We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
The Pediatric Forum |

The Role of Television Viewing and Education in Decreased Body Mass Indexes in Children—Reply

Leonard H. Epstein, PhD; James N. Roemmich, PhD; Jodi L. Robinson, MA, MBA; Dana D. Winiewicz, BA
Arch Pediatr Adolesc Med. 2008;162(9):899-900. doi:10.1001/archpedi.162.9.899-b.
Text Size: A A A
Published online


In reply

We appreciate the kind comments of Drs Krul and van Leeuwen regarding our study. They suggest that the informational newsletter may have contributed to or interacted with differences among families of low and high SES to reduce age- and sex-standardized BMI (zBMI). The intervention included a behavioral engineering device to reduce sedentary behavior as well as newsletters that were written at the eighth-grade level. It is possible that the newsletter interacted with the behavioral engineering device to reduce television watching and computer use to differentially reduce zBMI. Families of lower SES may have benefitted more from the information in the newsletter than families of higher SES, who may have already known some of this information. Krul and van Leeuwen also note that the families of higher SES showed greater zBMI changes than the families of lower SES, independent of group assignment, and they wonder whether this may have been due to the newsletters. While the families of higher SES did show larger overall zBMI reductions, the differences between the families of lower SES in the intervention group were not significantly different from the differences for the families of higher SES in the control or intervention groups at 2 years (− 0.19, − 0.22, and − 0.27 zBMI units, respectively). Newsletters were provided to both the intervention and control groups, but the newsletters were different between the groups. The newsletter for the intervention group included ideas about how television influences children and suggested ways to modify their environment and also included parenting tips, recipes, and activities, while the control-group newsletter provided no information on television and how it affects children or ways to change one's environment. Research is needed to determine the contribution of the newsletters when combined with a behavioral engineering device for preventing obesity in young children of lower SES and to determine whether families of higher SES could benefit from information provided in the control newsletter to reduce television watching and zBMI without the behavioral engineering device.



Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles