Field Testing of a Family-Based Media Literacy and Nutrition Program to Prevent Childhood Obesity Erica Weintraub Austin1, Jill Armstrong Shultz2, Mary Katherine Deen2, Marilyn Cohen3, Barbara Johnson3, Thomas Power4, Bruce Austin5, Michelle Kistler1, Zena Edwards1, Kit Kaiser1

1. WSU Murrow Center for Media & Health Promotion, 2. WSU Extension, 3. The NW Center for Excellence in Media Literacy, University of Washington 4. WSU Human Development Department, 5. WSU Learning & Performance Research Center.

Why Media Literacy? Media and marketing are major information sources for children about food, and just 1-2 exposures to food ads influence young children.

In a media-saturated environment, reducing exposure to media is not practical; however, mediating the influence of negative food mar-keting is possible through media literacy education integrated with nutrition information.

Year 4 of a 5-Year Project – Objectives: To conduct a field test of a family-based media literacy-nutrition education curriculum including pretest and post-test with intervention

and control groups (Family Cycle 1 – completed).

To conduct a field test of a Youth-Only version of the curriculum with pretest and post-test including pretest and post-test with intervention and control groups (in progress).

To conduct a 6-month delayed post-test for the Family Cycle 1 (in progress).

14/9

8/4

10/12

12/12 6/14

Parents

Age I C

25-29 3 2

30-35 10 15

36-40 9 10

41-45 16 13

46-50 7 7

51-55+ 4 4

Relation I C

Mother 45 42

Father 3 7

Grandparent 1 1

Other 1 1

Race/

Ethnicity I C

White 37 41

Black, Asian,

Native Amer-

ican and/or

other

8 10

Hispanic 9 7

Assistance Programs Received

Program SNAP Free or Reduced

Lunch WIC TANF Medicaid None

Intervention 17 29 4 0 21 18

Control 13 19 5 1 8 30

Youth

Age I C

8 yrs 0 1

9 yrs 11 9

10 yrs 13 7

11 yrs 11 17

12 yrs 5 7

13 yrs 7 4

14 yrs 3 6

Gender I C

Male 20 26

Female 30 25

Field Test Cycle 1 Family-Based Curriculum Participants

Parent-Child Dyads by County (Intervention/Control) 50 Intervention Dyads

51 Control Dyads

Results:

Child-Initiated Discussion and Critical Thinking Towards Food Advertising Content

Results:

Nutrition Outcomes

YOUTH: Increased Consumption of Fruits and Vegetables by Intervention Group

Wilcoxon rank signed tests

Increase in fruits eaten yesterday (Z = -3.199, p = .001)

Increase in vegetables eaten yesterday (Z = -3.010, p = .003)

No significant differences pre to post for controls.

PARENTS: Increased Frequency of Use of Food Labels

Increase of .416 standard deviations (SD) for the intervention

group over the control when controlling for pretest (p < .05)

.71 mean difference for the experimental group beyond that of the

control group at post-test (p < .05).

The experimental condition explained 40% of the variance.

Factor Loading (Pretest) Variable: Frequency of using food labels for choosing foods with...

.668 Less Calories

.838 Less Fat

.766 Less Salt

.645 Less Sodium

PARENTS: Improved Home Food Environment

MANOVA controlling for pretest scores

Summative score for inventory of less healthy foods

Intervention parents (x = 22.92, SD = 6.198)

lower than control (x = 26.13, SD = 5.110; p = .045)

Less Healthy Foods Included: Chocolates, candies, cakes, regular

chips, juice drinks, sugared sodas, sports drinks, whole or 2% milk

and sweetened breakfast cereal.

Results:

Child Social Support for Parents ’

Purchasing of Fruits and Vegetables

PARENTS: Increased Social Support for Purchasing Fruits

Increase of .399 SD for the intervention group over the control

when controlling for pretest (p < .05).

.71 mean difference between treatment and control on the scale

of the original variables

The experimental condition explained 49% of the variance.

PARENTS: Increased Social Support for Purchasing Vegetables

Increase of .344 SD for the intervention group over the control

when controlling for pretest (p < .05).

.72 mean difference between treatment and control on the scale of

the original variables

The experimental condition explained 55% of the variance.

Factor Loading (Pretest)

Variable: Parent report of frequency of child...

.826 Discussing Purchasing Fruit with Parent

.901 Reminding Parent to Purchase Fruit

.732 Approving When Parent Purchases Fruit

.601 Purchasing Fruit Themselves

.921 Asking Parent to Purchase Fruit

Factor Loading (Pretest)

Variable Parent report of frequency of child...

.895 Discussing Purchasing Vegetables with Parent

.952 Reminding Parent to Purchase Vegetables

.813 Approving When Parent Purchases Vegetables

.725 Purchasing Vegetables Themselves

.923 Asking Parent to Purchase Vegetables

Results:

Parent Efficacy and Expectations Toward Food and Food Advertising

YOUTH: Participating in FoodMania Predicts Child-Initiated Discussion with Parent

Which Predicts Child Critical Thinking and Talking with Parents about Food Label.

Intervention predicted posttest Child-Initiated Discussion

about Food Messages in the Media (CID) b = .191; p < .05

Child Initiated Discussion predicted Critical Thinking Towards

Food Message Content (CTC) b = .372; p < .05

Model explained:

54% of the variance in post-test CID

58% of posttest CTC

Model fit was moderately poor (CFI = .88 and RMSEA = .071).

Intervention predicted posttest Child-Initiated Discussion

about Food Messages in the Media (CID) b = .198; p < .05

CID predicted post-test frequency of Child Talking About Label

Nutrition Information with Parents (b = .593; p < .05)

Model explained:

58% of the variance in post-test CID

53% of posttest talking about labels

Model fit was moderately good (CFI = .921 and RMSEA = .079)

Conclusions:

FoodMania, a program based on the Message Interpretation Processing model and the Strengthening

Families Program, was successful in...

Fostering connections between nutrition and media literacy as well as parents and children

Empowering participants through changes in attitude and expectancies

Promoting nutrition behaviors likely to prevent childhood obesity

Challenges:

Program requires extensive staff resources for training and

implementation

Required extensive recruitment and retention efforts

Next Steps: Fall 2016

Analyze Family Cycle 1 6-month delayed posttest data

Complete Family Cycle 1 12-month delayed posttests

Complete Family Cycle 2 and Youth-only field test

Structural Equation Modeling (SEM) was used to test the relationship between participating in FoodMania and key outcomes while

controlling for pretest scores.

Increased positive expectancy for discussing media messages with child. “If I discuss media messages about food

with my child, it will help my child…

recognize the importance of

healthy eating.”

avoid junk food.”

develop a positive attitude toward

healthy eating.”

Increased expectancy toward positive family acceptance of healthier foods. “If I serve healthier foods my family...

will approve.”

will feel better.”

will enjoy it.”

will be happier.”

Increased efficacy for resisting food advertising. “I feel confident I can…

help my child resist advertising for less

healthy foods

resist pressure from child to buy foods

he/she has seen advertised. “

A media literacy and nutrition curriculum based on the Message Interpretation Processing (MIP) Model.

Developed by the University of Washington Northwest Center for Excellence in Media Literacy College

of Education in collaboration with WSU Extension and the WSU Murrow Center for Media and Health

Promotion.

Follows the Strengthening Families Programs design (http://sfp.wsu.edu/): each of six 2-hour units

provided 1-hour with youth and parents meeting separately, then a 1-hour joint session.

One unit per week at a community location (school, community center).

Parent-child dyads recruited for intervention and control groups in each of 5 Washington counties.

MIP Model constructs targeted: parental media management skills applied to food and drink ads and parental information efficacy

related to healthy foods; parents’ expectancies related to mediating food and drink advertising influence on their child; children’s skepticism toward, and critical thinking about, media messages about food and drink; children’s attitudes and expectancies about eating fruits and vegetables (F/V);

Curriculum design included: approaches to identifying and making healthier choices at home and away from home. learning activities such as deconstructing ads, reading food labels, conducting food and beverage

tastings, designing a media campaign, children’s presentations to parents, and parent discussions.

Evaluation: pre-test/post-test surveys for children and parents for estimating outcomes;

Implementation Logs from educators for process evaluation. Fidelity estimated to be 70% to 100% of topics/activities being completed for youth, parent and

combined sessions for the 6 units. Only significant relationships are shown as black arrow lines (p < .05) Green = Factor Loading Pretest, Blue = Factor Loading Post, Purple = Coefficients

FoodMania: Kids & Food In A Marketing-Driven World