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BackgroundMultiple chronic conditions (MCCs) are common among older adults and expensive to manage. Two-thirds of Medicare beneficiaries have multiple conditions (eg, diabetes and osteoarthritis) and account for more than 90% of Medicare spending. Patients with MCCs also experience lower quality of life and worse medical and psychiatric outcomes than patients without MCCs. In primary care settings, where MCCs are generally treated, care often focuses on laboratory results and medication management, and not quality of life, due in part to time constraints. eHealth systems, which have been shown to improve multiple outcomes, may be able to fill the gap, supplementing primary care and improving these patients’ lives. ObjectiveThis study aims to assess the effects of ElderTree (ET), an eHealth intervention for older adults with MCCs, on quality of life and related measures. MethodsIn this unblinded study, 346 adults aged 65 years and older with at least 3 of 5 targeted high-risk chronic conditions (hypertension, hyperlipidemia, diabetes, osteoarthritis, and BMI ≥30 kg/m2) were recruited from primary care clinics and randomized in a ratio of 1:1 to one of 2 conditions: usual care (UC) plus laptop computer, internet service, and ET or a control consisting of UC plus laptop and internet but no ET. Patients with ET have access for 12 months and will be followed up for an additional 6 months, for a total of 18 months. The primary outcomes of this study are the differences between the 2 groups with regard to measures of quality of life, psychological well-being, and loneliness. The secondary outcomes are between-group differences in laboratory scores, falls, symptom distress, medication adherence, and crisis and long-term health care use. We will also examine the mediators and moderators of the effects of ET. At baseline and months 6, 12, and 18, patients complete written surveys comprising validated scales selected for good psychometric properties with similar populations; laboratory data are collected from eHealth records; health care use and chronic conditions are collected from health records and patient surveys; and ET use data are collected continuously in system logs. We will use general linear models and linear mixed models to evaluate primary and secondary outcomes over time, with treatment condition as a between-subjects factor. Separate analyses will be conducted for outcomes that are noncontinuous or not correlated with other outcomes. ResultsRecruitment was conducted from January 2018 to December 2019, and 346 participants were recruited. The intervention period will end in June 2021. ConclusionsWith self-management and motivational strategies, health tracking, educational tools, and peer community and support, ET may help improve outcomes for patients coping with ongoing, complex MCCs. In addition, it may relieve some stress on the primary care system, with potential cost implications. Trial RegistrationClinicalTrials.gov NCT03387735; https://www.clinicaltrials.gov/ct2/show/NCT03387735. International Registered Report Identifier (IRRID)DERR1-10.2196/25175

BackgroundDepressive symptoms are the most prevalent mental health concern among older adults (possibly heightened during the COVID-19 pandemic), which raises questions about how such symptoms can be lowered in this population. Existing research shows that offline social connectedness is a protective factor against depression in older adults; however, it is unknown whether web-based social connectedness can have similar effects. ObjectiveThis study investigates whether social connectedness on a support website protects older adults against depressive symptoms over the course of a year, above and beyond the protective effect of offline social connectedness. The secondary aim is to determine whether older adults with increased depressive symptoms are more likely to engage in social connectedness on this website. Thus, we examine depressive symptoms as both an outcome and predictor of web-based social connectedness to fully understand the chain of causality among these variables. Finally, we compare web-based social connectedness with offline social connectedness in their ability to lower depressive symptoms among older adults. MethodsA total of 197 adults aged 65 years or older were given access to a social support website, where they were able to communicate with each other via a discussion forum for a year. Participants’ social connectedness on the web-based platform, conceptualized as message production and consumption, was measured using behavioral log data as the number of messages participants wrote and read, respectively, during the first 6 months (t1) and the following 6 months (t2) of the study. Participants self-reported their offline social connectedness as the number of people in their support networks, and they reported their depressive symptoms using the Patient Health Questionnaire-8 both at baseline (t1) and at 12-month follow-up (t2). To ascertain the flow of causality between these variables, we employed a cross-lagged panel design, in which all variables were measured at t1 and t2. ResultsAfter controlling for the effect of offline support networks at t1, web-based message consumption at t1 decreased older adults’ depressive symptoms at t2 (β=−.11; P=.02), but web-based message production at t1 did not impact t2 depressive symptoms (β=.12; P=.34). Web-based message consumption had a larger effect (β=−.11; P=.02) than offline support networks (β=−.08; P=.03) in reducing older adults’ depressive symptoms over time. Higher baseline depressive symptoms did not predict increased web-based message consumption (β=.12; P=.36) or production (β=.02; P=.43) over time. ConclusionsThe more messages older adults read on the web-based forum for the first 6 months of the study, the less depressed they felt at the 1-year follow-up, above and beyond the availability of offline support networks at baseline. This pinpoints the substantial potential of web-based communication to combat depressive symptoms in this vulnerable population. International Registered Report Identifier (IRRID)RR2-10.1186/s13063-015-0713-2

This meta-analysis synthesizes research on media use in early childhood (0-6 years), word-learning, and vocabulary size. Multi-level analyses included 266 effect sizes from 63 studies (N[subscript total] = 11,413) published between 1988-2022. Among samples with information about race/ethnicity (51%) and sex/gender (73%), most were majority White/Non-Hispanic and between 40%-60% female. Analyses revealed a small overall positive relation between screen media exposure and vocabulary (r = 0.23). Experimental studies yielded a small-to-medium effect (r = 0.30), with stronger effects for e-books than TV/video or games/apps, and non-significant effects for video chat. In correlational studies, there was no overall association between vocabulary size and naturalistic media exposure (r = 0.07), with the exception of naturalistic exposure to educational media (r = 0.17).

Fictional entertainment can serve as a vivid and easily comprehensible source of knowledge, but only if audiences are able to tell its kernel of truth apart from fantasy. In this article, we use the lens of social epistemology to develop a theoretical framework of knowledge acquisition and verification practices for fictional entertainment that integrates various extant lines of work on entertainment education, perceived realism, information processing, credibility assessment, and verification strategies. To flesh out the conceptual model derived from top-down theoretical integration, we use an inductive, bottom-up approach to theory building, assisted by qualitative research. The resulting model describes knowledge acquisition from fiction as an essentially social process characterized by a combination of epistemic trust and epistemic vigilance toward fictional content and sources, in which credibility is assessed via social knowledge sharing and verification practices. [ABSTRACT FROM AUTHOR]

Educational television for young children often combines factual content with fantasy. In 2 experiments, we examined 3- to 5-year-olds' reality judgments and the implications for their learning. In the 1st study, 145 children watched 3 clips featuring (respectively) a Hispanic, a Chinese American, and an Anglo character. Responses indicated age differences in character-reality judgments (e.g., "'X' can hear me"), acceptance of fantasy (e.g., talking backpacks), rejection of factual content (i.e., Spanish and Chinese words are "just pretend") but not perceived learning. Perceived reality of Chinese and Spanish words used by the characters partially mediated age differences in word comprehension, controlling for viewer ethnicity. In the 2nd study, 114 children were randomly assigned to see clips featuring either Hispanic or Chinese traditions and words. Age differences in reality judgments were replicated and were partially mediated by children's use of evidence or arguments to justify reality judgments and (to a lesser extent) by their cognitive flexibility. Further, children's reality judgments partially mediated age differences in learning of the educational content. Results suggest that reality distinctions improve with age, contributing to children's learning.

This meta‐analysis synthesizes research on media use in early childhood (0–6 years), word‐learning, and vocabulary size. Multi‐level analyses included 266 effect sizes from 63 studies (Ntotal = 11,413) published between 1988–2022. Among samples with information about race/ethnicity (51%) and sex/gender (73%), most were majority White/Non‐Hispanic and between 40%–60% female. Analyses revealed a small overall positive relation between screen media exposure and vocabulary (r =.23). Experimental studies yielded a small‐to‐medium effect (r =.30), with stronger effects for e‐books than TV/video or games/apps, and non‐significant effects for video chat. In correlational studies, there was no overall association between vocabulary size and naturalistic media exposure (r =.07), with the exception of naturalistic exposure to educational media (r =.17). [ABSTRACT FROM AUTHOR]

"Sesame Street" is broadcast to millions of children globally, including in some of the world's poorest regions. This meta-analysis examines the effects of children's exposure to international co-productions of "Sesame Street", synthesizing the results of 24 studies, conducted with over 10,000 children in 15 countries. The results indicated significant positive effects of exposure to the program, aggregated across learning outcomes, and within each of the three outcome categories: cognitive outcomes, including literacy and numeracy; learning about the world, including health and safety knowledge; social reasoning and attitudes toward out-groups. The effects were significant across different methods, and they were observed in both low- and middle-income countries and also in high-income countries. The results are contextualized by considering the effects and reach of the program, relative to other early childhood interventions. (Contains 6 tables.)

Two studies examined how adult age and time of measurement influence media preferences. Study 1 (using TV ratings data from 1970s to 1980s) found that the popularity of genres varied over time, but even after controlling for year, age groups differed in (a) genre choices (consistent with socioemotional selectivity theory) and (b) age of characters viewed (consistent with age identity theory). The average age of characters in each program partially mediated age differences in ratings of comedies and news, and suppressed a negative relationship between viewer age and ratings of violent programs. Study 2 (using 2005 survey data) found similar genre and character preferences. In addition, subjective age predicted age of favorite characters beyond the effect of chronological age.

Investigates the effects of talk-show viewing on high-school students' social-reality beliefs. Supports the hypothesis that viewers overestimate the frequency of deviant behaviors; does not find support for the hypothesis that viewers become desensitized to the suffering of others; and finds that talk-show viewing was positively related, among some age groups, to perceived importance of social issues. (SR)

Examines whether errors in memory (specifically source confusions) contribute to the link between television viewing and social reality judgments. Finds that a manipulation of the visual similarity of the news and fictional programming affected subjects' tendency to make source confusions. (RS)

Given children's difficulty comprehending prosocial narratives, we examined strategies to bypass comprehension (affiliative priming) and reduce cognitive burden (simplified lessons, adult scaffolding). In Study 1, one hundred seven 3- to 5-year-olds watched a prosocial narrative (helping vs. waiting) with affective primes (loving vs. funny) or a control narrative. Comprehension was low and behavioral outcomes were unaffected by lesson or prime. In Study 2, sixty-four 3- to 5-year-olds watched shorter stimuli (1-minute song videos) about loving or helping others. Those in the helping condition helped more, but the loving condition did not differ from a no-exposure control. In Study 3, 636 parents of 2- to 10-year-olds were surveyed about a time their child showed prosocial responses to media. Over 70% recalled an instance, a third of which involved songs. Reported response duration was positively predicted by family discussions after exposure (rather than at the time), including explicating the lessons and giving timely reminders/praise. [ABSTRACT FROM AUTHOR]

Two studies examined how adult age and time of measurement influence media preferences. Study I (using TV ratings data from 1970s to 1980s) found that the popularity of genres varied over time, but even after controlling for year, age groups differed in (a) genre choices (consistent with socioemotional selectivity theory) and (b) age of characters viewed (consistent with age identity theory). The average age of characters in each program partially mediated age differences in ratings of comedies and news, and suppressed a negative relationship between viewer age and ratings of violent programs. Study 2 (using 2005 survey data) found similar genre and character preferences. In addition, subjective age predicted age of favorite characters beyond the effect of chronological age. doi: 10.1111/j.1468-2958.2010.01380.x

Recent theorizing posits that parents and their children influence each other, and that media use is a locus of such mutual influence. Two surveys of LGBTQ 18- and 19-year-olds (N = 276; N = 369, the latter a replication) tested hypotheses that LGBTQ teens use media to socialize their parents about their sexual and gender identities, and that these uses elicit parental responses which have implications for the teen. In both studies, teens reported co-viewing and mediating their parents' exposure to LGBTQ content (i.e., encouraging positive exposure, discouraging negative exposure, critiquing/explicating depictions) and indicated that such moments sometimes elicited conversations about their own sexual or gender identities. In both studies, their perceptions of their parents' receptivity to these interactions varied widely. In both studies, teens' LGBTQ-media-related behavior and perceptions of parental receptivity were positively associated with perceptions that their parents supported their LGBTQ identity. Perceived receptivity (in Study 1) and perceived support for the teens' LGBTQ identities (in Study 2) were associated with teens' self-esteem and depressive symptoms. Overall, despite some inconsistencies between the two studies and the limitations of cross-sectional data, the findings are consistent with mutual influence. [ABSTRACT FROM AUTHOR]

Three groups of adults (aged 19-30, 65-70, and 71-78) watched two TV dramas. Half the adults within each age group were fans of the second program, thus were familiar with the characters, typical story lines, and production style. Comprehension was measured after each program, including memory for characters' emotions and relationships, recognition and recall and chronology of main events, and ability to make inferences about the content. The results indicated significant age differences in comprehension. Age differences were smaller for socioemotional content and for relatively easy tasks, larger for chronological sequencing and inference measures. Age differences on most comprehension variables (but not inference-making) were smaller among fans viewing familiar content. Keywords: Aging; Comprehension; Television; Media; Older

Two studies examined the effects of repeated viewing on children's comprehension of videos. In Study 1, 72 children aged 6-8 watched The Sword in the Stone. Afterwards, children who had seen the film before were compared with those for whom the film was novel. In Study 2, 291 children aged 4-8, watched one of two versions of a short story in which the main character's appearance was incongruous with her behavior. Children were tested after one or four exposures. Results of both studies indicated that repetition reduced initial developmental differences in comprehension and helped younger children inhibit the perceptual salience of characters' appearance. However, children's understanding of the more complex causal sequences and the moral of the film in Study 1 remained low, despite prior exposure. Keywords: Children; Television; Comprehension; Repetition; VCR

Research on ethnic-racial socialization in African American families has rarely examined parental messages about media, even though African American youth are among the heaviest media consumers, and media depictions are frequently biased. We surveyed 398 parents of African American 3- to 17-year-olds, asking how often they socialized their child using (a) ethnic-racial socialization, (b) parental mediation, and (c) media racial depictions. Results suggest that ethnic-racial socialization includes a specific set of practices involving encouraging, critiquing, and avoiding particular types of media racial depictions – strategies which we call Media-Based Ethnic-Racial Socialization (MBERS). Frequencies for all three socialization domains were predicted by parent and perceived child ethnic-racial identity strength and parental perceptions of racial bias and opportunity in the child's media. These results suggest the importance of media for ethnic-racial socialization practices and the centrality of race even for socialization domains that may not always be seen as racialized, such as parental mediation. [ABSTRACT FROM AUTHOR]

The chief hypothesis of this study was that errors in memory (specifically source confusions) contribute to the link between television viewing and social reality judgments. Fiction-to-news confusions (fictional programming remembered as news) were hypothesized to positively predict TV-biased judgments of reality. News-to-fiction confusions (news remembered as fiction) were hypothesized to negatively predict such judgments. The results of an experiment in which subjects watched television programming containing both news and fiction indicated that these hypotheses were supported. Levels of confusion interacted with daily television viewing and with the level of certainty attached to the confusions. A manipulation of the visual similarity of the news and fiction content affected subjects' tendency to make source confusions.

This study examined the effects of differently valenced portrayals of old age on the emotional responses of elderly viewers. Lonely and nonlonely elderly people (as determined in a pretest) were given a series of descriptions of television offerings and indicated the degree to which they desired to see each program. In a separate session, they were randomly assigned to view a negative portrayal (involving an unhappy, isolated old man) or a positive portrayal (involving a happy, socially integrated old man). The results indicated that lonely subjects showed greater interest in viewing negative than positive portrayals, whereas nonlonely subjects exhibited the opposite preference. In addition, lonely subjects felt better after viewing the negative portrayal than after the positive portrayal, whereas nonlonely subjects felt better after the positive than after the negative portrayal. The findings therefore indicated that elderly viewers may benefit from varied portrayals of old age more than from uniformly positive or negative depictions.

An experiment was conducted testing Armstrong and Greenberg's (1990) model of the effect of background television on cognitive performance, as it applies to reading comprehension and memory. Subjects completed a cued-recall test of the content of an expository prose passage read under quiet conditions or concurrently with the presence of one of two types of television content (prime-time drama versus commercials). Effects on immediate versus delayed recall were examined. Overall, significant deleterious effects of background television were found, controlling for prior abilities and motivation. Deleterious effects were stronger and more consistent when testing occurred immediately after reading, rather than after a five-minute filled delay. Background commercials resulted in more consistently negative effects than did TV drama.

This study examined young viewers' evaluations of the social and physical aggression that is endemic in tween sitcoms. Preadolescents (N = 176) were randomly assigned to watch a tween sitcom that featured a protagonist or antagonist committing social or physical aggression (two exemplars at each level). As suggested by recent work on disposition theory and moral development, participants' moral evaluations of the depicted aggression were related to their liking of the perpetrator, not their perceptions of the severity of the aggression. Furthermore, there was support for the causal chain proposed by Raney's formulation of disposition theory, whereby protagonist liking predicted moral indifference, which further predicted self-reported likelihood of imitating the aggression. This path was stronger at higher ratings of funniness. When aggressors were perceived as likable and their actions as funny, viewers reported more indifference and greater likelihood of imitation. [ABSTRACT FROM AUTHOR]