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Media framing of health issues reflects public opinion and impacts readers' perceptions and behavior. This study examines how meditation - a recommended stress coping strategy for college students - is framed in campus newspapers from 1997-2018.A total of 494 articles were analyzed.Semantic network analysis was used to automatically detect frames and the longitudinal trend.Five major frames emerged: (1) building a meditation community within a campus community, (2) meditation benefits, (3) yoga for enhancing mind and body awareness, (4) meditation techniques, and (5) secularizing meditation on campus. There is a shift in coverage from interest in religion to secular views of health benefits throughout the years. Discussions of adverse effects that have emerged from the literature were entirely absent.The trend of secularizing meditation practices on college campuses is evident. Emphasizing the techniques and benefits could encourage participation and build a learning community.

Objective: The objective of this study is to explore adolescent non-e-cigarette users’ interpretations of e-cigarette advertising and their engagement with e-cigarette information. Given adolescent...

Background Although reducing sugar-sweetened beverage (SSB) intake is an important behavioral strategy to improve health, no known SSB-focused behavioral trial has examined maintenance of SSB behaviors after an initial reduction. Guided by the RE-AIM framework, this study examines 6–18 month and 0–18 month individual-level maintenance outcomes from an SSB reduction trial conducted in a medically-underserved, rural Appalachia region of Virginia. Reach and implementation indicators are also reported. Methods Following completion of a 6-month, multi-component, behavioral RCT to reduce SSB intake (SIPsmartER condition vs. comparison condition), participants were further randomized to one of three 12-month maintenance conditions. Each condition included monthly telephone calls, but varied in mode and content: 1) interactive voice response (IVR) behavior support, 2) human-delivered behavior support, or 3) IVR control condition. Assessments included the Beverage Intake Questionnaire (BEVQ-15), weight, BMI, and quality of life. Call completion rates and costs were tracked. Analysis included descriptive statistics and multilevel mixed-effects linear regression models using intent-to-treat procedures. Results Of 301 subjects enrolled in the 6-month RCT, 242 (80%) were randomized into the maintenance phase and 235 (78%) included in the analyses. SIPsmartER participants maintained significant 0–18 month decreases in SSB. For SSB, weight, BMI and quality of life, there were no significant 6–18 month changes among SIPsmartER participants, indicating post-program maintenance. The IVR-behavior participants reported greater reductions in SSB kcals/day during the 6–18 month maintenance phase, compared to the IVR control participants (− 98 SSB kcals/day, 95% CI = − 196, − 0.55, p

Media literacy, the critical analysis and deconstruction of media messages, has the potential to promote favorable attitudes toward members of racial minority groups. This study reports on the deve...

Although adolescents are a group heavily targeted by the e-cigarette industry, research in cue-reactivity has not previously examined adolescents' behavioral and neural responses to e-cigarette advertising. This study addressed this gap through two experiments. In Experiment One, adult traditional cigarette smokers (n = 41) and non-smokers (n = 41) answered questions about e-cigarette and neutral advertising images. The 40 e-cigarette advertising images that most increased desire to use the product were matched to 40 neutral advertising images with similar content. In Experiment Two, the 80 advertising images selected in Experiment One were presented to adolescents (n = 30) during an functional magnetic resonance imaging brain scan. There was a range of traditional cigarette smoking across the sample with some adolescents engaging in daily smoking and others who had never smoked. Adolescents self-reported that viewing the e-cigarette advertising images increased their desire to smoke. Additionally, all participants regardless of smoking statuses showed significantly greater brain activation to e-cigarette advertisements in areas associated with cognitive control (left middle frontal gyrus), reward (right medial frontal gyrus), visual processing/attention (left lingual gyrus/fusiform gyrus, right inferior parietal lobule, left posterior cingulate, left angular gyrus) and memory (right parahippocampus, left insula). Further, an exploratory analysis showed that compared with age-matched non-smokers (n = 7), adolescent smokers (n = 7) displayed significantly greater neural activation to e-cigarette advertising images in the left inferior temporal gyrus/fusiform gyrus, compared with their responses to neutral advertising images. Overall, participants' brain responses to e-cigarette advertisements suggest a need to further investigate the long-run impact of e-cigarette advertising on adolescents.

Background: Health districts in southwest Virginia have one of the highest ultraviolet (UV) radiation exposure and sunburn rate. Due to higher levels of UV exposure, rural farm youth are at higher risk for skin cancer than non-farm youth. Few studies have been published that explore best practices for decreasing UV exposure among this population. Purpose: This 5-week study assessed the effectiveness of a health promotion intervention including a UV monitoring device in decreasing UV exposure among youth. Methods: A mixed methods research design (focus groups and a pretest-posttest one-group design) set in rural southwest Virginia, long tied to the agricultural sector, was used. Youth ages 14 to 16 (93.5% white, 87.1% female) participated in the 4-unit (90-minute each) intervention based on the Health Belief Model (n = 31). It also incorporated a user-friendly UV monitoring device. Results: Participants' knowledge of factors related to skin cancer (p

This study tested the double-edged desirability hypothesis to investigate whether a lack of reduction in desirability perceptions signified failure of a media literacy intervention to reduce the appeal of sexual portrayals or whether it instead represented an improved awareness of message-design techniques and, therefore, a successful intervention. Data from two media literacy curriculum evaluations, both pretest–posttest quasi-experiments with control groups (N1 = 922, M = 14.13, SD = 1.07; N2 = 1,098, M = 14.26, SD = 1.06) showed that the media literacy treatment in both studies eliminated the effect of desirability on participants’ attitudes, reduced the effect of message desirability on participants’ expectancies, and reduced the effect of message desirability on participants’ efficacy in one of the evaluations. The results supported the double-edged desirability hypothesis, which holds that media literacy education can diminish the influence of desirable but unrealistic sexual media messages on adole...

Media literacy describes the ability to access, analyze, evaluate, and produce media messages. As media messages can influence audiences’ attitudes and behaviors toward various topics, such as attitudes toward others and risky behaviors, media literacy can counter potential negative media effects, a crucial task in today’s oversaturated media environment. Media literacy in the context of health promotion is addressed by analyzing the characteristics of 54 media literacy programs conducted in the United States and abroad that have successfully influenced audiences’ attitudes and behaviors toward six health topics: prevention of alcohol use, prevention of tobacco use, eating disorders and body image, sex education, nutrition education, and violent behavior. Because media literacy can change how audiences perceive the media industry and critique media messages, it could also reduce the potential harmful effects media can have on audiences’ health decision-making process. The majority of the interventions have focused on youth, likely because children’s and adolescents’ lack of cognitive sophistication may make them more vulnerable to potentially harmful media effects. The design of these health-related media literacy programs varied. Many studies’ interventions consisted of a one-course lesson, while others were multi-month, multi-lesson interventions. The majority of these programs’ content was developed and administered by a team of researchers affiliated with local universities and schools, and was focused on three main areas: reduction of media consumption, media analysis and evaluations, and media production and activism. Media literacy study designs almost always included a control group that did not take part in the intervention to confirm that potential changes in health and risk attitudes and behaviors among participants could be attributed to the intervention. Most programs were also designed to include at least one pre-intervention test and one post-intervention test, with the latter usually administered immediately following the intervention. Demographic variables, such as gender, age or grade level, and prior behavior pertaining to the health topic under study, were found to affect participants’ responses to media literacy interventions. In these 54 studies, a number of key media literacy components were clearly absent from the field. First, adults—especially those from historically underserved communities—were noticeably missing from these interventions. Second, media literacy interventions were often designed with a top-down approach, with little to no involvement from or collaboration with members of the target population. Third, the creation of counter media messages tailored to individuals’ needs and circumstances was rarely the focus of these interventions. Finally, these studies paid little attention to evaluating the development, process, and outcomes of media literacy interventions with participants’ sociodemographic characteristics in mind. Based on these findings, it is recommended that health-related media literacy programs fully engage community members at all steps, including in the critical analysis of current media messages and the production and dissemination of counter media messages. Health-related media literacy programs should also impart participants and community members with tools to advocate for their own causes and health behaviors.

Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology.Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants.Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models.TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13-20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6-38%) and behaviour (average 30%, range 6-55%) were significant.Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases.

Understanding how adults' media literacy skill sets impact their sugar-sweetened beverage (SSB) intake provides insight into designing effective interventions to enhance their critical analysis of marketing messages and thus improve their healthy beverage choices. However, a media literacy scale focusing on SSBs is lacking. This cross-sectional study uses baseline data from a large randomized controlled trial to (a) describe the psychometric properties of an SSB Media Literacy Scale (SSB-ML) scale and its subdomains, (b) examine how the scale varies across demographic variables, and (c) explain the scale's concurrent validity to predict SSB consumption. Results from 293 adults in rural southwestern Virginia (81.6% female, 94.0% White, 54.1% receiving SNAP and/or WIC benefits, average 410 SSB kcal daily) show that overall SSB-ML scale and its subdomains have strong internal consistencies (Cronbach's alphas ranging from 0.65 to 0.83). The Representation & Reality domain significantly predicted SSB kilocalories, after controlling for demographic variables. This study has implications for the assessment and inclusion of context-specific media literacy skills in behavioral interventions.

This study, a pretest-posttest quasi-experiment conducted in the field (n = 1098), examined a media literacy curriculum to determine its influence on adolescents' responses to and interpretations of sexual media messages. Main effects were confirmed on seven of eight dependent variables tested. Treatment-group participants increased their understanding that media influence teens' decisions regarding sex and media depictions often misrepresent sexual behavior. They also became more likely to believe sexual abstinence is normative among adolescents, lowered their expectancies for engaging in sex and increased their efficacy for delaying sexual activity as compared to control-group participants. Sex-based differences independent of the curriculum existed on participants' attitudes toward delaying sexual activity and expectancies for engaging in sex.

Purpose. The purpose of this pilot study was to assess the impact of media literacy for tobacco prevention for youth delivered through a community site. Design. A randomized pretest-posttest evaluation design with matched-contact treatment and control conditions. Setting. The pilot study was delivered through the YMCA in a lower-income suburban and rural area of Southwest Virginia, a region long tied, both economically and culturally, to the tobacco industry. Subjects. Children ages 8 to 14 (76% white, 58% female) participated in the study (n = 38). Intervention. The intervention was an antismoking media literacy program (five 1-hour lessons) compared with a matched-contact creative writing control program. Measures. General media literacy, three domains of tobacco-specific media literacy (“authors and audiences,” “messages and meanings,” and “representation and reality”), tobacco attitudes, and future expectations were assessed. Analysis. Multiple regression modeling assessed the impact of the intervention, controlling for pretest measures, age, and sex. Results. General media literacy and tobacco-specific “authors and audiences” media literacy improved significantly for treatment compared with control (p < .05); results for other tobacco-specific media literacy measures and for tobacco attitudes were not significant. Future expectations of smoking increased significantly for treatment participants ages 10 and younger (p < .05). Conclusion. Mixed results indicated that improvements in media literacy are accompanied by an increase in future expectations to smoke for younger children.

Fearing the negative effect that alcohol advertising might have on adolescents' receptiveness to the consumption of alcohol, health educators have used media literacy as an effective strategy to mitigate the effect of these messages in the media. The present study applied parental mediation to the design and evaluations of a media literacy curriculum that targets alcohol decision-making processes illustrated in the message interpretation process model. The authors conducted a pretest-posttest quasi-experiment of 171 adolescents to examine the effect of a negative evaluative approach and a balanced evaluative approach (a combination of negative and positive evaluative strategies) to media literacy on modifying adolescents' responses to alcohol messages. Results showed that different media literacy approaches had varying degrees of effectiveness on adolescent boys and girls. After receiving a negative media literacy lesson, adolescent boys regarded television characters as less realistic and believed that drinking alcohol had negative consequences. In contrast, adolescent girls benefited more from a balanced evaluative approach as their media skepticism attitude was enhanced. Results suggest that health educators should choose tailored pedagogical approaches that are based on gender to improve decision making regarding alcohol consumption.

This study examined underage drinkers' responses to negative-restrictive versus proactive-nonrestrictive slogans in humorous anti-alcohol abuse advertisements. The authors conducted a posttest-only control group experiment with 91 teenagers and college-aged participants. For underage moderate drinkers, the negative-restrictive slogans (e.g., "Don't drink") increased participants' perceived risk of excessive drinking and increased a level of intention to change their drinking behavior. However, for underage binge drinkers, the negative-restrictive slogans lowered participants' risk perception of excessive drinking and intention to change their drinking behavior.

This Excessive sugar-sweetened beverage (SSB) consumption and low health literacy skills have emerged as two public health concerns in the United States (US); however, there is limited research on how to effectively address these issues among adults. As guided by health literacy concepts and the Theory of Planned Behavior (TPB), this randomized controlled pilot trial applied the RE-AIM framework and a mixed methods approach to examine a sugar-sweetened beverage (SSB) intervention (SipSmartER), as compared to a matched-contact control intervention targeting physical activity (Move-More). Both 5-week interventions included two interactive group sessions and three support telephone calls. Executing a patient-centered developmental process, the primary aim of this paper was to evaluate patient feedback on intervention content and structure. The secondary aim was to understand the potential reach (i.e., proportion enrolled, representativeness) and effectiveness (i.e. health behaviors, theorized mediating variables, quality of life) of SipS- martER. Twenty-five participants were randomized to SipSmartER (n = 14) or MoveMore (n = 11). Participants’ intervention feedback was positive, ranging from 4.2 - 5.0 on a 5-point scale. Qualitative assessments reavealed several opportuneties to improve clarity of learning materials, enhance instructions and communication, and refine research protocols. Although SSB consumption decreased more among the SipS-martER participants (?256.9 ± 622.6 kcals), there were no significant group differences when compared to control participants (?199.7 ± 404.6 kcals). Across both groups, there were significant improvements for SSB attitudes, SSB behavioral intentions, and two media literacy constructs. The value of using a patient-centered approach in the developmental phases of this intervention was apparent, and pilot findings suggest decreased SSB may be achieved through targeted health literacy and TPB strategies. Future efforts are needed to examine the potential public health impact of a large-scale trial to address health literacy and reduce SSB.

Despite excessive consumption of sugar-sweetened beverages (SSB), little is known about behavioral interventions to reduce SSB intake among adults, particularly in medically-underserved rural communities. This type 1 effectiveness-implementation hybrid RCT, conducted in 2012–2014, applied the RE-AIM framework and was designed to assess the effectiveness of a behavioral intervention targeting SSB consumption (SIPsmartER) when compared to an intervention targeting physical activity (MoveMore) and to determine if health literacy influenced retention, engagement or outcomes. Guided by the Theory of Planned Behavior and health literacy strategies, the 6 month multi-component intervention for both conditions included three small-group classes, one live teach-back call, and 11 interactive voice response calls. Validated measures were used to assess SSB consumption (primary outcome) and all secondary outcomes including physical activity behaviors, theory-based constructs, quality of life, media literacy, anthropometric, and biological outcomes. Targeting a medically-underserved rural region in southwest Virginia, 1056 adult participants were screened, 620 (59 %) eligible, 301 (49 %) enrolled and randomized, and 296 included in these 2015 analyses. Participants were 93 % Caucasian, 81 % female, 31 % ≤ high-school educated, 43 %

This chapter discusses the importance of incorporating media literacy into school and nonschool settings to combat childhood obesity in China. This chapter begins with an introduction of the obesity epidemic and the rising medical costs associated with obesity-related illnesses. The author then explains how food marketing contributes to childhood obesity by discussing food advertising expenditures, types of food advertising, and persuasive tactics used in food marketing to attract children’s attention.

This study was a theory-based, pretest-posttest quasi-experiment conducted in the field (N = 922) to determine whether and how a media literacy curriculum addressing sexual portrayals in the media would influence adolescents' decision-making processes regarding sex. Results of the evaluation, based on the Message Interpretation Process Model, indicated that participants who received media literacy training better understood that media influence teens' decision making about sex and were more likely to report that sexual depictions in the media are inaccurate and glamorized. In addition, participants who received media literacy lessons were more likely than were control group participants to believe that other teens practice abstinence and reported a greater ability to resist peer pressure. An interaction effect existed between gender and condition on attitudes toward abstinence, suggesting that the lessons helped girls and boys in somewhat different ways. Overall, the results indicated that media literacy strengthened key aspects of participants' logic-oriented decision-making process.

To describe sugar-sweetened beverage (SSB) consumption and to establish psychometric properties and utility of a Theory of Planned Behavior (TPB) instrument for SSB consumption.This cross-sectional survey included 119 southwest Virginia participants. Most of the respondents were female (66%), white (89%), and had at least a high school education (79%), and their average age was 41.4 ± 13.5 years. A validated beverage questionnaire was used to measure SSB. Eleven TPB constructs were assessed with a 56-item instrument. Analyses included descriptive statistics, 1-way ANOVA, Cronbach α, and multiple regression.Sugar-sweetened beverage intake averaged 457 ± 430 kcal/d. The TPB model provided a moderate explanation of SSB intake (R(2) = 0.38; F = 13.10, P.01). Behavioral intentions had the strongest relationships with SSB consumption, followed by attitudes, perceived behavioral control, and subjective norms. The 6 belief constructs did not predict significant variance in the models.Future efforts to comprehensively develop and implement interventions guided by the TPB hold promise for reducing SSB intake.

An online survey of 457 parents identifies factors associated with parents' intentions to allow their children to watch 18 common television scenes. Results of an exploratory factor analysis indicated that, with some exceptions, parents identified the scenes as 3 distinct factors representing violence, nudity and sexuality-related, and family-oriented content. Further, results from hierarchical multiple regression analyses indicated that mediation style explained a greater portion of the variance in parents' likelihood to let their children watch this content than either family communication patterns (FCP) or relevant demographic characteristics.

Objective To inform the implementation of media production activities with adult populations by describing the construction of counter-advertisements (counter-ads) within a behavioral intervention. Methods SIPsmartER participants could create 2 types of counter ads during the intervention's media literacy lesson. Participants (n = 40) were from rural southwestern Virginia. Most were female (85%) and white (93%), and 28% were low health literate. Descriptive statistics and Fisher exact tests were used to compare completion rates, content, techniques used, and persuasive intent with counter ad type and health literacy status. Results Each participant produced 2.1 (SD, 0.8) counter-ads. Ads included health risks (64%) and nutrition facts (16%). The majority used persuasive techniques (72%) and were persuasive for drinking fewer sugar-sweetened beverages (72%). There were differences by type but not health literacy status. Conclusions and Implications Findings suggested that counter-ads can be used in behavioral interventions for adults. Guidance is provided to support their implementation.

SIPsmartER is a 6-month behavioral intervention designed using a health literacy universal precautions approach that has been found effective at reducing sugary beverage intake in rural, low socioeconomic adults. The purpose of this mixed-methods study is to determine if health literacy status influenced participants' satisfaction and perceptions of each intervention component: small group classes, interactive-voice response (IVR) calls, personal action plans and self-monitoring logs. Of the 155 participants enrolled in SIPsmartER, 105 (68%) completed an interview-administered summative evaluation including 68 high and 37 low health literate participants. The quantitative findings show participant satisfaction with each intervention component was high (i.e. classes = 9.6, IVR calls = 8.1, action plans = 8.9-9.1, logs = 8.7 on a 10-point scale) and similar across both health literacy groups. The majority of qualitative responses were positive (81.8%) and code counts were comparable between literacy groups with a few exceptions. As compared with high health literacy respondents, low health literacy respondents more frequently mentioned liking the content and length of IVR calls, liking the motivational aspects of the personal action plans, and identified numeracy issues with the self-monitoring logs. Overall, applying a health literacy universal precautions approach is an effective and acceptable strategy for both high and low health literacy groups.

OBJECTIVES. Channel One is a public-affairs program that includes 10 minutes of news and 2 minutes of paid product advertising or public service announcements. Advocates assert that it increases public-affairs knowledge, but critics charge that it garners a captive audience for teen-targeted advertising. This experiment analyzed the differential effects of Channel One depending on whether early-adolescent viewers received a media-literacy lesson in conjunction with viewing the program. Outcomes included perceptions of Channel One news programming, recall of program content and advertising, materialism, and political efficacy.METHODS. Researchers used a posttest-only field experiment (N = 240) of seventh- and eighth-grade students using random assignment to conditions. Conditions included a control group, a group that received a fact-based lesson, and a group that received the same lesson content using a more emotive teaching style. It was expected that the emotion-added lesson condition would be more effective than the logic-only lesson condition because of its motivational component.RESULTS. On average, students remembered more ads from Channel One than news stories. Participants in the control group remembered fewer news stories than did the groups that received the lessons. Students reported having purchased during the preceding 3 months an average of 2.5 items advertised on the program. Both fact-based and affect-added training increased student skepticism toward advertisers. As expected, student liking of the program enhanced their learning from it and was associated with higher levels of political efficacy. Students held misconceptions about the role of their school in the production of Channel One.CONCLUSIONS. The use of Channel One by schools can have benefits, but these come with risk that some may consider unacceptable. On the positive side, student liking of the program was associated with their political efficacy. Although those who responded positively to program content and presentation style learned more from it, they also tended to want things that they saw in the advertisements. The data therefore show that the program can provide some benefits to young adolescents, but the results also provide justification for concerns about the commercialization of the classroom.

To provide a more complete picture of the existing state of knowledge regarding parental communication and media literacy in relation to substance use, this chapter discusses (1) parental mediation and its effects on children and adolescents, (2) relationships between parental communication and media literacy, and (3) how each factor (i.e., parental mediation and media literacy) relates to substance use. The chapter includes highlights from a survey that integrates parental communication and media literacy into substance use research among emerging adults. Findings suggest that negative active mediation is effective in fostering competency in media literacy into adulthood, whereas the passive activity of coviewing, the avoidance strategy of rulemaking and the reinforcement of message receptivity in positive mediation are weak or counterproductive influences for media literacy development. Deficiencies in media literacy can lead to risk-taking behaviors among adolescents and may exacerbate those behaviors when they reach emerging adulthood. It is suggested that future research should explore whether similar patterns emerge in other contexts, such as obesity, body image and Internet safety. Keywords: Parental mediation; media literacy; substance use; emerging adults; adolescents

To assess differences, by health literacy status and behavioral condition, in participants' abilities to self-monitor behaviors accurately and recall key behavioral messages using data from a teach-back call.Cross-sectional.Rural, southwestern Virginia.Adults (n = 301). The majority were female (81.1%), 31.9% had a high school education or less, 66.1% earned$25,000/y, and 32.9% were low health literate.First class session of 2 community-based behavioral interventions: SIPsmartER (reduce sugar-sweetened beverage intake) or MoveMore (increase physical activity).Reported accuracy of behavioral diary completion, proportion of behavioral messages recalled during the first round of teach-back, and rounds of teach-back.Descriptive statistics and generalized linear model.Low health literate participants were significantly less accurate in diary completion (P.001), recalled fewer behavioral messages correctly (P.001), and needed more rounds of teach-back (P.001) than high health literate participants. Compared with SIPsmartER participants, MoveMore participants more accurately completed diaries (P = .001) but recalled a lower proportion of behavioral messages correctly (P.001) and required more rounds of teach-back (P.001).Health literacy status and behavioral target affect the ability to self-monitor and recall key concepts. Researchers should consider using teach-back early in the intervention to assess and reinforce participants' ability to self-monitor.

The United States has the highest rates of teenage pregnancy and birth in the Western industrialized world, and research indicates that television and other mass media are important sources of sexual information for young people. The purpose of this study was to determine if a teen-led, media literacy curriculum focused on sexual portrayals in the media would increase adolescents' awareness of media myths concerning sex, decrease the allure of sexualized portrayals, and decrease positive expectancies for sexual activity. A posttest-only quasi-experiment with control groups was conducted at 22 school and community sites in Washington state (N = 532). The intervention, a 5-lesson media literacy curriculum targeted primarily to middle school students, encouraged sexual abstinence because of federal government funding requirements. Adolescents evaluated the program positively, with 85% rating it as better than other sex education programs. Compared to control-group participants, students were less likely to overestimate sexual activity among teens, more likely to think they could delay sexual activity, less likely to expect social benefits from sexual activity, more aware of myths about sex, and less likely to consider sexual media imagery desirable. The results showed that media literacy has promise as part of a sex education program by providing adolescents with a cognitive framework necessary to understand and resist the influence of media on their decision making concerning sex.