PEDIATRICS Vol. 105 No. 2 February 2000, pp. 343-349

The Role of Interpretation Processes and Parental Discussion in the Media's Effects on Adolescents' Use of Alcohol

Erica Weintraub Austin, PhD, Bruce E. Pinkleton, PhD, and Yuki Fujioka, MA

From the Edward R. Murrow School of Communication, Washington State University, Pullman, Washington.

	ABSTRACT

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Objective.  The process that connects media use with alcohol-related beliefs and behaviors has not been well documented. To address this issue, we examined adolescents' viewing patterns, beliefs about alcohol and media messages, and parental discussion of media messages in the context of a theoretical model of message interpretation processes. Measures included the degree to which adolescents found portrayals desirable, realistic, and similar to their own lives; the degree to which they wanted to be like (identify with) the portrayals; and the degree to which they associated positive outcomes with drinking alcohol (expectancies).

Design.  Cross-sectional survey.

Setting.  Two public high schools in the California central coastal area that include a diverse population in terms of ethnic origin, income level, and education level.

Participants.  Ninth-grade students (n = 252) and 12th-grade students (n = 326).

Outcome Measures.  Students reported the number of days within the past week watching various genres of television content, along with perceptions of realism of content, desirability of portrayals, identification with portrayals, expectancies toward alcohol use, personal norms for alcohol use, desire for products with alcohol logos, current alcohol use, frequency of parental reinforcement, and counter-reinforcement of television messages. Associations were examined via hierarchical multiple regression analysis.

Results.  Effects of media exposure on drinking behavior, controlling for grade level, ethnicity, gender, household income, and education levels were primarily positive and indirect, operating through a number of intervening beliefs, especially expectancies ( = .59; r² = .33). Direct associations, primarily with exposure to late-night talk shows ( = .12; r² = .01), were small. Parental discussion also affected behavior indirectly, operating through expectancies, identification, and perceived realism. The appeal of products with alcohol logos, which was higher among the younger students (t = 3.44) and predicted by expectancies ( = .37; r² = .13), sports viewing ( = .17; r² = .03) and late-night talk shows ( = .10; r² = .01), predicted actual drinking behavior ( = .22; r² = .04). Drinking behavior was higher among the older students (t = 2.515).

Conclusions.  Adolescents make drinking decisions using a progressive, logical decision-making process that can be overwhelmed by wishful thinking. The potential risk of frequent exposure to persuasive alcohol portrayals via late-night talk shows, sports, music videos, and prime-time television for underage drinking is moderated by parental reinforcement and counter-reinforcement of messages. Interventions need to acknowledge and counter the appeal of desirable and seemingly realistic alcohol portrayals in the media and alert parents to their potential for unintended adverse effects.adolescents, alcohol use, media, television, parents, music videos, talk shows, norms, prevention, prime time, sports.

It is clear that media messages have the potential to lead to underage abuse of alcohol,^1-6 but scholars have not successfully explained when and why adverse effects occur. Exposure to alcohol advertising and television programming, for example, has been shown to be associated with positive beliefs about drinking^1,4,7 and alcohol consumption.³ Exposure to music videos, more specifically, have been shown to be associated with early onset of drinking.⁸ Yet, some studies have found increased television exposure associated with more skepticism toward advertising⁹ and less alcohol consumption.¹⁰

Concern about the role of media effects in these high levels of alcohol use seems well placed. Alcoholic drinks are the most common beverage portrayed on television.¹¹ It is usually portrayed in positive or neutral contexts, with negative consequences almost never shown,^3,411-14 in portrayals that adolescents find appealing.¹ Individuals drinking alcohol in the media tend to be portrayed as glamorous, popular, and successful, with drinking associated with activities such as sexual behavior, sports, and vehicle use.^13-16 Research suggests that children and adolescents tend to learn more about alcohol from television and beer advertising than from more balanced sources such as parents, leaving them more knowledgeable about brands of beer than about potential health risks associated with drinking.^1417-19 Recent data show that between one third and one half of high school students begin experimenting with alcohol by 8th grade, with two thirds experimenting by 9th grade.^18,20 Among high school seniors, 45% report having been drunk by 10th grade, 80% report having tried alcohol, and 74% continue to use it, making alcohol unquestionably the drug of choice among adolescents.¹⁸

Research connecting exposure with beliefs and behaviors, however, has been criticized for taking an overly simplistic view of the way children make decisions.^4,21 Decades of mass media research have demonstrated that children do not absorb television messages in a passive or uniform manner^422-24 and that media effects do not occur in isolation from other influences in a child's life.^3,21 Important contributing beliefs to perceptions of the social world and to the likelihood of imitation found for media effects such as aggression, for example, have included how realistic portrayals seem and how much children want to be like individuals portrayed on television, called "identification."²⁵ These kinds of beliefs have been shown to contribute to beliefs about alcohol and intentions to drink.²¹ Parental modeling of alcohol use also has been documented as an important influence on children's perceptions and behaviors surrounding drinking,²⁶ and parental discussion of television messages has shown the potential to affect the levels of skepticism that children bring to their own understanding of media messages.^9,21,27

To better understand the process by which mediating beliefs and parental influences contribute to potential adverse effects of television viewing on underage alcohol use, we examined associations among media viewing patterns, adolescents' beliefs, and reported parental discussion patterns in a sociodemographically diverse sample of 9th- and 12th-grade students, applying a model of television interpretation processes from the communication literature called the Message Interpretation Process model (MIP).^21,28 According to the MIP model, individuals gradually internalize television portrayals applying a number of increasingly demanding tests, using a combination of logical and emotionally based strategies. The model traces decision-making by focusing on some of the important benchmarks that take an individual from message exposure to later behavior and has been tested in a series of studies with individuals ranging from 3rd grade to college age.^2128-32 The benchmarks include desirability, social norms and perceived realism, personal norms and perceived similarity, identification, expectancies, and behavior.

A child testing the logic of a message will determine the extent to which a portrayal seems realistic or generally normativethat is, "like most people."^21,32,33 If perceived as realistic, a logically processed message still may not survive yet a tougher test, which is to determine how closely the portrayal reflects personal experiences and norms, called perceived similarity.²¹ Tests of the model have shown that children as young as 3rd grade make distinctions between what is true for "most people" and what is true for their own family.^21,32 Portrayals that survive these veracity tests will tend to inspire the child to emulate (identify with) the portrayal, which can lead to changes in expectancies, perceptions of the social world, and behavior.^2128-31

The MIP model, however, acknowledges that decision-making is not purely logical. In particular, desirability of a portrayalits perceived attractivenesscan influence identification, the desire to emulate television characters.²¹ In addition, consistent with previous research,^28-31 we expected to find that desirability would directly affect expectancies, beliefs about positive benefits from drinking alcohol. Also based on previous findings,²¹ however, we expected to find that parents could mute the effects of desirability by affecting expectancies themselves, through negative reinforcement of messages. In contrast, positive reinforcement would magnify positive beliefs about media messages such as identification and expectancies. We further hypothesized that effects of television exposure itself would vary by genre viewed, relating most to content heavy with alcohol-related portrayals and advertising, such as sports, music videos, and night-time talk shows,^8,11 and emerging primarily for beliefs predictive of alcohol use rather than for alcohol-related behavior itself.

	METHODS

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Sample

A purposive sample of 578 9th- and 12th-grade students from 2 schools in the central California coast area participated in a cross-sectional pencil-and-paper survey in the spring of 1998. The schools were chosen because of the high representation of ethnic minorities, particularly Latino students, as well as for the district's economic diversity. Of the respondents, 10% (n = 55) were Asian, 2% (n = 11) were black, 34% (n = 197) were white, 45% (n = 258) were Latino, and 1% (n = 6) were Native American. The remaining respondents identified themselves as other. They identified their households, on average, as middle income, and their parents' education level, on average, as having some college education without a bachelor's degree.

An active consent procedure via a district mailing to parents was used with an original sample of ~900 students, yielding a 64% participation rate. The sample was largely representative of the community, based on comparisons of demographics with 1990 US census data. Missing responses were attributable more to noncontacts than to any refusal bias among parents. The sample included 252 9th-grade students (44%) and 326 12th-grade students (56%). Participants included 263 boys (46%) and 312 girls (54%), with 3 students failing to provide gender information. Students were asked, on a 5-point scale, whether parents had no high school degree (n = 117), a high school degree (n = 109), some college (n = 159), a bachelor's degree (n = 67), or some graduate school (n = 44). Among respondents, 51 were not sure and 31 left the question blank. Students also were asked whether they considered their household income to be very low (n = 14), low (n = 57), middle (n = 330), high (n = 75), or very high (n = 11), with 62 not sure and 29 leaving the question blank. They also were asked to indicate their race or ethnicity and were invited to "circle all that apply." The study procedures were approved by the institutional review board of Washington State University.

Measures

Perceived Realism To measure perceived realism, respondents indicated the extent to which "TV is a realistic source of information for" what makes people popular, what makes people successful, how teenagers act, and what is trendy, all on 4-point Likert scales ( = .79).

Desirability To measure desirability, the degree to which adolescents found media portrayals to be attractive, participants indicated the extent to which people drinking alcohol in beer advertisements seem to be having fun; people drinking alcohol in beer advertisements are attractive; people drinking alcohol on TV seem to have a lot of problems (reverse coded); people drinking alcohol in beer advertisements seem popular with their friends; bad things often happen to people shown drinking alcohol on TV (reverse coded); and people in beer advertisements seem happy, all on 4-point scales (never to often or strongly disagree to strongly agree) ( = .74).

Similarity To measure perceptions of norms relevant to their peer group for drinking, respondents indicated agreement or disagreement on a 4-point Likert scale that most teenagers drink alcohol.

Identification To measure identification, the extent to which participants wanted to be like media portrayals, they indicated how strongly they agreed, on 4-point scales, with 4 statements that included I wish I could be like people on TV programs; I wish I could be like people in TV advertisements; I wish I could do the things that people in advertisements do; and I wish I could look like people I see on TV ( = .81).

Expectancies Social expectancies, the extent to which individuals associated positive benefits with a behavior such a drinking alcohol, were indicated by participants' agreement or disagreement with the following 7 statements, on 4-point Likert scales: that drinking alcohol makes you feel happy; drinking alcohol makes a party more fun; drinking alcohol helps you fit in; beer is a good reward after a hard day; you will find beer at a good party; drinking together is a sign of a good relationship; and drinking alcohol is a good way to relax ( = .88). The measures for the various belief indices were drawn from previous studies using adolescent populations.^14,21,30

Alcohol Predrinking Behavior An alternative behavior measure, developed for use among children not yet making drinking decisions,^28,30 also was included. Preferences for products exhibiting beer or soda pop logos were determined based on the presentation of 6 items, which respondents rated on a scale of 1 to 5 (not wanting it at all to wanting it a lot). Each beer item had a corresponding item representing a soda pop logo to act as a comparison group and to make it possible to determine whether the index measured a desire for beer-related items specifically or more generalized consumerism. Items included balls, toy trucks, motorized "dancing" cans, shirts, piggy banks, towels, hats, and salt- and pepper-shakers, representing a variety of brands. Groups of 6 items from a total of 22 items were randomly assigned to classrooms in 1 of 8 balanced orders to avoid item-specific, brand-specific, or order-specific effects. Items in each order crossed gender stereotypes; for example, salt- and pepper-shakers countered athletic equipment. Each order included 3 items representing each theme (soda pop or beer). Only the beer items were used to create the prebehavior index ( = .61). The inclusion of the soda pop measures did not measurably improve the reliability of the index and on their own were not reliable ( = .47). The assumption that beer-related items would relate differently to key dependent variables was tested via correlations. As expected beer-themed items correlated positively with behavior (r = .45; P < .001), whereas soda pop-themed items correlated negatively (r = .10; P < .05). Similarly, beer-themed items correlated positively with advertisement content evaluations (r = .37; P < .001), identification (r = .23; P < .001) and expectancies (r = .45; P < .001), whereas soda pop-themed items were uncorrelated. Soda pop-themed items correlated negatively with desirability (r = .10; P < .05), with beer-themed items uncorrelated. Both beer- and soda pop-themed items correlated positively with perceived realism (r = .27; P < .001 and r = .17; P < .001, respectively). In sum, the pattern of associations did reveal some similarities suggestive of consumerism, specifically in the positive relationships found for perceived realism. The majority of relationships, however, demonstrated the expected distinctions between beer-themed and soda pop-themed products, with beer-themed items exclusively related positively to behavior, expectancies, identification, and desirability. Thus, the construct validity of the prebehavior measures of desire for beer-themed products was supported.

Behavior Measures were drawn largely from Johnston et al¹⁸ but were modified to include a measure of the number of products bearing alcohol logos owned by each respondent. Participants indicated the number of alcohol products owned "that display alcohol logos or products" on a 4-point scale (none; 1-2; 3-4; and 5 or more); the number of times "in the past 6 months" each respondent had been offered an alcoholic beverage; attended a party where alcohol was served; drank an alcoholic beverage; had 4 or more drinks in a row; rode with a driver who had been drinking alcohol; and got sick from drinking alcohol, all on 6-point scales (never; 1-2 times; 3-4 times; 1-3 times a month; 1 time a week; and over once a week). The measures were standardized to compute an index ( = .87) attributable to the 2 scales used.

Positive Reinforcement Items assessing the extent to which parents reportedly reinforced television messages, using the index validated by Austin et al,^34,35 included how often on 4-point scales (never to often) a "parent or guardian" would say they like a product in a TV ad; say they like a character or person on TV; say something on TV often happens in real life; imitate something they saw on a TV program or in an ad; and say they agree with something shown on TV ( = .73).

Negative Reinforcement Items assessing the extent to which parents reportedly counter-reinforced television messages, using the index validated by Austin et al,³⁴ included how often, on 4-point scales (never to often), a "parent or guardian" would speak up when they see something on TV they don't like; say something on TV is not true; talk about what advertisements try to do; say something in an advertisement looks better than it really is; say they disagree with something shown on TV; and tell you more about something you see on TV ( = .75). It has been demonstrated that positive and negative reinforcement operate differently and should be considered separately.³⁶

Media Use Exposure to TV was determined via participants' indication of how many days in the past week they had watched "any prime time TV (between 8 and 11 PM)," sports programs, news programs, daytime soap operas, music videos, late-night talk shows, and Spanish-language TV, on a scale from 0 to 7 days.

Statistical Analysis

Hypotheses predicting associations consistent with the MIP model were tested via hierarchical multiple regression analysis. Sex, grade, reported income, reported parental education, gender, and ethnicity were included as controls in a forced-entry series of blocks, with stepwise entry of variables used within each block. The equations tested the hypothesized decision-making process working backwards from the final decision, including all independent variables to allow for the possibility that direct effects could emerge where only indirect effects were expected.

	RESULTS

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Descriptive statistics for the sample and outcome measures are shown in Table 1. As Table 2 shows, the size of correlations among independent variables posed little danger of multicollinearity among the independent variables, as did the lack of large  swings in hierarchical regression analysis. Student's t tests demonstrated significant differences between the 2 age groups on most of the constructs. In particular, 9th-grade students watched more prime-time television, soap operas, late-night talk shows, sports, Spanish television, and music videos, had slightly higher levels of positive reinforcement, thought media portrayals more realistic, identified more with portrayals, and desired products with alcohol logos more than did the 12th-grade students. The older students, however, thought the portrayals more desirable and had higher levels of drinking behavior. The age groups did not differ on expectancies, similarity, news exposure, or negative reinforcement.

Predicting Behavior

Regression analysis showed that boys and non-white students used alcohol slightly more than did others. The primary predictor of drinking behavior was expectancies, followed by predrinking behavior. Exposure to late-night talk shows had a small but positive association ( = .12; P < .01) with drinking. Perceptions of realism had a small but significant negative association with drinking with the other variables controlled, although no significant raw correlation with behavior existed (r = .035; not significant).

Predicting Predrinking Behavior

Boys, Latino students and 9th-grade students were more attracted to the products bearing beer logos, with expectancies the largest predictor of predrinking behavior, associating with 13% greater desire for alcohol-themed products. Exposure to sports programming associated with 3% greater desire, with late-night talk shows associating with 1% greater desire.

Predicting Expectancies

Boys and non-white students exhibited more positive expectancies for alcohol use. The largest predictor of expectancies was similarity, associating with 12% more positive beliefs about the benefits of drinking, followed by identification with portrayals, which associated with 7% more positive beliefs. Negative reinforcement by parents associated with 3% reduced expectancies, whereas positive reinforcement associated with 1% higher expectancies. Desirability of portrayals associated with an added 1%. No exposure variables associated with expectancies.

Predicting Identification

Younger students identified with media portrayals more, with perceived realism increasing identification by 8%, desirability adding 4%, positive reinforcement adding another 2%, exposure to music videos adding 1%, exposure to news programming reducing identification by just under 1%, and exposure to prime-time television adding close to 1%.

Predicting Similarity

Girls were 2% more likely to think most teenagers drink alcohol. Perceptions of television realism also associated with 2% more positive personal norms or similarity, with exposure to late-night talk shows associated with 2% more positive personal norms.

Predicting Perceived Realism

The primary predictors of perceived realism were non-white ethnicity, which reduced perceptions of realism by 5%, and positive parental reinforcement, which associated with 5% higher increased perceptions of realism. Younger students found portrayals slightly more realistic, with exposure to music videos also associating with slightly higher realism.

Predicting Desirability

On the whole, the measures used in the analysis explained little about desirability, with boys and whites finding portrayals slightly more desirable, and with music videos associating with 1% lower assessments of desirability.

	DISCUSSION

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The purpose of this study was to examine adolescents' viewing patterns, beliefs about alcohol and media messages, grade level, and parental discussion patterns regarding media messages to determine their relative associations with predrinking and actual drinking behavior. The cross-sectional nature of the data makes it impossible to demonstrate causation unequivocally. Nevertheless, the results indicate that the biggest predictor of behaviors is expectancies. In addition, the results bolster the conclusions of other studies that expectancies-beliefs about the benefits of drinking alcohol develop over time and are influenced by perceptions of media messages even more than by media exposure itself.

Expectancies associated strongly with behavior, explaining 33% more frequent drinking behavior and 13% more positive predrinking behavior. The largest predictor of expectancies was perceived similarity (beliefs based on personal experience), explaining 12% more positive beliefs about the benefits of drinking. This was followed by identification (the desire to emulate media portrayals), explaining 6% more positive beliefs. This suggests that expectancies are an important influence on behavioral decision-making, and it further suggests that expectancies are influenced partly by logic and partly by wishful thinking.

Previous research has found that identificationthe desire to emulate media portrayals-is a relatively strong predictor of expectancies among 10- to 11-year-old children,²¹ suggesting that expectancies are in development among children younger than those participating in this study and that identification may play a more significant role than norms during that time. In addition, other research with 3rd-, 6th-, and 9th-grade students has found expectancies highest among 9th-grade students and identification highest among 6th-grade students, also suggesting that identification is a strong force in decision-making at that age.³⁰ The current study found expectancies unchanged between 9th and 12th grade, while drinking behavior increased. These findings together suggest that a process of decision-making may be taking place, gradually linking perceptions of media messages to actual behavioral outcomes.

The results further suggest that perceptions of media messages as desirable or realistic associate more strongly with decision-making outcomes than exposure to the messages does. Realism and desirability were the strongest predictors of variation in identification, with realism and use of late-night talk shows equal predictors of variation in similarity/personal norms. Together they were the strongest predictors of variation in expectancies. Desirability also had a weak but significant direct relationship to expectancies. No media exposure variables associated with expectancies. Music videos and late-night talk shows associated weakly but positively with identification, and news exposure weakly but negatively associated with identification. Media exposure variables also associated weakly with similarity and behaviors, together explaining at most 2% of the variance in any of the dependent measures. It may be that different, more sensitive media use measures than days or hours of exposure are required to account for the role of the media in decision-making, although a strength of this study was its breakdown of exposure by genres.³⁷ A multiyear, multiage panel design analyzed using structural equation models would be helpful to investigate the role of mediating personality-based, developmentally-based, and environmentally-based variables over time.

If perceptions of media content matter more than simple exposure, and perceptions about media content and about drinking differ across age groups, then prevention research needs to determine which perceptions matter along with how and when they develop. The research to date looking at age differences in perceptions of desirability, realism, and identification suggests that levels of desirability increase steadily between 3rd and 9th grade, and this study indicates that they continue to become more positive through 12th grade. Findings from this and previous studies also indicate that identification peaks around 6th grade, and expectancies peak around 9th grade. Finally, this and existing research indicate that the appeal of items with alcohol logosour measure of predrinking behavior proven reliable in past research^29,30also may peak by 9th grade, with actual drinking behavior lagging behind but positively predicted by the predrinking measure. Although longitudinal study is essential to determine causation, this combination of findings across studies and with a variety of samples suggests that the decision to drink is driven to some extent by media perceptions and that the process is well underway by 3rd grade.

The findings of Austin and Johnson²⁸ that desirability predicted 51% more positive perceptions of social norms about drinking among 3rd grade students adds additional support to the theory that media-related perceptions contribute to the early development of drinking predispositions. This implies that media literacy training may help children and adolescents resist the allure of appealing alcohol portrayals in the media. The Persuasion Knowledge Model³⁸ also suggests that people build up a resistance to persuasive strategies once they can identify them. Health campaigns countering appealing advertising and programming portrayals of unhealthful behaviors, therefore, should benefit from including media literacy components in their programs.

	CONCLUSIONS

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Finally, the results of this study indicate that the role of parents in decision-making, both as role models and as communicators, also needs to be examined longitudinally. This study found that parental discussion of the media had weak but significant associations with expectancies, identification, and perceived realism. The extent to which parents countered media messages associated with reduced expectancies, while the extent to which parents reinforced media messages associated with increased expectancies, identification, and perceived realism. Austin and Meili²¹ found that media messages seemed to have an influence only in the context of stronger parental influences among 10- and 11-year-old children; as a result, the weak associations found here suggest that parental influences are stronger at earlier ages. It is less likely that parental influences are inconsequential. The finding that parental discussion can worsen perceptions about the media is of particular concern and is gaining support in other studies.^17,36

In addition, exposure-based findings regarding media effects may be disguising important parental influences. For example, the apparent associations of attitudes and behaviors with media exposure variables in these data may not represent meaningful causes of drinking decisions. Instead, the associations may represent 2 separate symptoms of a permissive family environment in which adolescents watch more music videos and late-night talk shows. Weak and contradictory findings regarding media exposure in the literature,^8-10 therefore, may mask the important role that media use plays in the development of drinking decisions. More studies comparing the explanatory value of media exposure measures along with processing-related and perceptual variables would be useful.

The findings of this study should not be misinterpreted as an indication that media exposure plays a negligible role in underage drinking. On the contrary, the results add weight to arguments that the media play a sizable role. To discern that role, however, researchers need to deemphasize exposure-based explanations for media effects and further explore the logical and emotional processes of decision-making that can explain when and how media use affects underage drinking.

	ACKNOWLEDGMENTS

This investigation was supported in part by the Alcoholic Beverage Medical Research Foundation and by funds provided for medical and biological research by the State of Washington Initiative Measure 171.

We thank Larry Wright, Brad Dushane, and the participating schools and families for their assistance.

	FOOTNOTES

This research has been approved by the institutional review board at Washington State University (1834), using a written, active parental consent and a written, active child consent procedure.

Received for publication Mar 17, 1999; accepted Jul 16, 1999.

Reprint requests to (E.W.A.) Edward R. Murrow School of Communication, Washington State University, Pullman, WA 99164-2520. E-mail: eaustin{at}wsu.edu

	ABBREVIATIONS

MIP, Message Interpretation Process.

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