Background: Misleading news claims can be detrimental to public health. We aimed to improve the alignment\nbetween causal claims and evidence, without losing news interest (counter to assumptions that news is not\ninterested in communicating caution).\nMethods: We tested two interventions in press releases, which are the main sources for science and health news:\n(a) aligning the headlines and main causal claims with the underlying evidence (strong for experimental, cautious\nfor correlational) and (b) inserting explicit statements/caveats about inferring causality. The â??participantsâ?? were press releases on health-related topics (N = 312; c claim alignment = 64, causality statement = 79, both = 80)\nfrom nine press offices (journals, universities, funders). Outcomes were news content (headlines, causal claims,\ncaveats) in English-language international and national media (newspapers, websites, broadcast; N = 2257), news\nuptake (% press releases gaining news coverage) and feasibility (% press releases implementing cautious\nstatements).\nResults: News headlines showed better alignment to evidence when press releases were aligned (intention-to-treat\nanalysis (ITT) 56% vs 52%, OR = 1.2 to 1.9; as-treated analysis (AT) 60% vs 32%, OR = 1.3 to 4.4). News claims also\nfollowed press releases, significant only for AT (ITT 62% vs 60%, OR = 0.7 to 1.6; AT, 67% vs 39%, OR = 1.4 to 5.7). The\nsame was true for causality statements/caveats (ITT 15% vs 10%, OR = 0.9 to 2.6; AT 20% vs 0%, OR 16 to 156). There\nwas no evidence of lost news uptake for press releases with aligned headlines and claims (ITT 55% vs 55%, OR = 0.7\nto 1.3, AT 58% vs 60%, OR = 0.7 to 1.7), or causality statements/caveats (ITT 53% vs 56%, OR = 0.8 to 1.0, AT 66% vs\n52%, OR = 1.3 to 2.7). Feasibility was demonstrated by a spontaneous increase in cautious headlines, claims and\ncaveats in press releases compared to the pre-trial period (OR = 1.01 to 2.6, 1.3 to 3.4, 1.1 to 26, respectively).\nConclusions: News claims-even headlines-can become better aligned with evidence. Cautious claims and\nexplicit caveats about correlational findings may penetrate into news without harming news interest. Findings from\nAT analysis are correlational and may not imply cause, although here the linking mechanism between press\nreleases and news is known. ITT analysis was insensitive due to spontaneous adoption of interventions across\nconditions.
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