practice applications

TOPICS OF PROFESSIONAL INTEREST

Print vs Online: Can There Be a Cohabitation of
Competing Media and How Readers Can Benet
I
f youre reading this article on the
printed page, you realize that the
death of print has been greatly
exaggerated. Everybodys talking
about the death of print, but thats
just not going to happen, says Bob
Sacks, a publishing industry analyst.
Theres going to be billions of dollars
for the next 20 years in print. How-
ever, within the next 5 to 10 years,
the chances youll still be reading a
printed version of the Journal will
become at least a little less likely, as
devices like iPads (Apple, Cupertino,
CA) continue to improve and win
more converts, and as publishers con-
tinue to shift their focus to the elec-
tronic. Primarily the way people
read will be digital, Sacks says.
Across the publishing industry,
whether its books, commercial maga-
zines, or trade publications, econom-
ics and user habits are tipping toward
digital and away from print. That tip-
ping point may vary wildly across the
industry, perhaps even from title to
titlebut as a force, it is irreversible,
Sacks says. By 2020, according to me-
diaIDEAS, a consulting rm Sacks
owns with other industry analysts,
about 58% of the US periodical indus-
try will be digital (1). Recently, in a
highly publicized campaign, Maga-
zines: The Power of Print (2), commer-
cial magazine publishers championed
the growth of print subscribers as a
sign that business is returning to nor-
mal. But in an editorial for Publish-
ing Executive, citing data fromthe Pub-
lishers Information Bureau, Sacks
writes: This year we will publish more
printed magazine titles than we pro-
duced last year. Next year we will
probably publish and produce more
printed magazine titles than this
year. The unfortunate corollary to
this prediction is that in each year, we
have been and will continue to pro-
duce fewer and fewer printed pages.
The industry we know and love . . .
has fundamentally and irreversibly
changed (3).
The story is similar throughout
publishing. The sale of e-books is pre-
dicted to hit $3 billion by 2015, at
which point that format, not the bound
book as we know it, will drive that in-
dustry, predicts James McQuivey, a
consumer products analyst for For-
rester Research (4). Wharton Digital
Press (formerly Wharton School Pub-
lishing, a division of The Wharton
School of the University of Pennsyl-
vania and Pearson Education), which
publishes business books aimed at
managers, will cease printing titles
this year in favor of an e-bookonly
strategy, says executive director
Stephen Kobrin. As for niche trade
magazine publishers, something
like 60% or more have moved to a
digital magazine format, Sacks
says.
This big-picture transition, how-
ever, doesnt mean that the Journal
will stop printing copies anytime
soon. Member-driven health publica-
tions like the Journal may be among
the last to give up print, says Karen
Hunter, a senior vice president with
the Journals publisher Elsevier.
Hunter was instrumental in starting
the electronic database ScienceDirect
in the mid 90s. In 2007, she pub-
lished a paper examining the print to
digital transition called, The End of
Print Journals: (In)Frequently Asked
Questions. The biggest question, When
is the end, is still unanswered, she
says. Theres an understanding at
Elsevier and its partners that paper
will recede, Hunter says. But when-
ever she asks other executives if there
is an end-date for the printed journal
in mind, the answer is always no. As
long as theres still a demand for
print, its a disservice to everyone to
stop.
CONTENT 2.0: A SLOW CHANGE
The demise of print is actually an old
story. A 2010 study by the University
of California at San Diego nds that
Americans print consumption has de-
clined since 1960 (5). When people
say, Print is dead, what theyre re-
ally talking about is the habit of
print, says Jeff MacIntyre, founder
of Predicate, a content strategy con-
sultant for digital publishers. More
people are getting all of their daily
news online, or a great percentage of
it, or their sports scores, driving di-
rections, shoppingit adds up to be-
come this overwhelming media diet.
Meantime, reading has only in-
creased. First, the rise of computers
and then the Internet has boosted the
volume of the written word dramati-
cally, according to the same study:
Reading, which was in decline due to
the growth of television, tripled from
1980 to 2008, because it is the over-
whelmingly preferred way to receive
words on the Internet (5).
This shift in reader habits to more
screen time is rippling through the
publishing industry, forcing an ongo-
ing, often painful restructuring of the
way it does business. Although, as
mentioned previously, not necessarily
at the same pace. For many small
commercial publishers, going exclu-
sively digital saves money. We no
longer print because postage has gone
crazy, says Molly Joss, publisher of
the Seybold Report, an independent
newsletter on publishing and printing
technologies. I cant get the rates
that big publishers get. The change
also hit libraries swiftly. According to
a 2007 study by the Association of
Research Libraries (ARL), the num-
ber of institutional print subscrip-
tions drops every year, going from
64% of library subscriptions in 2002
to 30% in 2006 (6). In that same time
This article was written by Sara
Aase, a freelance writer and
frequent contributor in
Minneapolis, MN.
doi: 10.1016/j.jada.2011.02.017
500 Journal of the AMERICAN DIETETIC ASSOCIATION 2011 by the American Dietetic Association
period, e-only journals rose from just
5% to 37% of library collections. Pub-
lishers increasingly have ipped their
pricing so that print subscriptions are
charged at a premium (often 15%) on
top of a contract for electronic access
instead of online being an add-on, it
reports (6). In 2007, Elsevier counted
e-only subscriptions as nearly 40% of
its ScienceDirect subscription reve-
nues (7). (ScienceDirect is one of a few
different databases that carry the
Journal.) Today e-only subscriptions
are the vast majority, Hunter says.
Reduced demand for print results in
less shelf space and smaller print
runs, until eventually printing is no
longer economically viable. As online
measurability improves, more adver-
tisers will move online, too, further
shrinking a valuable revenue stream
for print (6).
Because the conversion from a
print-dominant to a digital-dominant
publishing world is such a slow, pain-
ful, and enormous change, its easy to
fall victim to circular logicie, the
decline of print in turn spells the end
of magazines, journals, and books.
This debate has gotten louder re-
cently as many newspapers and mag-
azines failed, and as the book indus-
try faces drastically shrinking sales.
Although we cant predict with cer-
tainty how the forms of journals,
magazines, and books might change
with the available technology, we can
be certain that the ideas transmitted
through the written word will be as
valuable as ever. The argument is a
function of a new industry, Kobrin
says. At some point well understand
and live with the advantages and dis-
advantages of both.
THE QUESTION OF UTILITY: PRINT STILL
RULES
The Internet has added tremendous
value to how we experience and inter-
act with published content. More than
ever before we can search for specic in-
formation quickly and browse frommore
diverse sources. There are myriad
ways to connect, comment, rebut, and
publish. We can even choose to watch
a video or listen to a podcast, in addi-
tion to, or instead of, reading text. But
until very recently, the attempt to
digitize books and periodicals has
failed to replicate many of the quali-
ties we value about print, such as the
ability to ip through a publication,
pore over lush, detailed illustrations,
carry it anywhere with us, dog-ear
pages, underline, and make nota-
tions.
The tactile nature of print is impor-
tant to usbut why? One reason may
be because the work of reading
quickly causes cognitive overload.
When we must learn or remember
something, or when we are expected
to respond to a written piecewith a
review or comments, for examplewe
take notes. On paper. By actively be-
ing involved with the text, users can
better memorize and understand it,
write the authors of a 2009 study
comparing paper-based and online
annotations. By contrast, annotating
on a computer-screen is an activity
that competes with the reading itself,
due to the lack of direct manipulation
(8). The study noted that in absence
of a quick, easy way to annotate arti-
cles delivered via Web browser, users
resorted to e-mailing themselves or
creating notes in separate text docu-
ments.
TOPICS OF PROFESSIONAL INTEREST
April 2011 Journal of the AMERICAN DIETETIC ASSOCIATION 501
Digital annotation is fast changing,
however. In the same study, users
were asked to try a new online anno-
tation tool, SpreadCrumbs, and found
that it worked as well as traditional
pen-on-paper notation for in-context
note-taking. And in some ways better,
in fact, as the notes could be shared
with others, searched, indexed, or-
dered, and rated. The Kindle (Ama-
zon, Seattle, WA) and iPad let readers
bookmark, highlight, and make notes
on e-books, all of which are search-
able and, through the Kindle, shar-
able.
The growing ability of digital de-
vices to mimic the printed book and
magazine experience will be a critical
factor in increasing adoption of this
new technology. Consider that, buck-
ing conventional wisdom, printed
magazines are still the most popular
with 18- to 34-year-olds (9). Likewise,
Journal readers with less than 5
years of dietetics experience were the
most likely to rely on the Journal for
dietetics-related information (10). Go-
ing even younger, three quarters of
college students surveyed said they
still preferred a bound textbook to the
digital versionnot only citing the
ease of use, as noted above, compared
to a digital book, but also the freedom
from connection to Facebook and
other online distractions. Granted, e-
textbooks are still exotic, currently
representing only 3% of textbook
sales (11).
HYBRID NATION: JOURNALS CAPITALIZE
ON PRINTELECTRONIC FORMATS
What about journals? Unlike books,
each of which usually stands alone,
the information in journals con-
stantly evolves around the needs of a
particular audience. Authors are fre-
quently in dialog with each other
across issueshence, readers expect
to be able to move easily between
them. Readers also are a more imme-
diate and interactive audience, inu-
encing and contributing to issue con-
tents. Because of these demands,
most magazine and journal publish-
ers nd themselves, like the Journal,
supporting a hybrid or multichan-
nel modebuilding up an online
presence that can more effectively en-
gage those readers, for example,
through blogs, podcasts, video, and
discussion forums.
At the same time, they still recog-
nize the value in offering a printed
journal, particularly to member sub-
scribers and advertisers, since digital
still cant beat print for visibility.
Publishers rmly expect to hold this
pattern for some time. According to a
2009 survey by the Audit Bureau of
Circulation, 78% of publishers said
their publication would not be in a
digital-only form within 5 years
(12). More recently, trade publication
sources and statistics show the suc-
cess of periodicals that offer both
print and online issues: [J]ournals in
print and online format were more
stable than those published in print
only or online only (13). As far as
Im concerned, print is not going away
for a long time for the Journal, prob-
ably not within my lifetime, says
Tony Trioli, senior publisher in
charge of the Journal at Elsevier. Be-
sides a strong member-based print
subscription base, Trioli noted that
Journal advertisers still overwhelm-
ingly prefer print.
In a still print-dominant world,
those who have moved too swiftly and
arbitrarily away from print have suf-
fered. According to the ARL study,
one society lost 25% of its members
after print was abruptly dropped at
the instigation of the board (6). The
latest reader survey shows that for
now, Journal subscribers are still
happy to have both printed and elec-
tronic versions. For example, 52% of
Journal subscribers visit the Web site
a little more than twice a month, and
well over half of regular visitors rated
the site highly for comprehensive-
ness, speed, appearance of new infor-
mation, ease of use, and application to
their personal needs. But of those
subscribers who hadnt visited the
Journals Web site, 28% said they
preferred print and 23% were not
aware of the site at all (10).
Publishers see great benet in ex-
ploiting all channels, including print,
for readers and advertisers. A 2009
study by BIGresearch found that
commercial magazines rank rst of
all media at inuencing consumers to
start an online search, and that mag-
azinesand their adsheld the un-
divided attention of readers much
longer than other media (14). Some
of the features that enable users to
nd and use digital contentfor ex-
ample, searchare keeping print alive,
says James Mathewson, search strategy
expert for IBM and author of Audience,
Relevance, and Search: Targeting
Web Audiences with Relevant Con-
tent. Another example is the place-
ment of so-called QR codes on maga-
zine pages. When captured by the
camera on a mobile phone, they take
the reader to a Web page, coupon,
online video, pricing information, re-
views, or other content (15). But all
publishers need to be pushing ahead
electronically. Companies need to
develop systems to manage and serve
print assets digitally, Mathewson
says. But the assets themselves will
continue to become less important as
information consumers tend to prefer
smaller, on-screen media to print.
Publishers are trying to expand
their online presence as they prepare
for the coming shift, when the oppor-
tunity cost of continuing to invest in
print becomes too great (6). Accord-
ing to the ARL study, most publish-
ers appear to recognize the risk that,
even in the scholarly world, readers
will eventually stop using informa-
tion that is not available online (6).
Kobrin of Wharton Digital Press is
such a reader. I look through aca-
demic journals digitally, nd the arti-
cles I want to read on the iPad, and
those I really need to work through, I
print out, he says. Its a lot better
than having a 2-inchthick journal
come to your ofce every 2 months.
Publishers know they need to build
utility for readers and new economic
models for themselves in anticipation
of an e-dominant world. We continue
to encourage members to register
their online accounts, Trioli says.
Were not at 100%, and nowadays
thats a head scratcher. Since regis-
tering an account at the Journals
Web site allows the reader to set up
search alerts and save searches, we
just assume theyll go to the site to do
their research or read back issues,
Trioli says. Im hopeful that will
catch up.
In January, the Journal rolled out
a new Web site with improved drop-
down menu navigation, browsing, and
search capabilities. Supplements are
broken out by themselves, so you wont
have to go through the entire table of
contents to nd them, Trioli says.
And were really going to exploit the
audio and video. For example, the
Journals recently launched podcast
series features conversations by ADA
authors and other experts that go into
TOPICS OF PROFESSIONAL INTEREST
502 April 2011 Volume 111 Number 4
depth behind the latest articles (www.
adajournal.org/content/podcast).
Other improvements include:
subject collections featured on the
homepage;
a most-viewed articles box;
Top 25 Hottest Articles (clicks
through to SciVerse ScienceDirect
database); and
CiteAlert, whichautomatically noties
authors by e-mail soonafter their work
is referenced in a newly published ar-
ticle on SciVerse ScienceDirect.
TRADING OLD-WORLD PROBLEMS FOR
NEW ONES
What would make you give up print,
or at least turn to it less often? Other
upheavals exchanging the buggy
for car, for example, or letters for e-
mailoccur when the new technol-
ogy becomes ubiquitous, affordable,
and offers clear advantages. In other
words, consumers have to adopt the
new technology as a need. The tran-
sition will depend a lot on howquickly
most of us adopt mobile devices, Joss
says. The International Telecommu-
nication Union predicts that mobile
Internet use will surpass that of desk-
top computers within 5 years (16). In
the meantime, most users dont ap-
preciate innovation for innovations
sake. We dont want to make a Kin-
dle version of the Journal available
just for the sake of doing it, Trioli
says. It has to be something the
membership really wants. We want to
make sure weve looked at all of the
pitfalls and benets rst. The Jour-
nal of the American College of Cardi-
ology is the rst Elsevier journal to
publish an iPad edition, which went
live in November. Depending on how
that pilot goes, we may roll that out to
other journals, Trioli says. Were
looking at e-readers, iPad applica-
tions, mobile applications.
A big hurdle to the digital transi-
tion for publishers is the cost of going
digital while maintaining a print
product. Our library customers at
rst thought there would be an imme-
diate end to print, and that the elec-
tronic-only version would be a lot
cheaper, Hunter says. But the pub-
lisher took on the added costs of hav-
ing to maintain two issues, and the
added costs of maintaining and dis-
tributing electronic versions along
with print. And, of course, simply
digitizing existing content does not a
great experience make. It takes re-
sources to create a Web site, applica-
tion, or other content that comple-
ments or replaces some aspects of the
print product. The Journals reader
survey shows, for example, that Web
site users want to see additional orig-
inal content, more of the latest indus-
try and product information, videos,
and more industry-related ads (10).
For publishers, the business models
for digitalwhat to do, how to do it,
and how to pay for itare still very
much in ux.
Concerns about prestige, issue au-
thenticity, and archiving are ongoing
concerns in the transition to a digital-
dominant publishing world, although
Hunter says that the last two have
mostly been resolved. Electronic jour-
nals are now considered the version of
record, Hunter says. They have links
to the underlying data set, or more
information, for example, on a partic-
ular molecule, she says. If there was
an error, the electronic version can be
amended with that correction. Its
not that the paper version is less com-
plete, its that the databases have so
many features you cant get in paper.
Likewise, archiving, which used to be
strictly the work of libraries, is now
handled by consortia of libraries and
publishers. Elsevier participates with
at least two of the large preservation
groups, such as the nonprot organi-
zation Portico, to hedge its bets about
changing technologies. It also main-
tains its own digital archives. But the
last question is still open. Do printed
journals still command more prestige
over their e-only counterparts? Who
wants to be rst to stop print?
Hunter says. We still dont know if
we stop doing print whether that will
stop authors from submitting manu-
scripts to us.
A POST-PRINT WORLD
Once print fades to an on-demand or
boutique offering, what might that
mean for the format of journals? Once
they slip their bindings, will the con-
cept of a unied journal fade away,
too? Since people continue to organize
themselves by interest, particularly
profession, it seems likely that they
will continue to want publications to
reect that need. In the same Pub-
lishing Executive editorial, Sacks
writes that the magazine must be
paginated, edited, designed, periodic,
permanent and date stamped, re-
gardless of its format (3). If that is the
case, magazines and journals will still
need editorial staffs and publishers to
ensure quality and distribution.
What about brands? Will they still
matter? The ARL article muses on
this question: For many societies
where the journal brand has played a
key role in attracting members, there
is the risk that their identity online
will be diluted. Electronic journals
are typically aggregated in a data-
base of articles that is known by the
name of the database. Since users of-
ten link directly to articles without
searching by journal name, publish-
ers are discovering the importance of
having the name of their society
and/or journal on each page of every
article, including backles as they are
put online (6). Hunter says this issue
has been a concern as Elsevier moves
to more article-based syndication ser-
vices. But overall, I honestly dont
think brand will go away that quickly
even in an article-based environ-
ment, she says. Its one of the lter
mechanisms people use still, particu-
larly for society journals that are well
respected. Kobrin agrees. I suspect
the biggest challenge for the transi-
tion is not the technology, but rather
how we make readers aware of whats
worthwhile, he says.
COMING ATTRACTIONS: DIGITAL
CATCHES UP
Signicant obstacles still stand in the
way of a digital-rst world. But when
you consider how rapidly technology
has changedparticularly the rapid
adoption of mobile Internet devices,
even in the midst of a recessiona
paperless world no longer seems so
elusive. Experts say we can expect
some of the following features and
perks:
More personalization
People will gravitate toward the
ability to curate their own informa-
tion in many ways, on many types of
devices. For instance, an iPad appli-
cation called Flipboard turns your
Twitter and Facebook links, photos,
and videos into a magazine format,
complete with headlines and full-color
text. Instead of scrolling, you simply
ip through the information (17).
TOPICS OF PROFESSIONAL INTEREST
April 2011 Journal of the AMERICAN DIETETIC ASSOCIATION 503
Easier collaboration
Findings change fast, and experts
all over the world want to nd others
they can collaborate with, says
Ahava Leibtag, principal of health
care consulting company AHA Media
Group. If you have digital copies of
studies, you have multiple ways to
organize it so that you can nd each
other, by cross-referencing the sub-
ject, author, country, publisher, jour-
nal, author name, or area of re-
search.
More meaningful connections
The more publishers are able to col-
lect and use data provided by online
clicks, the better they will become at
producing content for their readers,
Sacks says. When I open my iPad
and read Wired Magazine, they know
what pages I spend the most time on,
he says. And for advertisers, digital
data will give them the one-to-one re-
lationship they want. Joss says her
Web readership drives her editorial
content choices. When a news brief
gets a tremendous amount of hits, I
do an article expanding on that topic,
she says. With the ISP address, I can
often tell who is reading it, so I get a
sense of who is reading in real time.
Thats tremendously excitingsome-
thing that no publisher has ever had
before. The Internet, as weve seen,
also democratizes the ability to pub-
lish, creating the potential for anyone
to build an audience. Dietitians with
various specialties can easily produce
a niche product for that specialized
audience, Sacks says.
Innovation
What we experience online, on
handheld devices, and in print may be
entirely different offerings from the
same publication. For example, Ski-
ing Interactive, which debuted in No-
vember, is completely different from
its print-based publication (18). Many
commercial magazines have become
more like blogs online. Perhaps jour-
nals will go that route, tooable to
deliver new content daily or hourly.
More like . . . paper
The more technology improves its
ability to handle digital versions of
print, the more attractive it will be-
come as an alternative to paper. Pro-
cessing speeds will be faster, digital
devices will be rollable, foldable, and
exible, with full-color screens that
work with reective light, like paper,
Sacks says. Ive held some of these pro-
totypes in my hands, and they are com-
ing in 2011. When people are able to
save and annotate documents like pa-
per, carry around their publications
with them on one device, and relax,
untethered, in a favorite easy chair,
digital devices will replace most of their
printed counterparts, Sacks says.
PRINT WILL NEVER ABANDON US
Of course, this map of a new, paper-
less world is inevitably incomplete. At
a recent Web 2.0 conference, Facebook
founder Mark Zuckerberg pointed to a
map of todays online players and said,
I think the biggest part of the map
has got to be the uncharted territory.
Right? Its not zero sum (19). The
iPad and other mobile devices, ex-
perts point out, are still in their in-
fancy, as is the Web itself. Its early
days yet, Joss says. Were all still
feeling our way along.
Picturing a world where paper be-
comes like the vinyl recordstill trea-
sured and available for a niche follow-
ingleaves many issues unresolved.
Cost of new technologies and services,
for example. Bandwidth. Battery life.
Recycling. Not to mention that intangi-
ble something about print that nobody
has been able to measurethe feel, the
smell, the fact that the printed page
requires no clicking, no e-mail check-
ing, and wont suddenly disappear. Per-
haps that last point will be more impor-
tant than anyone is counting on, as
technology races forward nowat such a
pace as to render any gadget obsolete
the moment its packaging is ripped
away. It may be tting that the word
obscene is part of obsolescence, es-
pecially when applied to a technology
that dates to 1439. Yet even if we ulti-
mately abandon print, theres the secu-
rity that print will never abandon us.
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TOPICS OF PROFESSIONAL INTEREST
504 April 2011 Volume 111 Number 4