THE IMPACT OF MEDIA ON ADOLESCENTS' SEXUAL BEHAVIOR

Release Date:  June 10, 1998

PA NUMBER:  PA-98-079

P.T.

National Institute of Child Health and Human Development

PURPOSE

The effects of media consumption on young people's attitudes and behavior
regarding sex are of increasing interest to policy makers and program planners.
A recent comprehensive review of the factors leading to early sexual activity and
pregnancy concluded that surprisingly little empirical research had been
conducted on the effects of growing up in an environment saturated by often
problematic models of sexual behavior (Moore et al. 1996). One concern is the
extent to which frequent consumption of media with high levels of sexual content
and low levels of portrayal of responsible sexual conduct is a causal influence
on young people's subsequent sexual behavior, including the responsible use of
protection from pregnancy and disease.  Basic research is called for to address
the hypothesis that the content of various forms of media affects young people's
attitudes and behavior with regard to sexual intercourse. This program
announcement calls for research in three basic areas: (1) What sexual content do
youth pay attention to, and how do they interpret what they see and hear?; (2)
Does that media content affect their sexual beliefs and behavior?; and (3) How
could the mass media be used to promote responsible  sexual behavior among youth?

HEALTHY PEOPLE 2000

The Public Health Service (PHS) is committed to achieving the health promotion
and disease prevention objectives of "Healthy People 2000," a PHS-led national
activity for setting priority areas.  This Program Announcement (PA), The Impact
of Media on Adolescents' Sexual Behavior, is related to the priority areas of
family planning and prevention of HIV infection and STDs.  Potential applicants
may obtain a copy of "Healthy People 2000" (Full Report:  Stock No.
017-001-00474-0 or Summary Report:  Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington, DC
20402-9325 (telephone 202-512-1800).

ELIGIBILITY REQUIREMENTS

Applications may be submitted by domestic and foreign, for-profit and non-profit
organizations, public and private, such as universities, colleges, hospitals,
laboratories, units of State and local governments, and eligible agencies of the
Federal government.  Racial/ethnic minority individuals, women and persons with
disabilities are encouraged to apply as principal investigators.

MECHANISM OF SUPPORT

This PA will use the National Institutes of Health (NIH) research project grant
(R01) mechanism. Responsibility for the planning, direction and execution of the
proposed project will be solely that of the applicant.  The total project period
for an application submitted in response to this PA may not exceed five years.

The number of awards and level of support will depend on receipt of applications
of high scientific merit.  The usual policies governing grants administration and
management, including facilities and administrative costs, will apply.  Awards
pursuant to this program announcement are contingent upon availability of funds
for this purpose.  Funding beyond the first and subsequent years of the grant
will be contingent upon satisfactory progress during the preceding years and
availability of funds.

RESEARCH OBJECTIVES

Summary

Although it is often asserted that systematic communication can improve health
behavior, the studies that have been done have not shown profound impact (Piotrow
et al.,1997). Little empirical research has been conducted on the effects, if
any, of growing up in an environment saturated by media that focuses on sexual
behavior.  Some years ago, responding to an analogous concern, a large number of
research studies looked at the impact of violence in the media and demonstrated
that heavy exposure to violence-saturated media is related to individuals'
increasing acceptance of violence in human relationships (U.S. Surgeon General,
1972). However, interpersonal violence is seldom acceptable, and sexual
relationships often are, which suggests that parallels between the two situations
may not be warranted.  What is not known is whether frequent consumption of media
with high levels of sexual content and low levels of portrayal of responsible
sexual conduct is a causal influence on young people's subsequent sexual
behavior, or, alternatively, whether young people's understanding of the dynamics
and risks of sexual intercourse and its consequences are improved via their use
of media.  Basic research is called for to address the hypothesis that the
content of various forms of media affects young people's attitudes and behavior
with regard to sexual intercourse.

Background

Research has demonstrated that young people are heavy consumers of sexually-
oriented media including TV, both broadcast and cable channels, videos, movies,
magazines, and, more recently, the internet (Brown et al.1996).  Content analyses
have also demonstrated that broadcast television contains a high, growing and
increasingly explicit dose of sexual messages, and that a low proportion of such
messages display or model either restraint or contraceptive use (Kunkel, et al.
1997; Greenberg et al. 1997).  However, scientific evidence has not yet
established a causal relationship between exposure to sexual content in the media
and young people's attitudes concerning sexuality and their own sexual behaviors.

The availability of a body of research that addresses the nature and magnitude
of the role of media in adolescents' decisions regarding sexual intercourse and
protection from disease and unintended pregnancy might create data which could
guide future policy and programming, both in the government and in the media
industries.

Research Sought

This PA is interested in applications that propose research in three basic areas:
(1) What sexual content do youth pay attention to, and how do they interpret what
they see and hear?; (2) Does sexual media content affect youths' sexual beliefs
and behavior?; and (3) Can the mass media be used to promote responsible sexual
behavior among youth?

There have been two major categories of theories addressing issues of media
content and influence on subsequent behavior.  One major set of theories proposes
that the media provide behavioral models.  Young people engage in casual and
unprotected intercourse, for example, because they are doing what they see the
people they admire on TV doing.  A variation on this would argue that TV is a
"super peer."  A second category of theory could be called "cathartic," or
emotional release. This theory has ancient roots; Aristotle used it to argue for
the use of drama as a preventive tool against warfare. More recently, it has been
used to justify the display of violence in the media, in that individuals were
thought to obtain some understanding of the consequences of violence by seeing
it enacted and therefore would not desire to participate in such behavior
themselves. With reference to violence, there is no support for the theory as yet 
(Donnerstein, 1975, 1977, 1978, cited in McGuire, 1986; Strasburger, 1995).

Forms of media are changing constantly, so that media "diets" may be changing in
unknown, and as yet, uncharted ways.  Developmentally, young people gain more
control over their media use as they mature.  Individuals may selectively use and
change their use of media, in ways not clearly understood.  Age, gender,
race/ethnicity and social class may influence what media individuals have access
to and choose to pay attention to (Kaiser Family Foundation, 1998).  There are
also suggestions that self-definition as a member of a particular clique or crowd
may influence young people's choice of media.  No one form of media use
predominates in adolescence.

For the purposes of this PA, "media" are taken to mean information and images
delivered via: printed matter, such as newspapers, magazines, and comic books;
radio, both music and talk; TV, broadcast, cable and video, including music
videos; movies, tapes and compact discs and the games and information accessible
through computers on the Internet and World Wide Web. Program content and
advertising are both included. Unlimited access to the Internet and to the wide
range of services available on the World Wide Web is of growing interest. The
number of individuals who have ready access to computers is growing daily.

Mass media are to a great extent fueled by commercial enterprises which have as
their goals influencing individuals' purchasing decisions.  While messages may
be targeted to one or another group of individuals, there is limited or no
control over who actually listens to or understands or acts upon the information
or images disseminated.  This PA calls for research on the influence of media on
one segment of media consumers, U.S. residents ages 10 through 18.

Although media in other developed nations may be as high in sexual content as
that in the U.S., the sexual behaviors of their young people are often less risk-
laden.  The context within which these young people live may be quite different.
Accordingly,  research located solely in other countries is not encouraged. 
Research grant applications that propose to look comparatively or cross
culturally at the relationship between media use and adolescent sexual and
contraceptive behaviors should take into account presumed cultural and contextual
differences and clearly demonstrate the utility of any findings for U.S.
purposes.

Special Condition

Applications that address exposure to and/or interpretation of media content and
the linkages between such exposure and subsequent behaviors are strongly
encouraged.  Applications focusing exclusively on the measurement of sexual
content in the media will be of lesser programmatic interest.

Investigators may wish to consider the following issues when developing responses
to this PA:

Measures of exposure
Receptor measures:
o  What do young people hear and/or understand compared to what adults or media
think is being delivered?
o  How do formal features of programs -- their delivery modalities -- influence
this?

Content analysis:
o  Is it possible to create a more nuanced method to describe the context of
"sexual interactions"?  There are both "implied" and "explicit" sexual
interactions displayed in various media.  Would more complex measures provide the
means to clarify the purported  relationship between media use and subsequent
behavior?
o  How do effects vary with different levels of incorporation of information into
a story line (i.e., a major character, an ongoing story line or a minor role in
one performance)?

"Diet":
o  What mixes of media are individuals paying attention to?  Advertising,
editorial and substantive content each may merit attention.
o  How does this change with the age, race, gender, ethnicity or socioeconomic
status of the young people?  How do these variables interact?  How are these
exposures best measured?

Selection bias
Do young people with different levels of sexual experience or sexual interest
select different media to use? This would suggest that causal influence, if it
exists, could move in either or both directions.  It has been shown that young
people who have had sexual intercourse do watch shows with more sexual
content(Brown & Newcomer, 1991).  This finding demonstrates the need for
longitudinal analyses.
o  What other factors in young peoples' lives -- family, peers, social
environment -- might influence their selection of media, and have an effect on
subsequent behavior?

Context
Peers and Family:
How do young people's peers and families act as amplifiers or dampers or
interpreters of media content?

Public norms:
Is, and if so, how is the influence of the media effected through changes in
young people's perceptions of public norms about the appropriateness of sexual
behavior, or the proportion of their peers who are sexually experienced?

Dosage/Duration
Does the quantity and duration of exposure to media have a differential impact?
How is it possible to measure the long-term compound effect of many types of
exposure over a long period?  Does repeated exposure desensitize media users? Are
there delivery modality, developmental or other factors to be considered?  For
example, awareness of emergency contraception peaked after a 30-second mention
of its availability on the TV series "ER," but dropped within a month (Kaiser
Family Foundation, 1997).  After a news story about emergency contraception on
MTV and a 1-800 number listed at the end of the program, calls increased to the
hotline but there was no subsequent uptake in utilization (Trussell et al.1997).

Interventions

Applications may address the use of media to encourage sexual responsibility, for
example by using a new or ongoing show to deliver information, as has been done
in a number of developing countries (Kaiser Family Foundation, 1994). Challenges
in the translation of such programming into the U.S. context include the need to
utilize mainstream profit-oriented media channels and the understanding that
audiences in this country are highly fragmented.

The design, implementation and evaluation of media literacy skill training  to
encourage young people to "read" the media with greater understanding of risk and
responsibility is appropriate as a subject for an application.

Testing the impact of the inclusion of more refusal skill modeling on programs
for younger audiences, or of appropriate and consistent use of birth control
portrayed in media used by youth, is also an appropriate topic, as is examining
the impact of positive images of sexual behavior.

The evaluation of the impact of Public Service Announcements or other media
campaigns designed to change young people's behavior is also appropriate.

CAUTION

One reason for the paucity of scientifically sound research on the topic may be
that it is extremely difficult to design and implement studies that are able to
appropriately account for the pervasiveness of media in young people's lives, the
shifting mix of media diets, and the need for longitudinal approaches.  This PA
encourages researchers to consider innovative models and methods to address these
challenges.  Furthermore, dealing with sensitive issues such as exposure to media
that might be interpreted as sexually suggestive and working with individuals
under the age of 18 create the need for thoughtful and comprehensive approaches
to informed consent, which involve both the parent and the young person.

DATA SOURCES

Acceptable data sources include laboratory studies, ethnographic and other
qualitative research, surveys and combinations of these sources. Researchers must
pay attention to the media "diets" of youth of differing ages, genders, interests
and ethnicities in order to design appropriate studies.  Successful applicants
will have paid attention to the possibility of selectivity, in order to address
the concern that those who consume large amounts of sexually-laden media may be
a special subgroup of the population.

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the NIH that women and members of minority groups and their
subpopulations must be included in all NIH supported biomedical and behavioral
research projects involving human subjects unless a clear and compelling
rationale and justification is provided that inclusion is inappropriate with
respect to the health of the subjects or the purpose of the research.  This
policy results from the NIH Revitalization Act of 1993 (Section 492B of Public
Law 103-43).

All investigators proposing research involving human subjects should read the
"NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical
Research," which have been published in the Federal Register of March 28, 1994
(FR 59 14508-14513) and in the NIH Guide for Grants and Contracts, Volume 23,
Number 11, March 18, 1994.

NIH POLICY AND GUIDELINES ON THE INCLUSION OF CHILDREN AS PARTICIPANTS IN
RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of NIH that children (i.e., individuals under the age of 21)
must be included in all human subjects research, conducted or supported by the
NIH, unless there are scientific and ethical reasons not to include them. This
policy applies to all initial (Type 1) applications submitted for receipt dates
after October 1, 1998.

All investigators proposing research involving human subjects should read the
"NIH Policy and Guidelines on the Inclusion of Children as Participants in
Research Involving Human Subjects" that was published in the NIH Guide for Grants
and Contracts, March 6, 1998, and is available at the following URL address:
http://www.nih.gov/grants/guide/notice-files/not98-024.html

APPLICATION PROCEDURES

The research grant application form PHS 398 (rev. 5/95) is to be used in applying
for these grants.  Applications will be accepted on the standard receipt dates
indicated in the application kit.  These forms are available at most
institutional offices of sponsored research and from the Division of Extramural
Outreach and Information Resources, National Institutes of Health, 6701 Rockledge
Drive, MSC 7910, Bethesda MD 20892-7910, telephone 301-710-0267, Email
[email protected]; and from the program administrator listed under INQUIRIES.

The PA title and number must be typed on line 2 of the face page of the
application form.

Submit a signed, typewritten original of the application including the Checklist,
and five signed photocopies, in one package to:

CENTER FOR SCIENTIFIC REVIEW
NATIONAL INSTITUTES OF HEALTH
6701 ROCKLEDGE DRIVE, ROOM 1040, MSC 7710
BETHESDA MD  20892-7710
BETHESDA MD  20817 (for express/courier service)

REVIEW CONSIDERATIONS

Applications will be assigned on the basis of established PHS referral
guidelines.  As part of the initial merit review, a process may be used by the
initial review group in which applications will be determined to be competitive
or non-competitive based on their scientific merit relative to other applications
received.  Applications judged to be competitive will be discussed and be
assigned a priority score.  Applications determined to be non-competitive will
be withdrawn from further competition and the Principal Investigator and the
official signing for the applicant organization will be notified.  Following
review by the Initial Review Group, applications will receive a second level
review by the appropriate national advisory council or board.

Review Criteria

The goals of NIH-supported research are to advance our
understanding of biological systems, improve the control of
disease, and enhance health.  The reviewers will comment on the
following aspects of the application in their written critiques in
order to judge the likelihood that the proposed research will have
a substantial impact on the pursuit of these goals.  Each of these
criteria will be addressed and considered by the reviewers in
assigning the overall score weighting them as appropriate for each
application.  Note that the application does not need to be strong
in all categories to be judged likely to have a major scientific
impact and thus deserve a high priority score.  For example, an
investigator may propose to carry out important work that by its
nature is not innovative but is essential to move a field forward.

(1) Significance:  Does this study address an important problem?  If the aims of
the application are achieved, how will scientific knowledge be advanced?  What
will be the effect of these studies on the concepts or methods that drive this
field?

(2) Approach:  Are the conceptual framework, design, methods, and analyses
adequately developed, well-integrated, and appropriate to the aims of the
project?  Does the applicant acknowledge potential problem areas and consider
alternative tactics?

(3) Innovation:  Does the project employ novel concepts, approaches or methods?
Are the aims original and innovative?  Does the project challenge existing
paradigms or develop new methodologies or technologies?

(4) Investigator:  Is the investigator appropriately trained and well suited to
carry out this work?  Is the work proposed appropriate to the experience level
of the principal investigator and other researchers (if any)?

(5) Environment:  Does the scientific environment in which the work will be done
contribute to the probability of success?  Do the proposed experiments take
advantage of unique features of the scientific environment or employ useful
collaborative arrangements? Is there evidence of institutional support?

In addition to the above criteria, in accordance with NIH policy, all
applications will also be reviewed with respect to the following:

o  The adequacy of plans to include both genders, minorities and their subgroups,
and children as appropriate for the scientific goals of the research.  Plans for
the recruitment and retention of subjects will also be evaluated.

o  The reasonableness of the proposed budget and duration in relation to the
proposed research

o  The adequacy of the proposed protection for humans, animals or the
environment, to the extent they may be adversely affected by the project proposed
in the application.

The initial review group will also examine the provisions for the protection of
human subjects and the safety of the research environment.

AWARD CRITERIA

Awards will be made based on scientific merit as determined by peer review,
programmatic priorities, and the availability of funds.

INQUIRIES

Written, email, and telephone inquiries concerning this PA are encouraged.  The
opportunity to clarify any issues or questions from potential applicants is
welcomed.

Direct inquires regarding programmatic issues to:

Susan F. Newcomer, Ph.D.
Demographic and Behavioral Science Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 8B13
Bethesda, MD  20892
Telephone:  (301) 496-1174
FAX:  (301) 496-0962
Email:  [email protected]

Direct inquiries regarding fiscal matters to:

Ms. Melinda Nelson
Office of Grants and Contracts
National Institute of Child Health and Human Development
Building 61E, Room 8A
Bethesda, MD  20892
Telephone:  (301) 496-5481
FAX:  (301) 402-0915

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance No.
93.864, 93.121, and 93.242.  Awards are made under authorization of the Public
Health Service Act, Title IV, Part A (Public Law 78-410, as amended by Public Law
99-158, 42 USC 241 and 285) and administered under PHS grant policies and Federal
Regulations, 42 CFR Part 52 and 45 CFR Part 74.  This program is not subject to
the intergovernmental review requirements of Executive Order 12372, or to Health
Systems Agency review.

The PHS strongly encourages all grant and contract recipients to provide a
smoke-free workplace and promote the non-use of all tobacco products.  In
addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in
certain facilities (or in some cases, any portion of a facility ) in which
regular or routine education, library, day care, health care or early childhood
development services are provided to children. This is consistent with the PHS
mission to protect and advance the physical and mental health of the American
people.

References

Brown, Jane D. 1996. Sex and Hollywood: Should There Be a Government Role? Menlo
Park CA:Kaiser Family Foundation.

Brown, Jane D, B Greenberg, N Buerke-Rothfuss. 1993. "Mass Media, Sex and
Sexuality." in Strasburger, V, Comstock G (eds). Adolescents and the Media. Vol
4. Philadelphia PA: Hanley & Belfus, Inc.

Brown, Jane D and S Newcomer. 1991. "Television Viewing and Adolescents' Sexual
Behavior." Journal of Homosexuality. 21:77-91.

Greenberg, Bradley, R Lingangan, and A Soderman. 1993. "Adolescents' Reactions
to Television Sex." In Greenberg, Brown and Buerke-Rothfuss (eds.) Media, Sex and
the Adolescent. Cresskill NH:Hampton Press.

Huston, Aletha, E Wartella and E Donnerstein. 1998. Measuring the Effects of
Sexual Content in the Media: A Report to the Kaiser Family Foundation. Menlo Park
CA: Kaiser Family Foundation.

Kaiser Family Foundation. 1994. The Use of Mainstream Media to Encourage Social
Responsibility: The International Experience. Menlo Park CA: Kaiser Family
Foundation.

Kaiser Family Foundation. 1997. Documenting the Power of Entertainment
Television: The Impact of a Brief Health Message on One of TV's Most Popular
Dramas.  Menlo Park CA: Kaiser Family Foundation

Kaiser Family Foundation. 1998. National Survey of Teens: Teens Talk about
Dating, Intimacy and Their Sexual Experiences. Menlo Park CA: Kaiser Family
Foundation.

Kunkel, Dale, K Cope and C Colvin. 1996. "Sexual Messages on Family TV Hour:
Content and Context." delivered at a meeting in Santa Barbara convened by the
Kaiser Family Foundation and Children NOW, December 11, 1996.

McGuire, William J, 1986. "The Myth of Massive Media Impact: Savaging and
Salvaging." in C. Comstock (ed) Public Communication Campaigns. 2nd edition.
Newbury Park CA:Sage.

Moore, Kristin, B. Miller, D Glei and DR Morrison. 1995. Adolescent Sex,
Contraception and Childbearing: A Review of Recent Research. Washington DC:Child
Trends, Inc.

Piotrow, Phyllis, D.L. Kincaid, J, G. Rimon and W Rinehart. 1997. Health
Communication: Lessons from Family Planning and Reproductive Health. Westport:
Praeger.

Strasburger, Victor C. 1995. Adolescents and the Media: Medical and Psychological
Impact. Thousand Oaks, CA: Sage

Trussell, James, J Koenig, B Winikoff, P Blumenthal, V Gamble, S Patterson and
J Scott. 1997. "A National Campaign to Educate the Public on Emergency
Contraception." Paper presented at the annual meeting of the American Public
Health Association, Indianapolis IN, Monday November 9, session 1116.

U.S. Surgeon General. 1972. Television and Growing Up: The Impact of Televised
Violence, a Report from the Surgeon General's Scientific Advisory Committee on
Television and Social Behavior. Washington: USGPO PO.

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