(Some of) What we learned through a health intervention program for elementary school children

aejmc15Papers presented August 7, 2015 at the annual conference of the Association for Education in Journalism and Mass Communication, San Francisco, Calif. Information about accessing specific papers available by visiting the Academia page on dylanmclemore.com.

Recently, researchers with the University of Alabama Health Communication Lab spent two weeks with second- and third-grade children at a racially diverse public elementary school. We conducted a health intervention, leading physical education activities, talking about health and nutrition, and using new technologies to encourage physical activity and healthy diets. These are a portion of those findings:

Media Effect on Children’s Health

Media use is a popular target of blame for childhood health problems, particularly obesity. It is widely assumed that media use limits exercise by increasing sedentary activity, though most studies find that media simply displaces other types of sedentary activity. A second proposed media effect is that media content (especially advertising) teaches unhealthy attitudes and behaviors regarding nutrition. And while content analyses of children’s television programming find enough sugary snacks to rot your teeth, it’s less clear how effective those messages are at influencing children.

We asked children in our health intervention to report how often they consumed various media (not just television – a limitation of many prior studies). Turns out, pre-existing media use did not significantly moderate intervention effects on attitudes or knowledge. Perhaps more surprising, media use did not affect baseline values before the intervention. In other words, whether children were glued to their screens or were playing outside, what they knew and how they felt about exercising and eating healthy was roughly the same.

Existing studies largely emanate from medical disciplines, where many of the measures are behavioral or biological, and assume a powerful media effects paradigm that has been disputed for over 50 years. This study, grounded in communication theory, rebuffs the century-old powerful media effects paradigm and suggests that media influence on the formation of children’s knowledge and attitudes is less evident.

Active Video Games

As part of the physical education intervention, children took a break from real-life play to engage in active video game play. Using a series of sports training games for the Wii, we measured children’s heart-rate, as well as self-reports of enjoyment and exertion. One of the papers to come out of the Wii sessions focused on the efficacy of active video games as a physical activity option for African American children. African American children are typically less physically active than White children. Two causes were particular relevant to the present study – negative attitudes toward physical activity and limited access to quality places for such activity.

We found that the Wii games each resulted in increases in heart rate mimicking that of real-life physical activity. This was true regardless of gender or weight status. Even better, children enjoyed playing the games, and reported desire to continue to play. However, real-world play could not be disregarded. For at least one game – a basketball drill – perceived efficacy at real basketball predicted enjoyment of the simulated game. The results suggest that active video games might provide alternative physical activity spaces that are enjoyed and desired by African American children.

Tablet-Sized Portions

Children used an iPad app designed by the researchers to keep track of the foods they ate at each meal. Compared to pre-intervention measures, children’s nutritional knowledge significantly improved as they thought about the types and portions of food they ate. The results suggest that the interactivity offered by touch technologies may make for an accessible, appealing way to not only present nutrition information to children, but to engage them with it.

Taken together, we learned that the various unhealthy messages in media may not be as impactful as widely believed. However, interactive media offer viable routes to engaging children in exercise and learning about nutrition.

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Newspaper portrayals of celebrity suicide: Examining coverage of Robin Williams

The suicide of Robin Williams shocked his fans around the world. His depression and history of addiction, though not uncommon to celebrity biopics or news of suicide, did not pair with the Williams we thought we knew. We have a relationship with Williams through the characters he portrayed in film, from the Genie in Aladdin to a man who literally healed through humor in Patch Adams. Though roles for an actor, they become a public persona – one that we don’t associate with depression and suicide.

icaPresented May 23, 2015 at the annual conference of the International Communication Association, San Juan, P.R., Journalism Studies division. Information about accessing this paper and associated materials available here, or by visiting the Academia page on dylanmclemore.com.

The suicide of Robin Williams shocked his fans around the world. His depression and history of addiction, though not uncommon to celebrity biopics or news of suicide, did not pair with the Williams we thought we knew. We have a relationship with Williams through the characters he portrayed in film, from the Genie in Aladdin to a man who literally healed through humor in Patch Adams. Though roles for an actor, they become a public persona – one that we don’t associate with depression and suicide.

Research on media coverage of suicide mostly deals with the risk of imitation, what has been referred to as the Werther effect. Celebrity suicide, in particular, increases the amount and prominence of coverage, and the parasocial relationships fans have with those celebrities might exacerbate imitation.

Numerous advocacy organizations issue guidelines for journalists covering suicides, suggesting that the content of the story, and not simply the subject, may be at fault. However, this assumption turns out to be woefully under-investigated. What we do know is that media –both in news and entertainment – have a less than stellar track record of accurately representing people with mental illnesses. They are depicted as being disproportionately dangerous, and their identity is rarely examined beyond their illness.

The Williams suicide presented a unique case study to look at how the story of a prominent celebrity suicide was told through the media. This particular study considered coverage from the 20 highest circulation newspapers in the U.S., including tabloids, over the week immediately following Williams’ death. It looked at the types of sources and content used in articles, as well as how prominent those articles were in the newspaper. Findings were then compared to World Health Organization (WHO) guidelines for reporting on suicide and existing literature on media stigmatization of mental illness.

The degree of detail needed for this type of study required some intensive work on the part of our coders. The team analyzed almost 6,000 individual sentences within 174 stories that cited over 550 sources. If you’re one for reliability statistics and methodology, drop me a line and I’d be glad the details of achieving reliability with so many moving parts.

Among the Findings:

– The suicide was largely told through the lens of Williams’ celebrity – his career and reaction from fellow movie stars – rather than focusing on issues of mental health.

– Coverage became less celebrity-oriented as time passed, but the frequency and prominence of articles also declined considerably, meaning that while coverage became more substantive, it also became harder to find.

– While medical experts weren’t widely cited, they were relied upon for most health-related information. Only twice was sourcing problematic. Medical sources were lacking in articles regarding addiction and speculating as to possible reasons for suicide.

– Tabloids were behind most WHO guidelines violations. They were far more likely than traditional newspapers to speculate about external “triggers” for the suicide. These “reasons” were almost always attributed to celebrities or friends of Williams, oftentimes anonymously. Tabloids also described the suicide in the most graphic detail – something that, aside from taste, is thought to increase imitation. This New York Daily News cover pretty well sums up the problems with tabloid coverage:

hanged

Overall, print coverage of the suicide departed from stigmatizing presentations. As a result of Williams’ stature, he was not a faceless victim; rather, his identity was explored rather deeply. Aside from the tabloids, attempts to link the suicide to some “trigger” event were rare, and suicide as a form of escape was not promoted, despite that message being circulated by some very prominent sources. Most impressively, the stigma that people with mental illness were dangerous did not appear a single time in almost 6,000 sentences analyzed. This was especially surprising when drugs and alcohol entered the discussion.

However, there was still room for improvement. It took time for a medical angle to emerge and for medical experts to appear as sources. That leaves room for unwarranted speculation in the immediate aftermath, when audience attention is at its highest. Print coverage also appeared to miss an opportunity to talk about depression, addiction, and suicide in a more general context. Such extrapolation was isolated.

The real question is whether coverage was unique to the uniqueness of its subject. Is the press getting better at explaining mental illness, or was coverage more delicate because of the beloved actor who made us all laugh? Future research will tell us more, though we hope it is a long time before a context for investigation presents itself again.

This research was conducted by the University of Alabama Health Communication Lab, a part of the College of Communication and Information Sciences. McLemore served as the lead researcher for this study.