Influence of eating while watching TV on food preference and overweight/obesity among adolescents in China: a longitudinal study.

Background: Eating while watching TV was found associated with unhealthy food preferences and obesity in adolescents in foreign studies, which is not clear in China. The study aims to explore the influence of eating while watching TV on food preferences and overweight/obesity in Chinese adolescents. Methods: Data from 1768 adolescents (aged 12-17 years) in the 2006, 2009, 2011, and 2015 China Health and Nutrition Survey (CHNS) was analyzed. The height and weight were measured. Mixed effect models were used to identify the associations between eating while watching TV and adolescents' food preferences and overweight/obesity. Results: Adolescents eating while watching TV ≥1 time/week were more likely to prefer fast food, salty snacks and soft drinks than those eating while watching TV <1 time/week. Adolescents eating meals while watching TV ≥1 time/week were less likely to prefer vegetables than those eating meals while watching TV <1 time/week. In addition, adolescents eating snacks while watching TV ≥1 time/week were more likely to be overweight/obesity than those eating meals while watching TV <1 time/week (odds ratio [OR] = 7.16; 95% confidence interval [CI] 1.39-36.93). Conclusion: Eating snacks while watching TV was positively associated with adolescents' unhealthy food preferences and overweight/obesity. Eating meals while watching TV was associated with adolescents' unhealthy food preferences. Implementing web-based Community-based participatory research (CBPR) about reducing eating while watching TV may be a practical strategy to develop healthy food preferences and prevent overweight/obesity in Chinese adolescents.

Socio-demographic and other factors contributing to excessive leisure screen time in preadolescent children.

OBJECTIVES: Excessive screen use in early school age is associated with worsened health habits and negative child development in later age. We aimed to assess the time spent on modern and traditional screen-based devices and examine its associations with socio-demographic characteristics. METHODS: This population-based cross-sectional observation study was conducted in Czechia, Slovakia and Finland between April and June 2021. Participants (N = 1,915) were parents/caregivers of children attending elementary school grades 1 to 3, selected by stratified random sampling. Children's daily leisure screen time (LST) based on parental reports was the main outcome. Descriptive statistics, mean comparison and linear regression analysis were used for the analysis. RESULTS: The average daily LST was found to be as high as 3.5 hours and significantly associated with most socio-demographic variables. Eighty percent of children exceeded the threshold of two hours of LST per day, which was formerly introduced by the American Academy of Pediatrics. The most important predictor of LST in children was having their screen-based device(s) for their exclusive personal use (EPU). Linear regression with all predictors assessed together confirmed the significant effect of the screen-based devices' EPU, the child's sex and grade, the child's birth order and the parent's education, even when controlled for media parenting practices. CONCLUSIONS: Given the widespread availability of smartphones for exclusive personal use among young children, the regulation of EPU and the reinforcement of effective media parenting practices, particularly in families with lower education and income, are critical public health strategies to mitigate the negative impact of excessive screen time on child development and overall well-being.

Assessment of an interactive television that supports social connectedness among older adults living at home and in geriatric institutions: Usability and task performance analysis.

Introduction: Increasingly, geriatric institutions are adopting video calling services to promote social interactions between residents and their loved ones. However, a gap persists between the technologies used and the needs and abilities of older users. Interactive Televisions (iTVs) could be part of the solution as they provide a familiar and accessible way to strengthen the relationship between residents and their environment (family, friends, professionals). Methods: User tests were conducted to evaluate the ability of older adults (OAs) from different place of living to use iTV. A total of 32 user tests were carried out with OAs living at home, in residential facilities (RFs), and in nursing homes (NHs) between November 2022 and June 2023. Results: The quantitative analysis revealed mixed opinions on the iTV's usability. OAs living at home tended to produce less errors and needed less help to successfully use video calling and messaging functionalities of the iTV than others. However, participants in NHs required more repetitions to benefit from a learning effect, unlike participants in RFs and at home. Conclusions: This study proposed another approach to user testing, based on cognitive psychology methods. Based on the analysis of the critical stages, ergonomic recommendations were identified.

Recreational screen time and obesity risk in Korean children: a 3-year prospective cohort study.

BACKGROUND: Studies have shown that prolonged television watching increases obesity risk among children. However, few studies examined the associations with other types of screen time, such as computer and smartphone use, using a prospective cohort study design. Further, little is known about the specific non-screen time activity that may yield the most benefits when reallocating screen time to other activities. METHODS: We conducted a prospective cohort analysis using 3-year follow-up data from the Korean Children and Youth Panel Survey 2018 (n = 2,023; 4th grade elementary students who were not obese at baseline). Average time spent watching television, using computer and smartphone, and other after-school activities were self-reported at baseline. Weight and height were also self-reported at baseline and follow-up surveys through 2021. We performed multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between screen time and obesity incidence, adjusting for potential confounders. We also performed isotemporal substitution models to examine the associations of reallocating screen time to other non-screen time activities (physical activity, sleeping, hanging out with friends, reading, studying, and chatting with parents) in an equal time-exchange manner. RESULTS: Longer combined screen time (≥ 240 vs. <120 m/d) was statistically significantly associated with an increased obesity risk (OR [95% CI] = 1.68 [1.03, 2.73]). The direction of associations with television watching (≥ 180 vs. <60 m/d: OR [95% CI] = 2.86 [1.58, 5.20]), computer use (≥ 120 vs. <60 m/d: 1.38 [0.52, 3.64]), and smartphone use (≥ 180 vs. <60 m/d: 1.42 [0.76, 2.65]) were all positive, although the association was most apparent and statistically significant for television watching only. The associations did not change after additional adjustment for other lifestyle factors, including physical activity, sleep, and breakfast skipping. In the isotemporal substitution models, reallocating 1-hour of screen time to reading (OR [95% CI] = 0.67 [0.48, 0.93]) was associated with a decreased obesity risk. Reallocating 1-hour of screen time to physical activity was only marginally significantly associated with obesity risk (0.79 [0.62, 1.01]). CONCLUSIONS: Our data suggest that more efforts should focus on reducing screen time and increasing time for other non-screen time activities, particularly reading, for obesity prevention in children.

Leisure Screen Time and Food Consumption among Brazilian Adults.

BACKGROUND: Screen time, involving activities like watching television (TV), and using tablets, mobile phones, and computers (electronic devices), is associated with the consumption of unhealthy foods. This study aimed to analyze the association between prolonged leisure screen time and healthy and unhealthy food consumption indicators among Brazilian adults (≥18 years). METHODS: Data from the National Health Survey (NHS), conducted in 2019 (n = 88,531), were used. Prolonged leisure screen time (screen time ≥ 3 h/day) was analyzed in three dimensions: watching TV; use of electronic devices; and total screen time (TV and electronic devices). Food consumption was analyzed in two dimensions: healthy (in natura and minimally processed foods) and unhealthy (ultra-processed foods). Poisson regression models were used to calculate prevalence ratios (crude and adjusted (PRa)) by sociodemographic factors (sex, age, schooling, income, area of residence, and race/color) and health factors (weight status, self-rated health, and presence of noncommunicable disease), to assess the association between prolonged screen time and food consumption indicators. RESULTS: Among Brazilian adults, the prevalence of prolonged screen time was 21.8% for TV and 22.2% for other electronic devices for leisure. The highest frequency of watching TV for a prolonged time was observed among women, older adults, and those with a lower income and schooling. Prolonged use of electronic devices was more common among young adults and those with intermediate schooling and income. Prolonged screen time was associated with an unhealthy diet, due both to the higher consumption of unhealthy foods (PRa = 1.35 for TV, PRa = 1.21 for electronic devices, and PRa = 1.32 for both types) and the lower consumption of healthy foods (PRa = 0.88 for TV, PRa = 0.86 for electronic devices, and PRa = 0.86 for both). CONCLUSIONS: Prolonged screen time was negatively associated with the consumption of healthy foods and favored the consumption of unhealthy foods among Brazilian adults.

Recall of Netflix Scripted Content Known to Contain E-Cigarette-Related Imagery is Associated with Susceptibility to Use E-Cigarettes Among Young Adults.

INTRODUCTION: Netflix pledged to avoid depictions of e-cigarette use in scripted series and movies rated TV-14 or below. However, this policy did not extend to young adults, many of whom are below the legal tobacco purchasing age. This study examined the association between recall of Netflix scripted series and movies previously identified to contain e-cigarette imagery and susceptibility to use e-cigarettes among never users. MATERIALS AND METHODS: A non-probability representative sample of young adults (ages 18-24; N = 1500) living in California were recruited to complete an online survey assessing their recall of Netflix scripted series and movies previously identified to contain e-cigarette imagery and e-cigarette-related behaviors. Adjusted and weighted logistic regression analyses were used among participants who had never used e-cigarettes (n = 967). RESULTS: Among participants who had never used e-cigarettes, 68.1% (n = 659/967) recalled viewing at least one Netflix scripted series or movie previously identified to contain e-cigarette imagery, including 66.4% (n = 192/289) of participants under the legal tobacco purchasing age. Participants who recalled viewing at least one Netflix scripted series or movie previously identified to contain e-cigarette imagery, compared with those who did not, had greater odds of reporting susceptibility to use e-cigarettes among never users (AOR = 1.65, 95% CI = 1.20-2.25). CONCLUSIONS: Young adults living in California recalled Netflix scripted series or movies previously identified to contain e-cigarette imagery. Such recall was associated with susceptibility to use e-cigarettes among never users. These findings should motivate prevention programmers to design tobacco-related digital media literacy interventions for young adults.

Watching Televised Counter-Stereotypes Alone or with Mom: Studying the Effects on Preadolescents' Gender Attitudes and Beliefs.

Despite the dominant presence of traditional gender portrayals on television, there is a growing effort to incorporate more diverse gender representations, including in youth television series. The impact of such counter-stereotypical portrayals on preadolescents' gender attitudes and beliefs remains largely unexplored. This mixed-design experimental study among 75 mother-child dyads (Mage child = 10.69, SD = 1.37) examined the effects of watching an episode of an entertainment television program that positively portrays a transgender character, either alone or with the mother. The findings indicated that watching the episode lowered preadolescents' gender essentialism, but did not increase acceptability of and willingness to befriend gender-nonconforming peers. Maternal presence did not further impact the findings. Perceived similarity to and liking of the transgender character did not act as moderators, but had a direct impact on preadolescents' gender attitudes and beliefs. In conclusion, the results suggest that exposure to counter-stereotypes in entertainment television can influence components of preadolescents' gender attitudes and beliefs. Gender-diverse television characters who are perceived as highly similar and likeable appear to be particularly influential.

Using Interactive Television Instruction (ITV) to Reduce the Propensity to Engage in Substance Abuse and Drug Trafficking Among Vulnerable Adolescents in Nigeria.

This study examined the impact of ITV intervention on reduction in the propensity to abuse substances and engage in drug trafficking. The researcher conducted this study using an experiment of 517 vulnerable adolescents aged 10-19 years. The participants were randomly assigned to control (n = 258) and treatment (n = 259) groups. The researchers found a significant main effect of treatment conditions on reduction in the propensity to engage in substance abuse and drug trafficking among vulnerable adolescents. That is, before the intervention, there was no significant statistical difference between the control and treatment groups on the propensity to engage in substance abuse and drug trafficking. However, vulnerable children who received the intervention reported a significant reduction in propensity after the intervention. The results highlight the usefulness of ITV as a behaviour change strategy for vulnerable children.

2' Life-changing minutes: impact evaluation of a novel health promotion format on cancer prevention.

Cancer is one of the most important societal challenges in the world, with over 23 million new cases/year and 10 million deaths/year, that will only be properly tackled with a stronger focus on prevention. This calls for an informed population, aware of risk factors and willing to adopt preventive behaviors and early cancer screenings. For that purpose, 2' Life-changing minutes was created, the first ever televised Entertainment-Education series on cancer prevention. This study aims to evaluate the impact of 2' Life-changing minutes, a novel E-E format for cancer prevention, on knowledge gains and behavior changes. Two complementary studies were performed involving a total of 1314 participants: a test-screening (TS) study targeting potential viewers of the series, and a natural-screening (NS) study targeting those that spontaneously watched the series on television. We found (i) very high levels of appreciation and narrative engagement, and also willingness to see more episodes; (ii) statistically significant knowledge gains, ranging from 17% to 44%, on all four topics tested; (iii) evidence of effective behavior change. Regression analysis showed that narrative engagement was the best predictor of behavior change [NS: odds ratio (OR) = 3.38, 95% confidence interval (CI) = 1.70-6.74, p = 0.001; TS: OR = 2.05, 95% CI = 1.13-0.371, p = 0.018]. This study demonstrates the series' real impact and serves as a proof-of-concept for a novel strategy of cancer prevention that is based around compelling health narratives, rather than information or data, to engage viewers, increase knowledge and induce behavior change.

Television Viewing from Young Adulthood to Middle Age and Premature Cardiovascular Disease Events: A Prospective Cohort Study.

BACKGROUND: Previous literature has explored the relationship between television viewing and cardiovascular disease (CVD) in adults; however, there remains a paucity of longitudinal data describing how young adult television viewing relates to premature CVD events. OBJECTIVE: To ascertain the relationship between level and annualized changes in television viewing from young adulthood to middle age and the incidence of premature CVD events before age 60. DESIGN: The Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort with over 30 years of follow-up (1985-present). PARTICIPANTS: Black and White men and women who were 18-30 years old at baseline (1985-1986). MAIN MEASURES: Independent variables: Individualized television viewing trajectories were developed using linear mixed models. DEPENDENT VARIABLES: Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome. KEY RESULTS: Among 4318 included participants, every 1-h increase in daily hours of television viewing at age 23 was associated with higher odds of incident CHD (adjusted odds ratio [AOR] 1.26, 95% confidence interval [CI] 1.06-1.49) and incident CVD events (AOR 1.16, 95% CI 1.03-1.32). Each additional hour of daily television viewing annually was associated with higher annual odds of CHD incidence (AOR 1.55, 95% CI 1.06-2.25), stroke incidence (AOR 1.58, 95% CI 1.02-2.46), and CVD incidence (AOR 1.32, 95% CI 1.03-1.69). Race and sex modified the association between television viewing level at age 23 and CHD, heart failure, and stroke, with White men most consistently having significant associations. CONCLUSIONS: In this prospective cohort study, greater television viewing in young adulthood and annual increases in television viewing across midlife were associated with incident premature CVD events, particularly CHD. Young adulthood as well as behaviors across midlife may be important periods to promote healthy television viewing behavior patterns.

Mental health treatments and the influence of culture: portrayals of hypnotherapy and electroconvulsive therapy in Singaporean television dramas.

Stigma is one of the chief reasons for treatment-avoidant behaviour among people with mental health conditions. Stigmatising attitudes are spread through multiple determinants, including but not limited to: (i) individual beliefs; (ii) interpersonal influences; (iii) local cultural values and (iv) shared culture such as depictions in television shows. Our research indicates that popular television shows are currently understudied vectors for narratives that alternately reify or debunk assumptions and stereotypes about people with mental health conditions. Although such shows are fictional, they influence perception by normalising 'common sense' assumptions over extended periods of time. Consequently, representations of patients, psychiatrists and treatments influence knowledge and understanding of mental health and treatment-seeking behaviour. While storytelling about sickness can inspire possibilities and bestow meaning on traumatic experiences, fictional narratives written without sufficient care can have the inverse effect of curtailing horizons and limiting expectations. Problematic portrayals of patients, mental health professionals and psychological interventions are often reductive and may increase stigma and prevent treatment-seeking behaviour. This article analyses the representation of hypnotherapy and electroconvulsive therapy (ECT) in Singaporean television dramas that attract a wide, mainstream audience. Our diverse team investigated dramas in all four of the official languages of Singapore: English, Mandarin Chinese, Bahasa Melayu and Tamil. We found that depictions of hypnotherapy tend to produce problematic images of mental health professionals as manipulative, able to read minds, engaging in criminal behaviour, lacking in compassion and self-interested. Meanwhile, representations of ECT typically focus on the fear and distress of the patient, and it is primarily depicted as a disciplinary tool rather than a safe and effective medical procedure for patients whose condition is severe and refractory to pharmacotherapy and behavioural interventions. These depictions have the potential to discourage treatment-seeking behaviour-when early intervention has found to be crucial-among vulnerable populations.

Protocol for a Study Investigating Context-Specific Sedentary Behaviors and Cardiometabolic Health in College-Based Young Adults (CONTEXT-SB).

Background: Sedentary behavior (SB) is detrimental to cardiometabolic disease (CMD) risk, which can begin in young adulthood. To devise effective SB-CMD interventions in young adults, it is important to understand which context-specific sedentary behaviors (CS-SB) are most detrimental for CMD risk, the lifestyle behaviors that co-exist with CS-SBs, and the socioecological predictors of CS-SB. Methods: This longitudinal observational study will recruit 500 college-aged (18-24 years) individuals. Two laboratory visits will occur, spaced 12 months apart, where a composite CMD risk score (e.g., arterial stiffness, metabolic and inflammatory biomarkers, heart rate variability, and body composition) will be calculated, and questionnaires to measure lifestyle behaviors and different levels of the socioecological model will be administered. After each visit, total SB (activPAL) and CS-SB (television, transportation, academic/ occupational, leisure computer, "other"; ecological momentary assessment) will be measured across seven days. Discussion: It is hypothesized that certain CS-SB will show stronger associations with CMD risk, compared to T-SB, even after accounting for coexisting lifestyle behaviors. It is expected that a range of intra-individual, inter-individual, and physical environment socioecological factors will predict CS-SB. The findings from this study will support the development of an evidence-based, multi-level intervention to target SB reduction and mitigate CMD risk in CBYA.

Living happily alone in Plato's cave? On loneliness, technology and the metaphysics of presence.

In a lot of research on loneliness and technology, there is an underlying premise that actual, physical presence is more real than 'virtual' presence. This premise is rarely explicit, yet it implies a hierarchy of reality, where the 'here and now' is always on top. In this theoretical paper, we examine this latent hierarchy and the understandings of presence and mediation it implies. We point towards potential consequences of this understanding for research on the role of technology in reducing loneliness and social isolation. To do this, we draw on the philosophical analysis made by Martin Heidegger and Jacques Derrida of what they called 'the metaphysics of presence'. This is the tendency to privilege presence as the only immediate and truthful access to reality, whereas all forms of mediations constitute mere approximations, derivations and second-rate realities with dubious truth value. First, we present their diagnosis, and then we show how it pertains to research on virtual presence and loneliness by analysing some examples from this research. Finally, we discuss some potential implications of the metaphysics of presence through a case story compiled from our empirical research. Our foundational assertion is that the question of whether anyone experiences loneliness is an empirical and not a metaphysical question. If we want to properly understand loneliness and the potential for alleviating it through the use of teletechnologies, we might get off on the wrong foot if we carry with us assumptions suggesting the existence of ascending levels of reality and presence.

Association between screen time and self-reported balance disorders in middle-aged and older adults: national health and nutrition examination survey.

BACKGROUND: Balance disorders can give rise to sensations of instability, lightheadedness, vertigo, disequilibrium, or syncope, ultimately leading to grave medical, physical, emotional, and societal ramifications. These conditions are highly prevalent among individuals aged 40 and above. Screen time encompasses activities associated with television viewing, video game playing, and non-work-related computer usage. Prolonged screen exposure may engender a spectrum of health issues and even elevate overall mortality rates. However, the available evidence on the potential link between excessive screen time and balance dysfunction remains limited. AIMS: The primary aim of this study was to explore the possible association between prolonged screen exposure and impaired balance function. METHODS: This cross-sectional study utilized data from participants who completed a comprehensive questionnaire in the NHANES database between 1999 and 2002, all of whom were aged over 40 and under 85 years. Participants' screen time was categorized into two groups (< 4 h/d and ≥4 h/d) for subsequent data analysis. Logistic regression, combined with propensity score matching (PSM), was employed to investigate the correlation between screen time and balance disorders. RESULTS: A total of 5176 participants were enrolled in this study, comprising 2,586 men and 2,590 women, with a prevalence rate of balance disorders at 25.7% (1331/5176). The incidence of balance disorders was found to be significantly higher among individuals who spent 4 hours or more per day on screen time compared to those with less screen time (P<0.001). Multivariate logistic analysis conducted on the unmatched cohort revealed a significant association between screen time and balance disorders, with an odds ratio (OR) 1.8 (95%CI 1.57 ∼ 2.05). These findings remained consistent even after adjusting for confounding factors, yielding an OR 1.43 (95%CI 1.24 ∼ 1.66). Moreover, the association persisted when employing various multivariate analyses such as propensity score matching adjusted model, standardized mortality ratio weighting model and pairwise algorithmic model; all resulting in ORs ranging from 1.38 to 1.43 and p-values < 0.001. CONCLUSIONS: After controlling for all covariates, screen time (watching TV, playing video games, and using computers outside of work) was associated with balance dysfunction among middle-aged and older adults. This finding may offer a possible idea for the prevention of dizziness and balance disorders. Nevertheless, additional research is imperative to further validate these results.

Entertainment media as a source of relationship misinformation.

In this piece, we propose that entertainment media is an understudied source of misinformation and relationship science is an understudied domain of misinformation. We discuss two ways that relationship misinformation can appear in entertainment media - in the form of blatant claims and subtle content - and we provide an example of each from reality and entertainment television. We also propose an agenda for studying relationship misinformation and a set of questions to guide future research. We conclude by calling attention to the potential harms of such information on individuals and relationships.

Television watching during meals is associated with higher ultra-processed food consumption and higher free sugar intake in childhood.

BACKGROUND: The consumption of ultra-processed foods (UPFs) is associated with an increased risk of noncommunicable diseases and mortality in adults. The aim of this study was to analyse the association between mealtime television (TV) watching and UPF consumption in childhood. MATERIALS AND METHODS: Participants in the SENDO project recruited in 2015-2023 were classified into three categories based on the frequency at which they watched TV during meals. Dietary information was collected with a validated 147-item semi-quantitative food frequency questionnaire. Generalized mixed models were used to compare mean UPF consumption between groups after accounting for the main confounders. The predictive margins of participants who had a free sugar intake >10% of their energy intake in each category were also calculated. RESULTS: Totally 970 subjects (482 girls) with a mean age of 5.00 years (SD = 0.85) were studied. Children who watched TV during meals ≥4 times/week consumed a mean of 4.67% more energy from UPF than those who watch TV <3 times/month. The adjusted proportions of children who had a free sugar intake >10% of their energy intake in the categories of <3 times/month, 1-3 times/week and ≥4 times/week exposure to TV during meals were 44.9%, 45.9% and 58.7%, respectively. CONCLUSION: TV watching during meals is associated with higher consumption of UPFs and a higher risk of exceeding 10% of TEI in free sugar intake in childhood.

Advertisement design in dynamic interactive scenarios using DeepFM and long short-term memory (LSTM).

This article addresses the evolving landscape of data advertising within network-based new media, seeking to mitigate the accuracy limitations prevalent in traditional film and television advertising evaluations. To overcome these challenges, a novel data-driven nonlinear dynamic neural network planning approach is proposed. Its primary objective is to augment the real-time evaluation precision and accuracy of film and television advertising in the dynamic interactive realm of network media. The methodology primarily revolves around formulating a design model for visual advertising in film and television, customized for the dynamic interactive milieu of network media. Leveraging DeepFM+long short-term memory (LSTM) modules in deep learning neural networks, the article embarks on constructing a comprehensive information statistics and data interest model derived from two public datasets. It further engages in feature engineering for visual advertising, crafting self-learning association rules that guide the data-driven design process and system flow. The article concludes by benchmarking the proposed visual neural network model against other models, using F1 and root mean square error (RMSE) metrics for evaluation. The findings affirm that the proposed model, capable of handling dynamic interactions among images, visual text, and more, excels in capturing nonlinear and feature-mining aspects. It exhibits commendable robustness and generalization capabilities within various contexts.

The immediate impacts of TV programs on preschoolers' executive functions and attention: a systematic review.

BACKGROUND: Previous research has presented varying perspectives on the potential effect of screen media use among preschoolers. In this study, we systematically reviewed experimental studies that investigated how pacing and fantasy features of TV programs affect children's attention and executive functions (EFs). METHODS: A systematic search was conducted across eight online databases to identify pertinent studies published until August 2023. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. RESULTS: Fifteen papers involving 1855 participants aged 2-7 years fulfilled all the inclusion criteria for this review and were entered into the narrative synthesis. Despite the challenge of reaching general conclusions and encountering conflicting outcomes, a nuanced analysis reveals distinct patterns within various subgroups. The impact of pacing on attention is discernible, particularly in bottom-up attention processes, although the nature of this effect remains contradictory. Conversely, consistent findings emerge regarding top-down attention, suggesting any impact. Moreover, a subgroup analysis of different EF components yields valuable insights, highlighting the negative effect of fantasy on inhibitory control within the EF framework. CONCLUSION: The complexity of these outcomes highlights the need for further research, considering factors such as content, child-specific characteristics, environmental factors, and methodological approaches. These findings collectively emphasize the necessity of conducting more comprehensive and detailed research, especially in terms of the underlying mechanisms and their impact on brain function.

Acceptability and feasibility of an intervention for Alaska Native and American Indian couples.

Objective: This acceptability and feasibility study assessed a previously tested movie discussion intervention culturally adapted for a tribal health setting. Background: Despite family and relationships being important in Alaska Native and American Indian (ANAI) cultures, social health interventions supporting committed ANAI couples have not been investigated. Couples watching and discussing movies can promote and sustain relationship health as effectively as intensive skill-building classes. Method: This study culturally adapted a movie discussion intervention. Multiple stakeholders guided adaptations, including changes to intervention duration, recommended movies, discussion guide, and study measures. Eligible participants were cohabitating adults in a committed relationship, with at least one person in the couple being ANAI. Participants watched and discussed movies over 4 weeks at home or in person. Study measures assessed demographics, relationship characteristics, and intervention acceptability and feasibility. Results: Twenty-three couples participated: 87% chose at-home participation, 70% completed the intervention. Almost 90% of couples felt comfortable discussing the movies, felt the discussion guide improved communication, and would recommend the intervention to other couples, but 26% were mildly stressed by the discussions. Conclusion: This intervention was a feasible and acceptable way to help ANAI couples maintain positive relationship features. Implications: This intervention could support ANAI couples in regions with limited access to behavioral health services.