SEATTLE – A new index that captures the multiple and complex aspects of media use among today’s youth helps identify those at high risk for drinking, new data show.
In a cross-sectional study among 126 middle school students, relative to their peers having a media involvement index (MII) in the bottom tertile, those having an MII in the top tertile had four- to fivefold higher odds of being current drinkers after potential confounders were taken into account.
Students with a top-tertile MII also had similarly elevated odds of having alcohol risk factors in general, such as planning to drink in the next year, principal investigator Craig S. Ross reported at the annual meeting of the Society for Adolescent Health and Medicine.
In contrast, measures that have traditionally been used to assess media use among adolescents, such as time spent watching television, showed little or no association with these outcomes.
"Adolescents are really avid experimenters, and the new media environment provides inexpensive and powerful tools to facilitate experimentation," he said. "We need new measures in public health to reflect the changing media environment, and the MII shows promise as one such new measure."
The observed associations have several possible explanations, according to Mr. Ross, who is a doctoral student in the epidemiology department at the Boston University School of Public Health.
"Heavy media use may be a marker for sensation seeking or self-medication, or a need to belong among these young adolescents," he speculated. "It may expose them to more normalizing portrayals of alcohol use, and it may enable them to share potentially unhealthful messages with their peers."
Past studies have linked traditional measures of media use to both initiation and frequency of drinking among adolescents, Mr. Ross noted. "The key challenge we face today is that the media environment is rapidly changing, and adolescents really are at the vanguard of this change."
"In this changing media environment, we set out to determine which traditional measures of media use would be associated with alcohol risk factors among young adolescents, and whether we could identify new measures that capture the ubiquity of media access and multitasking behaviors," he explained.
The investigators studied 126 middle school students aged 13-15 years from a small New England city who were participants in the Measuring Youth Media Exposure Study. All were recruited from school and community settings.
Analyses were based on students’ self-reported data from computer-assisted interviews conducted at baseline between January and November 2009. Overall, 53% of the students were boys, 37% were black or Hispanic, and 44% lived with a single mother.
The MII captured multiple facets of media access and activity among the youth, including the presence of media in their bedroom, possession of portable media, media multitasking behaviors (such as using the phone while watching television), use of media while traveling, and home background media (such as having the television on while nobody is watching). Possible scores ranged from 0 to 23 points.
In terms of alcohol outcomes, 18% of the students fell into a general alcohol risk group because they were current drinkers, had positive attitudes about alcohol, and/or intended to drink within a year. Some 10% specifically were current drinkers.
Traditional measures of media use showed only limited associations with these outcomes, according to Mr. Ross. Time spent listening to music was associated with both having alcohol risk factors (P = .01) and being a current drinker (P = .01). And overall time spent using nonprint media was associated with the latter (P = .03).
But a variety of other individual measures – television time, video game time, cell phone time, and e-mail/chat time, among others – were not significantly associated with alcohol outcomes. "These isolated measures of time spent with different media really don’t reflect the modern media environment," he commented.
The students had MIIs ranging from 4 to 19, with an average of 10. When they were split into tertiles by MII, the bottom tertile had values of 4-7, and the top tertile had values of 12-19.
"Just to give you a sense of what these kids might look like from a media perspective, a typical participant in the upper tertile has a full complement of bedroom media, including a television hooked up to premium cable, a video game console, and a computer hooked up to the Internet. They will have a cell phone and a notebook computer, and they are going to be multitasking with these devices frequently," Mr. Ross explained.
"On the other end of the scale, a typical participant in the lower tertile may have a television in their bedroom, but it’s not hooked up to premium cable. They do not have a computer in their bedroom, and only half have a cell phone. Very few will have a notebook computer, and in this group, media multitasking is infrequent," he said.