title: Average household exposure to newspaper coverage about the harmful effects of hormone therapy and population-based declines in hormone therapy use.
abstract: BACKGROUND
  The news media facilitated the rapid dissemination of the findings from the estrogen plus progestin therapy arm of the Women's Health Initiative (EPT-WHI).
  
  
  OBJECTIVE
  To examine the relationship between the potential exposure to newspaper coverage and subsequent hormone therapy (HT) use. DESIGN/POPULATION: Population-based cohort of women receiving mammography at 7 sites (327,144 postmenopausal women).
  
  
  METHODS
  The outcome was the monthly prevalence of self-reported HT use. Circulation data for local, regional, and national newspapers was used to create zip-code level measures of the estimated average household exposure to newspaper coverage that reported the harmful effects of HT in July 2002.
  
  
  RESULTS
  Women had an average potential household exposure of 1.4 articles. There was substantial variation in the level of average household exposure to newspaper coverage; women from rural sites received less than women from urban sites. Use of HT declined for all average potential exposure groups after the publication of the EPT-WHI. HT prevalence among women who lived in areas where there was an average household exposure of at least 3 articles declined significantly more (45 to 27%) compared to women who lived in areas with <1 article (43 to 31%) during each of the subsequent 5 months (relative risks 0.86-0.92; p < .006 for all).
  
  
  CONCLUSIONS
  Greater average household exposure to newspaper coverage about the harms associated with HT was associated with a large population-based decline in HT use. Further studies should examine whether media coverage directly influences the health behavior of individual women.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120-1613, USA. jhaas@partners.org
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Haas
authors.forename: Diana L
authors.initials: DL
authors.lastname: Miglioretti
authors.forename: Berta
authors.initials: B
authors.lastname: Geller
authors.forename: Diana S M
authors.initials: DS
authors.lastname: Buist
authors.forename: David E
authors.initials: DE
authors.lastname: Nelson
authors.forename: Karla
authors.initials: K
authors.lastname: Kerlikowske
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Sarah
authors.initials: S
authors.lastname: Dash
authors.forename: Erica S
authors.initials: ES
authors.lastname: Breslau
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D020249:Hormone Replacement Therapy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009524:Newspapers as Topic; D044469:Racial Groups / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D012424:Rural Population; D014481:United States; D014505:Urban Population