framing of news regarding childhood obesity in the United States. Health Communication, 25, 709–717. doi:10.1080/10410236.2010.521913

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