Non-Branded Food Placements in Children’s Entertainment Programs: A Content Analysis

ABSTRACT

Food messages transmitted in media are considered to affect children´s eating habits. Depending on the healthiness of the food messages, these food portrayals can be supportive or non-supportive in educational food content, affecting eventually childhood obesity. This study aims to analyze how food references present in children´s animated cartoons are depicted, considering not only their prevalence and prominence but also their educational nature which is measured by the overall message that is being transmitted. A content analysis of non- branded food placements was conducted on the basis of 25 international cartoon series for children (aged 3–12) with 4,790 minutes of viewing. A total of 1,065 food placements occurred with a rate of one placement approximately every five minutes. A balance was found between the frequency of low and highly-recommended consumption foods and the same happened considering the educational nature of the global message. When the target age and the country of origin were considered, the least educational messages predominated in those series aimed at the oldest children group and produced in North America. This study intends to contribute to the problem of childhood obesity by indicating the educational nature of the food messages that children are confronted with. As prevalence and prominence of non-supportive food placements to educational food content is high, policy makers should consider these findings when designing public policies that aim to prevent childhood obesity.     

Helping behavior in Disney animated movies and children’s helping behavior in the Netherlands

This study is the first to examine whether Disney animated characters can inspire children to help others immediately upon exposure. This experiment involved 113 Dutch children (M = 9.03; SD = .738) and their friends. Children in the experimental condition were exposed to a Disney clip in which the main character helped a friend, while children in the control condition watched a clip without helping behavior. Afterward, children’s helping behavior toward their friends was assessed during a puzzle challenge. A regression analysis revealed that children exposed to the helping Disney character were more likely to help their friends than children who did not watch this. The findings indicate a short-term effect of watching a helping Disney animated character on children’s helping behavior.     

The Effect of Neighborhood and Individual Characteristics on Pediatric Critical Illness

The relationship between neighborhood/individual characteristics and pediatric intensive care unit (PICU) outcomes is largely unexplored. We hypothesized that individual-level racial/ethnic minority status and neighborhood-level low socioeconomic status and minority concentration would adversely affect children’s severity of illness on admission to the PICU. Retrospective analyses (1/1/2007–5/23/2011) of clinical, geographic, and demographic data were conducted at an academic, tertiary children’s hospital PICU. Clinical data included age, diagnosis, insurance, race/ethnicity, Pediatric Index of Mortality 2 score on presentation to the PICU (PIM2), and mortality. Residential addresses were geocoded and linked with 2010 US Census tract data using geographic information systems geocoding techniques. Repeated measures models to predict PIM2 and mortality were constructed using three successive models with theorized covariates including the patient’s race/ethnicity, the predominant neighborhood racial/ethnic group, interactions between patient race/ethnicity and neighborhood race/ethnicity, neighborhood socioeconomic status, and insurance type. Of the 5,390 children, 57.8 % were Latino and 70.1 % possessed government insurance. Latino children (β = 0.31; p < 0.01), especially Latino children living in a Latino ethnic enclave (β = 1.13; p < 0.05), had higher PIM2 scores compared with non-Latinos. Children with government insurance (β = 0.29; p < 0.01) had higher PIM2 scores compared to children with other payment types and median neighborhood income was inversely associated with PIM2 scores (β = ?0.04 per $10,000/year of income; p < 0.05). Lower median neighborhood income, Latino ethnicity, Latino children living in a predominantly Latino neighborhood, and children possessing government insurance were associated with a higher severity of illness on PICU admission. The reasons why these factors affect critical illness severity require further exploration.     

The case of the missing girls: distribution of gender roles in Indian children’s television programming

Children’s programming is booming in India with children having increased access to television. Given that television is a powerful socializing agent, this study seeks to identify how gender is being represented in it using content analysis. The gender and role of 826 major characters across 89 programmes, which were telecast on 11 channels during the evenings, was analysed. The results show that 91.01% of all the programmes were animated. There was a gender bias in the programme titles, as the majority contained only male or gender-neutral names. Males (74.94%) outnumber females (25.06%) across all channels, irrespective of their target audience. More males than females were cast in all the character roles except in the role of the protagonist’s family member, where both genders were cast equally. The underrepresentation of females in some character roles also veered towards 100% on certain channels. Overall, most programmes seem oriented towards boys than girls.     

How Young Children and Their Mothers Experience Two Different Types of Toys: A Traditional Stuffed Toy Versus an Animated Digital Toy

Background

Despite widespread use of digital toys, research evidence of how a digital toy’s features affect children’s development and the nature of parent–child interactions during play is limited.

Objective

The present study aimed to examine how mother–child dyads experience a traditional stuffed toy and an animated digital toy by comparing children’s conceptions of the toys, their play behaviors, and maternal interactive behaviors. The relationship pattern of how and degree to which children’s conceptions and maternal interactive behaviors are associated with children’s play were explored to examine how the toys’ animated and interactive function affected children’s play level and mother–child interaction.

Method

Forty-eight children (mean age 49.77 months; 32 boys and 16 girls) and their mothers participated in the present study. Mother–child play with the toys was observed, and the children’s conceptions of the toys were obtained through interviews.

Results

Children seemed to perceive that a digital puppy doll had psychological attributes. The mothers showed more interactive behaviors overall when playing with their children using digital toys. However, the associations between maternal interactive behaviors and children’s play in the two different play settings showed that a digital toy changed mother–child interaction owing to its technological features. Both children’s conception and maternal interactive behaviors of pretend play in the two different play contexts independently contributed to children’s pretense level.

Conclusions

The current findings confirmed the facilitating as well as mediating effects of a digital toy on children’s play and the role of parents during play with digital toys.

     

Media Impacts on Women’s Fertility Desires: A Prolonged Exposure Experiment

Media exposure may have implications for family planning, a public health issue of key importance. Drawing on social comparison theory and social identity theory, a prolonged exposure experiment examined whether media portrayals of women’s social roles affect fertility desires among 166 American, nonstudent, never married, childless women ages 21–35 years old. After sign-up and baseline sessions, participants viewed magazine pages five days in a row. Stimuli presented women in either mother/homemaker roles, beauty ideal roles, or professional roles. Three days later, participants again indicated their number of desired children and time planned until first birth. Exposure to mother/homemaker and beauty ideal portrayals increased the number of desired children across time. Exposure to professional portrayals increased the time planned until 1st birth compared to beauty ideal portrayals—this impact was partially mediated by a shift toward more progressive gender norms (per social identity theory) and assimilation (per social comparison theory).     

The Roles of Self-Socialization and Parent Socialization in Toddlers’ Gender-Typed Appearance

Children’s gender-stereotypical dress and appearance might be one of the first representations of children’s emerging sense of gender identity. Gender self-socialization theories posit that as children become more aware of gender categories, they become motivated to adhere to gender stereotypes, such as by expressing interest in dressing in feminine or masculine ways. Socialization theories predict that children’s gender-typed appearance reflects parents’ choices. For example, gender-traditional parents might dress their children in gender-stereotypical ways. At the same time, dressing in gender-stereotypical ways might contribute to children’s growing awareness of gender categories. The current study investigated the factors associated with gender-typed appearance among 175 (87 girls, 88 boys) Mexican American, Dominican American, and African American 2-year-olds. We examined both child and parent contributions to early gender-typed appearance. To measure children’s early conceptual understanding of gender categories, we assessed children’s use and recognition of gender verbal labels. To examine the influence of parent socialization, we assessed mothers’ gender-role attitudes. Children’s gender-typed appearance was observed and coded during an assessment. Surprisingly, mothers’ gender-role attitudes were not significantly associated with toddlers’ gender-typed appearance. However, toddlers’ gender labeling was associated with their gender-typed appearance, suggesting that self-socialization processes can be found as early as 24 months of age.     

Measuring Early Childhood Health and Health Disparities: A New Approach

Efforts to improve the health of U.S. children and reduce disparities have been hampered by lack of a rigorous way to summarize the multi-dimensional nature of children’s health. This research employed a novel statistical approach to measurement to provide an integrated, comprehensive perspective on early childhood health and disparities. Nationally-representative data (n = 8,800) came from the Early Childhood Longitudinal Study, Birth Cohort. Latent class analysis was used to classify health at 48 months, incorporating health conditions, functioning, and aspects of physical, cognitive, and emotional development. Health disparities by gender, poverty, race/ethnicity, and birthweight were examined. Over half of all children were classified as healthy using multidimensional latent class methodology; others fell into one of seven less optimal health statuses. The analyses highlighted pervasive disparities in health, with poor children at increased risk of being classified into the most disadvantaged health status consisting of chronic conditions and a cluster of developmental problems including low cognitive achievement, poor social skills, and behavior problems. Children with very low birthweight had the highest rate of being in the most disadvantaged health status (25.2 %), but moderately low birthweight children were also at elevated risk (7.9 vs. 3.4 % among non-low birthweight children). Latent class analysis provides a uniquely comprehensive picture of child health and health disparities that identifies clusters of problems experienced by some groups. The findings underscore the importance of continued efforts to reduce preterm birth, and to ameliorate poverty’s effects on children’s health through access to high-quality healthcare and other services.     

Improving cultural competence education: the utility of an intersectional framework

Medical Education 2012: 46: 545–551 Context Most US medical schools have instituted cultural competence education in the undergraduate curriculum. This training is intended to improve the quality of care that doctors, the majority of whom are White, deliver to ethnic and racial minority patients. Research into the outcomes of cultural competence training programmes reveals that they have been largely ineffective in improving doctors’ skills. In varied curricular formats, programmes tend to teach group‐specific cultural knowledge, despite the vast heterogeneity of racial and ethnic groups. This cultural essentialism diminishes training effectiveness. Methods This paper proposes key curriculum content changes and suggests the inclusion of an intersectional framework in the cultural competence curriculum. This framework maintains that racial and ethnic minority groups hold multiple social statuses, called social locations, which interact with one another to uniquely shape the health views, needs and experiences of the individuals within the groups. Social locations include those defined by race, ethnicity, gender, social class and sexuality, which are experienced multiplicatively, not additively, within a particular social context. Cultural competence education must go beyond simplified cultural understandings to explore these more complex meanings. Doctors’ ability to understand, communicate with and treat diverse groups can be vastly improved by applying an intersectional framework in academic research, self‐awareness exercises and clinical training. Results Integrating an intersectional framework into cultural competency education can better prepare doctors for caring for racial and ethnic minority patients. This paper recommends curriculum elements for the classroom and clinical training that can improve doctor knowledge and skills for caring for diverse groups. Medical schools can use the proposed model to facilitate the development of new educational strategies and learning experiences. These improvements can lead to more equitable care and ultimately diminish disparities in health care. Although these recommendations are designed with US schools in mind, they may improve doctor understanding and care of marginal populations across the world.     

Social Cohesion and Food Insecurity: Insights from the Geographic Research on Wellbeing (GROW) Study

Objectives Food insecurity in the United States is a stubborn public health issue, affecting more than one in five households with children and disproportionately impacting racial and ethnic minority women and their children. Past research and policy has focused on household predictors of food insecurity, but neglected broader factors, such as perceived neighborhood social cohesion, that might protect those most vulnerable to food insecurity. Methods We use a racially and ethnically diverse data set from the Geographic Research on Wellbeing study (N = 2847) of women and their young children in California to investigate whether social cohesion influences food insecurity and whether it moderates the relationship between race/ethnicity and food insecurity. Results We find that lower levels of perceived residential neighborhood social cohesion associate with higher odds of food insecurity even after considering important household socioeconomic factors. In addition, our results suggest that social cohesion is most relevant for reducing the risk of food insecurity among racial and ethnic minority mothers. For example, the probability of food insecurity for immigrant Latina mothers is nearly 0.40 in neighborhoods where mothers perceive little to no cohesion and less than 0.10 in neighborhoods where mothers perceive high cohesion. Conclusions for Practice Higher levels of neighborhood perceived social cohesion are protective against food insecurity in households with children and especially so for racial and ethnic minority households who are at a heightened risk of food insecurity. Supporting programs that focus on building closer knit communities may be a key to reducing food insecurity overall and for reducing disparities in food insecurity by race and ethnicity.     

Medical students' perceptions of racial diversity and gender equality

OBJECTIVES: To assess attitudes of medical students toward issues of racial diversity and gender equality and to ascertain changes in these attitudes during the pre-clinical curriculum. METHODS: Attitudes toward multiculturalism and gender equality were assessed using a 43-item questionnaire. The survey was completed by incoming Year 1 students in 2000 and 2001, and was completed again in 2002 by the students who had entered in 2000. Mean scores were analysed at baseline by gender, ethnic group and political affiliation using analysis of variance. The paired scores of the first and follow-up surveys of the 2000 entering class were compared using paired t-tests. RESULTS: Upon entry into medical school, women, minority group students and Democrats scored significantly higher on the cultural sensitivity scale than their comparison groups. No significant changes were seen overall in the matched data. However, minority groups showed a significant increase in scores, while Republicans and white men experienced a non-significant decline. In addition, incoming students judged cultural competency education to be important. The perceived need to increase the numbers of minority group doctors varied by gender, ethnic group and political affiliation. CONCLUSIONS: Among incoming medical students, perceptions of racial diversity and gender equality vary along ethnic, gender and political lines. Additionally, pre-clinical education was associated with increased cultural sensitivity by minority group students, but not by others. These findings demonstrate the continuing need for diversity in medical school and for medical students to recognise and address their personal and group biases.     

Parent,Teacher, and School Stakeholder Perspectives on Adolescent Pregnancy Prevention Programming for Latino Youth

Teen pregnancy remains a public health concern particularly among Latinos, whose pregnancy rate of 83.5 per 1000 girls constitutes one of the highest rates of teen pregnancy among all ethnic and racial groups in the United States. To enhance the effectiveness of interventions for diverse Latino populations in the US, it is crucial to assess the community’s understanding of the etiology of the problem of adolescent pregnancy and to implement programs that reflect the local community’s beliefs and preferences. We present findings from six focus groups held with parents (n = 18), teachers (n = 23) and school stakeholders (n = 8) regarding teen pregnancy prevention among Latino youth at a high school located in a large, Midwestern city. Two investigators analyzed data iteratively using a template organizing approach. A consensus emerged across the groups regarding content that emphasized respect for oneself and one’s family, a focus on personal and shared responsibility in reproductive health behavior, information about the “realities” or consequences associated with engaging in sexual activity, and information about contraceptives. The strong request from participants to include a parental education component reflects the community’s belief that parents play a crucial, protective role in the socialization and development of adolescent sexual behavior, a view that is supported by empirical research. Findings highlight the importance of involving local school communities in identifying adolescent pregnancy prevention strategies that are responsive to the community’s cultural values, beliefs, and preferences, as well as the school’s capacity and teacher preferences.     

STD and HIV risk factors among U.S. young adults: variations by gender, race, ethnicity and sexual orientation

CONTEXT: STDs, including HIV, disproportionately affect individuals who have multiple minority identities. Understanding differences in STD risk factors across racial, ethnic and sexual minority groups, as well as genders, is important for tailoring public health interventions. METHODS: Data from Waves 3 (2001–2002) and 4 (2007–2008) of the National Longitudinal Study of Adolescent Health were used to develop population‐based estimates of STD and HIV risk factors among 11,045 young adults (mean age, 29 at Wave 4), by gender, race and ethnicity, and sexual orientation (heterosexual, mixed‐oriented, gay). Regression analyses were conducted to examine associations between risk factors and young adults’ characteristics. RESULTS: Overall, sexual‐minority women in each racial or ethnic group had a higher prevalence of sexual risk behaviors—including a history of multiple partners, forced sex and incarceration—than their heterosexual counterparts. Mixed‐oriented women in each racial or ethnic group were more likely than heterosexual white women to have received an STD diagnosis (odds ratios, 1.8–6.4). Black men and sexual‐minority men also appeared to be at heightened risk. Gay men in all racial and ethnic groups were significantly more likely than heterosexual white men to report having received an STD diagnosis (2.3–8.3); compared with heterosexual white men, mixed‐oriented black men had the highest odds of having received such a diagnosis (15.2). CONCLUSIONS: Taking account of multiple minority identities should be an important part of future research and intervention efforts for STD and HIV prevention.     

Evidence of Social and Structural COVID-19 Disparities by Sexual Orientation,Gender Identity,and Race/Ethnicity in an Urban Environment

The ongoing COVID-19 pandemic has had widespread social, psychological, and economic impacts. However, these impacts are not distributed equally: already marginalized populations, specifically racial/ethnic minority groups and sexual and gender minority populations, may be more likely to suffer the effects of COVID-19. The COVID-19 Resiliency Survey was conducted by the city of Chicago to assess the impact of COVID-19 on city residents in the wake of Chicago’s initial lockdown, with particular focus on the experiences of minority populations. Chi-square tests of independence were performed to compare COVID-19-related outcomes and impacts on heterosexual vs. sexual minority populations, cisgender vs. gender minority populations, and White vs. racial/ethnic minority subgroups. Marginalized populations experienced significant disparities in COVID-19 exposure, susceptibility, and treatment access, as well as in psychosocial effects of the pandemic. Notably, Black and Latinx populations reported significant difficulties accessing food and supplies (p = 0.002). Healthcare access disparities were also visible, with Black and Latinx respondents reporting significantly lower levels of access to a provider to see if COVID-19 testing would be appropriate (p = 0.013), medical services (p = 0.001), and use of telehealth for mental health services (p = 0.001). Sexual minority respondents reported significantly lower rates of using telehealth for mental health services (p = 0.011), and gender minority respondents reported significantly lower levels of primary care provider access (p = 0.016). There are evident COVID-19 disparities experienced in Chicago especially for Black, Latinx, sexual minority, and gender minority groups. A greater focus must be paid to health equity, including providing increased resources and supplies for affected groups, adapting to inequities in the built environment, and ensuring adequate access to healthcare services to ameliorate the burden of COVID-19 on these marginalized populations.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11524-020-00497-9.     

Peer Victimization and Unhealthy Weight Control Behaviors—the Role of Intersecting Identities among New York City Youth

We investigated the intersection of sexual minority, gender, and Hispanic identities, and their interaction with peer victimization in predicting unhealthy weight control behaviors (UWCB) among New York City (NYC) youths. Using logistic regression with data from the 2011 NYC Youth Risk Behavior Survey, we examined the association of sexual identity, gender, ethnicity, and peer victimization (dating violence, bullying at school, electronic bullying) in predicting UWCB. Sexual minority youths, dating violence victims, and youths bullied at school had 1.97, 3.32, and 1.74 times higher odds of UWCB than their counterparts, respectively (P < 0.001). The three-way interaction terms between (i) dating violence, gender, and sexual identity and (ii) electronic bullying, gender, and sexual identity were statistically significant. The effect of dating violence on unhealthy weight control practices was strongest among sexual minority males (OR = 4.9), and the effect of electronic bullying on unhealthy weight control practices was strongest among non-sexual minority males (OR = 2.9). Sexual minority and gender identities interact with peer victimization in predicting unhealthy weight control practices among NYC youths. To limit the prevalence and effect of dating violence and electronic bullying among youths, interventions should consider that an individual’s experiences are based on multiple identities that can be linked to more than one ground of discrimination.     

Adverse Childhood Experiences and Health and Wellness Outcomes among Black Men Who Have Sex with Men

Black men who have sex with men (BMSM) are a population at the intersection of two minority statuses—racial minority and sexual minority. Membership in either group, compared to white or heterosexual group membership, may increase one’s risk of negative childhood and adult experiences. Baseline data from an HIV intervention efficacy trial (the Black Men Evolving Study) were used to explore the prevalence of adverse childhood experiences (ACEs) among 536 BMSM and associations between ACEs and adult mental and physical health outcomes. Overall, the prevalence of ACEs was high among this sample of BMSM with almost 90% experiencing at least one ACE. Findings revealed that ACE score was significantly associated with adult mental health (AOR = 1.21, 95% CI [1.12, 1.30]), but not with adult physical health. All ACEs were significantly associated with mental health, but only physical neglect and household substance abuse were significantly associated with physical health (AOR = 1.69, 95% CI [1.02, 2.74] and AOR = 1.57, 95% CI [1.03, 2.40], respectively). The findings support the need for interventions targeting improved adult health outcomes, particularly for minority groups, to consider the impact of early adversity on health and wellness.     

Population-Based Assessment of Asthma Symptom Burden in Children

The Minneapolis and St. Paul Controlling Asthma in American Cities Project (CAACP) used a school-based symptom survey to inform community-based programming and provide an intermediate outcome measure of progress toward reducing the burden of asthma. In collaboration with the two school districts, the project mailed the Child Asthma Short Form, a validated health-related quality of life instrument to parents of children in grades K–8 every other school year from 2003 to 2007. The survey was mailed to a randomly selected sample in four languages (English, Spanish, Hmong, and Somali). The overall response rate was 47%, 41%, and 32% for years 1, 3, and 5, respectively. Two out of three children for whom surveys were completed were children of minority populations; more than 50% were eligible for free or reduced-price meals. The changes in scores from the first round (2003–2004) to the third round (2007–2008) were statistically significant for daytime symptom burden (p?<?0.05). Improvements were noted, but not statistically significant, for nighttime symptoms and functional limitations. Children of some racial/ethnic minority groups and children eligible for free or reduced-price meals had the highest symptom burden. Findings were used to guide CAACP’s program development and delivery to populations in greatest need. CAACP’s experience in Minneapolis and St. Paul demonstrates the feasibility of administering a symptom burden survey at low cost and in compliance with school system and institutional review board requirements to maintain confidentiality. The symptom-based survey may be a useful tool to track trends and changes in health disparities at a community and population level.     

Demographic Characteristics,Components of Sexuality and Gender,and Minority Stress and Their Associations to Excessive Alcohol,Cannabis, and Illicit (Noncannabis) Drug Use Among a Large Sample of Transgender People in the United States

The current study examined demographics, sexual orientation, gender characteristics, and gender minority stress and their association to excessive alcohol, cannabis, and illicit (noncannabis) drug use among 1210 transgender adults living in the United States. The authors conducted a secondary analysis of data that included 680 transgender women (M _age = 32.63, SD _age = 12.29) and 530 transgender men (M _age = 26.14, SD _age = 7.42). A modified version of the Risk Behavioral Assessment quantified participants’ alcohol, cannabis, and illicit drug use in the past 3 months. Overall, 21.5% of participants reported excessive alcohol use; no significant differences were found on the rates of excessive alcohol use between transgender women and men. Cannabis use among our sample was 24.4%; trangender men reported significantly higher rates of cannabis use compared to transgender women. Illicit drug (noncannabis) use among our sample was 11.6%; transgender men also reported significantly higher rates of illicit drug use compared to transgender women. Multivariate analyses suggested that gender dysphoria was significantly associated with: excessive alcohol use for transgender women, cannabis use among both transgender women and men, and illicit (noncannabis) drug use among transgender women. A nonheterosexual orientation was associated with increased odds of cannabis use among transgender women and men; a nonheterosexual orientation was associated with greater odds of illicit substance use among transgender men but not among transgender women. Gender minority stressors were independently associated with excessive alcohol use among transgender men and cannabis use among transgender women. The authors suggest that minority stress may only partially account for substance use among transgender people. Consequently, the authors suggest that in addition to minority stress, other biopsychosocial mechanisms should continue to be examined to identify pathways that may lead to the development of effective substance use prevention efforts and treatment programs.     

Understanding the routinised inclusion of race, socioeconomic status and sex in epidemiology: the utility of concepts from technoscience studies

Abstract The multifactorial model of disease causation constitutes the dominant conceptual framework underwriting the epidemiology of chronic illness. Under this rubric, factors correlated with disease are analysed at the individual level; accordingly, race, social class and gender are routinely conceptualised and incorporated into epidemiological research as individualised measures of racial category, socioeconomic status and sex. This paper employs three concepts from the field of technoscience studies to elucidate how epidemiological constructions about bodily ‘differences’ are infused with authority and legitimacy. The multifactorial model and accompanying representations of race, class and gender can be usefully conceptualised as a black box ( Latour 1987 , Latour and Woolgar 1986 ), in which individualised inputs to epidemiological studies are routinised while the interior workings of the black box – how exactly ‘differences’ come to affect health – are taken for granted. Second, processes of triangulation ( Star 1985, 1986 ) are evident, as results from multiple lines of research on an array of different diseases are used to enhance the stability of the multifactorial model and associated constructions of ‘difference’. A final illuminating technoscience concept is that of the boundary object ( Star and Griesemer 1989 ), whose dual properties of conceptual flexibility and integrity help in understanding the proliferation and institutionalisation of epidemiological methods of studying race, class and sex/gender in chronic disease.