January 27, 2010

The Children's Television Act: An Update

By Vandana Y. Bhide, MD, FAAP, FACP
The Children's Television Act (CTA) was passed by Congress in 1990 with the goal of providing educational programming to children that "furthers the positive development of the child in any respect, including the child's cognitive/intellectual or emotional/social needs1."
Subsequent modifications of the Children’s Television Act required that:
1. Television stations provide a minimum of three hours per week of educational and informational shows targeted to children under the age of 16 during their prime viewing hours of 7 AM to 10 PM. Commercials were limited to 10 minutes an hour on weekends and 12.5 minutes an hour on weekdays.
2. Educational/informational children's shows had to show the "E/I" label on the television screen the entire length of the show.
3. As television transitioned from analog to digital, broadcasters, who can have up to six channels of programming in digital instead of one channel in analog, were required to provide the commensurate amount of children's educational/informational programming.
The FCC is also required to consider whether a television station has served children’s educational needs during the station’s license renewal process. In return for providing such educational programming, broadcast stations were given free access to public airwaves.
So twenty years after the Children’s Television Act was first passed, has it achieved its mission of promoting educational programming for children? Unfortunately, the answer is no.
For example, broadcasters once labeled the The Jetsons educational because it dealt with the futue and The Flintstones informational because it dealt with history. Although the show GI Joe had violent content, it was described by television stations as educational due to its pro-social themes. Networks also labeled Leave it to Beaver as educational because it had pro-social messages.
Children Now, a nonpartisan children’s research and advocacy organization, evaluated educational shows broadcast by the four major networks from 1997-2008. Children’s Now determined that in 2007-2008, only 13 % of programming described by networks as educational and informational was determined to be of high educational quality. 63 % of shows were found to have moderate quality and 23 % minimal quality.
Health and nutrition messages, especially those that addressed childhood obesity prevention, were "extremely rare." 2 The report concluded that current television programming does not meet the original intentions of the Children's Television Act.
The Senate Commerce, Science and Transportation Committee concurs. On July 22, 2009, Senator Jay Rockefeller, D-W.Va., Chairman of the committee, convened a hearing called "Rethinking the Children's Television Act for a Digital Media Age." The Senator said he planned to introduce legislation to regulate children's media content, citing his "grave concerns about violence and indecency in the media."
Clearly the Children’s Television Act has failed to increase educational children’s programming in a meaningful way. Even more discouraging is the fact that there have been a number of lawsuits filed by broadcasters in federal courts as well as before the FCC in an attempt to avoid their obligations to provide educational programming as stations convert from analog to digital.
What can pediatricians do to help parents when typically only three hours per week of television programming on a particular station is educational?
First, we can talk to our patients and parents about the educational programming requirements of the act, and what the “E/I” symbol means. Encourage parents to watch programs with their children to evaluate the educational value. Parents and pediatricians can notify the FCC about programming that lacks educational quality.
The FCC is generally responsive to parents who object to programming. For example, in 2007, the FCC entered into a consent decree with Univision to resolve petitions by children's and media organizations to deny the broadcaster's license renewal applications. It was alleged that Univision's children's programming did not comply with the educational requirements of the CTA. Univision voluntarily paid $24 million and developed a plan to comply with the rules of the Children's Television Act.
It is clear that most broadcasters adhere only to the minimum educational programming requirements of the Children’s Television Act. Therefore, the only way to encourage more educational television programming is to encourage the FCC and Senator Rockefeller’s committee to increase E/I programming requirements that stations must provide in order to continue to access the public airwaves for free.
1. "Policies and Rules Concerning Children's Television Programming Memorandum Opinion and Order," Federal Communications Commission Record 6,(1991): p.2114.
2. Executive Summary: Educationally/Insufficient? An Analysis of the Availability & Educational Quality of Children's E/I Programming. Children Now. Htttp://www.childrennow.org/eireport.

Why Pediatricians Need to Discuss Texting and Driving In Our Offices

By John Moore, MD, FAAP

As part of my daily commute from my home to my office and back, I spend about thirty minutes per day driving on Interstate 81 through central Virginia. That commute has allowed me the fascinating and frightening opportunity to observe first-hand the recklessness and aggression of the modern American driver. Over the last seven years, I have seen drivers of cars, trucks, motorcycles, and vans doing almost everything imaginable except paying attention to the road. I have witnessed people been drinking coffee, scolding their children, applying makeup, and even flossing their teeth.

While hard data on the numbers of drivers texting or surfing while driving are not available, anecdotal and observational studies are very concerning. A recent survey by Nationwide Insurance estimated that twenty percent of drivers either send or receive text messages while driving. That number of people who drive while texting reaches a staggering sixty-six percent when limited to 18-24 year-olds.

The exact impact of texting on automobile safety is impossible to gauge. No reliable data exists to associate texting, distracted driving and accidents. However, anecdotal data continued to accumulate and the potential impact may be staggering. Several recent, dramatic deadly crashes in New York and Florida have been associated with drivers sending and receiving text messages.

Fourteen states, including Virginia, New Jersey, and Washington DC, have taken action to address that issue. In July of this year, police in Virginia began fining drivers caught texting while driving. The penalty for those caught is only $20-$50, but the psychological impact may be more profound. Hopefully, the new legislation in Virginia and other states will make motorists think about their messages and exactly how important that text really is.

As pediatricians, we are faced with the task of helping our patients navigate the complex path from childhood to adulthood as smoothly as possible. We know that teens are at significantly increased risk of automobile accidents. In addition, teens are the quickest adaptors of new, exciting, and dangerous technology. In the case of texting and driving, that combination has proven to be deadly in several well-documented cases. If we can get one teen to ignore their phone and concentrate on the road a little closer, we have made immeasurable difference in their lives. In my opinion, the ability to make huge differences in lives is why we all became pediatricians in the first place.

When Patients Google for Medical Advice

By Jennifer Shu, MD FAAP
If you’ve been practicing in the 21st century, I’m willing to bet you’ve had patients come into your office armed with the latest “research” they’ve found on the Internet about condition X and either want to know what you think or demand the treatment recommended on the Web. I can’t say that I blame them for trying—after all, the Internet is open 24/7 and is often easier to access than the doctor’s office or nurse advice line. Since the Internet is here to stay, I believe physicians would do well to embrace this relatively new influence on our patients’ health literacy and channel our energy into helping them find the most accurate and reliable information out there.
I had the opportunity to present my views on finding credible healthcare information online at the BlogHer 2009 conference, a meeting of women (and some men) bloggers all over the country who make a living or hobby out of sharing their thoughts with online readers. As a member of a panel of experts moderated by our own Dr. Gwenn O’Keeffe, we had an audience outside of the usual realm of conferences geared toward medical professionals. I hope that by providing Googling-guidance to bloggers seeking health information, this information will then trickle down to their readers, who likely include healthcare consumers such as our patients’ parents.
I’m including some of the tips we provided and hope you’ll share your ideas too:
Look for .gov sites. Governmental sources are credible and reliable. Some great resources are http://medlineplus.gov and http://www.cdc.gov.
Visit medical organization pages. Professional associations such as the American Academy of Pediatrics www.aap.org offer accurate information. Also, consider www.medem.com (which contains a collection of information from multiple medical societies). The American Medical Association www.ama-assn.org and your state or local medical society may also provide helpful resources.
Check into a hospital site. One site with extensive information is http://www.mayoclinic.com/ but many hospitals offer credible web resources. You may wish to check out a local medical center’s site first.
See sites devoted to health information. Some examples are http://kidshealth.org/ (which has information targeted to kids and teens as well as to parents) and www.uptodate.com.
Strength in numbers. If several web sites give the same medical information, there’s an increased chance that it’s credible. Also check that there are multiple physician reviewers and that the information has been verified for accuracy recently.
Consider the source. Before getting too concerned about something you read online, consider who authors the site. Some organizations and individuals can look official but may not really provide trustworthy information.
Talk to your doctor. Your doctor should be your sounding board when it comes to making sense of online medical information. If you have questions about something you’ve read, be sure to ask your pediatrician, who can put the information into the context of your own child’s health. Better yet, ask your doctor for recommendations for favorite health web sites so you can go straight to a reliable source.