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Children's Violent Television Viewing: Are Parents Monitoring?

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Children's Violent Television Viewing: Are Parents Monitoring?

Tina L. Cheng, MD, MPH*‡§; Ruth A. Brenner, MD, MPH; Joseph L. Wright, MD, MPH‡§¶;

Hari Cheryl Sachs, MD#; Patricia Moyer, BS; and Malla R. Rao, MEngg, DrPH

ABSTRACT. Objective. Violent media exposure has

been associated with aggressive behavior, and it has been

suggested that child health professionals counsel families

on limiting exposure. Effective violence prevention

counseling requires an understanding of norms regarding

parental attitudes, practices, and influencing factors.

Both theories of reasoned action and planned behavior

emphasize that subjective norms and attitudes affect

people's perceptions and intended behavior. Few data

exist on violent television viewing and monitoring from

a cross-section of families. By understanding the spectrum

of parental attitudes, community-sensitive interventions

for violence prevention can be developed. The

objective of this study was to assess attitudes about and

monitoring of violent television viewing from the perspective

of parents.

Methods. An anonymous self-report assisted survey

was administered to a convenience sample of parents/

guardians who visited child health providers at 3 sites: an

urban children's hospital clinic, an urban managed care

clinic, and a suburban private practice. The parent questionnaire

included questions on child-rearing attitudes

and practices and sociodemographic information.

Results. A total of 1004 adults who accompanied children

for health visits were recruited for the study; 922

surveys were completed (participation rate: 92%). A total

of 830 (90%) respondents were parents and had complete

child data. Of the 830 respondents, 677 had questions on

television viewing included in the survey and were the

focus of this analysis. Seventy-five percent of families

reported that their youngest child watched television. Of

these, 53% reported always limiting violent television

viewing, although 73% believed that their children

viewed television violence at least 1 time a week. Among

television viewers, 81% reported usually or always limiting

viewing of sexual content on television and 45%

reported usually or always watching television with their

youngest child. Among children who watched television,

parents reported that they spent an average of 2.6 hours

per day watching television. Limitation of television violence

was associated with female parents and younger


Conclusions. There was variability in attitudes and

practices regarding television violence viewing and monitoring

among parents. Attitudes and practices varied on

the basis of the age of the child and the gender of the

parent. Pediatrics 2004;114:94 -99; media violence, television

viewing, violence prevention, anticipatory guidance,

parental norms.

ABBREVIATIONS. OR, odds ratio; CI, confidence interval.

The American Academy of Pediatrics has encouraged

child health professionals to be proactive

in addressing violence prevention in

child health supervision. The policy statement entitled

"The Role of the Pediatrician in Youth Violence

Prevention in Clinical Practice and at the Community

Level" suggests that health providers have an

emerging role in youth violence prevention and

management.1 Anticipatory guidance on media violence

exposure and encouraging media literacy are

examples of this role.

Effective violence prevention counseling requires

an understanding of norms regarding parental attitudes

and practices and the factors that influence

norms. The theory of planned behavior2 evolved out

of the theory of reasoned action and focuses on intentions

to act as important predictors of behavior.3

Both theories emphasize that perceptions about normative

behavior and attitudes about what others

think are associated with intended behavior.4 Although

data exist on children's media exposure, only

limited data focus specifically on violent television

viewing from a cross-section of families. By understanding

the spectrum of parental attitudes and behavior,

community-sensitive interventions for violence




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