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6. Tjaden P, Thoennes N. Extent, Nature, and Consequences of Intimate Partner Violence: Findings From the National Violence Against Women Survey. Washington, DC: US Dept of Justice Office of Justice Programs, National Institute of Justice;2000. 7. Patel SP, Gaw AC. Suicide among immigrants from the Indian subcontinent: a review. Psychiatr Serv. 1996;47:517–521. 8. Krishnan SP, Baid-Amin M, Gilbert L, El-Bassel N, Waters A. Lifting the veil of secrecy—domestic violence against South Asian women. In: Das Gupta S, ed. A Patchwork Shawl: Chronicles of South Asian Women in America. New Brunswick, NJ: Rutgers University Press; 1998:145–169. 9. Krishnan SP, Hilbert JC, VanLeeuwen D, Kolia R. Documenting domestic violence among ethnically diverse populations: results from a preliminary study. Fam Community Health. 1997;20(3):32–48. 10. Yoshioka M. Social support and disclosure of abuse: a comparison of African American, Hispanic, and South Asian battered women. J Interpersonal Violence. In press. 11. Dasgupta SD, Warrier S. In the footsteps of Arundati: Asian Indian women’s experience of domestic violence in the US. Violence Against Women. 1996;2: 238–259. 12. George MS, Rahangdale L. Domestic violence and South Asian women. N C Med J. 1999;60:157–159. 13. Jagannathan P. Caring for the caregivers: NAWHO’s pioneering report outlines the unique health needs of South Asian women. India Currents. April 1996. Available at: http://www.umiacs.umd.edu/ sahealth.html. Accessed April 14, 2000. 14. Straus MA, Hamby SL, Boney-McCoy S, Sugarman DB. The revised Conflict Tactics Scales (CTS2): development and preliminary psychometric data. J Fam Issues. 1995;17:283–316.

A Prospective Study of Exposure to Rap Music Videos and African American Female Adolescents’ Health | Gina M. Wingood, ScD, MPH, Ralph J. DiClemente, PhD, Jay M. Bernhardt, PhD, MPH, Kathy Harrington, MPH, MAEd, Susan L. Davies, PhD, MEd, Alyssa Robillard, PhD, and Edward W. Hook III, MD

Rap music videos are a media genre that is attracting considerable attention. Rap music has evolved from African American music forms, with influences from rhythm and blues, fusion, contemporary gospel, and bebop.1–3 Al-

though there is considerable concern regarding the themes and images expressed in rap music videos, limited empirical research has examined the effect of rap music videos on adolescents’ behavior.4 This investigation sought to determine whether exposure to rap music videos at baseline could predict the occurrence of health risk behaviors and sexually transmitted diseases among African American adolescent females over a 12-month followup period.

STUDY SAMPLE From December 1996 through April 1999, recruiters screened female teenagers residing in nonurban, lower-socioeconomic-status neighborhoods from school health classes and county health department clinics to determine their eligibility for participating in an HIV prevention program. Adolescents were eligible to participate if they were African American females, were between ages 14 and 18, had been sexually active in the previous 6 months, and provided written informed consent.

drugs (either tranquilizers, marijuana, amphetamines, lysergic acid diethylamide [LSD], cocaine, or crack), had multiple sex partners, or used condoms. Adolescents were also tested for 3 sexually transmitted diseases (chlamydia, trichomoniasis, and gonorrhea).6–8

Data Analysis Univariate analyses described music video viewing characteristics at baseline. Subsequent bivariate analyses examined the relations among adolescents’ level of exposure to rap music videos at baseline, potential covariates, and the occurrence of health risk behaviors over the 12-month follow-up. Health risk behaviors and covariates significantly associated (P < .05) with exposure to rap music videos in bivariate analyses were included in logistic regression analyses. A separate logistic regression analysis was conducted to examine the relation between level of exposure to rap music videos at baseline and the occurrence of each health risk behavior over the 12month follow-up. All logistic regression analyses controlled for covariates and the corresponding baseline health risk behavior.9

MEASURES RESULTS Level of exposure to rap music videos, the predictor variable, was determined by asking adolescents to estimate the number of hours they viewed rap music videos during an average day. This was multiplied by the number of days in the week that rap music videos were viewed. Music video viewing characteristics assessed included the primary type of rap music videos viewed (gangsta, bass, or hip-hop), with whom adolescents usually viewed rap music videos, and where the rap music videos were viewed. Covariates assessed included age, employment status, involvement in extracurricular activities, participation in religious events, family composition, family’s receipt of public assistance, parental monitoring of adolescents’ whereabouts,5 and group assignment to either the HIV intervention or the comparison condition.

Outcomes Health risk behaviors assessed whether adolescents had hit a teacher, been involved in a fight, been arrested, used alcohol or

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The study enrolled 522 single African American females. Of those enrolled, 92.2% completed 12-month follow-up assessments. Descriptive statistics on adolescents’ exposure to rap music videos are illustrated in Table 1. The median hours of exposure to rap music videos per week at baseline and at 6- and 12month follow-up were 14 hours, 14 hours, and 12 hours, respectively, suggesting relatively stable viewing habits. Greater exposure to rap music videos was associated with unemployment and less parental monitoring; therefore, these variables and group assignment were used as covariates in the logistic regression analyses. Over the 12-month follow-up, 37.6% acquired a new sexually transmitted disease, 4.8% hit a teacher, 12.1% reported being arrested, 14.8% had sexual intercourse with someone other than their steady partner, 44.2% reported using drugs, and 44.4% consumed alcohol. Logistic regression analyses illustrated that after controlling for covariates, greater expo-

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readily when the modeled behavior is salient, simple, and prevalent and has functional value. Thus, exposure to rap music videos, particularly gangsta rap (the most popular type of music video), which is explicit about sex and violence4 and rarely shows the potential long-term adverse effect of risky behaviors, may influence adolescents by modeling these unhealthy practices. Alternatively, African American female teenagers may identify with the characters and themes in rap music videos, and exposure to these videos may reinforce teenagers engaging in such behaviors. Moreover, African American females desiring greater independence may rebel against parental media restrictions. Adolescents striving for independence and autonomy may be more likely to engage in risky behaviors. Although not specifically referring to rap music videos, Poussaint11 noted that the glorification of drugs, violence, and sex in films is particularly dangerous to young African Americans who are not exposed to many positive role models in the media. This concern is equally, if not more, applicable to African

TABLE 1—Adolescents’ Exposure to Rap Music Videos (N = 522): Birmingham, Ala, 1999 Exposure characteristic Ever viewed rap music videos Yes No Primary type of rap music videos viewed Gangsta Bass Hip-hop With whom rap music videos are usually viewed Brothers, sisters, cousins Alone Friends Boyfriend or someone you are interested in Parents Where do you watch rap music videos? Home Relative’s home Boyfriend’s home Friends’ home Elsewhere

sure to rap music videos was independently associated with a broad spectrum of health outcomes. Compared with adolescents who had less exposure to rap music videos, adolescents who had greater exposure to rap music videos were 3 times more likely to have hit a teacher; more than 2.5 times as likely to have been arrested; 2 times as likely to have had multiple sexual partners; and more than 1.5 times as likely to have acquired a new sexually transmitted disease, used drugs, and used alcohol over the 12-month follow-up period (Table 2).

DISCUSSION This is one of the first studies to empirically show that greater exposure to rap music videos at baseline was prospectively associated with the occurrence of health risk behaviors and having a laboratory-confirmed new sexually transmitted disease 1 year later. Because potential mediating factors were not assessed, it is difficult to determine whether the relation between exposure to rap music videos and adolescents’ health status was causal. The results may be explained by social cognitive theory.10 A cornerstone of this theory states that modeling will occur more

No.

Percentage

498 24

95.4 4.6

355 83 60

71.3 16.7 12.0

228 118 83 79 9

44.1 22.8 16.1 15.3 1.7

429 28 28 23 5

83.6 5.5 5.5 4.4 1.0

TABLE 2—Unadjusted and Adjusted Analyses Measuring the Association Between Exposure to Rap Music Videos and Adolescents’ Health at 12-Month Follow-Up: Birmingham, Ala, 1999–2000 Bivariate Analyses Adolescents’ Healtha Violence Hit a teacher Been in a fight Antisocial behavior Was arrested Sexual behavior Had multiple sexual partners Never used condoms STD Acquired a new STD Drug use Used drugs Alcohol use Used alcohol

Multivariate Analyses

High Exposure

Low Exposure

PRb (90% CI)

P

ORc (90% CI)

P

7.1 55.8

2.4 50.5

3.0 (1.1, 8.1) 1.1 (0.9, 1.3)

.02 .28

3.0 (1.2, 7.3) 1.1 (0.6, 1.7)

.04 .60

17.3

7.2

2.4 (1.4, 4.3)

.002

2.6 (1.4, 4.6)

.009

19.3 14.8

11.0 13.7

1.8 (1.1, 2.8) 1.1 (0.7, 1.7)

.02 .74

2.0 (1.1, 3.4) 1.1 (0.7, 1.8)

.02 .80

41.9

33.0

1.3 (1.0, 1.7)

.08

1.6 (1.1, 2.3)

.04

50.8

37.7

1.4 (1.1, 1.7)

.008

1.6 (1.1, 2.4)

.04

53.7

46.3

1.2 (1.0, 1.5)

.04

1.6 (1.1, 2.3)

.05

Note. PR = prevalence ratio; CI = confidence interval; OR = odds ratio; STD = sexually transmitted disease. a Adolescent health behaviors and STD incidence were assessed over a 12-month follow-up period. b Adolescents having less exposure to rap music videos were the referent for computing PRs. c ORs are adjusted by parental monitoring and adolescents’ employment status.

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American female adolescents, given their high level of exposure to rap music videos and the degrading portrayal of African American females in many rap music videos.12,13 Future research on rap music videos should be conducted among different adolescent populations. Additional research should examine whether level of attention to rap music videos and changes in mediators, moderators, and exposure differentially affect the relation between exposure to rap music videos and adolescent health. Furthermore, public health practitioners are ideally suited to educate communities, schools, and advocacy groups about the potential public health risks associated with exposure to rap music videos in African American adolescent females.2

About the Authors Gina M. Wingood, Ralph J. DiClemente, Jay M. Bernhardt, and Alyssa Robillard are with Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, Ga. Gina M. Wingood and Ralph J. DiClemente are also with the Emory Center for AIDS Research, Atlanta, Ga. Ralph J. DiClemente is also with University School of Medicine, Department of Pediatrics (Division of Infectious Diseases, Epidemiology and Immunology), Emory University, Atlanta, Ga. Kathy Harrington is with the School of Medicine, Department of Pediatrics, University of Alabama, Birmingham. Susan L. Davies is with the School of Public Health, Department of Health Behavior, University of Alabama, Birmingham. Edward W. Hook III is with the School of Medicine, Department of Medicine, Division of Infectious Diseases, University of Alabama, Birmingham. Requests for reprints should be sent to Gina M. Wingood, ScD, MPH, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Rd, NE, Room 548, Atlanta, GA 30322 (e-mail: [email protected]). This brief was accepted June 12, 2002.

References 1. DiClemente RJ, Hansen W, Ponton LE. Adolescents at-risk: a generation in jeopardy. In: DiClemente RJ, Hansen W, Ponton L, eds. Handbook of Adolescent Health Risk Behavior. New York, NY: Plenum Publishing; 1996:1–4. 2. Brown JD, Stern SR. Mass media and adolescent female sexuality. In: Wingood GM, DiClemente RJ, eds. Handbook of Women’s Sexual and Reproductive Health. New York, NY: Plenum Kluwer Press; 2002:93–112. 3. Morley J. Introduction. In: Stanley LA, ed. Rap: The Lyrics. New York, NY: Penguin Books; 1992:vii–ix. 4. Jones K. Are rap videos more violent? Style differences and the prevalence of sex and violence in the age of MTV. Howard J Commun. 1997;8: 343–356. 5. DiClemente RJ, Wingood GM, Crosby R, et al. Parental monitoring: association with adolescents’ risk behaviors. Pediatrics. 2001;107:1363–1368. 6. Hook EW III, Ching SF, Stephens J, Hardy KF, Smith KR, Lee HH. Diagnosis of Neisseria gonorrhoeae infection in women by using the ligase chain reaction on patient-obtained vaginal swabs. J Clin Microbiol. 1997;35:2129–2132. 7. Hook EW III, Smith K, Mullen C, et al. Diagnosis of genitourinary Chlamydia trachomatis infections in women by using the ligase chain reaction on patientobtained vaginal swabs. J Clin Microbiol. 1997;35: 2133–2135. 8. Schwebke JR, Morgan SC, Pinson GB. Validity of self-obtained vaginal specimens for diagnosis of trichomoniasis. J Clin Microbiol. 1997;35:1618–1619. 9. Hosmer DW, Lemeshow S. Applied Logistic Regression. New York, NY: John Wiley & Sons; 1989. 10. Bandura A. Social cognitive theory of mass communication. In: Bryant J, Zillmann D, eds. Media Effects: Advances in Theory and Research. Hillsdale, NJ: Lawrence Erlbaum Associates; 1994:61–91. 11. Poussaint AF. Blaxploitation movies: cheap thrills that degrade blacks. Psychol Today. 1974;9:22–32. 12. Gow J. Reconsidering gender roles on MTV: depictions in the most popular music videos of the early 1990s. Commun Rep. 1996;9:151–161. 13. Seidman S. Revisiting sex-role stereotyping in MTV videos. Int J Instructional Media. 1999;26:11–25.

Contributors G. M. Wingood and R. J. DiClemente contributed to conception, design, acquisition, and analysis of the data. J. M. Bernhardt contributed to interpretation of the data. K. Harrington and S. L. Davies contributed to data acquisition. A. Robillard contributed substantially to the conception of the data. E. W. Hook III contributed by providing laboratory support for the assessment of sexually transmitted infections. All authors provided intellectual content for this brief.

Food Messages on African American Television Shows | Manasi A. Tirodkar, MA, and Anjali Jain, MD

Acknowledgment This study was supported by a grant from the Center for Mental Health Research on AIDS, National Institute of Mental Health (1R01 MH54412).

Human Participant Protection The study protocol was approved by the University of Alabama, Birmingham’s committee on human research.

African American households watch more television than the average American household—75 hours per week versus 52 hours per week—and are more likely to watch shows with predominantly African American charac-

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ters.1 African Americans also have a higher prevalence of obesity than the general American population (27% vs 19%).2 Television watching has been previously linked to the development of obesity.3–6 Televised images of products such as alcohol7 and tobacco8 have increased the use of these items, despite their adverse health effects. Despite advertisers’ and network executives’ advance knowledge of television content, no public studies have examined the health-related content of television aimed at specific racial/ethnic segments of the population. Therefore, we compared portrayals of food during popular African American television shows with those during general programming.

METHODS We videotaped the 4 most-watched situation comedy television shows (sitcoms) among the general population (“general prime time”) and the African American population (“Black prime time”) according to Nielsen ratings for fall 1999.1,9 The top shows on Black prime time—“Moesha,” “Malcolm and Eddie,” “Jamie Foxx,” and “The Parkers”—were aired on 2 national channels: WB and UPN. All of the top shows on general prime time for fall 1999—“Friends,” “Frasier,” “Jesse,” and “Stark Raving Mad”—were on NBC. Food and beverage episodes were defined as any programming segment in which food or beverages were mentioned by characters (verbal reference) or appeared on the screen (visual reference).10 Perceived race/ethnicity, sex, age, and weight status of each speaking character also were recorded. Commercials aired after the start of the opening sequence of a program and before the programs’ final credits were classified according to food category (e.g., candy, soda, juice). The programs and commercials were classified according to a coding sheet developed before taping and viewing the programs. Comparisons between Black prime time and general prime time were made by t tests and χ2 analyses with the SPSS 8.0 statistical analysis package (SPSS Inc, Chicago, Ill). One of the authors (A. J.) independently viewed and coded the content of 8 (25%) shows. There was complete (100%) agreement between authors regarding the number

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