Violence depicted in advertisements on LinkNYC kiosks in Manhattan, New York City.

Violence has a profound negative impact on the lives of youth. Exposure to violence may be a precursor to violence later in life. The purpose of this study was two-fold: (1) to estimate the prevalence of violence depicted in advertisements on LinkNYC kiosks in Manhattan, NYC, and (2) to determine if violent advertising varied based on the median annual income of the zip code in which the kiosk was located. This cross-sectional study involved observations of advertisements on 100 LinkNYC kiosks that were selected randomly from 500 that were listed in Manhattan, NYC. The frequency and type of violent depictions were recorded. The kiosks were grouped into quartiles of median annual income (1) $40,782 and below (2) $40,783 to $86,801 (3) $86,802 to $105,500 and (4) $105,501 and above. Of the 2025 total advertisements observed, including duplicates, a total of 190 (9.4%) included violent content. These 190 advertisements were observed on 68 of the 100 kiosks and included 339 depictions of violence. The overwhelming majority (n = 136; 71.6%) of violent depictions were for movies. There were significant differences in the frequency of violent content based on income quartiles, χ2 (3, n = 190) = 19.00, p < 0.001. The highest two income quartiles had fewer violent advertisements than would be expected and the lowest quartile had more violent advertisements than expected. Symbols of violence were the most frequent type of violence portrayed observed in 85% of the violent advertisements observed (n = 161). Weapons, crime and fighting were observed in 5-11% of the advertisements. Our study suggests that greater alignment between the city's aims to improve community health and reduce health disparities and advertising policies on LinkNYC warrants consideration.

Missed opportunities: Do states require screening of children for health conditions that interfere with learning?

METHODS: Investigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion. RESULTS: No state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC). CONCLUSION: The lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.

An Analysis of Electronic Cigarette and Cigarette Advertising in US Women's Magazines.

BACKGROUND: Traditional cigarette advertising has existed in the US for over 200 years. Studies suggest that advertising has an impact on the initiation and maintenance of smoking behaviors. In recent years, electronic cigarettes (e-cigarettes) emerged on the market as an alternative to the traditional tobacco cigarette. The purpose of this study was to describe advertisements in popular US magazines marketed to women for cigarettes and e-cigarettes. METHODS: This study involved analyzing 99 issues of 14 popular US magazines marketed to women. RESULTS: Compared to advertisements for traditional cigarettes, advertisements for e-cigarettes were more often found in magazines geared toward the 31-40-year-old audience (76.5% vs. 53.1%, P = 0.011) whereas traditional cigarette advertisements were nearly equally distributed among women 31-40 and ≥40 years. More than three-quarters of the e-cigarette advertisements presented in magazines aimed at the higher median income households compared to a balanced distribution by income for traditional cigarettes (P = 0.033). CONCLUSIONS: Future studies should focus on specific marketing tactics used to promote e-cigarette use as this product increases in popularity, especially among young women smokers.

Widely Viewed English Language YouTube Videos Relating to Diabetic Retinopathy: A Cross-Sectional Study.

BACKGROUND: An emergent source of information on health issues is the Internet. One such platform with 1 billion users is YouTube, the global video-sharing service. OBJECTIVE: The purpose of this study was to describe the content and characteristics of the most widely viewed YouTube videos related to diabetic retinopathy. METHODS: Videos were sorted according to number of views using the key words "diabetic retinopathy." For each video, general descriptive information was collected. This information included date and source of upload (news, professional, or consumer), length, and total number of views as of July 18, 2016. Content categories were largely informed by a National Eye Institute fact sheet. Each video was viewed to determine which, if any, of the given content categories were present. RESULTS: Of the 98 most widely viewed videos related to diabetic retinopathy, 42 were generated by consumers, 40 were generated by professionals, and 16 were generated from news-based sources. The largest number of views were generated from professionals (624,770/994,494, 63.82%). Compared with professional videos, consumer videos were viewed less frequently (W=622, P=.04). The main purpose of the majority of videos was to provide information (59/98, 60%), and most of the videos showed or mentioned retinopathy in general (75/98, 77%). Smaller numbers offered information about specific types of retinopathy, namely proliferative (26/98, 27%) and nonproliferative (17/98, 17%). Compared with consumer-generated videos, professional videos were 5.57 times more likely to mention that diabetic retinopathy can go unnoticed (95% CI 1.59-26.15). More than 80% (80/98) of the most widely viewed videos did not address the asymptomatic nature of the disease, only about one-third (33/98) mentioned prevention, and only 58 of the 98 videos (59%) mentioned screening. CONCLUSION: Future research is needed to identify aspects of YouTube videos that attract viewer attention and best practices for using this medium to increase diabetic retinopathy screening among people with diabetes.

Marketing strategies and warning labels on children's toothpaste.

PURPOSE: The overconsumption of toothpaste has negative consequences, particularly for children. This study's objectives were to describe misleading marketing strategies used in selling children's fluoridated toothpaste and identify warning label characteristics. Two researchers independently coded the packaging from 26 over-the-counter toothpastes that are specifically marketed for children. Aggressive marketing strategies targeting children were identified: every toothpaste in this sample displayed at least 1 children's animated character, 50% had at least 1 picture of a food item, 92.3% stated they were flavored and 26.9% depicted a full swirl of toothpaste, directly contradicting dentist recommendations for young children. Further, on most toothpaste tubes, warnings regarding fluoride overconsumption for young children were only listed on the back and in very small font. Misleading marketing strategies are regularly used in selling children's toothpaste as if it is a food product, while warnings regarding overconsumption among youth are minimized. Dental hygienists are in an important position to help parents of young children implement safe oral care practices.

Analysis of YouTubeTM videos related to bowel preparation for colonoscopy.

AIM: To examine YouTubeTM videos about bowel preparation procedure to better understand the quality of this information on the Internet. METHODS: YouTubeTM videos related to colonoscopy preparation were identified during the winter of 2014; only those with ≥ 5000 views were selected for analysis (n = 280). Creator of the video, length, date posted, whether the video was based upon personal experience, and theme was recorded. Bivariate analysis was conducted to examine differences between consumers vs healthcare professionals-created videos. RESULTS: Most videos were based on personal experience. Half were created by consumers and 34% were ≥ 4.5 min long. Healthcare professional videos were viewed more often (> 19400, 59.4% vs 40.8%, P = 0.037, for healthcare professional and consumer, respectively) and more often focused on the purgative type and completing the preparation. Consumer videos received more comments (> 10 comments, 62.2% vs 42.7%, P = 0.001) and more often emphasized the palatability of the purgative, disgust, and hunger during the procedure. Content of colonoscopy bowel preparation YouTubeTM videos is influenced by who creates the video and may affect views on colon cancer screening. CONCLUSION: The impact of perspectives on the quality of health-related information found on the Internet requires further examination.

A comparative study of the sodium content and calories from sugar in toddler foods sold in low- and high-income New York City supermarkets.

Information from the nutrition facts labels of toddler foods marketed in low- and high-income New York City zip codes were analyzed for sodium content, the proportion of sugar-derived calories, and presence of sugar and/or high-fructose corn syrup as an added sweetener in the list of ingredients. Among the 272 toddler foods analyzed, more than a quarter were high in sodium, over one-third derived at least 20% their calories from sugar, and more than 41% of the foods had sugar and/or high-fructose corn syrup listed among the first five ingredients. The proportion of foods with such nutritional characteristics did not significantly differ between the low- and high-income neighborhood supermarkets. Median sodium content was highest among "side dishes" and "meals." The proportion of calories derived from sugar was found to be highest among "snacks and yogurt blends" in both low- and high-income neighborhoods and "breakfast foods and cereals" in low-income neighborhoods. When compared to high-income neighborhoods, more than three times the proportion of total calories in "breakfast foods and cereals" sold in low-income neighborhoods were derived from sugar. Since taste preferences established during childhood can have long-lasting influence on dietary habits, it is imperative to limit the promotion of toddler foods that are high in sodium and sugar as well as educate parents to make nutritionally sound decisions at the point of purchase.

Skin cancer prevention coverage in popular US women's health and fitness magazines: an analysis of advertisements and articles.

The desire to be tan is a phenomenon that public health researchers have investigated, as exposure to UV radiation increases the chances of developing skin cancer.  Media messages in women's magazines have been shown to contribute to this problem. Much less is known about the prevalence of skin cancer prevention messages in these magazines. This study's aim was to identify the number and type of articles and advertised products devoted to skin health (sun protection and skin cancer prevention in particular) within five popular U.S. greater than women's health and fitness magazines. We analyzed articles and advertisements over seven months of issues of the following popular women's health and fitness magazines: Fitness, Health, Self, Shape, and Women's Health, March 2013 through September 2013. Overall, 31 issues of the five magazines with a total of 780 articles and 1,986 advertisements were analyzed. Of the 780 articles, a mere 2.9% (n=23) were devoted to skin. Of the 258 skin product advertisements, less than 20% of the products contained sun protection factor (SPF). These findings suggest that women's health and fitness magazines can improve their efforts in informing women of skin cancer risks and preventive measures to minimize these risks. The role of these magazines in building health literacy among their readers is also discussed.

An examination of marketing techniques used to promote children's vitamins in parenting magazines.

More than a third of children and adolescents in the United States take vitamins even though professional medical organizations do not endorse their use in healthy children. Regardless of their efficacy, children's vitamin products are aggressively promoted. Therefore, the goal of this study was to describe and analyze advertisements related to vitamins in the following three popular parenting magazines, Parents, Parenting Early Years, and Parenting School Years. A total of 135 magazines across four years were reviewed.  There were 207 advertisements for children's vitamins, all in the form of chewy or gummy.  None of these advertisements included a dosage or a warning.  Almost all (92.3%) included a cartoon in the advertisement.  Almost a quarter (23.2%) of the advertisements promoted their product with the theme of prevention and more than half (51.2%) included the theme of peace of mind.  Parenting magazines are a popular medium for providing exposure to products geared towards children.  Companies that market children's vitamins in these magazines can increase awareness among parents of the risks by providing warning and dosage information in their advertisements.  Magazines can also play a role by encouraging responsible marketing and providing editorial content on children's vitamins and potential consequences of pediatric overdose.

Price, promotion, and availability of nutrition information: a descriptive study of a popular fast food chain in New York City.

Legislation in NYC requires chain restaurants to post calorie information on menu boards in an effort to help consumers make more informed decisions about food and beverage items they are purchasing. While this is a step in the right direction in light of the current obesity epidemic, there are other issues that warrant attention in a fast food setting, namely the pricing of healthy food options, promotional strategies, and access to comprehensive nutrition information. This study focused on a popular fast-food chain in NYC. The study's aims were threefold: (1) to determine the cost differential between the healthiest meal item on the chain's general menu and meal items available specifically on a reduced cost menu for one dollar (US$1.00); (2) to identify and describe the promotions advertised in the windows of these restaurants, as well as the nutrition content of promoted items; and (3) to ascertain availability of comprehensive nutrition information to consumers within the restaurants. We found the healthiest meal item to be significantly higher in price than less nutritious meal items available for $1.00 (t=146.9, p<.001), with the mean cost differential equal to $4.33 (95% CI: $4.27, $4.39). Window promotions generally advertised less healthful menu items, which may aid in priming customers to purchase these versus more healthful options. Comprehensive nutrition information beyond calorie counts was not readily accessible prior to purchasing. In addition to improving access to comprehensive nutrition information, advertising more of and lowering the prices of nutritious options may encourage consumers to purchase healthier foods in a fast food setting. Additional research in this area is needed in other geographic locations and restaurant chains. 

Food advertisements in two popular U.S. parenting magazines: results of a five-year analysis.

Obesity rates among American youth have prompted an examination of food advertisements geared towards children. Research indicates children's high exposure to these advertisements and their influence on food preferences. Less is known about the presence of these advertisements in parenting magazines. This study's objective was to examine prevalence of food advertisements in popular parenting magazines and identify products by USDA food category. We analyzed 116 issues of two popular U.S. parenting magazines across five years. All food and beverage advertisements for USDA Food Category were coded. Breakfast cereals were coded for nutritional quality. The coding took place at varied libraries in New Jersey, in the United States. A total of 19,879 food and beverage products were analyzed. One-third of advertisements (32.5%) were for baked goods, snacks, and sweets -- products generally low in nutrient density. Two-thirds of the breakfast cereals were low in nutritional quality (64.6%). Beverages comprised 11% of the advertisements, fruit juices the highest proportion. Less than 3% of advertisements were for fruits and vegetables combined. No significant food product trends were evident across the five-year period. Food advertisements identified in parenting magazines were generally low in nutritional value. Additional research is necessary to determine the influence of food advertisements on parents' purchasing habits.

Improving understanding about tanning behaviors in college students: a pilot study.

OBJECTIVE: Melanoma is the second most common cancer diagnosed among 15- to 29-year-olds. This pilot study assessed behaviors, barriers, and beliefs relevant to sun exposure and protective behaviors. PARTICIPANTS: The sample comprised 153 undergraduate students at a large state university in western New York. METHODS: Participants completed an online survey about sun safety habits, barriers to using sunblock, and beliefs about tanning and sun exposure. RESULTS: Response rate was 90.8% (n = 139). Most students (87.8%) reportedly spent ≥ 3 hours per day outside in the summer, but only 17.3% reported always using sunblock during this time. Sixty percent reported recent indoor tanning and 41% reported more than 10 lifetime sunburns. The greatest barrier to using sunblock was forgetting (84.2%). CONCLUSIONS: Demographics coupled with inconsistent and low levels of sunblock use, high annual prevalence of indoor tanning, and multiple lifetime sunburns indicate that this sample is at high risk for skin cancer.