ICAN: Infant, Child, & Adolescent Nutrition http://can.sagepub.com/ High School Journalists Write About Nutrition and Physical Activity Jeffrey S Hampl, Donna M. Winham and Christopher M. Wharton ICAN: Infant, Child, & Adolescent Nutrition 2012 4: 93 originally published online 23 January 2012 DOI: 10.1177/1941406411435170 The online version of this article can be found at: http://can.sagepub.com/content/4/2/93 Published by: http://www.sagepublications.com Additional services and information for ICAN: Infant, Child, & Adolescent Nutrition can be found at: Email Alerts: http://can.sagepub.com/cgi/alerts Subscriptions: http://can.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Citations: http://can.sagepub.com/content/4/2/93.refs.html >> Version of Record - Mar 14, 2012 OnlineFirst Version of Record - Jan 23, 2012 What is This? Downloaded from can.sagepub.com at ARIZONA STATE UNIV on March 24, 2012 vol. 4 • no. 2 ICAN: Infant, Child, & Adolescent Nutrition Adolescents High School Journalists Write About Nutrition and Physical Activity Jeffrey S Hampl, PhD, RD, Donna M. Winham, DrPH, MCHES, and Christopher M. Wharton, PhD Abstract: Many content analyses of mass media and health messages have been conducted, but little is known regarding the perceptions of high school students about health-related topics. The authors conducted a content analysis of 218 newspapers collected from 25 Arizona high schools published during the 2003-2004 academic year. Two independent evaluators read each entire newspaper, identified qualifying articles (n = 95), and categorized content by the 2005 Dietary Guidelines for Americans. Evaluators sorted each article’s content into one or more groups reflecting the MyPyramid food categories and tracked article themes related to harms or benefits of lifestyle choices. Articles were also scored regarding information accuracy. Categorizing by the 2005 Dietary Guidelines, the most frequently mentioned article topics were “carbohydrates” or “reduced sugars” in foods (55%), “weight management” (53%), and “physical activity” (45%). In all, 15% of articles included some incorrect information in their text. These data show that healthy eating and active lifestyles are important concerns for high school journalism students. Journalism and dietetics professionals should volunteer with high school journalism classes to encourage these interests and to promote greater coverage of nutrition and health issues as well as more accurate reporting. Keywords: adolescents; nutrition; high school newspapers; content analysis; journalism The average US adolescent accumulates more than 10.5 hours of media exposure each day, and arguably, the media are among the leading providers of information to adolescents.1 With topics ranging from fashion to fitness, media in all forms influence youth and are considered actionable sources of health information.2-4 particular.6 These data do not include time spent reading online magazines or newspapers.1 Adolescents consider newspaper reading to be a source of clout— the result of respect from peers and adults—and the amount of time spent reading newspapers, albeit a fraction of total media exposure, increases significantly throughout the teenage years.7 A multitude of research publications have documented the health-related content of nationwide, city, and college,8-10 and newspaper articles have been found to influence health behaviors.11 However, studies that use high school journalists or “. . . adolescents tend to be influenced to a greater extent by peers than by parents, thereby shaping assorted health behaviors, . . .” Although adolescents pay particular attention to “screen-based” media (eg, television), reading remains a popular leisure-time activity for young people.5 Data from the Kaiser Family Foundation show that 43% of 15- to 18-year-olds spend at least 30 minutes a day reading books, magazines, or newspapers, and 43% of these spend at least 5 minutes a day reading newspapers in newspapers as a data source are quite rare. This gap in the research literature is surprising because high school newspapers have become a sophisticated medium produced by and for adolescents. Given the impact of newspaper articles on well-being,11 high school newspapers—one of the few peer-based media available to students—could serve as utilizable sources of information and DOI: 10.1177/1941406411435170. From Nutrition Program, School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona. Address correspondence to Donna M. Winham, DrPH, MCHES, Nutrition Program, School of Nutrition and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004; e-mail: donna.winham@asu.edu. For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. Copyright © 2012 The Author(s) 93 Downloaded from can.sagepub.com at ARIZONA STATE UNIV on March 24, 2012 April 2012 ICAN: Infant, Child, & Adolescent Nutrition motivators for behavior change related to nutrition and physical activity.12 This is evidenced by research documenting effects of peer-led, school-based education strategies on a variety of health behaviors.13,14 Furthermore, adolescents tend to be influenced to a greater extent by peers than by parents, thereby shaping assorted health behaviors, including food and beverage choices; use of marijuana, tobacco, and alcohol; and sexual activity.15-17 Background Social cognitive theory provides a theoretical basis for understanding how high school newspapers might influence adolescents’ dietary intake and physical activity. Founded on reciprocal determinism—a triad of environmental determinants, cognitive and personal factors, and behavior patterns—social cognitive theory holds that these 3 factors interact, influence, and cannot be separated from each other.18 Based on social cognitive theory, nutrition- and physical activity–related articles in high school newspapers could reverberate and influence students’ health choices. For example, a high school journalism student in the school’s cafeteria (ie, the environment) may be prompted to write an article on high-fat foods for the school’s newspaper. Students reading the article can become aware (cognitive) of the importance of fruits and vegetables in the diet and set goals (personal) to eat 5 or more servings of fruits and vegetables a day. The hopeful outcome is that health-related articles gradually can influence students’ eating patterns or actions (behavior) to bring changes to school cafeteria menus (environment, once again). As a theoretical framework of mass communication research, agenda-setting theory holds that news media determine the importance and salience assigned to issues, or, as Cohen19 argued, mass media “may not be successful much of the time in telling people what to think, but is stunningly successful in telling people what to think about.” According to agenda-setting theory, information flows in 2 steps. First, media-informed individuals become aware of a health-related topic. Second, they use interpersonal skills to share information with less media-dependent peers. Agendasetting theory has predominantly focused on political science and election outcomes. Increasingly, health researchers have used the theory as the crux of their research. For example, Jones et al20 assessed agendasetting theory related to mammography use and breast self-exams. The authors found that mothers in their sample served as the primary media contact. They then shared this information with their daughters, who were less likely to encounter breast health issues in the mass media. In reference to high school newspapers, reporting on health topics would be the first step in agenda setting. Individuals reading these articles would then go on to share healthrelated information with peers who may not read the newspaper. High school newspapers have potential as an effective means of health promotion. However, to our knowledge, only 2 previous studies have used high school journalism programs as a data source, and neither collected data on nutrition or physical activity. To determine what high school students write about related to tobacco use, Malone et al17 collected surveys from 136 student newspaper editors and found that 78% reported their high school had published tobaccorelated articles during the 2 years prior to data collection. Student editors then self-selected tobacco-related articles (n = 257) and submitted them to the researchers, who reported that nearly half of all articles focused on tobacco control policies but only 16% focused on tobacco’s heath effects. Freeman et al21 assessed advertisements for ultraviolet (UV) tanning, which increases the risk of melanoma, in 3 Colorado counties’ high school newspapers. Representatives from each participating school (n = 23) self-selected 3 or more newspaper issues to be sent to the authors, who reported that at least 1 newspaper issue from 11 schools contained a UV tanning advertisement and only 2 of the total 40 advertisements included a reference to parental guidance. 94 Downloaded from can.sagepub.com at ARIZONA STATE UNIV on March 24, 2012 Often, health scientists take a paternalistic approach to adolescent health. Little is done, though, to listen to what high school students themselves have to say about nutrition and physical activity. The current study was part of a larger research project aimed at advancing reporting among high school journalism students.22,23 The study objective was to assess Arizona high school newspapers from the 2003-2004 academic year to gain insight into nutrition- and physical activity– related health topics of concern to student journalists. Methods Recruitment The Arizona Interscholastic Press Association provided contact information for newspaper and yearbook advisers employed by Arizona high schools during late summer 2003. Of 156 high schools on the list, 42 produced yearbooks but not newspapers. Contacts at the remaining 114 schools verified that they supervised a student journalism program that produces periodic newspapers. We invited advisors to provide a copy of each newspaper issue printed during the 2003-2004 academic year. To encourage participation and to minimize schools’ costs, we provided the advisors large, self-addressed, postagepaid envelopes so newspaper issues could be mailed to us as they were printed during the academic year. Journalism advisors from 49 schools originally consented to send newspapers. However, 9 schools did not participate because of lack of time (n = 3), lack of interest (n = 3), or because their journalism program was terminated during or prior to the study period (n = 3). An additional 15 schools sent some newspaper issues but not their complete set. These schools were excluded from analysis because of missing content. A total of 25 schools provided complete sets of newspapers to be used as a data source for a content analysis of students’ articles and their relevance to nutrition and physical activity issues. The participating 25 schools were located in both urban and rural sectors of Arizona. The majority of vol. 4 • no. 2 schools (76%) were in the metro Phoenix area, which is the major population hub of Arizona. Codebook Development Two evaluators, who were unaware of the exact study purpose developed a codebook to ensure consistency in identifying articles appropriate for the content analysis. Evaluators went through several hours of training with the principal investigator spread over multiple days to ensure consistency. The codebook itself was pilot-tested using 5 high school newspaper issues not included in the final sample to verify uniform interpretation of coding categories. To be deemed appropriate by evaluators, an article’s coverage of nutrition or physical activity topics had to occupy at least 2 full paragraphs or more than one third of the full story as measured by line count of the item. Letters to the editor and articles reporting sports events outcomes, student athlete profiles, restaurant reviews, or recipes were not included. Articles covering a specific disease (eg, anorexia nervosa) were excluded unless disease prevention or health promotion via nutrition or physical activity was included. Articles covering nutrition supplements were rejected if they did not mention obtaining nutrients from foods. Based on the 5 A Day program’s standards, evaluators did not consider french fries or other fried potatoes to be vegetables when categorizing articles that mentioned foods.24 When newspaper articles mentioned a food or beverage, evaluators used previous research as a guide to categorize combination foods by their dominant ingredient (eg, hamburgers belonged to the meat and beans group).25 This was done to sort articles into food groups of MyPyramid, the official eating guide of the United States.26 High-energy, lownutrient foods were counted as “discretionary calories” in MyPyramid. For purposes of this study, discretionary calories comprised fats and sweeteners added to foods (eg, sugar and butter) and food and beverage items that are mostly fats (with the exception of oils, which comprise a unique food group), caloric ICAN: Infant, Child, & Adolescent Nutrition sweeteners, and/or alcoholic beverages (eg, soda, candy, and beer). Articles with terms such as garbage foods, junk foods, and fast foods without additional clarification were coded as discretionary calories. Interrater Scores Working separately, each evaluator reviewed newspapers to identify articles appropriate for inclusion in the content analysis (100% overlap). Each evaluator coded newspaper articles separately, but came together twice during the procedure to ensure consistency in application of codebook rules in accordance with established newspaper coding procedures.27 In each instance, evaluators alleviated differences of opinion by reviewing codebook rules and determining their most appropriate application. Evaluators determined each article’s relevance to one or more of the 9 topics of the 2005 Dietary Guidelines for Americans.28 When articles mentioned food or beverages, evaluators categorized them into one or more categories of MyPyramid. Following the methodology of Main et al,29 newspaper articles were coded for the presence or absence of each of the Dietary Guidelines and MyPyramid categories, rather than forcing evaluators to select one guideline or category if 2 or more were covered in an article. Finally, evaluators tracked the reporting of incorrect nutrition and physical activity information in articles, for example, stating that sports drinks produce dehydration, and so on. SPSS (version 17.0, SPSS, Chicago, IL) was used for data entry and analyses. Cohen’s k values were calculated to assess intercoder reliability for the 17 categorical values on our coding form. Four variables had k values of 1.0, indicating complete agreement between coders. The remaining variables had k values between 0.83 and 0.96, indicating excellent agreement.30 Frequency analyses were also conducted to describe content analysis outcomes. Human Subjects Approval The Human Subjects Committee of the Institutional Review Board at Arizona State University approved this research project. Results Overall, we received 218 newspapers, or complete sets of all issues from 25 participating high schools in Arizona. Schools printed a mean of seven newspaper issues (median = 8) during the 2003-2004 academic year. Evaluators determined that 116 issues mentioned ≥1 article related to the Dietary Guidelines or ≥1 article related to a MyPyramid food group. These articles were included in the content analysis, yielding a mean of 0.53 health-related articles per issue. Categorizing by the 2005 Dietary Guidelines for Americans (Table 1), our data showed that most articles (55%) discussed carbohydrates, whereas 53% and 45% of articles focused on weight management and physical activity, respectively. Very few articles covered sodium and potassium (8% of articles), alcoholic beverages (7%), or food safety (3%). Coding by MyPyramid categories (Table 2), most articles (87%) that mentioned foods and beverages included discretionary calorie items, followed by meats and beans (50%) and grains (44%). The oil group was least commonly mentioned (14%) within articles that mentioned foods or beverages. Our data showed that 15% of articles contained erroneous information, ranging from misuse of words to blatant misstating of facts (Table 3). Discussion Article titles such as “Shedding Holiday Pounds,” “Possible Statewide Junk Food Ban in Schools,” and “Soda Gets the Boot” indicate that high school journalists are interested in local news, in particular those topics that relate directly to themselves and their peers. Spear12 did not assess nutrition- or physical activity– related health topics, but she did report that high school journalists cover issues found in their schools, such as racial tension and alcohol abuse. Based on this premise, our sample of high school journalists reported on topics observed in their schools. There was a particular interest in the growing overweight problem and its sequelae in the 95 Downloaded from can.sagepub.com at ARIZONA STATE UNIV on March 24, 2012 April 2012 ICAN: Infant, Child, & Adolescent Nutrition Table 1. References to the 2005 Dietary Guidelines for Americans in High School Newspaper Articles Dietary Guideline Guideline Message Articles Mentioning Guideline; n = 116 (%) Example Articles Carbohydrates Choose and prepare foods and beverages with little added sugars. 55 “Vending Machines May Be No More” Palantir, Tucson, AZ; “Junk Food Debunked” Arcadian, Phoenix, AZ Weight management Balance calories from foods and beverages with calories expended. 53 “Eating Unhealthy and Loving it” Jackrabbit, Mesa, AZ; “Group Lists Best, Worst Snacks for Kids” Apache, Fort Thomas, AZ Physical activity Engage in regular physical activity and reduce sedentary activities. 45 “Teenagers Abuse Nicotine to Lose Extra Pounds, fat” Demon Dispatch, Phoenix, AZ; “Feel Like Taking a Walk?” Prowler, Peoria, AZ Adequate nutrients within calorie needs Choose foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol. 37 “Westwood: A Snack-Free School” War Chant, Mesa, AZ; “Teen Dieting: Fad Diets Can Be Unhealthy” Papoose, Globe, AZ Fats Keep total fat intake between 20% and 35% of calories; consume <10% of calories from saturated fatty acids and <300 mg/day of cholesterol. 28 “Healthy Conscience” String, Sedona, AZ; “Low Carbohydrate Diets Actually Dangerous” Challenge, Phoenix, AZ Food groups to encourage Choose a variety of fruits and vegetables; consume ≥3 whole-grain products per day; consume 3 cups per day of fat-free or low-fat milk. 25 “Healthy Alternatives” Paw Print, Chandler, AZ; “Diets Do Not Measure up to People’s Expectations” Paradise Press, Paradise Valley, AZ Sodium and potassium Consume <2300 mg of sodium per day; consume potassiumrich foods, such as fruits and vegetables. 8 “Eating Healthy Remains Hefty Problem” Utopian, Glendale, AZ; “Know Your Nutrition Facts” Ashes, Scottsdale, AZ Alcoholic beverages Alcoholic beverages should not be consumed by children and adolescents; adults who choose to drink alcoholic beverages should do so sensibly and in moderation. 7 “Shedding Holiday Pounds” Cooper Chronicle, Bisbee, AZ; “Teens Admit Drinking to Help Relieve Stress” Demon Dispatch, Phoenix, AZ Food safety Clean hands, food contact surfaces, and fruits and vegetables; cook foods to safe temperature; avoid raw milk, eggs and sprouts and undercooked meat and poultry. 3 “Fast Food Nutrition and Law Suits” Wolf Howl, Chandler, AZ; “Cafeteria Cleanliness Measures up to State Standards” View, Phoenix, AZ 96 Downloaded from can.sagepub.com at ARIZONA STATE UNIV on March 24, 2012 vol. 4 • no. 2 ICAN: Infant, Child, & Adolescent Nutrition Table 2. References to MyPyramid Categories in High School Newspaper Articles MyPyramid Category Example Foods and Beverages Articles Mentioning Category; n = 91 (%) Example Articles Discretionary calories Doughnuts, salad dressing, sugar, syrup, butter, potato chips, soda, french fries, wine, beer 87 “School’s on a Diet: Proposal Seeks to Prohibit Junk Food” Demon Dispatch, Phoenix, AZ; “Soda Gets the Boot” Jackrabbit, Mesa, AZ Meat and beans Beef, ham/pork, chicken, eggs, soy beans, peanut butter, veggie burgers, mixes nuts, canned tuna 50 “Homemade Lunches: Time-Efficient, CostEffective” Knightly News, Avondale, AZ; “Cafeteria Needs Vegetarian Options” Challenge, Phoenix, AZ Grains Oatmeal, tortillas, noodles, ready-to-eat breakfast cereals, spaghetti, pretzels, wild rice 44 “Got Carbs?” El Guerrero, Tucson, AZ; “‘No Meat for Me!’ Says HHS Vegetarian” Paw Print, Chandler, AZ Vegetables Spinach, tofu, corn, iceberg lettuce, tomato juice, carrots, potatoes, mushrooms 42 “How to be a Healthier Person” Paradise Press, Paradise Valley, AZ; “Ways to Eat Healthy” Prowler, Peoria, AZ Fruits Apples, bananas, strawberries, grapes, oranges, raisins, 100% fruit juice, fruit cocktail 42 “Atkins Annoyance” Arcadian, Phoenix, AZ; “Possible Statewide Junk Food Ban in Schools” Cooper Chronicle, Bisbee, AZ Milk Milk, pudding, ice cream, yogurt, cheese 37 “Shape Up, Eat Right, Get Fit, Be Healthy” Utopian, Glendale, AZ; “Exercising Good Eating Habits” View, Phoenix, AZ Oils Olive oil, canola oil, butter 14 “Fit or Fat: The Real Way to Lose Weight” Knightly News, Avondale, AZ; “Students Discuss Cafeteria Choices” Mustang Express, Peoria, AZ United States. Data from Ogden et al31 showed that the prevalence of overweight (ie, gender-specific body mass index [BMI] for age greater than or equal to the 95th percentile) more than tripled during the past 20 years. Students who are overweight or at risk for overweight (ie, gender-specific BMI for age 85th to 94th percentile) not only have an increased risk of chronic disease but are also more likely to suffer from poor self-esteem and disordered eating. For example, Thompson et al32 documented that high school girls who were overweight or at risk for overweight were more likely than other girls to be dissatisfied with their bodies and were more likely to diet and to make disparaging remarks about their bodies. Research using agenda-setting theory has shown a direct relationship between media content and public policy interest on that issue.33 This premise was useful in this study, in that 87% and 55% of articles focused on discretionary calories and carbohydrates, respectively. The majority of these stories covered “pouring rights” (ie, contracts that give soft drink companies exclusive access to school districts) and repeated attempts to ban sodas from Arizona schools.34 In 2004, a 97 Downloaded from can.sagepub.com at ARIZONA STATE UNIV on March 24, 2012 April 2012 ICAN: Infant, Child, & Adolescent Nutrition Table 3. Inclusion of Incorrect Information in High School Newspaper Articles Articles With Incorrect Information 15% Example Text “High-protein, low-carb diets have been proven to cause several long-term health defects, including . . . kidney damage,” Arcadian, Phoenix, AZ “You should also drink less alcohol and eat more sweets,” Copper Chronicle, Bisbee, AZ “Proteins do boost one’s level of activity,” Challenge, Phoenix, AZ “Big Mac healthier than Mc’Salad,” Jackrabbit, Mesa, AZ “[Sports drink] contain sugar that can further dehydrate you,” Palantir, Tucson, AZ pilot project sponsored by the Arizona Department of Education led 8 schools to remove high-sugar foods from their campuses.35 Knowing the potential impacts of this initiative, journalism students in our sample frequently reported on the policy of banning foods and beverages from schools, thereby priming their fellow students on this topic. Despite the outcry of high school journalists and their peers, the Arizona legislature and governor passed a bill in April 2005 that banned all soda and other high-energy, low-nutrient foods and beverages in kindergarten through eighth grade schools that offer meals through the National School Lunch Program.36 High schools can also participate in the ban on a voluntary basis. This bill went into effect during the 2006-2007 academic year. Student journalists may be setting agendas for their peers related to the nutritional value of items in school vending machines and cafeterias. Beyond the frequent mention of discretionary calorie items, such as soda and “junk foods,” student journalists also wrote about the importance of food choices. Overall, 37% of articles were coded as adequate nutrients within calorie needs (eg, choose foods that limit the intake of saturated and trans fat). In articles categorized as food groups to encourage, students specifically noted that schools should offer more low-energy fruits and vegetables with meals. Even though almost one half of the articles related to physical activity, few noted the significant lack of exercise or physical activity among adolescents or within high schools. Instead, most articles reviewed various types of physical activity (eg, yoga for flexibility). These results indicate that student journalists may not be aware that school-based foci on physical education have been waning for years. According to the Centers for Disease Control and Prevention, only 29% of high school students attend daily physical education classes, compared with 15 years ago when 42% of high school students did so. Additionally, 35% of high school students do not participate regularly in vigorous physical activity.37 The impact of student newspapers— or newspapers altogether—on adolescents’ physical activity is not known, but several studies suggest a positive relationship between the two. For example, Marks et al38 used an Internet-based physical activity intervention for adolescent girls, in comparison with a printed 98 Downloaded from can.sagepub.com at ARIZONA STATE UNIV on March 24, 2012 workbook that presented identical information. After exposing the girls to either medium for 2 weeks, the authors found that the girls reading the print version of the intervention had significantly greater intentions to be physically active and more self-reported physical activity than did girls using the Internet version of the intervention. More than one third (37%) of newspaper articles that mentioned foods and beverages referred to MyPyramid’s milk group, showing that students did not prioritize inadequate calcium intakes as much as other newsworthy topics. Our data do not allow us determine why this is so, but one reason could be the ambitious “milk mustache” campaign of the National Fluid Milk Processor Promotion Board. During the time frame of data collection, the milk mustache campaign was aggressively reaching out to 13- to 19-year-olds to promote intake of dairy products.39 With a strong media focus on dairy products already in place, student journalists may not have considered milk or other sources of dietary calcium as being as newsworthy as physical activity or carbohydrates. Despite student journalists’ lack of attention to dairy products however, most adolescents do not consume the recommended amount of calcium through dairy products or other vegetable sources thereby limiting their potential peak bone mass.40 This information should be shared with adolescents, either by high school newspapers or other media. Miscommunication, inaccurate reporting, and sensationalism of health-related topics are commonly found in newspaper reporting.41 For example, Caspermeyer et al42 assessed the accuracy of the New York Times and 8 regional newspapers on topics related to neurological diseases. Their data showed that 20% of sample stories contained medical errors or exaggerations. A tendency for inadequate health reporting can be found among professionally trained journalists as well. For example, Voss43 reported that 25% of Midwestern journalists (n = 115) reported they were not at all or only somewhat confident in their ability to report health news. Additionally, 40% of her sample vol. 4 • no. 2 members agreed that most health reporters lack requisite training to cover their beat. A comparably high percentage (15%) of articles written by student journalists in our study contained false information. Errors in students’ writings can be explained by their lack of formal education as science writers. However, it is important for them to be trained in responsible reporting at their nascent stage of development as journalists. Unlike Malone et al17 and Freeman et al21—whose newspaper databases were derived from school representatives hand-selecting previously published articles or newspaper issues—we had complete sets of newspaper issues from all participating schools for our review. We could have increased the sample of high schools by including the 9 additional schools that sent incomplete volumes of their 2003-2004 newspapers, but we felt doing so would be a threat to internal validity. All the same, our sample of newspaper articles for the content analysis was larger than that of Freeman et al21 who reviewed just 40 advertisements on UV tanning parlors in their study. However, there were some limitations to this study. For example, we cannot conclude that our data are representative of all high schools in the United States because our content analysis included 218 newspaper issues. However, our data set did comprise complete sets of newspaper issues from rural and urban high schools from all regions of Arizona. Also, because universal participation of Arizona schools could not be achieved despite consistent incentives offered to schools, we gathered a convenience sample rather than a fully randomized sample of schools. Our data show that nutrition- and physical activity–related health topics are newsworthy to student journalists. However, further research is needed to determine how much of an impact, if any, high school newspapers have on peer students’ knowledge, attitudes, and behaviors related to nutrition, physical activity, and other health topics. Additionally, further research could compare health outcomes of the traditional paper medium ICAN: Infant, Child, & Adolescent Nutrition of high school newspapers against the growing popularity of Internet-based student newspapers. 11. Author Note This project was supported by the Cooperative State Research, Education, and Extension Service of the US Department of Agriculture (contract no. 03-35200-13445, J. S. Hampl, Principal Investigator; D. M. Winham, Co -Principal Investigator). 12. 13. 14. References 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Rideout VJ, Foehr UG, Roberts DF. (2010). Generation M2: Media in the Lives of 8-18 Year-Olds. Menlo Park, CA: Kaiser Family Foundation; 2010. Brown JD, Halpern CT, L’Engle KL. 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