PEDIATRICS Vol. 121 No. 4 April 2008, pp. 718-724 (doi:10.1542/peds.2007-1546)
ARTICLE |
Characteristics Associated With Older Adolescents Who Have a Television in Their Bedrooms
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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ABSTRACT |
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 TOP ABSTRACT METHODSRESULTSDISCUSSIONREFERENCES |
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OBJECTIVES. The goals were to examine the prevalence of adolescents having a television in their bedroom and to describe associated personal, social, and behavioral characteristics.
METHODS. Participants included 781 adolescents (mean age: 17.2 years) who completed a mailed Project Eating Among Teens II questionnaire. The relationships between adolescents having a television in their bedroom and sociodemographic, behavioral, and personal characteristics were examined.
RESULTS. Nearly two thirds (62%) of participants had a bedroom television. Gender, race/ethnicity, socioeconomic status, and age were associated with the presence of a bedroom television. Compared with girls without a bedroom television, girls with a bedroom television reported less time spent in vigorous activity (1.8 vs 2.5 hours/week), more time spent watching television (20.7 vs 15.2 hours/week), lower vegetable intake (1.7 vs 2.0 servings per day), greater sweetened beverage consumption (1.2 vs 1.0 servings per day), and fewer family meals (2.9 vs 3.7 meals per week). Compared with boys without a bedroom television, boys with a bedroom television reported more time spent watching television (22.2 vs 18.2 hours/week), lower fruit intake (1.7 vs 2.2 servings per day), fewer family meals (2.9 vs 3.6 meals per week), and lower grade point average (2.6 vs 2.9). Twice as many youths with a television in their bedroom were heavy television users (watched >5 hours/day), compared with youths without a television in their bedroom (16% vs 8%).
CONCLUSIONS. Adolescents with a bedroom television reported more television viewing time, less physical activity, poorer dietary habits, fewer family meals, and poorer school performance. Refraining from placing a television in teenagers’ rooms may be a first step in helping to decrease screen time and subsequent poor behaviors associated with increased television watching.
Key Words: television • screen time • adolescents • bedroom • physical activity • school performance • dietary patterns
Abbreviations: TV—television • GPA—grade point average • SES—socioeconomic status • EAT—Eating Among Teens
It has been well documented that adolescents spend a great deal of time watching television (TV).1–3 Using a large, nationally representative sample, the Kaiser Family Foundation study on media use found that youths 8 to 18 years of age watch TV for >3 hours/day.3 Heavy TV use is of concern because greater amounts of TV viewing are associated with negative behavioral and physical outcomes, such as poor school performance,4 poor dietary habits related to fruits and vegetables5 and fat intake,6 and greater BMI.7
A related factor that may contribute to increased TV viewing and is associated with negative outcomes is the presence of a TV in adolescents’ bedrooms. For low-income preschool-aged children8 and 9- to 12-year-old youths,9 the presence of a TV in the bedroom was found to be a stronger predictor of obesity than the amount of time spent watching TV. The American Academy of Pediatrics recommends that parents remove TV sets from children's bedrooms.2 Despite this recommendation, 68% of youths 8 to 18 years of age have a TV in their bedroom, with the average household having >3 TVs available.3 On average, youths who have a bedroom TV watch almost 1.5 hours more of TV per day than do youths who do not have a bedroom TV.3
Although there is much research regarding TV viewing behavior among youths,10 little is known about the profiles of adolescents who have a bedroom TV. The current study examines the prevalence of having a bedroom TV among a large, population-based sample of adolescents 15 to 18 years of age and compares sociodemographic, personal, and behavioral characteristics of adolescents with and without a bedroom TV. We hypothesized that adolescents who reported having a TV in their bedroom would spend more time watching TV, would have a greater BMI, and would exhibit a variety of negative personal and behavioral characteristics.
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METHODS |
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Study Design and Population
The data analyzed for the current study were from Project Eating Among Teens (EAT)-II, the follow-up portion of a study that examined socioenvironmental, personal, and behavioral determinants of dietary intake and weight status in adolescents. In Project EAT-I, 4746 junior and senior high school students in 31 Minnesota schools completed in-class surveys and anthropometric measurements during the 1998–1999 academic year. Project EAT-II resurveyed participants by mail 5 years later, as the younger cohort progressed from early adolescence to middle adolescence and the older cohort progressed from middle adolescence to late adolescence/young adulthood. Of the original study sample, 1074 subjects (22.6%) were lost to follow-up monitoring for various reasons, primarily missing contact information at EAT-I (n = 411) and no address found at the follow-up time (n = 591). Of the remaining 3672 participants contacted by mail, 2516 completed surveys, representing 53.0% of the original cohort and 68.4% of participants who could be contacted for Project EAT-II. Of the participants who completed surveys, 32.0% (n = 805) were in the younger cohort and 68.0% (n = 1711) were in the older cohort. Because the current research was designed to examine adolescents who had not yet entered young adulthood, the sample included only participants from the younger cohort. Of the 805 adolescents from the younger cohort, 24 had missing data on whether they had a TV in their bedroom. The final sample included in the current analyses was an ethnically and socioeconomically diverse group of 781 adolescents, including 427 girls (54.7%) and 354 boys (45.3%). The mean age was 17.2 ± 0.62 years, with 60% in 12th grade and
20% each in 11th grade and not in school. The original Project EAT-I survey completed by participants at baseline was revised for Project EAT-II, to improve the relevance of items for older adolescents and to explore topics of emerging importance, such as having a TV in the bedroom. Because items regarding having a bedroom TV and eating behavior while watching TV were available only in the Project EAT follow-up survey, the current study uses only data from Project EAT-II.
The University of Minnesota institutional review board human subjects committee approved all study protocols, and completion of the survey implied consent to participate. Before distribution of surveys to participants, a letter was mailed to the parents of the adolescents to obtain passive consent for the survey.
Measures
Presence of Bedroom TV
To assess the main variable of interest, participants were asked, "Do you have a TV in the room where you sleep?" Responses were dichotomous (yes or no). Participants who did not answer this survey item were deleted from the analyses (n = 24).
Physical Activity
Physical activity was measured by using a modified version of the Leisure Time Exercise Questionnaire.11 Participants were asked 3 questions to assess how many hours were spent in strenuous-, moderate-, and mild-intensity physical activity during a typical week. Test-retest correlations for strenuous- and moderate-intensity activities were 0.63 and 0.52, respectively.12 The responses (0, <0.5, 0.5–2, 2.5–4, 4.5–6, or 
6 hours/week) were recoded (0, 0.3, 1.3, 3.3, 5.3, or 8 hours/week) and summed to create a score that represented the total time spent in physical activity. Moderate/vigorous physical activity was assessed by summing the hours spent in strenuous- and moderate-intensity activity.
Sedentary Behaviors
Items adapted from the Planet Health study assessed the usual time spent (1) watching TV and videos, (2) reading and doing homework, and (3) using a computer (not for homework).13 Participants reported average hours per weekday spent engaging in these behaviors, as well as average hours per weekend day. Test-retest correlations for these survey items ranged from 0.66 to 0.80.14 Validation of similar questions was described in detail elsewhere.15 Categorical responses ranged from 0 to 5 hours per average weekday or average weekend and were summed and weighted according to day of the week to calculate the total number of hours per week spent in each of the sedentary behaviors. To be comparable with literature reports describing patterns of sedentary activity,3 heavy media use was defined as watching TV for 5 hours/day or using a computer for 2 hours/day.
Dietary/Eating Behaviors
Fruit Intake
Total fruit intake was measured by using the Youth/Adolescent Food Frequency Questionnaire.16,17 Participants were asked how often in the past year they consumed a serving of the following 11 fruits and juices: raisins; grapes; bananas; cantaloupe and/or melons; apples and/or applesauce; pears; oranges and/or grapefruits; strawberries; peaches, plums, and/or apricots; orange juice; and apple and/or other fruit juices.
Vegetable Intake
Total vegetable intake was also measured by using the Youth/Adolescent Food Frequency Questionnaire.16,17 Participants were asked how often in the past year they consumed a serving of the following 16 different foods: beans, lentils, and/or soybeans; broccoli; beets (not greens); corn; peas and/or lima beans; mixed vegetables; spinach; greens and/or kale; green and/or red peppers; yams and/or sweet potatoes; zucchini, summer squash, and/or eggplant; cooked carrots; raw carrots; celery; lettuce and/or tossed salad; and coleslaw. Analyses were performed with and without the inclusion of French fries, and results were similar. To be consistent with previous studies,18 and because of their high fat content, French fries were excluded from total vegetables in the analyses presented.
Sweetened Beverage Intake
Total sweetened beverage intake was also measured by using the Youth/Adolescent Food Frequency Questionnaire.16,17 Participants were asked how often in the past year they drank a can or glass of nondiet soda or a glass of fruit punch, lemonade, sugar sweetened powdered mix drink, or other noncarbonated fruit drink.
Fast Food Intake
Participants were asked, "In the past week, how often did you eat something from a fast food restaurant (like McDonald's, Burger King, or Hardee's)?" Response options ranged from never to >7 times.
Family Meals
Frequency of family meals was assessed through participants reporting how many times during the past 7 days all or most of their family members living in the house ate a meal together. Response options ranged from never to >7 times.
Snacking While Watching TV
Participants were asked how often they snacked while watching TV (no time reference was specified). Response options were on a 5-point scale, ranging from always to never.
Personal Factors
Demographic Features
Participants self-reported their age, gender, and race/ethnicity. Socioeconomic status (SES) was assessed with an algorithm that accounted for the highest level of parental educational attainment, family eligibility for public assistance, eligibility for free or reduced-cost school meals, and parental employment status.19
Weight Status
BMI was based on self-reported height and weight and was calculated as kilograms per square meter.
Grade Point Average
Participants were asked to record the 2 grades they received most often (A to F).20 Grades were assigned the following numeric scores: A = 4, B = 3, C = 2, D = 1, and F = 0. If participants reported receiving only 1 grade, rather than 2, then that grade was used. In cases in which the 2 grades received most often were consecutive (for example, A and B), a middle score was created to indicate the participant's academic success (AB, which equaled a score of 3.5). If the 2 grades were 1 step apart (for example, A and C), then the middle grade was used (B, which equaled a score of 3.0). Students (n = 91) who indicated that the 2 grades they received most often were 2 steps apart (for example, A and D) were dropped from analyses dealing with grade point average (GPA) but not from the other analyses.
Family Connectedness
On the basis of previous work by Resnick et al,20 participants were asked 2 questions about parent-child communication and caring for each parent, as follows. (1) "How much do you feel you can talk to your mother (father) about your problems?" (2) "How much do you feel your mother (father) cares about you?" Response options were on a 5-point Likert scale ranging from not at all to very much.
Depression
Depressive symptoms were evaluated with a 6-item scale developed and validated by Kandel and Davies.21 Participants were asked how much, over the past 12 months, they were bothered or troubled by each of the following symptoms: feelings of tiredness, trouble sleeping, unhappiness, hopelessness, nervousness, and worry. Response options were on a 3-point scale including not at all, somewhat, and very much.
Statistical Analyses
For descriptive purposes, proportions and sample sizes of adolescents with a bedroom TV were calculated within gender, race/ethnicity, and SES categories; 
2 tests were used to test for significant differences. For the continuous variable age, mean differences between adolescents with and without a bedroom TV were evaluated by using t tests. Analytically, means for activity, dietary behaviors, and personal factors, adjusted for race/ethnicity and SES, were generated to contrast those with and without a bedroom TV. These means were calculated within gender strata by using general linear regression models. In additional models with both girls and boys, the gender differences in the effects of bedroom TV on outcomes were assessed by including the gender main effect and interaction with bedroom TV.
All analyses were conducted by using SAS 9.1 (SAS Institute, Cary, NC) and were weighted to adjust for different response rates for Project EAT-I and Project EAT-II by using the response propensity method. With this method, the inverse of the estimated probability that an individual responded in 2003–2004 was used as the weight.22 Use of response propensity weights in this study helped influence estimates so that they were close to the estimates that would have been obtained if all of the high school students who participated at baseline as middle school students had completed surveys in 2003–2004, making the sample more representative of the Minneapolis-St Paul, Minnesota, metropolitan area.
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RESULTS |
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Sixty-two percent of teenagers reported having a TV in their bedroom. Gender, race/ethnicity, and SES were associated with the presence of a TV in the bedroom (Table 1). Adolescents with a bedroom TV were slightly older than adolescents without a bedroom TV (17.2 ± 0.03 vs 17.1 ± 0.04 years; P = .008). Having a bedroom TV was more prevalent among boys (68.3%) than girls (57.6%; P = .002). A larger proportion of black youths (81.5%) and a smaller proportion of Asian youths (39.0%) reported having a TV in their bedroom, compared with other racial/ethnic groups (P < .001). The prevalence of a TV in the bedroom was lower among youths from high-SES households (39.2%), compared with adolescents from lower-SES households (60.9%–71.7%; P = .008).
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Time spent in vigorous physical activity and watching TV, as well as fruit and vegetable intake, sweetened beverage consumption, number of weekly family meals, and GPA, differed according to the presence of a bedroom TV (Table 2). More specifically, girls with a bedroom TV reported less time engaging in vigorous activity, more time watching TV, lower vegetable intake, higher sweetened beverage consumption, and fewer family meals, compared with girls without a bedroom TV. Boys with a bedroom TV reported more time watching TV, lower fruit intake, fewer family meals, and lower GPA than did boys without a bedroom TV. There was no significant difference in weight status (BMI) according to the presence of a TV in the bedroom for either gender (P > .11).
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The prevalence of snacking while watching TV did not differ according to the presence of a bedroom TV (P > .13). Of the 488 teenagers with a TV in their bedroom, 38% reported that they always or usually snacked, 42% sometimes snacked, and 20% rarely or never snacked while watching TV. Of the 293 teenagers without a TV in their bedroom, 32% reported that they always or usually snacked, 45% sometimes snacked, and 23% rarely or never snacked while watching TV.
Twice as many teenagers with a TV in their bedroom reported heavy TV use (5 hours/day), compared with teenagers without a bedroom TV (16.4% vs 8.2%; P = .002). However, there was no difference in the prevalence of heavy computer use (2 hours/day) between the 2 groups (Fig 1).
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DISCUSSION |
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TOPABSTRACTMETHODSRESULTSDISCUSSIONREFERENCES |
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Nearly two thirds of adolescents in our sample had a TV in their bedroom. Adolescents with a bedroom TV differed according to gender, race/ethnicity, and SES and exhibited more unhealthy behavioral patterns than did adolescents without a bedroom TV. Girls with a bedroom TV reported significantly less vigorous physical activity, more TV watching, lower vegetable intake, more sweetened beverage consumption, and fewer family meals, whereas boys with a bedroom TV also reported more TV watching and fewer family meals, as well as lower fruit intake and lower GPA. No differences in mean BMI or snacking behavior while watching TV were found between adolescents with a bedroom TV and those without a bedroom TV.
This study found a strong association between having a TV in the bedroom and a number of concerning behaviors. Although these less-than-favorable behaviors may be attributable to the presence of a TV in the bedroom, the current, cross-sectional study does not allow for a determination of causal relationships (ie, only associations). It may be that having a TV in the bedroom makes it easier for teenaged girls to displace active time with TV viewing time or teenaged boys to displace homework time with TV viewing time. The lower levels of physical activity found among girls with a bedroom TV are of concern, given the decrease in physical activity seen among girls as they advance through adolescence.23 The lower reading/homework levels and, subsequently, GPA found for boys with a bedroom TV are of concern, given the lesser time devoted to reading and doing homework (compared with girls). The poorer dietary intakes of both girls and boys may be attributable to advertising on TV,24 fewer family meals,25 or other familial factors.
Studies showed direct positive associations between having a TV in the bedroom and increased total TV viewing time for children and adolescents.8,9,26,27 Those studies also showed that having a bedroom TV and total TV viewing time were associated with weight status. Two studies showed that having a TV in the bedroom was a stronger predictor of overweight than was the amount of time spent watching TV.8,9 Contrary to our hypotheses, our study did not find an association between having a bedroom TV and mean BMI status. Posthoc analyses revealed no relationship between total TV viewing time and weight status in our sample. This lack of association might be attributable to the error associated with self-reported height and weight or to the age of our sample. Previous studies found associations between total TV viewing time, presence of a bedroom TV, and weight status for preschool-aged children 1 to 4 years of age,8 youths 9 to 12 years of age,9 and youths 12 years of age.27 Although the proportions of children and adolescents with a TV in their bedroom were found to be consistent across age groups (8–10, 11–14, and 15–18 years of age),3 8- to 14-year-old youths watched, on average, almost 5 hours more of TV per week than did 15- to 18-year-old youths.3 Older adolescents with a bedroom TV are spending more time watching TV than are their counterparts without a bedroom TV. However, they are still spending less time than younger children, and their behavior may not have as great an impact on their weight at that age. Furthermore, our data showed that older adolescents with a TV in their bedroom were not snacking while watching TV more than were adolescents without a bedroom TV.
It is not known how the behavior of having a TV in the bedroom manifests as older adolescents progress into adulthood. As older adolescents advance toward young adulthood, they begin exhibiting the behaviors of adults. Although the exact proportions or effects of having a bedroom TV in the adult population are not known, it may be more normative for adults to have a TV in their bedroom. Because research indicates that adolescents with a bedroom TV watch TV for more hours than do adolescents without a bedroom TV, we hypothesize that adults with a bedroom TV also watch more TV than do adults without a bedroom TV. Furthermore, adults who watch more TV exhibit more negative psychosocial behaviors. TV watching was negatively associated with body satisfaction among female college seniors and quality of life and GPA among male college seniors.28 Adult women (mean age: 30.7 ± 11.6 years) who watched TV for >2 hours/day reported negative characteristics related to loneliness, hopelessness, shyness, self-esteem, depression, weight satisfaction, perceived attractiveness, life satisfaction, and eating disorder tendency, compared with women who watched no TV and women who followed the American Academy of Pediatrics guidelines and watched TV for <2 hours/day.29 Despite negative outcomes associated with TV viewing, it is difficult for parents to remove a TV from their children's bedrooms and it may be just as difficult for young adults not to place a TV in their bedrooms as they become older and move out of their parents’ home and into their own living spaces.
Strengths of this study are the use of a large, ethnically diverse sample and the comprehensive assessment of characteristics of potential relevance to the presence of a TV in the bedroom. Few studies have focused primarily on the prevalence and characteristics of adolescents with a bedroom TV and, to our knowledge, our study is the first to explore this factor in a sample of older adolescents. Limitations of the study are the cross-sectional design and the potential bias attributable to self-reported data. We were unable to determine how much time adolescents spent watching TV in their bedrooms only.
From these cross-sectional analyses, we do not know whether having a TV in the bedroom is leading to increased time watching TV and decreased time in potentially more-valuable activities. Longitudinal studies of bedroom TV viewing behavior and participation in other activities and intervention studies exploring decreasing total TV viewing time with an emphasis on bedroom TV viewing time are needed to clarify whether there is a causal relationship between TV viewing behavior, having a bedroom TV, and poor behavioral characteristics.
These exploratory analyses are important and pertinent to the health of adolescents and have implications for parents considering whether they should allow their children to have a TV in their bedrooms. Many parents work outside the home30 and may not be able to monitor their children's behavior as closely as previous generations. Because of this, parents may not be able to regulate the number of hours that their children watch TV; however, parents usually are able to control whether there is a TV in their children's bedrooms. Although additional research is needed, findings from the current study reinforce the American Academy of Pediatrics recommendation and suggest that refraining from placing a TV in adolescents’ bedrooms may be a first step in helping to decrease screen time and subsequent poor behaviors associated with increased TV watching.
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ACKNOWLEDGMENTS |
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This study was supported by grant R40-MC00319 from the Maternal and Child Health Bureau, Health Resources and Services Administration, and by Adolescent Health Protection Research Training Grant T01-DP000112 from the Centers for Disease Control and Prevention.
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FOOTNOTES |
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Accepted Aug 31, 2007.
Address correspondence to Daheia J. Barr-Anderson, PhD, MSPH, Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 South 2nd St, Suite 300, Minneapolis, MN 55454. E-mail: barranderson{at}epi.umn.edu
The authors have indicated they have no financial relationships relevant to this article to disclose.
| What's Known on This Subject The prevalence of having a bedroom television and the association of having a bedroom television with increased television watching have been found repeatedly. However, there is not a clear understanding of the characteristics of adolescents with a bedroom television.
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| What This Study Adds This study details the characteristics of adolescents with a bedroom television and compares their behaviors with those of adolescents without a bedroom television. To our knowledge, no other research has explored this population to this extent.
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