Given modern globalization, there is a fundamental gap in understanding how to combat the negative impact of US cable TV programs and advertising on the eating habits of youth and families in low- and middle-income countries (LMIC) like Jamaica, especially for those who adopt a part-American identity through a remote accul- turation process. Persistence of this gap represents an important problem because, until it is filled, the effec- tiveness of nutrition interventions designed to combat obesity and non-communicable diseases (NCDs) for populations in and from LMICs will be limited. The long-term goal is to implement effective health promotion and NCD prevention programs and policies, which address Americanization, for LMIC youth and families. The current objective is to use Jamaica as a case study to 1) evaluate a school-based food-focused media literacy intervention which specifically targets US media within the local media landscape; and 2) cement key partner- ships to translate these research findings into national and regional practice and policy. The central hypothesis is that this intervention will help protect Jamaican adolescents and their mothers against harmful media food messages by significantly increasing media literacy and improving intentions and behaviors regarding healthy and unhealthy eating. This hypothesis has been formulated based on applicants? preliminary data from Ja- maica. The rationale for the proposed research is that successful completion would provide, as a model for other LMIC contexts, an evidence-based NCD prevention program to be leveraged across Jamaican schools, and a critical partnership among stakeholders to ensure sustainability of efforts. Guided by strong published (US) and preliminary (Jamaica) data, this hypothesis will be tested by pursuing two specific aims: 1) Conduct a randomized control trial in Jamaica to evaluate a face-to-face food-focused media literacy workshop with sup- plementary SMS/text messages among 90 adolescent-mother dyads; and 2) Facilitate the formation of a Healthy Families partnership that will incorporate media literacy addressing US cable TV programs/advertising into existing school-based policy and intervention efforts. Under the first aim, a brief evidence-based, school- based media literacy curriculum shown to be efficacious for US youth in the applicants? published research will be condensed into a workshop delivered to adolescent-mother dyads recruited from the applicants? long-stand- ing partner schools in Jamaica. Some dyads will also receive SMS messages reinforcing workshop themes, and others will receive no intervention. Under the second aim, the CDC partnership evaluation plan will be used to identify and convene key stakeholders to engage in a series of partnership-building meetings. The ap- proach is innovative because the remote acculturation framework allows the application of a US media literacy intervention to Americanizing LMIC youth and families in a theory-driven manner. The proposed research is significant because it has potential to make a substantial positive contribution to reducing the risk for obesity and NCDs in Jamaica and LMICs and among US immigrants from LMIC regions in a cost-effective manner.
The proposed research is relevant to public health because the demonstration of an effective scalable school- based health intervention and stakeholder partnership which combats problematic US media influence on healthy eating habits in Jamaica will serve as a model for other developing countries. The proposed intervention is ultimately expected to improve the effectiveness of health promotion and NCD prevention efforts among populations in developing regions, including potential future US immigrants from those regions. Thus, the proposed research is relevant to the NIH mission to facilitate global health research which addresses global health needs (FIC), and to lead scientific research to improve the health of US minorities (NIMHD).
