Journal of Child and Family Studies

, Volume 22, Issue 6, pp 749–756

Television Viewing and Televisions in Bedrooms: Perceptions of Racial/Ethnic Minority Parents of Young Children

Authors

    • Department of Family Relations and Applied NutritionUniversity of Guelph
  • Ashley O’Brien
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care
  • Julia McDonald
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care
  • Roberta E. Goldman
    • Department of Society, Human Development and HealthHarvard School of Public Health
    • Department of Family MedicineWarren Alpert Medical School of Brown University
  • Marie Evans-Schmidt
    • Center for Media and Child HealthChildren’s Hospital Boston
  • Sarah Price
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care
  • Stacy King
    • Cambridge Health Alliance
  • Bettylou Sherry
    • Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and Prevention
  • Elsie M. Taveras
    • Obesity Prevention Program, Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care
Original Paper

DOI: 10.1007/s10826-012-9629-6

Cite this article as:
Haines, J., O’Brien, A., McDonald, J. et al. J Child Fam Stud (2013) 22: 749. doi:10.1007/s10826-012-9629-6

Abstract

Understanding parents’ perceptions of their young children’s viewing behaviors and environments is critical to the development of effective television reduction interventions. To explore parents’ attitudes, perceptions, and experiences regarding their children’s television viewing and the use of televisions in their children’s bedrooms, we conducted focus groups with 74 racial/ethnic minority parents of children aged birth to 5 years. We analyzed transcripts of the focus group discussions using immersion-crystallization. Over 50 % of parents reported that their children watch more than 2 h of television per day and 64 % reported that their children have a television in their bedrooms. In general, parents were unconcerned about the amount of television their children watched. However, parents did express concern about the content of their children’s viewing. Discussion of potential harmful effects of television viewing focused mainly on the impact television viewing may have on children’s behavior and academic outcomes and only rarely on a concern about weight. Most parents were unaware of adverse consequences associated with children having a television in their bedroom and many reported that having a television in their child’s bedroom helped keep their child occupied. To effectively engage parents of young children, television reduction interventions should include messages that address parents’ key concerns regarding their children’s viewing and should provide parents with alternative activities to keep children occupied.

Keywords

TelevisionChildrenQualitative methods

Introduction

In spite of the American Academy of Pediatrics recommendation (American Academy of Pediatrics 2001) that children under the age of 2 watch no television and that children over 2 years of age limit their television viewing to <2 h, research suggests that the vast majority of young children are exposed to high levels of screen media (Rideout et al. 2005). Many young children also have televisions in their bedrooms; data from a nationally representative sample of parents of children under the age of six show that 18 % of 0 to 2-year-olds, 43 % of 3 to 4-year-olds, and 37 % of 5- to 6-year-olds have a television in their bedroom (Vandewater et al. 2007). Black and Hispanic children are more likely to have a television in their bedroom than White children (Dennison et al. 2002). Having a television in the bedroom is associated with greater television use (Wiecha et al. 2001) and research suggests that once a television is in a child’s bedroom, it is not often removed (Saelens et al. 2002). Both television viewing and having a television in the bedroom have been found to be associated with greater odds of obesity (Adachi-Mejia et al. 2007; Dennison et al. 2002; Lumeng et al. 2006), problematic social behaviors (Sisson et al. 2011), and attention and learning difficulties (Johnson et al. 2007).

Our comprehensive review of the literature revealed few interventions aimed at reducing young children’s television viewing and no published interventions specifically targeting television in children’s bedrooms (Schmidt et al. 2012). To implement effective and culturally-relevant interventions to reduce television viewing and to remove televisions from the bedrooms of young children and/or prevent their placement in children’s bedrooms, it is necessary to understand the attitudes, perceptions, and experiences of parents, who are the gatekeepers of young children’s access to televisions.

Few studies have explored the attitudes and experiences of parents of young children regarding their children’s television viewing or having television in their children’s bedrooms. One Canadian study used qualitative methods to examine parents’ perceptions of their preschool-aged child’s screen viewing behaviors among a primarily Caucasian and well-educated sample (He et al. 2005; Irwin et al. 2005). Two U.S. studies used quantitative surveys to examine the main reasons parents put televisions in their young children’s bedrooms (Taveras et al. 2009; Vandewater et al. 2007). Building on this existing research, the aim of our study was to conduct an in-depth examination of parents’ attitudes, perceptions, and experiences regarding their children’s television viewing, and specifically the use of televisions in their children’s bedrooms. To achieve this aim, we employed qualitative methods to allow parent participants the opportunity to communicate their perspectives in detail (Krueger 1994). This study is the first step in a larger study to develop and evaluate a television reduction intervention among racial/ethnic minority parents.

Methods

Study Design, Sampling, and Population

From April 2010 to June 2010, we conducted 9 focus groups with 74 parents of children aged birth to 5 years 11 months. We used stratified purposeful typical case sampling (Kuzel 1999) to recruit participants from the 3 particular ethnic/cultural groups to be included in the broader intervention study for which this research was conducted: (1) English- and Spanish-speaking Hispanic/Latino families, (2) Haitian Creole-speaking Haitian-American families, and (3) English-speaking African-American/Black families. We selected these groups based on national (Dennison et al. 2002; Vandewater et al. 2007) and local data (Cambridge Middle Grades Health Survey 2007) that show that children from these racial/cultural groups watch more television and are more likely to have a television in their bedroom than their Caucasian peers. We recruited participants through community health centers and social service agencies in Boston, Cambridge, and Somerville, Massachusetts that serve these populations. Participants were eligible to participate in the study if they had a child from birth to 5.11 years of age.

Data Collection

Members from the research team, including one expert in qualitative methods (initials removed to ensure blind review), developed the moderator’s guide for the focus groups. A Community Advisory Board to the study, which included parents of young children and staff from various community agencies that serve parents of young children, reviewed the questions to help ensure they were culturally and contextually appropriate for the target populations.

We designed our moderator’s guide for the focus groups to elicit participants’ attitudes towards, beliefs about, and experiences with their children’s television viewing broadly, and with having televisions in their children’s bedroom specifically. To gain insight into intervention strategies that would engage and help parents reduce their children’s television viewing and remove the television from children’s bedrooms, we asked participants about their experiences trying to limit children’s television/removing television from their children’s bedrooms or what could be done to motivate them to make these changes. We expected that some parents may not be interested in reducing their children’s television viewing so we attempted to frame our questions to inquire about possible motivators and strategies for behavior change in a non-judgemental way; for example, we discussed how some parents think they should limit their children’s television time and asked what some of the possible negative effects of television that parents may be trying to avoid? We then asked what strategies could be useful in helping parents who want to limit their children’s television viewing. By exploring parents’ opinions about negative effects of television and potential strategies to limit television viewing among all parents, including those not contemplating the changes, we hoped to gain important information on how to motivate, engage and support parents in future television reduction interventions.

Table 1 lists selected questions and probes used in the focus groups. In general, the same questions and probes were used across all focus groups. The one exception was a question about parents’ opinions about using electronic time monitors to limit television viewing. A parent mentioned this strategy in one of the first few focus groups and we decided to add a specific question about this strategy to the guide for the remaining 5 focus groups.
Table 1

Discussion topics addressed in focus groups and sample questions from moderator script

Topic

Excerpt from moderator script

Perceptions of children’s television viewing

Some parents think they should limit the amount of TV their children watch, while others think differently. What do you think about that?

How do you feel about your own child’s TV time?

What do you know about some of the possible effects that television can have on children?

Reasons for having television in children’s bedroom

What are some reasons why parents may put a television in the room where their child sleeps?

How do you feel about having a TV in the room where your child sleeps? Why might some parents not allow a television in the room where their children sleep?

Strategies to help parents reduce children’s television viewing

What kinds of things could we include in a program to help parents about ways to reduce the amount of television their children watch?

Strategies to help parents keep televisions out of their children’s bedroom

What kinds of things may make it hard for parents to not put televisions in the rooms where their children sleep? What makes it hard for parents to remove televisions once they are in the room where their children sleep?

What kinds of things could we include in a program to help parents learn…

 

 …about how not to put a television in the rooms where their children sleep?

 

 …ways of removing televisions that are already in rooms where their children sleep?

Three focus groups were conducted in Haitian-Creole, 1 in Spanish, and 5 in English. Moderators were fluent in the group’s language, experienced in qualitative data collection, and familiar with our moderator’s guide. Focus groups were held at community health centers and a local apartment building and lasted approximately 2 h. We audio-recorded the focus group discussions and took detailed notes. We had the audiotapes professionally transcribed and the Haitian-Creole and Spanish focus groups professionally translated into English. Participants also completed a brief survey to obtain basic demographic information (race/ethnicity, primary language, education level) and data regarding participants’ home television environment (number of televisions in the home, presence of television in child’s/parent’s bedroom, time spent watching television).

The Harvard Pilgrim Health Care Human Subjects Committee reviewed and approved all study protocols and all participants provided written informed consent. Participants received a $40 cash honorarium, a meal, childcare, and a $5 travel reimbursement.

Data Analysis

The project analysis team conducted a group method of iterative data analysis known as immersion/crystallization (Borkan 1999). Our team of 7 researchers, including project investigators and project staff, independently read all transcripts and wrote analytic notes for each. Between June and September 2010, the research team held 8 group meetings to discuss the transcripts; we audio recorded each meeting and took detailed notes of our discussions. We also maintained a running document that tracked the themes and our evolving interpretations of each transcript. Through these meetings, we became “immersed” in the data within the context of each complete transcript. We compared the data from the transcript under discussion with the data from those we had analyzed previously, and we compared the data across racial/ethnic groups.

We endeavored to ensure the soundness and rigor of this qualitative study and our findings in several ways (Cohen and Crabtree 2008; Holliday 2002; Malterud 2001; Mays and Pope 1995). As Malterud (2001) states, it is essential for researchers to recognize their preconceptions so as to avoid falling into the trap of developing biased interpretations of data. By holding regular meetings with our multi-disciplinary team during the implementation and analysis of the focus groups, we were able to discuss the study process as it developed and as it evolved, and to work through differences and preconceptions stemming from these academic and personal viewpoints (Holliday 2002). Meeting to analyze the data iteratively, as the focus group transcripts became available, provided us a forum to critically review and discuss our data interpretation as it developed, and to consider current findings in light of findings from previous transcript analysis sessions. This iterative process also allowed us to recognize when no new themes were being generated and data saturation was achieved. To ensure study reliability for potential replicability (Mays and Pope 1995), we kept notes about decision points, changes, progress, and created a document to clearly track how we arrived at emerging themes. To provide for soundness (Mays and Pope 1995) of our findings, we ensured that our questions reflected our intended meanings by piloting them initially, and carefully noting in focus groups how they were being understood, clarifying as necessary. We also presented our results to our community advisory board to seek their input regarding our interpretation of the data.

Results

Of the 74 participants, 97 % (n = 72) were female. Approximately 73 % (n = 54) self-identified as Black/African-American, 15 % (n = 11) as Hispanic, 3 % as White (n = 2), and 6 % (n = 5) as other and 3 % (n = 2) did not respond to the race/ethnicity item on the demographic survey. The majority (64 %, n = 47) of parents reported that there was a television in their children’s bedrooms and 84 % (n = 62) reported having a television in their own bedroom. Table 2 provides information regarding participant demographics and television-related characteristics.
Table 2

Characteristics of focus group participants, N = 74

Characteristics

% or Mean (SD)

Gender

 Male

3

 Female

97

Age

34.1 (8.6)

Relationship to childa

 Mother

81

 Father

4

 Grandmother

3

 Foster parent

1

Age of child

3.2 (1.6)

Race/ethnicityb

 White

3

 Hispanic/Latino

15

 Black/African Americanc

74

 Other

6

Education

 High school graduate or less

41

 Some college or college graduate

55

 Post graduate

4

Language spoken at home

 English

61

 Spanish

8

 Haitian Creole

11

 Haitian Creole/english combination

13

 Spanish/english combination

7

Televisions in the home

2.7 (1.3)

Television in child’s bedroom (% yes)

64

Television in own bedroom (% yes)

84

Child watches >2 h/weekday (% yes)

52

Child watches >2 h/weekend day (% yes)

62

a8 participants did not answer this item

b2 participants did not answer this item

c33 % indicated they spoke Haitian Creole

We identified four main themes in our analysis: parents’ attitudes and perceptions regarding children’s television viewing; reasons for having televisions in children’s bedrooms; suggestions for ways to reduce their children’s television viewing; and suggestions for ways to keep televisions out of their children’s bedroom. We summarize these themes and provide representative quotes in the sections below.

Parents’ Attitudes and Perceptions Regarding Their Children’s Television Viewing

In general, parents were relatively unconcerned about the amount of television their children were viewing. The majority of participants indicated that they did not set time limits on their children’s television viewing: “My kids…they just watch TV all day.” A few parents even described trying to get their child to watch more television to keep them occupied: “My daughter…is just now getting into TV. And she likes watches 15 min at a time…but I want her to watch more.”

While they were relatively unconcerned about the amount of television their children watched, parents in all focus groups discussed the importance of monitoring the content of what their children watched. Parents talked about the importance of ensuring the programs their children watched were age-appropriate and did not promote violence or undermine the social or moral values that they are trying to teach their children. As one mother described: “He does stuff like Sponge Bob, it’s not good. Sponge Bob makes a kid go crazy…because they start acting like [him].” Parents also talked about certain shows ‘overstimulating’ children, which could adversely affect their children’s behavior or academic outcomes: “It affects them in school…because of the pace of things on television shows.” Some parents also expressed concern that television advertising leads to their children making more frequent demands for material goods. A few parents in one focus group discussed that the commercials on television could influence children’s intake of unhealthful foods and subsequent obesity risk: “And then the commercials. I mean, food, food, food.”

Participants in all focus groups talked about using television to keep their children occupied. Many mothers talked about their need to keep their children safe and still while they were busy with their own schoolwork or household chores and that television served as the most effective way to achieve this.

Parents’ Reasons for Having Televisions in Their Children’s Bedroom

Keeping children occupied in a room separate from the main living area emerged as the most common reason for having televisions in their children’s bedroom. Parents talked about how having televisions in their children’s bedroom allowed them to complete their household chores and keep the main living space clean. As one mother commented: “I feel I can get more stuff done because I know he is secure in the room watching TV.”

Another common reason for having a television in their children’s bedroom was to help their children fall and stay asleep. Some parents reported that the television was the “only thing” that was effective in getting their children to fall asleep.

Many parents also identified that they put a television in their children’s bedroom so that they could watch their own television shows on another television. One mother described that having a television in her child’s bedroom helped: “to alleviate the fighting so that when you want your time you can go in your room and have your time without having to worry about sharing with them.”

Parents’ Suggestions for Reducing Children’s Television Viewing

Providing parents with ideas for alternative activities to do with their children emerged as the most common suggestion to help parents limit their children’s television viewing. The majority of ideas were for activities outside of the home, such as free passes to the children’s museum. One mother suggested: “You could email us and say ‘Hey this Friday this is what is going on, bring the kids.’ Something to keep us busy.” Parents also identified the need for home-based activities that children could implement independently without parent involvement: “I do things with my kids, but after awhile they become repetitive…so a list of things that they can do on their own.”

Many participants suggested that hosting group meetings, where parents could learn about general parenting skills as well as strategies to reduce children’s television viewing, would be helpful and would allow for shared learning among parents. Some also suggested that helping parents create “routines” or a “set schedule” would help to limit the amount of television their child watched.

In the five focus groups where we asked if electronic time monitors for televisions in the home would be useful in helping parents limit the amount of television children watched, most participants indicated that this strategy would help them set concrete limits for children to follow and that they would want to try using the monitors.

Parents’ Suggestions for Keeping Televisions Out of Their Children’s Bedroom

In general, parents were unaware of any adverse consequences associated with children having a television in their bedroom. They identified that to get parents to remove a television from a child’s bedroom they would need to be convinced that televisions in bedrooms are associated with adverse consequences. One mother stated: “You got to convince me, the parent, why it’s important that the TV doesn’t belong in the room…Because I honestly, I don’t see a problem.” Some parents talked about wanting to see “scientific evidence” of the adverse consequences for their children. Physicians were identified most often as trusted sources to communicate the message regarding adverse consequences of television viewing/televisions in bedroom: “Like if a doctor said to me ‘TV is harming your child’ in any way, shape or form. It’s done. We can take all of the TVs out of the house.” A few participants recommended providing an incentive to the parents or to the families as a way to motivate parents to remove televisions that have already been placed into children’s bedrooms. For example, one father commented: “I think that it would be good to have a reward system for the parents (to remove TVs) …, like tickets for the aquarium, tickets for other things they never have done before.”

Discussion

In this study we examined racial/ethnic minority parents’ attitudes, perceptions, and experiences regarding young children’s television viewing and the use of televisions in children’s bedrooms. Few qualitative studies have explored parents’ perceptions of their children’s television viewing, and none have examined parents’ attitudes regarding television in their children’s bedrooms. To develop television reduction interventions that are culturally-relevant, able to engage parents, and change parental behaviors, it is critical that we understand parents’ opinions and attitudes towards their children’s viewing behaviors. The longer term goal of this research is to inform the development of an intervention to reduce television viewing and television in young children’s bedrooms among ethnic/minority families. The key implications of our findings for future intervention development and suggested intervention strategies and messages are outlined in Table 3.
Table 3

Key implications and suggested strategies and messaging for interventions to reduce children’s television viewing and remove televisions from children’s bedrooms

Key implication

Suggested intervention strategies or messaging

Create persuasive messages that will elicit buy-in from parents by designing intervention messages about reducing television/television in bedrooms that address issues that have relevance for parents

Frame messages to focus on the impact television can have on children’s attention, learning, and academic outcomes, children’s behavior (through role modeling what seen on television), as well as children’s health

Include an endorsement from the children’s physician to reduce television viewing and to remove televisions from children’s bedrooms

Emphasize the American Academy of Pediatrics recommendations to limit television viewing and remove televisions from children’s bedrooms

Identify non-screen, home-based activities that will keep children occupied

Educate parents on ways to ‘use’ the children’s television time by scheduling the children’s viewing time during times of the day when parents have a specific task to complete (e.g., preparing dinner). Help parents find alternative activities for their children at other times during the day

Provide parents with ideas and supplies for other alternative activities to engage their children, such as books on tape, coloring pages, and easy to complete puzzles

Correct misconceptions that some parents hold regarding the role television viewing/television in child’s bedroom can play in aiding their child’s sleep

Educate parents on recommended number of hours their children should sleep

Provide parents with data and evidence from the literature regarding how television adversely affects children’s sleep. Emphasize how poor sleep can affect children’s attention, learning, behavior, and weight

Using an actigraph or sleep monitor to demonstrate to parents how television viewing adversely affects their children’s sleep

Help parents create and implement a calming bedtime routine that does not involve television viewing

Address general parenting skills, such as creating family routines, to help reduce children’s television viewing

Guide parents in reviewing their family’s daily schedule and what times of the day are most challenging. Identify how implementing structured routines during mealtime, playtime, and bedtime could be helpful in addressing challenging times of the day without the use of television

In this racially/ethnically diverse sample of parents of young children, we found that parents were relatively unconcerned about the amount of television their children watched and most parents did not set time limits on their children’s viewing. Parents did report monitoring the content of what their children watched. Similar results were found by He et al. (2005), who examined Canadian parents’ perceptions of their preschool children’s television viewing via focus groups. Potential harmful effects of television viewing identified by parents focused mainly on the impact television viewing may have on children’s behavior and academic outcomes and only rarely on a concern about weight. We found that the majority of parents were not aware of adverse consequences of having a television in their children’s bedrooms and that they would need to be convinced of such consequences to motivate behavior change. These results suggest that to effectively engage parents of young children, television reduction interventions should include messages that address potential risks associated with children’s television viewing and televisions in children’s bedrooms and that these messages should focus on issues of key relevance to parents, such as the impact television can have on children’s behavior and academic outcomes.

We found that keeping children occupied so parents could achieve other tasks in the home was an expressed need of parents and that having their children watch television and having a television in their children’s bedrooms were tools that many parents used to meet this need. Our findings were consistent with He et al.’s (2005) qualitative study, as well as previous quantitative, survey-based studies with parents (Taveras et al. 2009; Vandewater et al. 2007). Vandewater et al. (2007) explored reasons why parents put a television in their young children’s bedroom among a nationally representative sample of parents and found that 38 % of parents reported that having a television in their children’s bedroom allows parents to get more things done by keeping the children busy. Interestingly, when responding to questions about ideas for ways to reduce their children’s television viewing, parents in our study talked most often about wanting information about, or passes to, activities/community events outside the home. Although attending these activities outside of the home present useful alternatives to television viewing they do not address the expressed need by parents to keep children occupied while they complete tasks in the home. Our findings suggest that, to be effective, television reduction interventions will need to identify alternative activities that keep children engaged.

Many parents identified that having a television in the children’s bedroom helped their child fall and stay sleep. Some talked about “needing” the television to get their child to fall asleep. Research suggests that having a television on during sleep may reduce the quantity and quality of sleep among children (Owens et al. 1999; Thompson and Christakis 2005). Our results suggest that television reduction interventions will need to correct the misconception held by some parents that television may help children sleep. Using an actigraph or sleep monitor to show parents how television viewing may be influencing their child’s sleep may be one way to communicate this message.

This present study has several strengths, including our in-depth exploration of parents’ attitudes, perceptions, and experiences regarding the use of televisions in their children’s bedrooms. This is the first study to qualitatively examine parents’ opinions and experiences with televisions in their children’s bedrooms. Given the high prevalence of televisions in bedrooms of young children and the associated health risks (Vandewater et al. 2007), interventions to remove televisions from children’s bedrooms are sorely needed. Our results will help inform such an intervention. This study focused on racial/ethnic minority families. Research suggests that minority children watch more television (Vandewater et al. 2007) and are more likely to have a television in their bedroom (Dennison et al. 2002) than their white peers and results from this study will inform the development of television reduction intervention among racial/ethnic minority populations.

A limitation of this study is that the sample is small and limited to a purposive sample of parents in one urban city in the Northeastern United States. Therefore, the study population is not necessarily representative of broader populations of parents. While caution should be taken when generalizing the results to broader populations, our findings were similar to previous research conducted with a nationally representative sample (Vandewater et al. 2007), suggesting that some of the themes may be relevant for family-based television reduction interventions targeting different populations. Although we recruited parents with children aged birth to 5 years, the vast majority of parents had preschool aged children; only 6 of the 74 participants had a child (first child) as young as 6–12 months. Thus, our results may be more relevant for informing interventions aimed at parents with preschool aged children. We were not able to explore if the concerns and issues for these parents of very young children were different than for those with older children in the current study. Further research is needed to examine specific issues among families with very young children to inform potential intervention strategies for this subgroup.

In conclusion, interventions aimed at reducing young children’s television viewing and removing televisions from children’s bedrooms are needed. To effectively engage racial/ethnic minority parents of young children, television reduction interventions should include messages that address parents’ key concerns regarding their children’s viewing and should provide parents with alternative activities to keep children engaged and occupied.

Acknowledgments

This work was supported by the Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (CCDPH) (Prevention Research Centers Grants, 1U48DP00194). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Copyright information

© Springer Science+Business Media, LLC 2012