Soledad Liliana Escobar-Chaves

Media and Risky Behaviors.

Liliana Escobar-Chaves and Craig Anderson investigate two important trends among American youth and examine the extent to which the two trends might be related. First, the authors note that U.S. youth are spending increasing amounts of time using electronic media, with the average American youngster now spending one-third of each day with some form of electronic media. Second, the authors demonstrate that American adolescents are engaging in a number of unhealthful behaviors that impose huge societal costs.Escobar-Chaves and Anderson detail the extent of five critical types of adolescent health risk behaviors identified by the Centers for Disease Control and Prevention—obesity, smoking, drinking, sexual risk taking, and violence. Obesity, the authors note, has become an epidemic among Americas young people. Cigarette smoking among adolescents is one of the ten leading health indicators of greatest government concern. Alcohol abuse and alcohol dependence are widespread problems among the nations youth and are the source of the three leading causes of death among youth. More than 20 percent of American high school students have sexual intercourse for the first time before they reach the age of fourteen. And twelve- to twenty-year-olds perpetrated 28 percent of the single-offender and 41 percent of multiple-offender violent crimes in the United States in 2005.Escobar-Chaves and Anderson present and evaluate research findings on the influence of electronic media on these five risk behaviors among adolescents. Researchers, they say, have found modest evidence that media consumption contributes to the problem of obesity, modest to strong evidence that it contributes to drinking and smoking, and strong evidence that it contributes to violence. Research has been insufficient to find links between heavy media exposure and early sexual initiation.The authors note the need for more large-scale longitudinal studies that specifically examine the cumulative effects of electronic media on risky health behavior.

Sexual Risk Avoidance and Sexual Risk Reduction Interventions for Middle School Youth: A Randomized Controlled Trial

PURPOSE To evaluate the efficacy of two, theory-based, multimedia, middle school sexual education programs in delaying sexual initiation. METHODS Three-armed, randomized controlled trial comprising 15 urban middle schools; 1,258 predominantly African American and Hispanic seventh grade students followed into ninth grade. Both programs included group and individualized, computer-based activities addressing psychosocial variables. The risk avoidance (RA) program met federal abstinence education guidelines; the risk reduction (RR) program emphasized abstinence and included computer-based condom skills-training. The primary outcome assessed program impact on delayed sexual initiation; secondary outcomes assessed other sexual behaviors and psychosocial outcomes. RESULTS Participants were 59.8% females (mean age: 12.6 years). Relative to controls, the RR program delayed any type of sexual initiation (oral, vaginal, or anal sex) in the overall sample (adjusted odds ratio [AOR]: .65, 95% CI: .54-.77), among females (AOR: .43, 95% CI: .31-.60), and among African Americans (AOR: .38, 95% CI: .18-.79). RR students also reduced unprotected sex at last intercourse (AOR: .67, 95% CI: .47-.96), frequency of anal sex in the past 3 months (AOR: .53, 95% CI: .33-.84), and unprotected vaginal sex (AOR: .59, 95% CI: .36-.95). The RA program delayed any sexual initiation among Hispanics (AOR: .40, 95% CI: .19-.86), reduced unprotected sex at last intercourse (AOR: .70, 95% CI: .52-.93), but increased the number of recent vaginal sex partners (AOR: 1.69, 95% CI: 1.01-2.82). Both programs positively affected psychosocial outcomes. CONCLUSIONS The RR program positively affected sexually inexperienced and experienced youth, whereas the RA program delayed initiation among Hispanics and had mixed effects among sexually experienced youth.

The fun families study: intervention to reduce children's TV viewing.

Media consumption may contribute to childhood obesity. This study developed and evaluated a theory‐based, parent‐focused intervention to reduce television and other media consumption to prevent and reduce childhood obesity. Families (n = 202) with children ages 6–9 were recruited from a large, urban multiethnic population into a randomized controlled trial (101 families into the intervention group and 101 into the control group), and were followed for 6 months. The intervention consisted of a 2‐hour workshop and six bimonthly newsletters. Behavioral objectives included: (i) reduce TV watching; (ii) turn off TV when nobody is watching; (iii) no TV with meals; (iv) no TV in the childs bedroom; and (v) engage in fun non‐media related activities. Parents were 89% female, 44% white, 28% African American, 17% Latino, and 11% Asian, mean age 40 years (s.d. = 7.5); 72% were married. Children were 49% female, mean age 8 years (s.d. = 0.95). Sixty‐five percent of households had three or more TVs and video game players; 37% had at least one handheld video game, and 53% had three or more computers. Average childrens weekday media exposure was 6.1 hours. At 6 months follow‐up, the intervention group was less likely to report the TV being on when nobody was watching (adjusted odds ratio (AOR) = 0.23, P < 0.05), less likely to report eating snacks while watching TV (AOR = 0.47, P < 0.05), and less likely to have a TV in the childs bedroom (AOR = 0.23, P < 0.01). There was a trend toward reducing actual media consumption but these outcomes did not reach statistical significance. Effective strategies to reduce childrens TV viewing were identified.

Mediators of Maternal Depression and Family Structure on Child BMI: Parenting Quality and Risk Factors for Child Overweight

Risk factors for child obesity may be influenced by family environment, including maternal depression, family structure, and parenting quality. We tested a path model in which maternal depression and single parent status are associated with parenting quality, which relates to three risk factors for child obesity: diet, leisure, and sedentary behavior. Participants included 4,601 5th‐grade children and their primary caregivers who participated in the Healthy Passages study. Results showed that associations of maternal depression and single parenthood with child BMI are mediated by parenting quality and its relation to childrens leisure activity and sedentary behavior. Interventions for child obesity may be more successful if they target family environment, particularly parenting quality and its impact on childrens active and sedentary behaviors.

Is obesity associated with reduced health-related quality of life in Latino, black and white children in the community?

Objective:Few studies have examined the impact of obesity on health-related quality of life (HRQOL) in non-clinical community samples of children, and methodological limitations have hindered drawing firm conclusions, especially whether the impact is similar across racial/ethnic groups. The present aims were to examine at what levels of non-normal weight, school-aged children experience lower HRQOL and whether this differs among racial/ethnic groups, when controlling for socioeconomic status (SES) differences.Design:Cross-sectional community cohort survey.Subjects and methods:Data are from the Healthy Passages, reporting on 4824 Latino, black and white 5th graders in a population-based survey conducted in three United States metropolitan areas. Children’s weight status was classified from measured weight and height into underweight (1%), normal weight (52%), overweight (19%), obese (13%) and extremely obese (14%). Children reported their own HRQOL using the Pediatric Quality of Life Inventory and additional scales addressing global self-worth, physical appearance and body satisfaction. Parents reported children’s overall health status.Results:Each increment in higher non-healthy weight class—overweight to obese to extremely obese—was associated with significantly lower scores in more domains of psychosocial HRQOL compared with that in normal weight. However, only extremely obese children reported significantly lower physical HRQOL. Differences among weight classes remained when adjusting for SES and were independent of race/ethnicity. Underweight children generally reported HRQOL that was not significantly different from normal weight children.Conclusions:Overweight, obese and extremely obese 5th graders on average experience worse HRQOL than normal weight children, especially in psychosocial domains including self-worth and peer relationships, regardless of race/ethnicity. If messages can be conveyed in a sensitive and supportive manner, the desire to improve HRQOL could provide additional motivation for children and their parents in addressing unhealthy weight.

Media and Sex among Alternative School Students.

Abstract A school-based, cross-sectional survey was conducted among 927 Latino and African American students attending 10 alternative schools in Houston, Texas, to investigate mass media consumption and its influence on sexual risk-taking behavior. Among males, exposure to television increased their risk of engaging in early sexual intercourse. Females who reported a preference for watching television programs that show sex were more likely to ever have sex than their counterparts, more likely to have more than one partner during the past three months, and more likely to use condoms.