Content analysis of tobacco in episodic programming popular among youth and young adults.

BACKGROUND: While evidence exists supporting a causal relationship between exposure to tobacco content in movies and youth smoking, research is limited on the prevalence and impact of tobacco content in episodic programming aired on television (TV) and online streaming platforms. The purpose of this study was to analyse episodic programming popular among young people to estimate the prevalence of tobacco imagery. METHODS: An online survey of participants aged 15-24 years (n=750) recruited from an existing panel was used to gauge viewership of episodic programming aired on Netflix, broadcast TV and cable TV. Two trained coders independently watched the entire 2015/2016 and 2016/2017 seasons of 14 programmes aired on a streaming platform, Netflix, and across broadcast and cable TV. The coding scheme was based on existing methods which involve documenting both the type of tobacco product featured and, if applicable, user information. RESULTS: Eighty-six per cent of Netflix programmes and 86% of broadcast and cable TV programmes had at least one occurrence of tobacco. Netflix programmes had more total occurrences (n=1185) compared with the broadcast or cable programmes (n=482). Most of the tobacco occurrences included cigarettes being actively used by a character. CONCLUSIONS: Given the high prevalence of tobacco use found in these entertainment channels, the level of exposure to tobacco use among youth and young adults is very concerning and is serving to circumvent the restrictions of tobacco advertising on broadcast TV. Further research is needed to understand the influence of this exposure on smoking behaviour.

Examination of the association between lifestyle behavior changes and weight outcomes in preschoolers receiving treatment for obesity.

OBJECTIVE: Preschoolers (ages 2-5 years) have been significantly underrepresented in the obesity treatment outcome literature, despite estimates that 12.1% are already obese. As such, little is known about the most important intervention targets for weight management within this age group. The aims of this study were (a) to examine lifestyle behavior changes for 30 obese preschoolers participating in a weight-control intervention and (b) to explore which lifestyle behavior changes predicted changes in body mass index (BMI) z score. METHOD: Preschooler height, weight, diet (three 24-hr recalls), physical activity (accelerometry), and television use (parent report) were measured at baseline and posttreatment (6 months). A linear regression was conducted to examine pre- to posttreatment changes in diet (i.e., intake of calories, sugar-sweetened beverages, fruits and vegetables, and sweet and salty snacks) and activity (i.e., moderate-to-vigorous activity and television use) behaviors on changes in BMI z score. RESULTS: Despite significant reductions in sugar-sweetened beverage intake and television use, and increases in fruit and vegetable intake, only reductions in absolute caloric intake significantly predicted reductions in BMI z score. CONCLUSION: Our findings suggest that attaining healthy caloric goals may be the most important component of weight-control interventions for preschoolers. Future research using innovative methodologies, such as the Multiphase Optimization Strategy, may be helpful to prospectively identifying the lifestyle behavior changes that are most effective in helping families to achieve healthy weight outcomes for preschoolers and thereby improve intervention efficiency and decrease treatment burden for families.

Alcohol imagery on popularly viewed television in the UK.

BACKGROUND: Exposure to alcohol consumption and product imagery in films is associated with increased alcohol consumption among young people, but the extent to which exposure also occurs through television is not clear. We have measured the occurrence of alcohol imagery in prime-time broadcasting on UK free-to-air television channels. METHODS: Occurrence of alcohol imagery (actual use, implied use, brand appearances or other reference to alcohol) was measured in all broadcasting on the five most popular UK television stations between 6 and 10 p.m. during 3 weeks in 2010, by 1-min interval coding. RESULTS: Alcohol imagery occurred in over 40% of broadcasts, most commonly soap operas, feature films, sport and comedies, and was equally frequent before and after the 9 p.m. watershed. Brand appearances occurred in 21% of programmes, and over half of all sports programmes, a third of soap operas and comedies and a fifth of advertising/trailers. Three brands, Heineken, Budweiser and Carlsberg together accounted for ∼40% of all brand depictions. CONCLUSIONS: Young people are exposed to frequent alcohol imagery, including branding, in UK prime-time television. It is likely that this exposure has an important effect on alcohol consumption in young people.

Estimated activity patterns in British 45 year olds: cross-sectional findings from the 1958 British birth cohort.

OBJECTIVE: To investigate patterns of, and associations between, physical activity at work and in leisure time, television viewing and computer use. SUBJECTS: 4531 men and 4594 women with complete plausible data, age 44-45 years, participating in the 1958 British birth cohort study. METHODS: Physical activity, television viewing and computer use (hours/week) were estimated using a self-complete questionnaire and intensity (MET hours/week) derived for physical activity. Relationships were investigated using linear regression and chi(2) tests. RESULTS: From a target sample of 11,971, 9223 provided information on physical activity, of whom 75 and 47% provided complete and plausible activity data on work and leisure time activity respectively. Men and women spent a median of 40.2 and 34.2 h/week, respectively in work activity, and 8.3 and 5.8 h/week in leisure activity. Half of all participants watched television for > or =2 h/day, and half used a computer for <1 h/day. Longer work hours were not associated with a shorter duration of leisure activity, but were associated with a shorter duration of computer use (men only). In men, higher work MET hours were associated with higher leisure-time MET hours, and shorter durations of television viewing and computer use. Watching more television was related to fewer hours or MET hours of leisure activity, as was longer computer use in men. Longer computer use was related to more hours (or MET hours) in leisure activities in women. CONCLUSIONS: Physical activity levels at work and in leisure time in mid-adulthood are low. Television viewing (and computer use in men) may compete with leisure activity for time, whereas longer duration of work hours is less influential. To change active and sedentary behaviours, better understanding of barriers and motivators is needed.

The prevalence of sedentary behavior and physical activity in leisure time: A study of Scottish adolescents using ecological momentary assessment.

OBJECTIVE: To report time and prevalence of leisure time sedentary and active behaviors in adolescents. METHOD: Cross-sectional, stratified, random sample from schools in 14 districts in Scotland, 2002-03, using ecological momentary assessment (n=385 boys, 606 girls; mean age 14.1 years; range 12.6-16.7 years). This is a method of capturing current behavioral episodes. We used 15 min time intervals. RESULTS: Television viewing occupied the most leisure time. The five most time consuming sedentary activities occupied 228 min per weekday and 396 min per weekend day for boys, and 244 min per weekday and 400 min per weekend day for girls, with TV occupying one-third to one-half of this time. In contrast, 62 min was occupied by active transport and sports/exercise per weekday and 91 min per weekend day for boys, with 55 min per weekday and 47 min per weekend day for girls. A minority watched more than 4 h of TV per day, with more at weekends. Other main sedentary behaviors for boys were homework, playing computer/video games, and motorised transport and, for girls, homework, motorised transport, and sitting and talking. CONCLUSION: Scottish adolescents engage in a variety of sedentary and active behaviors. Research into sedentary behavior must assess multiple behaviors and not rely solely on TV viewing.

Creating demand for prescription drugs: a content analysis of television direct-to-consumer advertising.

PURPOSE: American television viewers see as many as 16 hours of prescription drug advertisements (ads) each year, yet no research has examined how television ads attempt to influence consumers. This information is important, because ads may not meet their educational potential, possibly prompting consumers to request prescriptions that are clinically inappropriate or more expensive than equally effective alternatives. METHODS: We coded ads shown during evening news and prime time hours for factual claims they make about the target condition, how they attempt to appeal to consumers, and how they portray the medication and lifestyle behaviors in the lives of ad characters. RESULTS: Most ads (82%) made some factual claims and made rational arguments (86%) for product use, but few described condition causes (26%), risk factors (26%), or prevalence (25%). Emotional appeals were almost universal (95%). No ads mentioned lifestyle change as an alternative to products, though some (19%) portrayed it as an adjunct to medication. Some ads (18%) portrayed lifestyle changes as insufficient for controlling a condition. The ads often framed medication use in terms of losing (58%) and regaining control (85%) over some aspect of life and as engendering social approval (78%). Products were frequently (58%) portrayed as a medical breakthrough. CONCLUSIONS: Despite claims that ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; they show characters that have lost control over their social, emotional, or physical lives without the medication; and they minimize the value of health promotion through lifestyle changes. The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health.

Nutritional content of foods advertised during the television programs children watch most.

OBJECTIVES: We sought to code food (nutritional content and food type and eating occasion) and character (cartoon and live action) attributes of food advertisements airing during television programs heavily viewed by children, and to represent and evaluate the nutritional content of advertised foods in terms of the nutrition facts label. METHODS: Food advertisements (n=426) aimed at general and child audiences were coded for food and character attributes. "Nutrition Facts" label data for advertised foods (n=275) were then analyzed. RESULTS: Convenience/fast foods and sweets comprised 83% of advertised foods. Snacktime eating was depicted more often than breakfast, lunch, and dinner combined. Apparent character body size was unrelated to eating behavior. A 2000-calorie diet of foods in the general-audience advertisements would exceed recommended daily values (RDVs) of total fat, saturated fat, and sodium. A similar diet of foods in the child-audience advertisements would exceed the sodium RDV and provide 171 g (nearly 1 cup) of added sugar. CONCLUSIONS: Snack, convenience, and fast foods and sweets continue to dominate food advertisements viewed by children. Advertised foods exceed RDVs of fat, saturated fat, and sodium, yet fail to provide RDVs of fiber and certain vitamins and minerals.

Advertising of medicines on New Zealand television.

AIMS: To measure the frequency of advertising of medicines on New Zealand television and to describe the distribution of advertising. METHODS: A stratified random sample of 35 days (577.5 hours) of television was video-recorded, including five free to air channels for each day of the week. Videotapes were watched, then advertisements were recorded on a pre-designed form. RESULTS: 340 advertisements for medicines were identified, an average of 1 per 102 minutes; 37% of advertisements were for medicines available for general sale, 24% for dietary supplements, 21% for pharmacy- or pharmacist-only medicines, and 18% for prescription-only medicines. Four channels had similar amounts of advertising. Channels varied in the kind of medicines they had advertisements for. There were more advertisements per hour in the afternoon than in the morning or evening. Advertisements for medicines were found in a wide range of programmes, including children's programmes. CONCLUSIONS: People who watch particular programmes, or who watch television at some times of days may be exposed to considerably more than one medicine's advertisement per 102 minutes. While this study does not examine the effect of medicines advertisements on consumer behaviour, previous research suggests this may be significant.

Prenatal and delivery care and childhood immunization in Guatemala: do family and community matter?

In this paper we investigate family choices about pregnancy-related care and the use of childhood immunization. Estimates obtained from a multilevel logistic model indicate that use of formal (or "modern") health services differs substantially by ethnicity, by social and economic factors, and by availability of health services. The results also show that family and community membership are very important determinants of the use of health care, even in the presence of controls for a large number of observed characteristics of individuals, families, and communities.