Mammography messages in popular media: implications for patient expectations and shared clinical decision-making.

OBJECTIVE To examine the relationship between the quantity and content of information about mammography in popular magazines and the educational level of their target audience. DESIGN Articles published in popular magazines from January 1988 through April 1994 in which >or= 25% of all readers were females >or= 35 years of age were identified (n=65). We used the proportion of readers who were college graduates to stratify the magazines into three education levels. We used a content analysis to assess the relationship between media messages about mammography and readers' education levels. RESULTS Seventy-eight percent of lowest education level articles were categorized as persuasive or prescriptive compared with 28% of articles in the highest education level (P < 0.01). Only 26% of the lowest education level articles that discussed screening guidelines for women under 50 years of age considered the issue controversial, while 59% of the high education level articles considered it controversial (P < 0.01). CONCLUSION Women with lower education levels received a clearly persuasive or prescriptive message urging mammography screening, while higher educated women received more balanced and informative messages. Such differences suggest that women may be entering their physicians' offices with very different sets of information from which to draw when faced with clinical decisions. Physicians and other health-care providers should be aware of these potential differences, and further research should be done to explore the relationship between women's preferences for participation in shared decision-making and the types of messages they are receiving from popular media.