TV Viewing,Perceived Similarity,Coviewing,and Mental Well-Being Among African American,Latino,and White Children

Abstract

Research among adults has demonstrated concurrent and prospective negative associations between TV viewing and mental health, yet little research has examined these associations among African American and Latino youth or examined the role of children’s involvement with TV and parental mediation of TV viewing via coviewing. The purpose of the present study is to examine associations between TV viewing, perceived similarity, and coviewing and mental well-being in African American, Latino, and White children. Results from Healthy Passages™, a study of 4,824 African American (30%), Latino (47%), and White (23%) fifth graders, indicated that TV viewing and perceived similarity were negatively associated with mental well-being among most groups of children, and coviewing was positively associated with mental well-being among Latinos. This study extends findings from adult research on media exposure and mental well-being into a diverse sample of fifth graders and illuminates the role of perceived similarity and coviewing.

Keywords

children media television mental health coviewing parental mediation

Television remains the dominate source of media exposure among children, with an average of 5 hours per day of exposure among 11- to 14-year-olds (Rideout, Foehr, & Roberts, 2010). Television and other media exposure among children have been linked to a number of negative health-related behaviors, including aggression, sexual risk behavior, eating disorders, and substance use, as well as school-related difficulties (see Strasburger, Jordan, & Donnerstein, 2010, for a review). Additional evidence has begun to link media exposure and mental health, including self-esteem, depression, and anxiety in both children and adults, such that greater levels of media exposure are associated with poorer mental health. Hamer, Stamatakis, and Mishra (2010) demonstrated a cross-sectional association between television and other screen-based entertainment and mental health in adults. Primack, Swanier, Georgiopoulos, Land, and Fine (2009) reported a prospective relationship between media exposure during adolescence and the development of depression in young adulthood, particularly for young men. In a cross-sectional study of adults, de Wit, van Straten, Lamers, Cuijpers, and Penninx (2011) found a significant association between television viewing and anxiety and depression. Dotterer, McHale, and Crouter (2007) found that more time watching television was associated with less school-related self-esteem and school bonding. Singer, Slovak, Frierson, and York (1998) demonstrated a positive association between heavy media use and depression, anxiety, and dissociation symptoms in a sample of over 2,200 third to eighth graders.

A limitation in previous research on the association between media and children’s well-being is that potential differences among racial/ethnic groups in parental mediation have rarely been considered, despite well established differences in media consumption among minority children (Rideout et al., 2010). Specifically, African American and Latino youth watch television over 2 additional hours per day compared with White youth (Rideout et al., 2010). Thus, research is needed that examines these associations among African American and Latino children in the United States.

Several explanations have been proposed for the association of media exposure with lower mental health. One is the idea of displacement—that is, children who watch more television spend less time in other activities that may be associated with positive development. Evidence in support of displacement is mixed. Dotterer et al. (2007), in a study of 140 African American 13-year-olds found that television viewing was not correlated with other youth activities, including homework, other academically oriented activities (e.g., reading or going to the library), or time spent with friends. Television viewing was, however, negatively associated with participation in extracurricular activities (e.g., school clubs or teams) for boys, but not for girls. de Wit et al. (2011) showed that sedentary behaviors and physical activity were weakly negatively correlated with one another among adults and that television viewing was significantly associated with depression and anxiety disorders even after controlling for physical activity. Yet, the Kaiser Family Foundation Report (Rideout et al., 2010) found that children’s levels of media consumption were not associated with amount of time in physical activity.

Social cognitive theory provides another explanation for the negative association between media exposure and mental health (Bandura, 1986). The “reality” presented in mass media is typically one of unattainably attractive individuals (American Psychological Association [APA], Task Force on the Sexualization of Girls, 2007), overly dramatic and instantaneous romantic connections (Ward, 2003), and social conflicts that are resolved quickly. Women and girls are particularly vulnerable to the high standards and importance of beauty depicted in media, which more often target females. Exposure to these beauty ideals is associated with decreased body image (APA, Task Force on the Sexualization of Girls, 2007). Males are also subject to impossible standards of male attractiveness and masculinity in most forms of mass media. Acceptance of unrealistic television portrayals as reality could lead to discontent with children’s own real lives. Thus, males and females are both socialized to gender roles through media, and a small but consistent effect has been found for television viewing on the acceptance of gender stereotypes regarding acceptable appearances, occupations, sexual behaviors, and violence/aggression (Hust & Brown, 2008). The acceptable gender roles and stereotypes differ, of course, for males and females, and thus it is important to consider these groups separately. In addition, African American and Latino characters on television are often underrepresented, but when present, portrayed in limited (i.e., primarily in sitcoms and crime dramas) and stereotyped roles (Greenberg & Mastro, 2008). This limited and stereotyped representation may serve to reinforce negative stereotypes among children, some of whom may internalize these portrayals as reality (Greenberg & Mastro, 2008).

Television Involvement and Perceived Similarity

In line with social cognitive theory, factors such as involvement with material viewed on television may serve to heighten the effects of exposure to media by increasing children’s identification and acceptance of television as reality. Ward and Rivadeneyra (1999) defined several elements of television involvement, including identifying with characters, perceiving television as relevant to the self, and perceiving television as real life. Research on aggression has shown that greater identification with characters is associated with increased aggressive behavior following exposure to violent media, specifically video games (Konijn, Bijvank, & Bushman, 2007). Ward and Rivadeneyra (1999) also demonstrated that higher levels of involvement with television were associated with increased sexual activity and more casual attitudes toward sex among adolescents. Research has found that African American and Latino children express greater belief in the reality of television compared with White children (Greenberg & Mastro, 2008). Given the association of media involvement with different aspects of adolescents’ health, it should be an important concept in studying media effects on children. In addition, examining the association between involvement in television and mental well-being allows for a test of social cognitive theory as a potential explanation between media exposure and children’s well-being. However, no research to our knowledge has examined the potential role of perceived similarity or other facets of involvement in children’s mental well-being, particularly among African American and Latino children.

Parental Mediation and Coviewing

In order to limit the potential negative effects of media exposure, the American Academy of Pediatrics (AAP) recommends that parents mediate their children’s television and media exposure. Parental mediation of television viewing can take several forms, including restrictive, or setting rules and limits; instructive (also known as active mediation) or discussing television content; and coviewing (Barkin, Richardson, Klinepeter, Finch, & Krcmar, 2006). Research on the effects of parental mediation has revealed that among younger children (ages 2-11), mediation can reduce negative effects of viewing violent programming (Nathanson, 1999) and that parents who engage in mediation have greater awareness of negative media effects (Barkin et al., 2006). Research has yet to examine how parental mediation may moderate media’s effect on children’s mental well-being. Most research has shown that parental mediation is beneficial to children. Yet research has shown that among adolescents, a restrictive mediation style may have unintended effects of creating more positive attitudes toward violent or sexual television content, and restrictive mediation may lead to negative attitudes toward parents (Nathanson, 2002). In one of the few studies to examine parental mediation among diverse parents, Barkin et al. (2006) found that African American and Latino parents were more likely to allow unlimited media use compared with White parents. In addition, Latino parents were found to be significantly less likely to use restrictive mediation compared with White parents. As pointed out by Barkin et al. (2006), this combination of increased television viewing and decreased parental mediation may make African American and Latino children particularly vulnerable to increased effects of television viewing.

Rationale and Hypotheses

Although previous research among adults has identified a link between television exposure and mental health, this study is among the first to extend the research into children, particularly African American and Latino youth, who may be at increased risk of health effects from media given higher television exposure. Research has begun to describe parental mediation and child involvement with media, but little has examined how these factors may relate to mental well-being. Therefore, this is also among the first studies to examine the roles of television viewing, perceived similarity, and coviewing, a specific form of mediation, in mental well-being among a diverse sample of children. In selecting a sample of children, we were particularly interested in examining the age prior to adolescence, as mental health issues and risky behaviors often emerge during adolescence, in order to study potential influences and risk factors related to these outcomes. In addition to this rationale, several aspects of middle childhood were of particular interest and relevance to the current study. First, prior research has demonstrated that children use social comparison, particularly upward comparison, when transitioning into new stages, such as middle school, and acquiring new skills (Pomerantz & Newman, 2000). Given that preadolescence and fifth grade represents a time of transition into adolescence, adolescent romantic relationships, and often middle school, it likely represents a time of increased upward social comparison. In addition, children also increasingly use social comparison for self-evaluation as they progress from early childhood to middle childhood/preadolescence (Pomerantz, Ruble, Frey, & Greulich, 1995). This time of childhood also represents a period where children’s self-evaluation becomes more realistic and, as a result, self-esteem often declines (Salley, Vannatta, Gerhardt, & Noll, 2010). Parents also contribute to children’s self-concept during this time, with strong correlations seen between self-concept among middle childhood children and parent appraisals of child self-concept (Hergovich, Sirsch, & Felinger, 2002; Nurra & Pansu, 2009). Parents of middle childhood also spend significantly less time with their children compared to early childhood (Collins, Madsen, & Susman-Stillman, 2002), and thus coviewing during this age may play an important role in children’s mental well-being and self-esteem. In examining the role of perceived similarity to television, this study is able to test, in a proximal manner, a concept related to social cognitive theory as an explanation for the potential association between television viewing and mental well-being.

Our aims were to examine levels of, and relationships among, mental well-being, television viewing, perceived similarity, and coviewing among a diverse sample of children and to fill the research gap regarding racial/ethnic differences in media use and associations with mental well-being (Bickham et al., 2003). In addition, given that gender socialization is different for males and females, we chose to analyze male and female participants separately to examine potential differences. We define mental well-being in terms of self-reported self-esteem and emotional quality of life (QL). We examined differences in levels of the variables of interest with the following hypotheses:

Hypothesis 1: African American children would have higher levels of self-esteem, than White children, who would have higher levels than Latino children. This hypothesis was based on Twenge and Crocker’s (2002) meta-analysis of racial differences in self-esteem.

Hypothesis 2: Latino and African American children would have higher levels of television viewing than White children (based on Rideout et al., 2010).

Hypothesis 3: White children would have higher levels of parental mediation, measured as coviewing or watching television with a parent/primary caregiver, compared with Latino and African American children (based on Barkin et al., 2006).

Hypothesis 4: African American and Latino children would have higher levels of perceived similarity compared with White children (based on Greenberg & Mastro, 2008).

We also tested the following hypotheses regarding relationships among the variables of interest:

Hypothesis 5: Television viewing would be negatively associated with mental well-being particularly for African American and Latino females, given that previous research has found that African American and Latino youth view more television, and given that African American and Latino and female characters tend to be underrepresented and/or negatively represented (e.g., as stereotypes) in media (Greenberg & Mastro, 2008).

Hypothesis 6: Based on social cognitive theory, perceived similarity would be negatively associated with mental well-being by increasing the impact of potentially negative or harmful messages.

Hypothesis 7: Coviewing would be positively associated with mental well-being, given the general positive associations between parental mediation and child well-being.

Hypothesis 8: Perceived similarity and parental mediation would moderate the association between television viewing and mental well-being, such that the associations between perceived similarity, parental mediation, and mental well-being would be greater at higher levels of viewing.

Method

We used data from Healthy Passages™ Wave I, a multisite community cohort study of adolescent health and health behaviors and their correlates initiated in 2004 (Schuster et al., 2012; Windle et al., 2004). Institutional review boards at each study site and the Centers for Disease Control and Prevention approved this study.

Participants

The sample frame included fifth graders at public schools with ≥25 students enrolled in regular classrooms in districts in Birmingham, Alabama; Los Angeles County, California; and Houston, Texas. To ensure adequate sample sizes of Latino, non-Latino African American, and non-Latino White students, we took a random sample of schools with probabilities designed to provide a balanced sample across these racial/ethnic groups (described in Windle et al., 2004). Information was disseminated to the fifth-grade children in the 118 selected schools, with 11,532 students, to bring their parents (or caregivers). The parents of 6,663 agreed to be contacted, and 5,147 (77%) of their children participated. Exclusion criteria included not attending a regular academic classroom or having a parent who could not complete interviews in English or Spanish. The 6% who were not identified as being Latino, African American, or White (see details below) was eliminated from the current analysis, resulting in 4,824 in the final sample with the unweighted (and weighted) distribution of 36% (30%) African American, 38% (47%) Latino, and 26% (23%) White, 51% (49%) females, and child age $\bar{X}$ = 11.12 years (SD = 0.56 years), with 92% of children aged 10 or 11. Additional demographics are provided in Table 1.

Table 1.

Sample Demographics for Fifth Graders in Healthy Passages Study.

	Total analysis sample (n = 4,824)		African American (n = 1,755)	Latino (n = 1,813)	White (n = 1,256)
	Raw %	Wtd %	Wtd %	Wtd %	Wtd %
Child’s age
≤10	44	39	45	45	37
11	49	50	46	46	59
≥12	7	10	9	9	3
Child’s gender
Female	51	49	50	50	46
Male	49	51	50	50	54
Highest education in household
Some high school	18	24	10	45	3
High school graduate/GED	20	22	31	24	9
Some college or 2-year degree	27	25	37	21	17
Bachelor degree or higher	34	29	23	10	71
Household income
0-14,999/year	35	26	30	35	4
15,000-29,999/year	24	21	30	24	4
30,000-49,999/year	22	22	25	22	14
50,000-79,999/year	12	14	9	12	24
80,000-124,999/year	4	10	4	4	24
125,000-199,999/year	1	5	2	1	18
200,000 and up	0	3	0	0	11

Note. Weighted% is calculated with weights to reflect sampling. Household income levels were collapsed from 20 to 7 levels by summing across income levels. Missing data (2%) account for % totaling less than 100 for highest education. Wtd = Weighted; GED = general education diploma.

Procedures

Two trained interviewers completed the full Healthy Passages™ assessment protocol with a child and one of his or her parents (mother, 88%; father, 6%; other, 6%) separated in private spaces at their home or a research facility. Both computer-assisted personal interview and computer-administered self-interview methods were used (Windle et al., 2004). The parent could choose whether material would be presented in English or Spanish. The following variables were used in this study.

Measures

Self-Esteem was measured with the Global Self-Worth (α = .70; all αs reported here are for the current sample) subscale of the Self-Perception Profile (Harter, 1983). Children are asked for each of six items to identify which contrasting description best fits them (e.g., “some kids like the kind of person they are, other kids often wish they were someone else”) and how much it fits them (sort of true or really true). Construct validity is supported, for example, by substantial differences in scores between healthy children and those with depression and anxiety problems (Muris, Meesters, & Fijen, 2003). Higher scores indicate better self-esteem (range = 6-24). Only the Global Self-Worth and Physical Appearance (not reported here) subscales were administered from the Self-Perception Profile.

Emotional Quality of Life (QL) was measured with child self-report on the Emotional subscale (α = .71) of the Pediatric Quality of Life Inventory Version 4.0™ (PedsQL™; Varni, Seid, & Kurtin, 2001), a widely used, well-validated measure of children’s QL and well-being. For example, this subscale demonstrated good construct validity when healthy children scored significantly better on the Emotional subscale than chronically ill peers (Varni, Burwinkle, Seid, & Skarr, 2003). The PedsQL™ provides a hierarchical scale structure with four subscales that has been replicated across racial/ethnic groups (Limbers, Newman, & Varni, 2009), including the Emotional subscale. Each of five items on this subscale asks how much a certain emotional experience (e.g., “I feel sad or blue,” “I worry about what will happen to me”) has been a problem in the past month, which are reported on a 5-point scale (0 = never a problem, 4 = almost always a problem), but scale scores are linearly transformed such that a higher score indicates better emotional QL (range = 0-100). In unweighted sample analyses, emotional QL and self-esteem were moderately correlated, r = .41 (p < .01).

Television Viewing was measured with five child self-report items assessing typical hours of television watched during a specific time frame (e.g., after school, Friday night, Saturday). Participants indicated the number of hours using categorical scales ranging from 4 to 6 categories depending on the maximum hours available in that time frame (e.g., 1 = 0 hours of television viewing and up to 4 = more than 2 hours, 5 = more than 4 hours, or 6 = more than 7 hours). In unweighted sample analyses, these television viewing items were significantly correlated with one another (rs ranging from .31-.52) and, in principle component analyses, loaded on a single component (ranging from .67-.73). Therefore, all television viewing items were summed (range = 5-26, α = .75), so that higher scores indicate more hours of television viewing in a typical week. Given the content and variability of the response scale across the five items, the sum of items does not reflect actual numbers of hours of viewing and actual number of hours cannot be computed.

Perceived Similarity was measured with the item “While watching TV, how often do you think about how the shows are like your own life?” This item captures one aspect of television involvement and was based on Ward and Rivadeneyra’s (1999) conceptualization of involvement with television. Children responded on a 4-point scale where 1 = almost never, 2 = sometimes, 3 = often, and 4 = almost always.

Coviewing was assessed with the item “How often do you and (your parents or primary caregiver(s) watch TV together?” which assesses one important facet of parental mediation (Nathanson, 1999). Children responded on a 4-point scale where 1 = almost never, 2 = sometimes, 3 = often, and 4 = always. This single-item measure of coviewing reflects current practices and the accepted definition of coviewing (Jago, Edwards, Urbanski, & Sebire, 2013).

Socioeconomic status

Highest level of educational attainment in the household (4 categories) and household income (20 categories, where 1 = less than US$5,000 per year and 20 = US$250,000 and up per year) were reported by the parents and used as separate indicators of socioeconomic status.

Race/ethnicity

The parent was asked which one or more of seven racial/ethnic categories describe the child. The child was classified as Latino if so indicated, regardless of other racial/ethnic indications. Children not categorized as Latino were classified as African American, White, or Other (this latter category was excluded from the analysis).

Statistical Analysis

All descriptive and regression analyses were conducted using SPSS Complex Sampling module, which accounts for the effects of design and nonresponse weights, clustering of children within schools, and stratification by site (see Windle et al., 2004, for details). Interaction terms for total television viewing by perceived similarity and coviewing, respectively, were created by centering each variable with the grand median, given that the variables are ordinal (i.e., subtracting the estimated median for the entire sample from each individual’s score on each variable; Kraemer & Blasey, 2004) to reduce multicollinearity and then multiplying the variables in question. Mean level differences among racial/ethnic groups and genders were tested using a generalization of a t test, which accounts for the weights and study design. Associations were tested by regressing mental well-being variables using the general linear module, in which the covariates of parental education and household income and all television variables and interactions were entered simultaneously. This was done separately within each gender and racial/ethnic group (i.e., African American females, African American males, Latina females, Latino males, White females, White males) as well as separately within males and females, regardless of race/ethnicity. Given that television viewing may affect males and females differently due to different socialization pressures (e.g., girls may experience more body image pressure, boys may experience more aggression or violence exposure), the analyses were conducted separately with males and females. We focus on the results pertaining to television variables of substantive interest here, while adjusting for differences in socioeconomic status (see Table 1) that exist among the racial/ethnic groups.

Results

Racial/Ethnic and Gender Differences

Results pertaining to Hypotheses 1 to 4 are reported in Table 2. Several significant differences emerged from levels of self-esteem, emotional QL, and television variables across racial/ethnic groups, although not fully as predicted.

Table 2.

Means (and Standard Errors) and Racial/Ethnic Differences by Gender for Mental Well-Being and TV Variables.

Scale	(SD)	African American	Latino	White	Total
Females
Self-esteem	(3.9)	18.98 (.14)_a	18.64 (.19)_a	20.67 (.20)_b	19.23 (.13)
Emotional QL	(15.2)	73.42 (.59)_a	72.50 (.64)_a	79.04 (.92)_b	74.30 (.50)
TV viewing	(4.1)	17.79 (.17)_a	16.44 (.13)_b	14.86 (.22)_c	16.46 (.13)
Perceived similarity	(0.81)	2.19 (.03)_a	2.07 (.03)_b	1.94 (.04)_c	2.08 (.02)
Coviewing	(0.91)	2.85 (.04)	2.81 (.03)	2.77 (.05)	2.82 (.02)
Males
Self-esteem	(3.7)	19.32 (.16)_a	18.58 (.15)_b	20.69 (.16)_c	19.34 (.13)
Emotional QL	(15.2)	73.05 (.81)_a	72.83 (.46)_a	76.19 (.80)_b	73.81 (.44)
TV viewing	(4.1)	18.00 (.16)_a	16.75 (.16)_b	15.17 (.25)_c	16.73 (.14)
Perceived similarity	(0.85)	2.18 (.03)_a	2.00 (.03)_b	1.90 (.03)_c	2.03 (.02)
Coviewing	(0.92)	2.80 (.05)_a	2.63 (.04)_b	2.67 (.04)_b	2.69 (.02)

Note. SD is standard deviation based on unweighted sample. Means estimates with different subscripts within each row differ significantly at p < .05 using t tests. QL = quality of life.

Mental well-being

Among females, White girls reported significantly higher levels of self-esteem and emotional QL than Latina and African American girls, who did not differ significantly from one another. A similar pattern was seen among males, with White males reporting significantly higher levels of self-esteem and emotional QL, followed by African American males, who were significantly higher than Latino males. Thus, Hypothesis 1 regarding self-esteem was not supported.

Television variables

Significant differences were seen across racial/ethnic groups for most television variables, and patterns were similar for males and females across most variables. As was generally predicted by Hypothesis 2, for both females and males, African Americans reported the highest level, followed by Latinos, and then Whites. Contrary to Hypothesis 3, African American males reported significantly greater levels of coviewing compared with Latino and White males. There were no significant differences among females. Hypothesis 4 was supported. African American females and males reported significantly higher levels of perceived similarity, followed by Latino males and females, and then White males and females.

Associations Between Television Variables and Mental Well-Being

Addressing Hypotheses 5 to 8, the next set of analyses examined the associations of television viewing, involvement, and coviewing, as well as interaction terms between television viewing and involvement and coviewing, with the mental well-being variables. Unweighted correlations among media and mental well-being variables are presented in Table 3. Results are presented in Table 4 for self-esteem and Table 5 for emotional QL. Hypothesis 5 was partially supported, with television viewing being negatively associated with self-esteem among White males and negatively associated with emotional QL among African American males, Latino females, and White females and males. Television viewing was not associated with either mental well-being variable among African American females or Latino males.

Table 3.

Unweighted Correlations Among Mental Well-Being and Media Variables (n = 5,115).

Variable	1	2	3	4
1. Self-esteem	—
2. Emotional QL	.41**,^a	—
3. TV viewing	−.14**	−.16**	—
4. TV involvement	−.12**	−.18**	.11**	—
5. Coviewing	.04**	.02	.04**	.08**

Note. QL = quality of life.

n = 5,146.

p < .01.

Table 4.

Regression of Self-Esteem on TV Variables Among Females and Males.

	African American		Latino		White		Total
Variables	Female b	Male b	Female b	Male b	Female b	Male b	Female b	Male b
TV viewing	−.045	−.055	−.053	−.043	−.081	−.141*	−.060**	−.074**
Perceived similarity	−.459*	−.753**	−.185	−.016	−.703	−.251	−.425**	−.339**
Coviewing	.133	.142	.592**	.329*	.034	−.122	.370**	.199*
TV viewing × Involvement	−.045	.015	.157**	−.091*	.060	−.015	.050	−.033
TV viewing × Coviewing	.059	−.025	.005	.073	−.021	−.097	.011	.000
Parental education	.525*	.445*	.504**	.327*	.047	.583*	.475**	.558**
Parental income	.069	.030	.071	.021	.126**	.032	.101**	.054**
Total model R²	.05*	.06*	.07*	.03	.08*	.06*	.09*	.07*

Note. All variables were entered simultaneously in each within group regression. b represents unstandardized regression coefficients as SPSS complex sample program does not compute standardized regression coefficients or standard deviations. QL = quality of life.

p < .05. **p < .01.

Table 5.

Regression of Emotional QL on Media Variables Among Females and Males.

	African American		Latino		White		Total
Variables	Female b	Male b	Female b	Male b	Female b	Male b	Female b	Male b
TV viewing	−.123	−.349*	−.657**	−.202	−.454*	−.693**	−.387**	−.383**
Perceived similarity	−3.127**	−3.925**	−2.306**	−2.524**	−2.536	−.746	−2.781**	−2.657**
Coviewing	.313	.187	1.276*	.417	−.632	.496	.665	.377
TV viewing × Involvement	−.191	−.028	.037	−.403*	.021	.169	−.046	−.150
TV viewing × Coviewing	−.022	−.176	−.265	.593**	−.302	−.108	−.169*	.170
Parental education	1.382*	2.225*	2.054**	.329	1.497	2.165	1.745**	1.073**
Parental income	.396**	.004	.196	.145	.625**	.400*	.388**	.141
Total model R²	.07*	.07*	.08*	.07*	.12*	.10*	.10*	.07*

p < .05. **p < .01.

Hypothesis 6 was largely supported. Perceived similarity was negatively associated with self-esteem for African American females and males, and was negatively associated with emotional QL across all groups except White females and males. Hypothesis 7 was supported among Latinos only. Coviewing was positively associated with self-esteem among Latino males and females, as well as with emotional QL among Latina girls.

Some support emerged for Hypothesis 8 regarding coviewing and perceived similarity as moderators of the association between television viewing and mental well-being, but only among Latino youth. Three significant interactions were observed between Perceived similarity × Television viewing in relation to self-esteem among Latino females and males, and in relation to emotional QL among Latino males. Probing the first interaction among Latino females for significant regions revealed that among girls with low levels of involvement, those who watch less television have higher levels of self-esteem. However, the interaction was also significant at high levels of involvement, such that, in contrast to expectations, among girls with high levels of involvement, those who watch more television have higher levels of self-esteem.

Probing the two significant interactions among Latino males revealed patterns in line with expectations. Among Latino males with high levels of involvement, those who watch less television have higher levels of self-esteem and higher levels of emotional QL. There was one significant interaction for Coviewing × Television viewing in relation to emotional QL among Latino males. Probing this interaction for significant regions revealed that among boys who have low levels of coviewing, those who watch less television have higher emotional QL, which is in line with Hypothesis 8. No other significant interactions emerged.

Discussion

This study examined the role of television viewing, perceived similarity, and coviewing of television exposure in children’s mental well-being and racial/ethnic differences among these variables in a large diverse sample of fifth graders. Four hypotheses were tested regarding mean level differences among African American, Latino, and White children on mental well-being and television variables, and three were generally supported. As expected, African American and Latino children reported watching significantly more television than White children. However, African American males reported significantly higher amounts of coviewing than other males. Contrary to expectations, both African American and Latino children reported lower levels of self-esteem when compared with White children. Finally, African American children had higher involvement with television than Latino children, who had higher levels of involvement than White children. In interpreting the meaning of these significant differences across racial/ethnic groups, an unweighted estimate of Cohen’s d suggests that the effect sizes for these mean level differences in self-esteem and emotional QL range from medium to small (Cohen, 1992). The small effect sizes likely do not correspond to functional differences, but whether or not the medium effect sizes correspond to specific differences among children cannot be determined from these data.

One likely explanation for the results found for self-esteem, which differ from those of Twenge and Crocker (2002), could be Twenge and Crocker’s finding that the effect size increased in size from elementary school to junior high and was largest at college age. Thus, it may be that later waves of the Healthy Passages study will replicate this result which is less pronounced in fifth grade. Another possible contribution to this difference is Twenge and Crocker’s finding that lower socioeconomic status was associated with a lower effect size difference in self-esteem between Black and White children and adults. Given the socioeconomic differences in the Healthy Passages sample, this could contribute to our results as well. In addition, the meta-analysis focused on measures other than Harter’s (1983) Self-Perception Profile, such as the Rosenberg Self-Esteem Scale (Rosenberg, 1965). Although prior research has found strong convergent validity between Harter and Rosenberg’s scales (Hagborg, 1993), it is certainly possible that the Self-Perception Profile contributes to the findings.

Four hypotheses were tested regarding associations between mental well-being and television variables, and each hypothesis was at least partially supported. Television viewing and perceived similarity were found to be negatively associated with mental well-being, although not consistently across all groups. Coviewing was positively associated with mental well-being, though only among Latino children. Finally, little evidence supported the role of perceived similarity or coviewing as moderators of the association between television viewing and mental well-being. This was only found to be the case among Latino children. In interpreting the implications of the significant associations, if we compare the R² with Ferguson’s (2009) recommended minimum effect size for indication of a practical difference, all significant R² meet this cutoff, and calculation of f² (Cohen, 1992) indicates small to medium effects.

Although previous work has demonstrated a negative association between television viewing and adult mental health, this study is among the first to demonstrate that television viewing is also related to children’s mental well-being. Multiple interpretations are possible for this finding. First, as demonstrated in research among adults, television viewing may lead to poorer mental well-being through displacement of more positive activities (Dotterer et al., 2007) or through pressures experienced by youth from unrealistic portrayals of relationships and physical appearance (APA, Task Force on the Sexualization of Girls, 2007; Ward, 2003). Another possible explanation is that children with poorer mental well-being turn to television for various reasons in order to cope with their negative emotions. Television viewing and mental well-being could also function through a negative feedback loop, such that regardless of the nature of the initial relationship, once children begin to watch high levels of television, it could lead to poorer mental well-being, which could lead to increased television viewing, and so on. In addition, it is possible that higher television viewing and poorer mental health could each reflect family disorganization or other factors that influence both without the two being directly related. Future research should examine the relationship among children between television viewing and mental well-being in prospective analyses. However, despite the unclear causal relationship between television viewing and mental well-being, given that children in this age range watch the highest levels of television among youth aged 8 to 18 (Rideout et al., 2010), the association is important and may be worthy of consideration by parents, practitioners, and researchers.

One particularly novel and robust finding from this study is the negative association between perceived similarity and mental well-being across most racial/ethnic groups and genders. Very little research has examined the effect of television involvement or perceived similarity on mental well-being. A possible explanation for this association comes from Huston et al. (1995), which found that higher levels of involvement, defined as social realism or perceiving television characters and events as similar to real life, were associated with greater vicarious emotional reactions to television characters. Children who perceive television as true to life may be more strongly affected by portrayals of drama, conflict, violence, and unattainable beauty (APA, Task Force on the Sexualization of Girls, 2007; Ward, 2003) than children who recognize media as artificial. Perceived similarity likely results in children feeling less adequate than characters portrayed on TV. Among females, for example, prior research has demonstrated that increased comparison with female characters is associated with body dissatisfaction (McLean, Paxton, & Wertheim, 2013). This likely reflects the fact that most female characters on TV represent a very narrow standard of beauty that is difficult for most females to achieve (Lopez-Guimera, Levine, Sanchez-Carracedo, & Fauquet, 2010). In addition, portrayals of sexuality and intimacy in media appear to contribute to unrealistic sexual and romantic expectations (APA, Task Force on the Sexualization of Girls, 2007). Perceived similarity toward mainstream media is associated with sexual dissatisfaction and negative attitudes toward functional aspects of the human body, such as menstruation, sweat, and breastfeeding (APA, Task Force on the Sexualization of Girls, 2007). Although no known research has examined comparison with other attributes of characters, such as socioeconomic status and popularity, which may also be quite salient to young viewers, it is likely that additional comparisons could similarly result in dissatisfaction. This finding can be interpreted in line with social cognitive theory (Bandura, 2001) and its explanation for associations between media exposure and mental health. It also provides a potentially meaningful target for future media literacy interventions such as those targeting eating disorders (Wade, Davidson, & O’Dea, 2003) and violence and substance abuse (Moore, DeChillo, Nicholson, Genovese, & Sladen, 2000).

Another consistent finding in this study was the positive association between coviewing and mental well-being among Latinos but not other groups of children. This finding can be interpreted in multiple ways. First, the act of watching television with parents may reflect more time spent with parents in general, which could result in better mental well-being. Second, when families watch television together, the content may differ from what children may choose when viewing on their own. The content viewed as a family may somehow be more positive for children. In addition, there may be interactions occurring during coviewing, either in relation to the television content or other topics that are beneficial for children. The fact that this effect was seen only among Latino youth is interesting and could reflect unique aspects of Latino families in the United States and the role that media plays among Latino children (Bickham et al., 2003). Further research is warranted to explore the positive effect of coviewing among Latino families.

Although other variables may have larger effects on children’s mental well-being, this study has demonstrated that television viewing, involvement, and parental mediation have an impact as well. These novel findings are directly relevant to ongoing media literacy efforts aimed at prevention and intervention of a variety of health issues, including violence, body image issues, and substance use (Jeong, Cho, & Hwang, 2012), as well as research on media use and mental health. Given that preadolescence and adolescence represent a time of risk for mental health concerns, as well as the establishment of health habits, it is important to identify social influences on health and well-being including media.

Limitations

One limitation of the current research is related to the restricted measurement of key variables due to this research being embedded in a broad-ranging epidemiological survey (Windle et al., 2004). Although most hypotheses were at least partially supported, future research would benefit from more comprehensive and multidimensional measures of perceived similarity and parental mediation to more fully explore relationships between these variables and children’s mental well-being. However, single-item measures can be preferable in situations such as the Healthy Passages study when participants are completing multiple repeated measures over time as well as when the construct being measured is unidimensional (Hays, Reise, & Calderon, 2012; Postmes, Haslam, & Jans, 2012). In fact, a number of studies have now demonstrated that single-item measures can perform similarly to multiple-item measures (Postmes et al., 2012; Robins, Hendin, & Trzesniewski, 2001; West, Dyrbye, Satele, Sloan, & Shanafelt, 2012). Despite this support, further work is needed that explores these constructs, such as parental coviewing and mediation of media use, in a multidimensional manner and results in more comprehensive and valid measures. In addition, future research would greatly benefit from the inclusion of more comprehensive and multidimensional assessment of coviewing, other forms of mediation, and involvement with media. It would also be useful to add parental report for some of the television variables. Although this research does not examine all possible factors relevant to media and mental well-being, this study illuminates one important aspect of associations between media use and well-being.

In addition to the above limitations, the current analyses are cross-sectional and thus are unable to address the causal nature of these relationships. Perceived similarity, for example, could be an outcome of poorer mental well-being, rather than contributing to reduced mental well-being. Longitudinal analysis would be valuable but needs to be complemented by experimental studies. This sample covers three geographic regions, so caution should be used in generalizing. The Latino participants in this study were located primarily in the Houston and Los Angeles areas and therefore might primarily represent a heritage from Mexico and other Central American regions, given that these are the most commonly represented origins among Latinos in Texas and California (U.S. Census Bureau, 2010). Given that identity development and socialization is affected by ethnic identity and family (Knight, Bernal, Garza, Cota, & Ocampo, 1993), there may be distinct characteristics among different Latino subgroups that are not represented here.

Future Directions

Understanding the role of television content is an important area for future research. The field would benefit from looking at the role of fairly well understood genres, such as violent television, as well as less explored genres, such as reality programming, music videos, drama, and comedy, on children’s mental well-being. For example, Martino et al. (2006) found that exposure to degrading sexual lyrics, compared with exposure to nondegrading sexual lyrics, predicted initiation of sexual intercourse and engagement in advanced noncoital sexual behavior among youth over time. Identifying the potential role of media variables beyond exposure is significant for both theoretical and applied reasons. Theoretically, examining the role of involvement is relevant to social cognitive theory and its hypotheses on the impact of media—if television is perceived as real, the messages and images will theoretically have a greater impact on children’s mental world. In contrast, if parents provide mediation, particularly in the form of discussing television content and its realism, this could help mitigate the effect of television exposure. From an applied perspective, identifying additional significant variables related to television viewing can help broaden intervention and prevention messages and programs. A more multifaceted approach to media literacy campaigns and education (e.g., Moore et al., 2000; Wade et al., 2003), addressing media content, parents’ roles, and children’s roles, could potentially be more effective. This study is a step in that very important direction of identifying significant media correlates of children’s mental well-being among a large, racially and ethnically diverse sample of fifth graders.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded through cooperative agreements (U19DP002663, U19DP002664, and U19DP002665) from the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

Author Biographies

Elizabeth McDade-Montez, PhD, is a research associate at ETR Associates studying adolescent sexual and reproductive health, media effects on children and adolescence, and sexualization in popular children’s media. Her program of research also examines assessment of depression and anxiety among medical populations and scale construction. She completed her PhD in clinical psychology from the University of Iowa, her clinical internship at the VA Palo Alto Health Care System, and her postdoctoral fellowship at University of California, Merced.

Jan Wallander, PhD, is a professor of psychological sciences at the University of California, Merced. His research is in the area of health psychology focused on children and adolescents, with a particular interest in quality of life and well-being in childhood, especially in vulnerable groups due to chronic illness or disability, and health disparities in children and adolescents.

Marc Elliott (PhD., Statistics, Rice University) is a senior statistician in RAND Health. His expertise includes health disparities, Medicare, vulnerable populations, experiences with health care, profiling of health care institutions, survey sampling, experimental design, causal inference, and case-mix adjustment (CMA). He has developed Bayesian methods of estimating race/ethnicity and associated disparities using surname and address information. Being a summa cum laude graduate of Rice University, a fellow of the American Statistical Association, and first recipient of its Mid-Career Award (Health Policy Section), he has published more than 200 articles in a range of journals, including Journal of the American Medical Association (JAMA), New England Journal of Medicine (NEJM), British Medical Journal (BMJ), Journal of General Internal Medicine (JGIM), American Journal of Public Health (AJPH), Health Services Research, Medical Care, Pediatrics, Public Opinion Quarterly, Statistics in Medicine, Survey Methodology, and Chance.

Jo Anne Grunbaum has a doctor of education (EdD) from the University of Houston and is the team lead of the Research and Evaluation Team for the Prevention Research Centers (PRC) Program at the Centers for Disease Control and Prevention. She has 27 years experience in public health research in academia and federal settings. Her experience includes designing and implementing research related to the health of youth and conducting the national evaluation of the PRC Program.

Susan Tortolero, PhD, is the director of The University of Texas Prevention Research Center and an associate professor of health promotion and behavioral sciences, as well as the Allan King professor of public health, at The University of Texas School of Public Health. She is also the director of the Center for Health Promotion and Prevention Research at The University of Texas School of Public Health. In addition to her numerous academic, professional, and research activities, She is actively involved in the community, serving as vice chair for the Texas Campaign to Prevent Teen Pregnancy and as a member of the Children at Risk Institute, and speaks frequently in cities across Texas to educate parents, policymakers, and practitioners on the importance of implementing effective sexual health programs.

Paula Cuccaro, PhD, is the associate director of training for The University of Texas Prevention Research Center as well as the project director for Healthy Passages, a longitudinal study of adolescent health. She is a faculty associate in the Center for Health Promotion and Prevention Research at The University of Texas School of Public Health.

Mark A. Schuster, MD, PhD, is William Berenberg Professor of Pediatrics at Harvard Medical School and chief of general pediatrics and vice chair for health policy in the Department of Medicine at Boston Children’s Hospital. He received his MD from Harvard Medical School, his MPP from the Kennedy School of Government at Harvard, and his PhD in Public Policy Analysis from the Pardee RAND Graduate School. He conducts research primarily on child, adolescent, and family issues.

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