title: Regional media coverage influences the public's negative attitudes to policy implementation success in Sweden.
abstract: BACKGROUND
  One central aspect of health literacy is knowledge of patients' rights. Being an important source of information about health and health care, the media may influence health literacy and act as a policy implementer.
  
  
  OBJECTIVE
  To investigate whether regional news media coverage in Sweden is linked to (i) the public's awareness and knowledge of a patient's rights policy, the waiting-time guarantee and (ii) the public's attitudes to how the guarantee's time limits are met, that is, implementation success.
  Three types of data are used. First, a national telephone survey of the public's awareness, knowledge and attitudes; second, media coverage information from digital media monitoring; and third, official waiting-time statistics. Bivariate and multivariate regression analyses are performed with the 21 Swedish county councils/regions as a base.
  
  
  RESULTS
  In the county councils/regions, non-awareness ranged from 1 to 15% and knowledge from 47 to 67%. There are relatively large differences between population groups. The amount of regional media coverage shows no significant correlation to the level of awareness and knowledge. There is, however, a significant correlation to both positive and negative attitudes; the latter remains after controlling for actual waiting times.
  
  
  CONCLUSIONS
  At the national level, the media function as a policy implementer, being the primary source of information. At the regional level, the media are part of the political communication, reporting more extensively in county councils/regions where the population holds negative views towards the achievement in implementing the guarantee. We conclude that Swedish authorities should develop its communication strategies to bridge health literacy inequalities.
authors.affiliation: Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.
authors.forename: Mio
authors.initials: M
authors.lastname: Fredriksson
authors.affiliation: The National Board of Health and Welfare, Stockholm, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Tiainen
authors.affiliation: Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.|The National Board of Health and Welfare, Stockholm, Sweden.
authors.forename: Marianne
authors.initials: M
authors.lastname: Hanning
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006291:Health Policy; D006801:Humans; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D015397:Program Evaluation; D011639:Public Opinion; D011795:Surveys and Questionnaires; D013548:Sweden; D014850:Waiting Lists; D055815:Young Adult
keywords: Sweden; health literacy; implementation; media; patients' rights; waiting times