title: Understanding newsworthiness of an emerging pandemic: international newspaper coverage of the H1N1 outbreak.
abstract: OBJECTIVE
  During an evolving public health crisis, news organizations disseminate information rapidly, much of which is uncertain, dynamic, and difficult to verify. We examine factors related to international news coverage of H1N1 during the first month after the outbreak in late April 2009 and consider the news media's role as an information source during an emerging pandemic.
  
  
  METHODS
  Data on H1N1 news were compiled in real time from newspaper websites across twelve countries between April 29, 2009 and May 28, 2009. A news sample was purposively constructed to capture variation in countries' prior experience with avian influenza outbreaks and pandemic preparation efforts. We analyzed the association between H1N1 news volume and four predictor variables: geographic region, prior experience of a novel flu strain (H5N1), existence of a national pandemic plan, and existence of a localized H1N1 outbreak.
  
  
  RESULTS
  H1N1 news was initially extensive but declined rapidly (OR = 0.85, P < .001). Pandemic planning did not predict newsworthiness. However, countries with prior avian flu experience had higher news volume (OR = 1.411, P < .05), suggesting that H1N1 newsworthiness was bolstered by past experiences. The proportion of H1N1 news was significantly lower in Europe than elsewhere (OR = 0.388, P < 0.05). Finally, coverage of H1N1 increased after a first in-country case (OR = 1.415, P < .01), interrupting the pattern of coverage decline.
  
  
  CONCLUSIONS
  Findings demonstrate the enhanced newsworthiness of localized threats, even during an emerging pandemic. We discuss implications for news media's role in effective public health communication throughout an epidemic given the demonstrated precipitous decline in news interest.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. kasmith@jhsph.edu
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Smith
authors.forename: Rajiv N
authors.initials: RN
authors.lastname: Rimal
authors.forename: Helena
authors.initials: H
authors.lastname: Sandberg
authors.forename: John D
authors.initials: JD
authors.lastname: Storey
authors.forename: Lisa
authors.initials: L
authors.lastname: Lagasse
authors.forename: Catherine
authors.initials: C
authors.lastname: Maulsby
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rhoades
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Barnett
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Links
mesh_terms: D000328:Adult; D004196:Disease Outbreaks; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification / Q000502:physiology; D053124:Influenza A Virus, H5N1 Subtype / Q000302:isolation & purification / Q000502:physiology; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D038622:Internationality; D008402:Mass Media; D009524:Newspapers as Topic / Q000706:statistics & numerical data*; D058873:Pandemics; D011634:Public Health
keywords: Agenda setting; H1N1; international news media; pandemic influenza; preparedness communication