ABSTRACTMEDIA USE AND AFFECTIVE STATE AS MEDIATORS OF HEALTH-PROMOTING BEHAVIORS IN SCHOOL-AGE CHILDRENByPanarat Chenchob Background/Purpose: While children's health status in the United States differs from state to state, the health status of children is generally less than optimal. The contributions of health-promoting behaviors (HPBs) and the factors influencing health behaviors in school-age children have rarely been reported in literature. The objective of this study is to assess whether exposure to television, video game, and computer (media use) mediates the relationships between peer social support and peer hostility and bullying at school (school context), parental emotional support, closeness and involvement (home context) and dietary intake and physical activity (HPBs) among school-age children. Framework: The conceptual framework used for this study is the Pender's Health Promotion Model (HPM). Research Questions: 1) Is there a direct relationship between events that occur in school and home contexts for school-age children and health-promoting behaviors? 2) To what extent does children's affective state and use of media mediate the relationship between school and home influences on health-promoting behaviors? 3) Is there a relationship between media use and affective state in school-age children? 4) Do mediation effects vary as a function of sex? Methods: The study is a secondary analysis of a de-identified longitudinal data set from the "Coordinated Community Assessment (CCA)." The sample consisted of 1,370 students. A cross-sequential design included respondents from the initial cohort recruited from primary school students who were in fourth to sixth grades at schools located in a Midwestern state. Instrument: The instrument used for measuring selected variables was the Coordinated Community Student Survey (C2S2) and its subscales for measuring affective state, school context, home context, media use and health-promoting behaviors. Procedure: Analysis will involve descriptive statistics, and structural equation modeling (SEM) using Mplus. Result: Research Question 1: there is no direct effect of school context (β =0.000, p=0.999) on HPBs two years after school context was assessed. Alternately, home context ((β =0.179, p=0.000) had a significant direct effect on HPBs. Research Question 2: only children's affective state mediated the effects of school context on children's HBPs (100% mediation). Children's media use and affective state mediated the effects of home context on children's HPBs (14% mediation), although home context also independently contributed to HPBs. Research Question 3: affective state was found to be significant positively related with media use (β <.091, p=000). Research Question 4: For both boys and girls, home context independently contributed to HPBs while school context did not have a direct effect on HPBs. Media use was a significant predictor of HPB's for boys only. Affective state mediated the relationship between home and school contexts and HPBs for boys and girls. Alternatively, media use was a mediator in the relationship between home context and HPB for boys only. Implication: Nurses can provide specific information to enhance support from peers and parents, increased self-esteem for HPBs within the context of school-age children. Future research examining health-promoting behaviors in children should identify additional external and internal factors related to how children make decisions about dietary intake and physical activity. Policy can be better structured to induce the provision of behavior change interventions, by fostering linkages with supportive community based resources, and rewarding broad efforts to improve the population health and quality of life.
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