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. Author manuscript; available in PMC: 2025 Jun 1.
Published in final edited form as: Fam Syst Health. 2023 Oct 23;42(2):226–238. doi: 10.1037/fsh0000855

Associations between parent-adolescent health-related conversations and mealtime media use among Hispanic families

Gabriela M Martinez a, Sonia Vega-López a,b,*, Stephanie Ayers b, Anaid Gonzalvez b, Meg Bruening a,c, Beatriz Vega Luna b, Flavio F Marsiglia b,d
PMCID: PMC11035490  NIHMSID: NIHMS1938645  PMID: 37870808

Abstract

Introduction:

Whereas parents play an important role in shaping the home environment, it is unknown whether health-related parent-adolescent conversations may be associated with different health-promoting parenting practices, such as limiting adolescent mealtime media use in Hispanic families.

Methods:

For this cross-sectional analysis, Hispanic parents (n=344; 40.4±6.6 years; 89.2% female) of 6th-8th grade adolescents self-reported the frequency of having health- or weight-related conversations with their adolescent child, and the frequency of adolescent mealtime media device use. Spearman’s rank correlations were used to assess whether parent-adolescent health-related conversations are associated with mealtime media device use by adolescents.

Results:

Over 75% of parents reported having conversations about healthy eating and being physically active at least a few times per week. Fewer parents reported having frequent weight-related conversations. Frequency of mealtime media use was low, except for television/movie watching (only 30% of parents reported their child rarely/never watching television during family meals). Having conversations related to the adolescent weighing too much was correlated with the mealtime use of television (r=.207; p<.001), cellphones (r=.134; p=.018), and headphones for music listening (r=.145; p=.010). Conversations about exercising to lose weight were correlated with television/movie watching during mealtimes (r=.129; p=.035).

Discussion:

Findings suggest the co-occurrence of less health-promoting parenting behaviors, such as focusing on weight-related conversations and allowing the use of media devices during mealtimes. Focusing on health- rather than weight-related parent-adolescent conversations and implementing mealtime media use rules may have the potential to shape a home food environment which ultimately could improve an adolescent’s overall health outcomes.

Keywords: adolescents, health-related conversations, mealtimes, parent-adolescent conversations, weight-related conversations

Introduction

In the United States (U.S.), Hispanic1 individuals, both adults and children, have a higher probability of becoming obese when compared to non-Hispanic white individuals (Ochoa & Berge, 2017). Obesity prevalence among U.S. Hispanic adolescents (25.6%) is substantially higher than among non-Hispanic white adolescents (16.1%; Fryar et al., 2020). Obesity is a major public health concern because it is related to an increased risk of developing multiple chronic conditions, including type 2 diabetes, stroke, hypertension, coronary heart disease, depression, sleep apnea, and some cancers (Sanyaolu et al., 2019). This is especially concerning in adolescents because children with obesity are more likely to become adults with obesity, which increases their risk of experiencing adverse health outcomes earlier in their life (Sanyaolu et al., 2019). Children with obesity are also more likely to be bullied and have low self-esteem, which could further contribute to poor health status (Farhat, 2015).

Despite the need to address obesity in the Hispanic population, few healthy nutrition interventions are culturally tailored to Hispanic families (Delaney et al., 2021). Further, a particular obesity prevention challenge identified by Martinez et al. (2017) in a study of Hispanic families, most of them of Mexican descent, is the conflict that overweight is generally perceived as negative or unhealthy in the U.S. but more accepted in Mexico due to historical times of scarcity. This may impede parents from acting early on to address their children’s overweight or obese status.

The connection between parental feeding practices, parental concerns, and a child’s health status has been demonstrated in multiple studies (Mais et al., 2017; Scaglioni et al., 2018; Seburg et al., 2014; Tschann et al., 2015). Among positive parental feeding practices, having more frequent family meals has been correlated with positive eating behaviors, better diet quality in children, and healthier weight status into adulthood (Berge et al., 2015b; Couch et al., 2014; Watts et al., 2017). Parent concerns about their children’s weight status further influence parenting behaviors, often resulting in less healthful parental feeding practices, particularly when parents express having concerns about their own weight (Moore et al., 2012; Peyer et al., 2015). Within Hispanic households, research suggests that parents tend to pressure and control their children’s eating (LeCroy et al., 2019), feeding practices that have been positively associated with a child’s BMI and risk of obesity (Ochoa & Berge, 2017). Sociocultural factors further influence feeding practices among Hispanic parents. For example, higher levels of acculturation and longer residence time in the U.S. have been positively associated with obesogenic parental feeding practices, such as pressure to eat, control, and using food as a reward (Arandia et al., 2018; Bekelman et al., 2020; Johansen et al., 2020; Mojica et al., 2019; Power et al., 2015).

Healthy role modeling behaviors, which include providing and eating healthy foods, are established ways for caregivers to influence adolescents’ diet (Pearson et al., 2009). In a focus group study, 7th grade adolescents, most of whom were of Hispanic background, reported that they would like to see their parents and caregivers model healthy eating behaviors, and expressed frustration that most of the time, the adults in their lives bought and consumed unhealthy food (Masek et al., 2023). However, Lindsay et al., (2018) highlighted some of the barriers and difficulties faced by mostly immigrant Hispanic parents when it comes to modeling healthy behaviors and providing healthy foods. Parents stated they were aware of the importance of these behaviors but day to day stresses and lack of time after work drove them to choose easy, quick, calorie-dense but nutritionally-deficient, foods.

There is limited information about how specific rules or the environmental context during family meals may be associated with dietary behaviors among adolescents. Rules pertaining to snacks, limiting fast food intake, and limiting television watching during meals have been associated with healthier diets in both children and adolescents (Bailey-Davis et al., 2017; Couch et al., 2014; Pyper et al., 2016). In contrast, eating in front of the television has been consistently associated with lower fruit and vegetable consumption, higher consumption of energy-dense snacks, and lower healthy eating index (HEI) scores among adolescents (Jusienė et al., 2019; Mais et al., 2017; Pearson et al., 2018; Pyper et al., 2016; Shang et al., 2015). Recent U.S. Census data suggests that Hispanics have more frequent family meals than other groups (Mayol-García, 2022). Research with Hispanic mothers suggests that having the television on during mealtimes is common, and often viewed as a family activity (Hammons et al., 2020). Whereas mealtime television watching may be viewed as a culturally-accepted behavior among Hispanic families, as is in many other groups, its downstream effects on diet quality and weight status needs to be further studied.

Emerging evidence that social media use is associated with eating behavior concerns, such as skipping meals, in adolescents and young adults (Sidani et al., 2016; Wilksch et al., 2020), raises the possibility of an additional mechanism through which parenting practices limiting media use during mealtimes may be beneficial for adolescent diets. However, there is scant information on how the easy mobility and growing availability and access of the latest media devices, such as tablets, smartphones, gaming consoles, and laptop computers, may influence the mealtime environment, particularly among Hispanic adolescents.

Having health-related conversations between a parent and their adolescent could provide an opportunity for parents to promote healthy behaviors and prevent obesity. Prior research suggests that conversations with adolescents that emphasize healthy eating are more beneficial rather than those focusing on weight loss (Berge et al., 2013, 2015a; Gillison et al., 2016). Conversations that focus on weight loss are potentially associated with increased psychological distress, disordered eating behavior, and higher body mass index (BMI) in adolescents (Berge et al, 2013, 2015a; Gillison et al., 2016). Whether having health-related parent-adolescent conversations is associated with parenting practices that are also more likely to promote a healthy mealtime environment, such as setting rules for media use, remains to be studied. Further, it is important to take into consideration the culturally different feeding practices and family dynamics of a Hispanic family in the U.S. (Farhat, 2015; Fryar et al., 2020; Mais et al., 2017; Mazarello Paes et al., 2015; Sanyaolu et al., 2019; Scaglioni et al., 2018; Seburg et al., 2014; Tschann et al., 2015). Therefore, the purpose of this study was to investigate the associations between health-related parent-adolescent conversations and mealtime media use among Hispanic families with adolescent children. It was hypothesized that parent-adolescent health-related conversations would be inversely associated with media device use by adolescents during family meals.

Methods

Study Design

This study is a cross-sectional analysis of baseline data from a randomized controlled trial assessing the efficacy of Families Preparing the New Generation Plus (FPNG Plus), a parenting intervention program that focuses on the promotion of healthy nutrition and substance use prevention delivered in middle schools to parents of Hispanic families residing in the Phoenix Metropolitan area (Vega-López et al., 2020).

Participants and Recruitment

Study recruitment strategies are described in detail elsewhere (Vega-López et al., 2020). Briefly, schools were eligible to participate if they met the following requirements: (a) public school that offered grades 6th-8th with a minimum of 65 students for each grade level; (b) located in Maricopa County, AZ; (c) student population of at least 60% Hispanic; (d) Title I fund recipient; and (e) willing to offer the randomly assigned study intervention programs at the school (Vega-López et al., 2020). Fliers were distributed at eligible middle schools to all 6th-8th grade students to recruit participants. Fliers had information about the study as well as contact information for team members to answer questions from interested parents. Study staff also attended select school events attended by parents to promote the study and answer questions. Parents were eligible to participate if they were 18 years or older and had a child enrolled in the school in any grade level. Adolescents were eligible if they participated in 6th-8th grade. For purposes of this analysis, parent data were excluded if their adolescent child had not participated in the study. All study protocols were approved by the Institutional Review Board at Arizona State University (Protocol ID: STUDY00006797). All participating parents provided written informed consent and parental permission for their adolescent child to participate. Adolescent participants provided written assent to participate in the study. Parents received $10 and adolescents received a non-monetary gift (e.g., water bottle, key chain, flash drive) as a token of appreciation for completing baseline data collection activities. This study is registered in ClinicalTrials.gov (Identifier: NCT03517111).

Data Collection

All baseline data collection activities took place prior to the start of the parent study intervention. Parents completed a self-administered electronic survey at baseline in their language of preference (English or Spanish). In addition to questions pertaining to sociodemographic information, the survey included questions about the mealtime environment (i.e., setting rules and media use during mealtimes and the type and frequency of health-related conversations they have with their adolescent children) derived from Project F-EAT (Families and Eating and Activity Among Teens) survey (Berge et al., 2015a, 2015b). Questions about parent-adolescent health- and weight-related conversations (Cronbach’s α=0.88) were adapted by Project F-EAT investigators from the Parental Energy Index (Lytle, et al., 1999), and have been used extensively among multi-cultural samples of children and adolescents (Neumark-Sztainer, et al., 2002; Winkler et al., 2018). Questions about the frequency of media use during mealtimes, and setting rules about media use during mealtimes (Cronbach’s α=0.76) were developed for Project F-EAT (Berge, et al., 2012) based on the work of Roberts et al. (2005). Only adolescents’ responses to demographic (age, gender, and ethnicity) survey questions were used for purposes of this analysis. The data were collected in 2019 and early 2020 (pre-COVID-19 pandemic).

Health- and Weight-related Conversations

For health-related conversations, parents were asked, “How often in the past year have you had a conversation with your child about healthy eating habits?,” “How often in the past year have you had a conversation with your child about being physically active?,” and “How often in the past year have you had a conversation with your child about his/her weight or size?”

Regarding weight-related conversations, parents were asked, “How often in the past year have you mentioned to your child that he/she weighs too much?,” “How often in the past year have you mentioned to your child that he/she should eat differently in order to lose weight or keep from gaining weight?,” and “How often in the past year have you mentioned to your child that he/she should exercise in order to lose weight or to keep from gaining weight?” The frequency of conversations was ranked from 1 to 5; one representing the least frequency of “Never or rarely” and five representing “Almost every day.”

A Health-Related Conversations scale was calculated as the mean of the responses for the first three questions (Cronbach’s α = 0.813). A Weight-Related Conversations scale was calculated as the mean of the responses for the last three questions that focused on the adolescent weighing too much or partaking in weight loss strategies (Cronbach’s α = 0.888). Resulting values for both scales range from 1–5. An overall higher mean represents higher frequency of parents having that type of conversations with their adolescent child.

Media Used During Mealtime

Parents were first prompted to think about a typical family dinner at their home, to which they could indicate “We never eat family dinners.” Parents who reported not having family dinners were not asked questions about media use during mealtimes. Parents who reported having family meals were asked, “How often does your child do the following at family meals?” Parents had to answer this question for each of the following responses: “Watch television or movies,” Play with hand-held games (e.g., DS, PSP, Game Boy, etc.), “Talk on the phone (cell or other),” “Text message,” and “Listen to music with headphones (e.g., with iPod, MP3 player, or other devices).” The frequency of media use was ranked from 1 to 4; one representing “Never or Rarely” and four representing “Always.”

A Frequency of Media Use Scale was calculated as the mean of the responses to the frequency of use of all devices listed above (Cronbach’s α = 0.812). Resulting scale values range from 1–4, where an overall higher mean reflects a higher frequency of overall media use.

Statistical Analysis

SPSS Software, Version 26 was utilized to conduct statistical analyses. Sample size for this secondary data analysis was based on available data from the parent study (Vega-López et al., 2020). For the analysis, the Health-Related Conversations, Weight-Related Conversations, and Frequency of Media Use scales were used to test the associations of the responses collectively with the other variables. Partial correlations were used to assess the associations between health-related conversations and media use frequency during mealtime. Descriptive analyses for ethnicity, gender, sociodemographic status, and highest level of education were also carried out. Statistical significance was set at p-value < 0.05. Data is presented in mean ± standard deviation and/or as a frequency (percentages).

Results

Characteristics of Study Participants

Participant characteristics are listed in Table 1. Mean age of parents was 40.4 ± 6.6 and the mean age of adolescents was 12.4 ± 0.9. The parent-adolescent dyads consisted of 307 female parents (89%), 37 male parents (11%), 154 female adolescents (45%), and 190 male adolescents (55%). Most parents and adolescents self-identified as Mexican/Mexican American (70% and 91%, respectively). The most frequently reported annual income levels from parents were $15,000-$24,999 (31%) and $25,000-$49,999 (31%). Most parents (80%) had an education level of high school or lower.

Table 1.

Characteristics of Study Participants

Variable Mean ± SD Frequency n (%)
Parents (n=344)
Gender
 Female 307 (89.2)
 Male 37 (10.8)
Age (years) 40.4±6.6
Ethnicity ( n=342)
 Mexican or Mexican American 239 (69.5)
 Hispanic 101 (29.4)
Income (n=334)
 <$14,999 93 (27.1)
 $15,000-$24,999 106 (30.8)
 $25,000-$49,999 105 (30.5)
 $50,000 or more 30 (8.7)
Education (n=330)
 Highschool or less 263 (79.7)
 Some college or higher 67 (20.3)
Adolescents (n=344)
Gender
 Female 154 (44.8)
 Male 190 (55.2)
Age (years) 12.4± 0.9
Ethnicity (n=330)
 Mexican or Mexican American 313 (91.0)
 Hispanic 17 (4.9)
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Parent-reported Frequency of Health-related Conversations with their Adolescent Child

About 44% and 39% of parent participants reported having conversations with their adolescent child almost every day about healthy eating habits and being physically active, respectively (Table 2). In contrast, 48%, 32%, and 29% of parents reported never having conversations with their adolescent child about their adolescent weighing too much, eating differently to lose weight, or exercising to lose weight, respectively.

Table 2.

Parent-reported frequency of health-related conversations with their adolescent child

Number of parents n (%)
Conversation topic Never/Rarely Few times/yr. Few times/mo. Few times/wk. Almost every day
Healthy eating habits (n=343) 3 (0.9) 20 (5.8) 50 (14.5) 118 (34.3) 152 (44.2)
Being physically active (n=343) 3 (0.9) 23 (6.7) 53 (15.4) 130 (37.8) 134 (39.0)
Weight/size (n=343) 21 (6.1) 25 (7.3) 75 (21.8) 100 (29.1) 122 (35.5)
Weighing too much (n=343) 166 (48.3) 42 (12.2) 57 (16.6) 50 (14.5) 28 (8.1)
Eat differently to lose weight (n=342) 109 (31.7) 47 (13.7) 51 (14.8) 76 (22.1) 59 (17.2)
Exercise to lose weight (n=343) 98 (28.5) 51 (14.8) 47 (13.7) 77 (22.4) 70 (20.3)
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Parent-reported Frequency of Media Use During Mealtimes by their Adolescent Child

Of all participating parents, 7.8% (n=27) reported never having family meals. Of the parents who indicated having family meals, more than half reported that their adolescents never or rarely listened to music with headphones (50%), text messaged (54%), played with hand-held games (58%), and talked on the phone (61%) during mealtime (Table 3). In contrast, only 30% of parent participants reported their adolescent child never or rarely watched television or movies during mealtimes.

Table 3.

Parent-reported frequency of media use by their adolescent child during mealtimes

Number of parents n (%)
Conversation topic Never/Rarely Sometimes Usually Always
Watch television or movies (n=310) 103 (29.9) 120 (34.9) 63 (18.3) 28 (8.1)
Play with hand-held games (n=310) 201 (58.4) 56 (16.3) 34 (9.9) 19 (5.5)
Talk on the phone (cell or other) (n=316) 208 (60.5) 65 (18.9) 31 (9.0) 12 (3.5)
Text message (n=312) 187 (54.4) 76 (22.1) 33 (9.6) 16 (4.7)
Listen to music with headphones (n=314) 171 (49.7) 77 (22.4) 44 (12.8) 22 (6.4)
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Associations Between Frequency of Parent-adolescent Health-related Conversations and Frequency of Adolescent Media Use During Mealtimes

Correlations between frequency of health-related conversations between parents and adolescents and parent-reported frequency of media use by their adolescents during mealtime are outlined in Table 4. Correlations between the frequency of healthy eating-related or being physically active-related conversations and the frequency of adolescents watching television or movies during mealtime were not statistically significant (r=−.015, p=0.79 and r=−.083, p=0.14, respectively). There were significant, positive correlations between the weight-related conversations scale and frequency of media use (r=.122; p=.035). The frequency of conversations about weighing too much were significantly and positively associated with the frequency of adolescents watching television or movies (r=.207; p=<.001), talking on the phone (r=.134; p=.018), and listening to music during mealtime (r=.145; p=.010). The frequency of conversations about exercising to lose weight were significantly and positively associated with the frequency of adolescents watching television or movies during mealtime (r=.129; p=.023).

Table 4.

Associations between frequency of health-related conversations between parents and adolescents and parent-reported frequency of media use by their adolescents during mealtime

Conversation topic
Media use Health-related scale Healthy eating habits Being physically active Weight/size Weight-related scale Weighing too much Eat differently to lose weight Exercise to lose weight
Freq. media use scale .038 (p=.517) .122 (p=.035)
Watch television or movies −.015 (p=.791) −.083 (p=0.14) .118 (p=.083) .207 (p=<.001) .052 (p=.364) .129 (p=.023)
Play with hand-held games .003 (p=.957) .010 (p=.862) .017 (p=.762) .082 (p=.149) .052 (p=.363) .040 (p=.482)
Talk on the phone .003 (p=.955) −.013 (p=.812) −.010 (p=.854) .134 (p=.018) .059 (p=.294) .090 (p=.113)
Text message −.021 (p=.710) .001 (p=.988) .011 (p=.853) .091 (p=.111) .044 (p=.411) .063 (p=.267)
Listen to music −.004 (p=.948) .051 (p=.368) .022 (p=.701) .145 (p=.010) .032 (p=.580) .064 (p=.261)
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*

All correlations reported as r (p value). [Bold significant values ≥ 0.05]

Discussion

The purpose of the current study was to determine if health-related conversations between Hispanic parents and their adolescent children are associated with the frequency of media devices used by adolescents during mealtime. Study findings suggest there were no significant associations between overall health-related conversations between parents and their adolescent child and media use during mealtimes. However, when focusing specifically on weight-related conversations, the frequency of weight-related conversations was significantly associated with the frequency of the adolescent’s media use during mealtime. This is important because weight-related conversations and media use during mealtime are both home food environment factors that could contribute to an increased risk of obesity in Hispanic adolescents.

Participants from the current study reported having more health- than weight-related conversations with their adolescent children. This is relevant because conversations that focus on health rather than weight have been associated with healthier attitudes and behaviors about diet (Baiocchi-Wagner & Talley, 2013; Berge et al., 2013, 2015a; Gillison et al., 2016). It is noteworthy that the health-related conversations scale used for the current study includes a question about whether parents report having conversations with their adolescent child about weight in general. In the current study, over 60% of parents reported having weight/size conversations at least a few times per week, and about 40% of parents reported having conversations about diet or exercise strategies for weight loss a few times per week or more. It has been suggested that weight-related conversations are more often reported by parents with concerns about their child’s weight or by parents who have a child who is overweight (Berge et al., 2013, 2015a; Trofholz et al., 2018). Several studies have reported significant, positive associations between weight-related conversations and weight shaming and an adolescent’s BMI, risk of disordered eating, depression, and low self-esteem, especially among adolescents whose parents have parent-adolescent weight-related conversations (Berge et al., 2013, 2015a; Gillison et al., 2016; Lydecker et al., 2018). Despite the fact that adolescent body weight data was not available for the current study, it is possible that some of the participating adolescents in the current study already had overweight or obesity, prompting their parents to have weight-related conversations with them given the higher rates of obesity among Hispanic/Mexican American adolescents relative to their non-Hispanic white counterparts (Fryar et al., 2020). Whether weight-related conversations take place because a child has overweight or obesity, or whether repeated exposure to weight-related conversations results in the Hispanic adolescent developing overweight/obesity remains to be determined.

Media use among adolescents in the U.S. is pervasive and has been increasing over time. According to a Kaiser Family Foundation study from 2010 (Rideout et al., 2010), adolescents aged 11–14 years were spending over 8.5 hours per day, with music, television, computer, and video games being the main sources of media use. The frequency with which adolescents are currently using media is likely to be much higher given the proliferation of social media and availability of mobile devices in the U.S. A 2022 survey from the Pew Research Center (Vogels et al., 2022) indicated that among U.S. adolescents aged 13–14, over 90% reported owning a smartphone and about 36% reported being online almost constantly. Data from the same survey suggest that media use among Hispanic adolescents is comparable to that of adolescents from other ethnic/racial groups (Vogels et al., 2022). The wide use of media among adolescents at the expense of physical activity and other health-promoting behaviors is deeply concerning due to its association with negative health implications including aggressive behavior, substance use, obesity, poor body image, and decreased school performance (Committee on Public Education, 2001).

According to results from prior research, both health and weight-related conversations seem to occur primarily during mealtimes, but have also been shown to occur in other environments such as the grocery store (Menendez et al., 2020; Trofholz et al., 2018). Conversations during mealtimes could be negatively impacted by the use of media, particularly if adolescents are engaging in media use through individual devices (e.g., tablets, smartphones) or if the entire family is engaged in media use (e.g., the family watching television together during a meal). Most participants from the current study reported that their adolescents never/rarely engaged in media use during mealtimes, with the exception of television watching. Adolescents’ overall daily screen time use consists of talking/texting with friends on the phone, listening to music with headphones, and playing on the computer and/or videogames (Furthner et al., 2018; Pyper et al., 2016; Ramirez et al., 2011; Tripathi & Mishra, 2020). However, research is limited on whether these media devices are used by adolescents during mealtimes. In contrast, existing research suggests that the majority of adolescents and children engage in television viewing during mealtime (Fulkerson et al., 2014; Furthner et al., 2018; Jusienė et al., 2019; Pearson et al., 2018; Pyper et al., 2016; Ramirez et al., 2011; Shang et al., 2015; Tripathi & Mishra, 2020). Across all demographics, watching television is a recurring theme in the home food environment that has been linked to poor dietary intake and obesity in adolescents and children (Fulkerson et al., 2014; Furthner et al., 2018; Jusienė et al., 2019; Mais et al., 2017; Pearson et al., 2018; Pyper et al., 2016; Shang et al., 2015; Tovar et al., 2013; Tripathi & Mishra, 2020). Given the rapid proliferation of tablets and smartphones that give adolescents easy and frequent access to social media, further research is needed to better understand whether limiting device screen time could have additional benefits related to eating behaviors among adolescents. Nevertheless, television seems to be the most pervasively used device within households. Among adolescents, more than 2 hours per day of screen time has been associated with lower consumption of fruit, vegetable and fiber, lower HEI scores, and higher junk food consumption (Fulkerson et al., 2014; Jusienė et al., 2019; Mais et al., 2017; Pearson et al., 2018; Pyper et al., 2016; Shang et al., 2015). Despite the negative health outcomes associated with television viewing, studies have found that Hispanic families perceive television as an educational tool for their children and as another way to strengthen familial connections (Barroso et al., 2020; Duch et al., 2013; Hammons et al., 2020; Ochoa & Berge, 2017; Thompson et al., 2018). The different perspective of television in Hispanic communities could be an area of opportunity to facilitate healthy behaviors through positive communication.

In the current study, the frequency of having weight-related conversations (altogether) was positively and significantly associated with adolescent media use during mealtimes. More specifically, watching television/movies, talking on the phone, and listening to music with headphones were positively and significantly associated with the frequency of weight-related parent-adolescent conversations about their adolescent “weighing too much.” A cross-sectional study with middle and high school adolescents revealed positive, significant correlations between weight-related conversations and overall screen time use (Berge et al., 2015a). A mixed-methods study revealed that parents of adolescents, regardless of weight status, discussed health- and weight-related topics, including healthy eating, weight/size, and eating differently to lose weight (Trofholz et al., 2018). However, parents of adolescents whose weight is within recommendations had a higher frequency of having these conversations during a family meal relative to parents of children who are overweight (Trofholz et al., 2018). It is possible that the family meal environment could be a safe realm for parents to discuss health-related issues before they become a concern. Nevertheless, there is a need to further understand whether contextual factors within family meals (e.g., which members of the family are present, frequency of family meals, which members of the family partake in media use during meals) may play a role in the nature of conversations parents hold during meal times, and whether conversations may be effective from a prevention point of view.

The present study has several strengths and limitations worth discussing. Strengths of the study include the sample size, as well as its homogeneity regarding participants’ ethnic background: most of the participants identified as Mexican, Mexican American, or Hispanic, which builds upon the limited research in the food environment and media use in these populations. Another strength of the study is that the survey questions were available in both English and Spanish to better accommodate the participant’s linguistic preferences.

Limitations of the study include the cross-sectional design because it can only draw associations between the variables and cannot test causality. For example, findings from this study do not explain whether health-related conversations influence adolescents’ media use or vice versa. The findings are also not generalizable to the United States population since participants were of Hispanic descent or origin and most were female. Study data were subjective and self-reported by participants, both of which can result in increased bias. For example, social desirability bias could occur because parents feel they need to report a better mealtime environment. In an effort to reduce social desirability bias, participants were assured that their responses would be anonymous and only used in the aggregate form for analyses, and survey questions used neutral language that did not qualify responses. There is also a component of self-selection bias because not all parents agreed to participate in the intervention, and therefore did not provide baseline information for the current study. Whereas the health- and weight-conversations scales may suggest a reciprocal exchange of information between the parent and their adolescent child, data from the current study does not allow confirmation that conversations reported by the parents were held between the two parties nor that adolescents perceived them as conversations. Only self-reported data from parents was used for the current study; not including adolescent data did not allow for comparisons between parents and children’s perceptions. The lack of parent and adolescent anthropometric data is an additional limitation. The media device scale used does not include more current devices such as tablets and laptops, not to mention, the gaming capabilities available on smartphones nowadays. In addition, because the scale only asks about media use during family mealtime, it is unknown whether adolescents may have different media use patterns when meals are not consumed together as a family. Lastly, the current study did not account for family meal frequency or family communication; these variables could have further explained the prevalence of specific media devices being used by adolescents during mealtime.

Conclusion

In conclusion, findings from the current study suggest that parents reported engaging in more health- than weight-related conversations with their adolescent children. Furthermore, higher frequency of weight-related conversation is associated with higher usage of media devices during mealtimes. Given the potential public health significance of these behaviors, further research addressing the implications of these findings is warranted, particularly among populations at greater risk for developing obesity and subsequent chronic conditions. Parents should also consider the effects that different types of conversations could have on their child’s well-being. Focusing on positive, health-related conversations with their child rather than negative conversations that focus on weight loss could pave the way for healthier behaviors without compromising an adolescent’s self-esteem.

Most existing research emphasizes the parental perceptions of their children’s mealtime behaviors and health outcomes, leaving the need to incorporate adolescents’ input in future work. Further, families should involve all family members in the promotion of health-related behaviors, including limiting mealtime media use. Family mealtime has the potential to be protective against poor health outcomes, but inconsistency in the mealtime environment could hinder its benefits. It is imperative that future studies continue to explore the home food environment in Hispanic populations to better understand factors influencing the high rates of obesity in Hispanic adolescents. Parenting styles, parent-adolescent conversations, and media use rules may have the potential to shape a home food environment, which ultimately could improve an adolescent’s overall health outcomes. Understanding how Hispanic parents communicate with their adolescents about health and weight-related issues can pave the way for future interventions to be created in efforts to diminish the prevalence of obesity within Hispanic populations.

Acknowledgments

This manuscript is supported by NIMHD/NIH, award 2U54 MD002316–13 (PI: Marsiglia) and by the HRSA of the U.S. Department of Health and Human Services as part of Maternal Child Health Bureau Nutrition Training Grant, The TRANSCEND Program in Maternal Child Health Nutrition and Childhood Obesity Prevention (T79MC31884; PI: Bruening). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.

Footnotes

Conflicts of Interest and Sources of Funding: The authors have no conflicts of interest to disclose.

1

The terms Latino/a/x and Hispanic are often used interchangeably in the literature to describe a diverse ethnic group. For consistency, this ethnic group will be referred to as Hispanic in this manuscript, except when citing work that particularly focused on a specific subgroup of this population (e.g., Mexican Americans) or when describing self-reported ethnicity.

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