Media Preference and Use Pattern among Diabetes Patients in Enugu State, Nigeria
Chika Euphemia Asogwa*
Department of Mass Communication,
Federal University Oye-Ekiti, Oye-Ekiti, Ekiti,
- *Corresponding Author:
- Chika Euphemia Asogwa
Department of Mass Communication
Federal University Oye-Ekiti
Received Date: July 22, 2017; Accepted Date: September 21, 2017; Published Date: September 30, 2017
Citation: Asogwa CE. Media Preference
and Use Pattern among Diabetes Patients in
Enugu State, Nigeria. Global Media Journal
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This study investigated media preference and use among diabetes patients in Enugu State, Nigeria with attention to type of media preferred, time used, duration and reason for media use. Survey research design was used to achieve the study objectives. Within the framework of Media Richness and Uses and Gratification theories, a total of 274 respondents were purposively selected from University of Nigeria Teaching Hospital, Bishop Shanahan Hospital and Federal Medical Centre all in Enugu State, Nigeria. The questionnaire was used to collect data for the study while data was analyzed using the Statistical Package for Social sciences version 22. Result showed that TV was the most preferred medium. It was also found that time of the day had a significant influence on the choice of media. While TV was largely preferred at night, newspaper was preferred in the early morning and radio in the afternoon. Result further showed that longer duration was used to in watching TV than consuming any other medium. The researcher concludes that media preference was determined by time of the day and gratification sought. The researcher recommends, among others, that health communication should be guided by media preference and use of target population.
Diabetes; Media; Patients; Preference and use
Over the years, diabetes has proved to be one of the dangerous
diseases globally. Apart from the health danger that comes
with the disease, it is very common and efforts at stemming
its spread have not significantly achieved the desired result.
Diabetes describes a group of metabolic diseases in which the
person has high blood glucose (blood sugar), either because
insulin production is inadequate, or because the body's cells do
not respond properly to insulin, or both (WHO 2015). According
to Chinenye  patients with high blood sugar are likely to
experience polyuria (frequent urination), and this eventually
makes them become increasingly thirsty (polydipsia) and hungry
The World Health Organization  in its report on diabetes
revealed that the ailment caused 1.5 million deaths in 2012 and
that higher-than-optimal blood glucose caused the death of an
additional 2.2 million because of increased risks of cardiovascular
and other diseases. The World Health Organization adds that
many of these deaths (43%) took place under the age of 70 and
that in 2014, 422 million people in the world had diabetes – a
prevalence of 8.5% among the adult population. WHO regrets
thus: ‘The prevalence of diabetes has been steadily increasing
for the past 3 decades and is growing most rapidly in low- and
Commenting on the imperative of the mass media and information
dissemination in combating diabetes, WHO notes: ‘‘Mass media
campaigns and social marketing can influence positive change
and make healthy behaviours more the norm. These strategies
have the potential to reduce the occurrence of type 2 diabetes
and may also reduce complications associated with diabetes (p.
15).” Suffice it to say that mass media campaigns are essential for
reducing the increasing risk of diabetes, it then follows logically
that understanding media preference and consumption of
diabetes patients is very essential in developing communication
strategies for managing diabetes.
Scholars  have investigated media consumption and preference
of media audience. For example, Singh and Singh studied the
media preference of judges and reported that newspaper is the
most preferred media for the judges in the morning hour showing
that information precedes over entertainment in early part of the day while choice of Television programmes at night and late night
show that entertainment precedes over information. Hanson, et
al.  in a study of Community Health Center patients reported
that they preferred that their providers use email, cell phones
for texting, and Facebook and cell phone apps for sharing health
information. Significantly more Hispanic than white patients
believed their providers should use Facebook (P=0.001), YouTube
(P=0.01), and Twitter (P=0.04) for sharing health information. Use
and intentions to use social media for health-related purposes
were significantly higher for those patients with higher subjective
norm scores. The media consumption pattern of the audience
has been thought to account for the success or failure of health
campaigns. Wakefield  corroborates that communication
campaigns involving diverse topics and target audiences have
been conducted for decades and some reasons why information
campaigns fail is largely because exposure to such messages
is, generally passive. Wakefield adds that such campaigns are
often competing with factors, like pervasive product marketing,
powerful social norms, and behaviours driven by addiction or
habit. Variables of media preference and use that are likely to
affect health campaigns include: the type of media use, the time
of media use and the average duration for media consumption.
Based on this background, this study investigated media
preference and use of diabetes patients in Enugu State, Nigeria.
Statement of the Problem
The increasing cases of diabetes globally have constituted a
health challenge to medical experts. While complete cure of
the disease has remained a daunting challenge to scientist,
managing it has been identified as a vibrant way of avoiding it
from becoming complex. The American Diabetes Association
(2017) reveals that given the complex and chronic nature of
diabetes, requiring continuous medical care with multi-factorial
risk-reduction strategies beyond glycemic control, ongoing
patient self-management education and support are critical
to preventing acute complications and reducing the risk of
long-term complications. This means that knowledge of media
preference and use among diabetes patients is very essential for
effective campaigns managing diabetes. However, the increasing
number of diabetes patients in Nigeria has not been greeted with
corresponding literature on the media preference and use among
these patients as areas like the type of media most preferred,
the time of media use, the duration as well as reasons for media
preference and use have not been significantly investigated.
Rather, previous studies [1,6,7] have focused more on media
coverage, causes and prevention. This gap in literature is the
problem and motivation for this study.
Objectives of the Study
The general objective of this study is to determine the media
preference and use among diabetes patients. Specifically, the
study sought to determine the following:
• The most preferred media among diabetes patients in
Enugu State, Nigeria.
• The time of media use among diabetes patients in Enugu
• The duration of media use among diabetes patients in
Enugu State, Nigeria.
• The reasons for media use and preferences among
diabetes patients in Enugu State Nigeria.
Overview of Diabetes in Nigeria
Nigeria is one of the 32 countries of the International Diabetes
Federation, African region. Figures from the Federation revealed
that there were 3.747 million cases of diabetes in Nigeria in 2014.
The result of the Federation further revealed that the prevalence
of diabetes in adults (20-79 years) is 4.6%. The number of cases of
adults that are undiagnosed was put at 1,723.4. Cost per person
with diabetes (USD) was put at 178.8 while the number of deaths
in adults due to diabetes was put at 105,091. Dahiru, Aliyu and
Shehu  did a study wherein twenty population-based studies
that had been conducted on the prevalence of diabetes in Nigeria
between 1990 and December 2013 were reviewed and reported
that the prevalence of diabetes ranged from 0.8% to 11% involving
both urban and rural populations, with varying sampling schemes.
The International Diabetes Federation Diabetes Atlas, shows that
Nigeria is the leading country in Africa in terms of the number
of people with diabetes which is estimated to increase annually
by 125,000 between 2010 and 2030. This over views shows the
danger diabetes poses to the Nigerian people.
Media preference, use and health
Media preference and use of the audience is a very fundamental
criterion in planning and implementing health campaigns.
Knowledge of media preference and use of the target population
is a sin qua non for successful health campaigns. The United States
Department of Health and Human Services,  corroborates that
to effectively reach the targeted audiences health promotion
and communication activities should reflect audiences preferred
formats, channels, and contexts. This suggests that for effective
communication on health related issues, the preferences of
information from the audience should be consistent with the
channels in which the health information is sent. Uittenhout 
avers that the Internet, television and newspapers are among the
types of mass media that can be used for health communication.
Hartman,  opines that giving that the media choice of
individuals is not always made deliberately and can be influenced
by an inner drive or impulse including habitual and even addictive
media choices more popular forms of media are often used for
health communication. Cassell, Jackson and Cheuvront, 
submit that as an alternative to direct communication with
doctors, health professionals can use the popularity of mass media
for health communication through these channels. This cannot
be achieved without knowledge of media use and preferences of
the target population. Therefore, in any health communication
the following questions about the target population must be
answered: Which medium/media do they prefer? What time do
they access the medium/media? How long do they access the
medium/media? These tripod will significantly determine the
success or otherwise of health communication.
Health communication is a broad concept that covers sharing
of health related information. Ratzan  describes health
communication as the art of informing, influencing, and motivating
individual, institutional, and public audiences about health issues
through planned learning experiences based on sound theories.
The overall aim of health communication is promote healthy
living through interventions, advocate health policies, among
others. No matter how well crafted a health intervention is, if it is
done without the target population in mind, the communication
will fail. Bennett and Glasgow  posit that the effectiveness of
a health communication programme can be ascertained through
the measuring of the impact vis-a-vis improving the quality of life
or reducing the negative effects of diseases on individuals, which
in this case, diabetes. Uittenhout  avers that when launching
health communication, attention should be paid to how the
information will be made available to the target population,
how to influence the target population as well as motivate them.
Therefore, in the chain of health communication, the target
population is the king. Just like in the production process, the
health communication is never complete until it reaches the
target population. This makes the communication behaviour
of the population measured in media preference and use very
essential for health communication undertakings.
Media preference and use of diabetes patients
Information is a very fundamental need of patients. Patients
require information to better manage their ailments. The Pew
Internet and American Life Project avers that patients with
chronic health conditions are usually looking to the Internet for
information and support related to their illness. An analysis of
the ten most popular social media websites with emphasis to
individuals living with a chronic disease revealed that the sites
had an average of 6,700 members and up to 100 new posts
daily, depending on the day and topics . Greene, et al. 
examined the content of Internet-based discussion groups for
those with diabetes through thematic analysis of posts and group
discussion threads using the Facebook accounts of patients with
diabetes and found that sharing personal clinical information,
requesting disease-specific guidance, and receiving emotional
support were the most common topics among users. Armstrong,
et al.  reported the same topic areas after a study of a peerto-
peer discussion group used by a sample of patients with
diabetes living in the United Kingdom. Armstrong et al further
reported that Diabetes self-management; new possibilities
in treatment, and coping psychologically with the disease
were most commonly discussed among patients in the United
Kingdom. This implies that diabetes patients were seeking for
information for the management and psychological support of
their medical condition. This information is very useful for health
communication because it will help in packaging communication
contents for diabetes patients. This is also likely to influence their
media preference and use. Bahammam  studied 454 diabetes
patients in Saudi and reported family and friends were the
main source of diabetes-related information, and the Internet
was the least likely source. Liebreich, et al.  investigated
the effectiveness of a 12-week online intervention targeting physical activity among a sample of older patients with Type 2
diabetes – mean age = 54 years. The programme was hosted on a
website containing didactic content and interactive components
with elements of social networking such as message boards and
personalized weekly emails from a counselor. In sharp contrast to
those in a control group, intervention participants demonstrated
increased amounts of physical activity and also reported high
levels of satisfaction with the online delivery mode. This result
paints a picture of the importance of information in diabetes
Shaffer-Hudkins et al.  studied social media use among
individuals with Diabetes in the United States. The researchers
describe a study surveying 244 participants of four national
diabetes online communities with a view to understanding
the frequency, motivating factors, and preferences of social
media use as well as related outcomes. The result showed that
participants are regularly active in diabetes online communities,
with over half accessing such sites daily or even multiple times
per day. Differences in frequency of use were not evidenced
across age groups or relation to diabetes (i.e. patient versus loved
one or caregiver). The result also showed that almost half of the
respondents indicated that they engage in diabetes social media
use regularly regardless of health status or personal situation
at the time. Topics of most interest when accessing diabetesrelated
were found to include diabetes management, the latest
technology, and nutrition. From the studies reviewed, there is
little or no evidence on media preference of diabetes patients in
from Nigeria even though the country has the highest number of
diabetes patients in Africa.
This study found expression in Uses and Gratification theory.
The Uses and Gratification Theory was propounded by Katz in
1970. The main idea of the theory is how people use media for
gratification of their needs. The theory holds that people use
media for many purposes and that the audience is active and
its media use is determined by goal. People have various needs
they seek to satisfy through media. Audience members take
initiative to link need gratification to a specific media. The theory
propounds the fact that people choose what they want to see or
read and the different media compete to satisfy each individual’s
This theory was found useful because it helps in understanding
media preferences and use among diabetes patients. It provided
the basis for understanding the gratification that diabetes
patients seek in their media preference and uses.
Design and area of the study
The researcher applied descriptive survey to achieve the study
aim. The study was conducted in Enugu State, Nigeria. Enugu is
located in South East Nigeria with three Senatorial zones. Enugu
was considered appropriate for the study because evidence in
literature [20,21] suggest that there is the prevalence of diabetes
in the State.
A total of 274 registered diabetes patients were selected from
the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla,
(n=116), Bishop Shanahan Hospital Nsukka (n=34) and Federal
Medical Centre Enugu (n=124). One hospital was selected from
each senatorial zone. To recruit participants for this study,
request letters were written and addressed to the authorities of
the health centers. In the letters, the authorities were requested
to provide contact details of registered diabetes patients. When
this was done, the research team contacted the diabetes patient
and requested their consent to participate in the study. Those
who agreed were further requested to fill a consent form. Only
those who filled the consent form were included in the study.
In the consent form, the participants were assured that that
information provided will be used solely for the study and that
their identities will not be revealed.
Instrument of data collection
The researcher developed a questionnaire to collect data for
the study. The questionnaire was divided into two parts. The
first part sought the demographics of the participants while the
second part sought information on their media preference and
use. The response format was a multiple option. To ascertain the
reliability of the instrument, a pre-test copy was prepared and
administered to diabetes patients (they were not part of the
final study). After a period of two weeks, the same instrument
was administered to the same respondents, the Guttmann scale
of reproducibility was used to determine its reliability and this
yielded 0.90, an indication of high reliability.
Administration of instrument and analysis
The instrument of this study was administered to the respondents
on a face-to-face basis and retrieved immediately. The instrument
was administered to the respondents at their private houses.
The reason was to further conceal their identities and provide a
conducive atmosphere for them to respond to the questionnaire.
It was also meant to avoid high attrition rate. For the analysis of
data for the study, simple percentages and SPSS version 22 was
The sample for this study was 62 percent female and 48 percent
male. The dominance of female in the sample is not surprising
because previous studies [21,22] have shown that there are
more female diabetes patients than there are males. The mean
age of the respondents was 45 (range 24 and 65 years). Most (89
percent) of the respondents were married. The mean number
of years that the respondents had been diabetic was found
to be 4 years (range 2 and 6 years). In the area of income, the
average annual income of the respondents was 925,000 (range
350,000 and 1,500,000). Most (87 percent) of the respondents
were entrepreneurs. This is not surprising because Enugu State is
predominantly occupied by the Igbos who is renowned for their entrepreneurial spirit. Also, 87 percent of the sample was from
Table 1 revealed that most of the respondents reported that
they prefer the TV followed by radio. This result may have been
influenced by the respondent’s location because people who are
in urban areas are more likely to express preference for TV than
those in rural areas.
Table 1 Media preference of diabetes patients.
Table 2 showed that time of the day had a significant influence
on the choice of media. While TV was largely preferred at night,
newspaper was preferred in the early morning and radio in the
Table 2 Media preference and time of use.
||Time and Use
|% of Total
|% of Total
|% of Total
|% of Total
|% of Total
|% of Total
Table 3 revealed that longer duration was used in watching TV
than consuming any other media. This is because the respondents
spend five hours and above watching TV while they spend
between 0 to 2 hours reading newspapers.
Table 3 Duration of media use.
||5 hours and above
|% of Total
|% of Total
|% of Total
|% of Total
|% of Total
|% of Total
Table 4 showed that diabetes patients use newspapers for
information, TV for entertainment and social media for social
integration. TV was also used for personal identity.
Table 4 Reason for media preference and use.
|% of Total
|% of Total
|% of Total
|% of Total
|% of Total
Discussion of Findings
This study investigated media preference and use among
diabetes patients in Enugu State, Nigeria. The result of this study
revealed that TV was the most preferred media among diabetes
patients. This result is contrary to a survey conducted by the
National Bureau of Statistics  which showed that 82.9% of
Nigerians have access to radio. A breakdown of the figure reveals
that 53.3% only have access to radio, and 30.6% owned radio
as against 31.5% and 13.3% access and ownership of television
respectively. This result is also inconsistent with that of Hanson,
et al.  who found that patients preferred that their providers
use email, cell phones for texting, and Facebook and cell phone
apps for sharing health information. The result also run contrary
to that of Bahammam  who found that diabetes patients
prefer to get information from family members and friends. The
difference between this study and other ones could be because
of the area of study.
The result of this study also revealed that the media preference of
the respondents was influence by time of the day. While TV was
mostly preferred at night, newspaper was preferred in the early
morning and radio in the afternoon. This result is similar to that of
Singh and Singh  who studied the media preference of judges
and reported that Television programmes was largely preferred
at night and late night show. Even though the current study and
that of Singh and Singh studied different people, the similarity in
the result could be because TV is generally needed at night when
most family members must have come back from work.
Result also revealed that most of the diabetes patients spend
longer duration watching TV than consuming any other media
and that diabetes patients use newspapers for information, TV for
entertainment and social media for social integration. This result
has implications on the Uses and Gratification theory because it
suggests that diabetes patients express their media preference
and use based on the gratification they have to meet. This is in line with the postulation of Katz who noted that media audience
is active, as such; make use of the media to meet some needs.
The result of this study is also consistent with that of Shaffer-
Hudkins, et al.  who reported that diabetes patients select
their media with a view to getting information on treatment and
management of the disease.
This study has shown that media preference and use of diabetes
patients is largely dependent on time of the day and the type
of gratification they seek. The duration for the use of media has
also been revealed. This information has implications on health
communication in general and communication to diabetes
patients in particular. For health communication, this result has
provided tips that will form part of a larger strategy when planning
and implementing health communication campaigns. Although
the result may not be applicable to people with other ailments,
it has provided cues on for health communication efforts. With
regards to campaigns targeted at diabetes patients, this result has
answered specific questions; the type media diabetes patients
prefer, the time of the day they use each medium, the duration
they use the media and the gratification for using each of the
media. This revelation is not only useful to communication health
expert, media practitioners and researchers but also advertisers
and manufacturers who may want to market special products
to diabetes patients. Therefore, the contribution of this study is
beyond filling a gap in literature as it can also serve as a working
tool for health campaigns. It is also the conclusion of this study
that the Uses and Gratification theory have been confirmed by
this study. This is evident in the fact that the choice of media by
diabetes patients was found to be influenced by the perceived
capacity of the medium to convey the needed information. The
preference and use of the media was also found to be determined
by expected gratification, this is at the center of the Uses and
Based on the result of this study, the researcher makes the
1. Health communication should be deeply planned with the
understanding of media preference and use of the target
population in mind.
2. Advertisers wishing to market products made for diabetes
patients should make use of the TV and place their adverts
3. Advertisers who may not have enough money to place
their adverts via the TV but still want to rich diabetes
patients should place in via the radio in the afternoon.
4. Health communication aimed at reaching diabetes
patients should be guided by their media preference and
5. Further studies should be expanded to cover more
ailments for better understanding.
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