WHAT'S KNOWN ON THIS SUBJECT:Media use has been shown to negatively affect child sleep, especially in the context of evening use or with a television in the child's bedroom. WHAT THIS STUDY ADDS:Increased sleep problems were observed in preschool-aged children for each additional hour of daytime violent media content or evening media use. No such effect was observed with nonviolent daytime use. abstract BACKGROUND: Media use has been shown to negatively affect a child's sleep, especially in the context of evening use or with a television in the child's bedroom. However, little is known about how content choices and adult co-use affect this relationship. OBJECTIVE:To describe the impact of media content, timing, and use behaviors on child sleep. METHODS:These data were collected in the baseline survey and media diary of a randomized controlled trial on media use in children aged 3 to 5 years. Sleep measures were derived from the Children's Sleep Habits Questionnaire. Media diaries captured time, content title, and co-use of television, video-game, and computer usage; titles were coded for ratings, violence, scariness, and pacing. Nested linear regression models were built to examine the impact of timing, content, and co-use on the sleep problem score. RESULTS:On average, children consumed 72.9 minutes of media screen time daily, with 14.1 minutes occurring after 7:00 PM. Eighteen percent of parents reported at least 1 sleep problem; children with a bedroom television consumed more media and were more likely to have a sleep problem. In regression models, each additional hour of evening media use was associated with a significant increase in the sleep problem score (0.743 [95% confidence interval: 0.373-1.114]), as was daytime use with violent content (0.398 [95% confidence interval: 0.121-0.676]). There was a trend toward greater impact of daytime violent use in the context of a bedroom television (P ϭ .098) and in low-income children (P ϭ .07). CONCLUSIONS:Violent content and evening media use were associated with increased sleep problems. However, no such effects were observed with nonviolent daytime media use. Pediatrics 2011;128:29-35 AUTHORS:

WHAT'S KNOWN ON THIS SUBJECT: Children have been shown to imitate behaviors they see on screen. WHAT THIS STUDY ADDS:Modifying what children watch can improve their observed behavior. abstract BACKGROUND: Although previous studies have revealed that preschoolaged children imitate both aggression and prosocial behaviors on screen, there have been few population-based studies designed to reduce aggression in preschool-aged children by modifying what they watch. METHODS:We devised a media diet intervention wherein parents were assisted in substituting high quality prosocial and educational programming for aggression-laden programming without trying to reduce total screen time. We conducted a randomized controlled trial of 565 parents of preschool-aged children ages 3 to 5 years recruited from community pediatric practices. Outcomes were derived from the Social Competence and Behavior Evaluation at 6 and 12 months. RESULTS: At 6 months, the overall mean Social Competence and Behavior Evaluation score was 2.11 points better (95% confidence interval [CI]: 0.78-3.44) in the intervention group as compared with the controls, and similar effects were observed for the externalizing subscale (0.68 [95% CI: 0.06-1.30]) and the social competence subscale (1.04 [95% CI: 0.34-1.74]). The effect for the internalizing subscale was in a positive direction but was not statistically significant (0.42 [95% CI: 20.14 to 0.99]). Although the effect sizes did not noticeably decay at 12 months, the effect on the externalizing subscale was no longer statistically significant (P = .05). In a stratified analysis of the effect on the overall scores, low-income boys appeared to derive the greatest benefit (6.48 [95% CI: 1.60-11.37]).CONCLUSIONS: An intervention to reduce exposure to screen violence and increase exposure to prosocial programming can positively impact child behavior. Pediatrics 2013;131:431-438

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Cardiovascular (CV) disease is the leading cause of death in the United States (Hoyert & Xu, 2012), and low-income and ethnic minorities are disproportionally affected. Relationship education (RE) interventions have been shown to improve relationship quality and reduce distress in individuals and couples, including low-income and ethnic minority populations. This study examined the effect of an evidenced-based, individual-oriented, RE intervention, within my reach, (WMR), on emotional distress in a population of mostly low-income and ethnic minority individuals with existing CV disease and/or CV disease risk factors (CVD) to those without disease or risk factors (non-CVD). Results showed significant improvements in overall distress for both the CVD and non-CVD groups, but neither group improved significantly more than the other. The authors found similar changes in distress levels when we examined a subset of the population that met the criteria for clinical distress. Also, data showed that CVD participants presented with significantly greater overall distress than non-CVD participants. These findings are consistent with prior research that showed the effectiveness of the WMR curriculum in stress reduction. Furthermore, this study contributes knowledge about a unique population, individuals with CV disease and/or CVD, who may greatly benefit from interventions focused on stress reduction.