Humans living in environments where they feel safe are more likely to create, learn and be productive, while humans living in insecure environments are likely to use most of their energy on survival and self-protection.
The environment can also impact how much stress or discomfort people feel. Studies in hospitals have shown that as little as five minutes of exposure to nature every day can reduce stress and improve moods. Instead, she began to work with Sue on her schedule and habits. She insisted that Sue cut one after-school activity and be home for dinner at least four nights a week. She took Sue to a yoga class, where Sue began learning how to work with her breath, and to focus on the moment without fixating on worries about things that were out of her control.
In the mornings before swim practice, she began doing 10 minutes of seated meditation with her mother. After addressing the stress, Sue was still very busy, but she slept better, had more energy, and her stomach problems disappeared. There is a great deal of very rigorous research that links the physical environment of hospitals to health outcomes.
According to Ulrich and Zimming, authors of the report, The Role of the Physical Environment in the 21st Century Hospital , there are more than credible studies that show how aspects of healthcare design can influence medical outcomes. Essentially, this research shows that the conventional ways hospitals have been designed contribute to stress and adverse patient and staff outcomes. Poor design can adversely impact health and wellbeing, as well as staff productivity and ability to deliver great patient care.
For example, because of poor design, nurses in most hospitals spend a great deal of time just gathering the material they need for care. One study showed that almost one-third of nursing staff time was spent walking.
Ulrich, p5. On the other hand, improving the physical environment can make healthcare settings less stressful, safer, and better places to work. Experts in the new area of evidence-based design have identified five environmental factors that can have a large impact on health outcomes.
Changes in these areas help create a healing environment that is psychologically supportive for patients, families, and staff. And many hospitals and healthcare settings are applying these findings. Research demonstrates that improvement in five environmental factors reduces stress and improves patient outcomes:. Many studies produce strong evidence that even three to five minutes of contact with nature can significantly reduce stress and have a complex impact on emotions, reducing anger and fear and increasing pleasant feelings.
This effect can be achieved by providing: views to the outside, interior gardens or aquariums, or art with a nature theme. Offering choices increases the patient's sense of control, which can significantly lessen stress. Options include the ability to: adjust lighting and temperature, choose music, select places to sit, and control the timing of meals. In addition, better wayfinding signs and information about where to go reduces disorientation and helps patients feel in control, as does better hospital layouts that allow frail patients to be more independent in getting around.
There is extensive evidence that social support from family and close friends has important benefits. For example, studies show that social support improves recovery in heart patients, and emotional wellbeing and quality of life in late-stage cancer patients.
The connectome is where nature meets nurture. And it might be true that just the mere act of thinking can change your connectome; an idea that you may find empowering. Think about the way you act, your facial expression, the values accepted by you, the way you talk, everything, and remember that they are a result of your environment.
The nature nurture debate … is dead … for the following reason: the brain is very, very malleable. Little boys worldwide are punished more frequently for transgressions. Even at a young age, dads sometimes are very, very scared if their little boy is showing any version of effeminate behaviors. For example, I remember flying coast to coast with a guy who sat next to me. So the way we raise little boys, and we raise little girls, our brain circuits are so malleable.
You do practice, practice, practice. You can retrain brain circuits, to do a variety of things. All of our life, we are trained, gender trained, to be more one way or the other.
Gorman-Smith also discussed interventions, noting that there have been three primary approaches to keeping communities intact as opposed to changing their demographic composition. One is to work with individuals and families to manage or cope with the stresses of living in a disadvantaged neighborhood. A third approach is to focus on economic development to improve neighborhood conditions, for example, through business development. Although research on neighborhood effects on adolescent development has produced mixed results, it may be due to the limited nature of this research to date.
Most of the research has focused on census data to define disadvantage and poverty, but this may be too limiting a conceptualization of neighborhood. More attention to factors other than information found in census data may be necessary to more fully understand how neighborhood context may influence adolescent development.
These data may include information about crime, community businesses and organizations, social factors such as perceptions of fear, or adult monitoring. In addition, Leventhal noted, it may be necessary to examine mediating factors that may help explain neighborhood effects and moderating effects that neighborhoods may have to either exacerbate the negative effects of other risks or enhance the positive effects of adolescent assets and resources.
Most of the research to date has focused on the direct or main effects of neighborhoods. Any list of the sorts of devices and programming to which young people may have access is likely to be at least somewhat outdated within months, but researchers have begun actively exploring both the effects of media on adolescent behavior and ways of structuring both their interactions with it and interventions designed to address media-related problems, as Michael Rich, Jane D.
Brown, and Blair Johnson explained. He presented some data on media use and its effects, cautioning that the field has not been well funded and that much of the data are cross-sectional and based on self-reports. He focused on data from the Center on Media and Child Health related to the links between media consumption and adolescent sexuality. First, he described current patterns of use. On average, 8- to year-olds use media actively for 6 hours and 21 minutes of every day, often using multiple media at the same time Roberts et al.
Because nearly a quarter of teenagers use two or more media at the same time, they may be cumulatively exposed to more than 8. During the — television season, 71 percent of programs included sexual content, with an average of 6.
Among programs directed at teenagers, 82 percent included sexual talk and two-thirds included sexual behavior 4 percent portrayed sexual intercourse Farrar et al. In a survey, 75 percent of college students reported that they were first exposed to sex in the media when they were minors, and 15 percent had persistent imagery and thoughts related to that exposure.
In , more than two-thirds of movies released that year portrayed sexual behavior, and Rich indicated that the percentage has increased each year since Cantor et al.
Internet access, now widely promoted even for very young children through toy-related game websites designed as part of product promotion campaigns and the like, has introduced a new source of influence with complex implications. In , there were 44 million Internet users under the age of 18, and 47 percent of 8- to year-olds went online every day Roberts et al. Average use was 1 hour per day, although some reported being online as long as 10 to 14 hours per day.
And 42 percent had clicked on pornographic sites; 4 percent had been asked for sexual pictures of themselves by someone they did not know Wolak et al. Rich cautioned that all of these figures have probably grown since While sexual predation by adults is actually quite rare, other kinds of influence may also cause concern.
Rich described weblogs created by teens who have chosen anorexia nervosa and bulimia as a lifestyle and post tips for others who would like to adopt it to live life as an extremely thin person. Social isolation related to social networking usage, cyber bullying, and sexting sending sexual images or text via cell phone are all new problems for adults to understand and address.
Text and images transmitted electronically may in some cases be impossible to expunge, and because the legal code related to the Internet is in its infancy, young people may face serious lasting consequences from a single impulsive act.
A total of 70 percent of adolescents have been exposed to pornography on the Internet, and two-thirds of college students report that they consider doing so acceptable Rideout et al.
What are the effects of this exposure? A number of studies, Rich indicated, have shown that the more sexual content young people have seen on television, the more likely they are to initiate sexual activity Collins et al. As one example, in one study, to year-olds exposed to sexuality in television, movies, music, and magazines were more than twice as likely than those not exposed to have sex by age 16 Brown et al.
Another study showed that 6- to 8-year-olds who watched adult programming were significantly more likely than those who did not to engage in sex by ages 12 to 14 Delgado et al. Another showed that youth whose parents limited television to less than 2 hours per day had half the rate of sexual initiation as those whose parents spoke to their children about not having sex but did not limit their viewing Ashby et al.
Researchers with several theoretical perspectives have examined possible links between media exposure and changes in sexual attitudes and behaviors, Rich observed. Social learning theory, which has also been applied in the study of media violence, suggests that when individuals see a behavior portrayed in a positive way, they have a tendency to imitate and adopt it. Cultivation theory suggests a slightly different explanation, that what individuals see on television supersedes their own perceptions of the real world around them.
Thus, if the social norm on television is extremely prevalent sexuality, individuals who watch the programming begin to think that it is the social norm and believe sexuality is more prevalent than it actually is. A third theoretical model posits that adolescents use media as part of their individuation process. They use their preferences for programming or music to convey messages about their social identity, in the same way that their choices of clothing and peer groups do.
Rich sees media use as so pervasive as to be both a public health and environmental health issue. They are neutral. They are not malignant.
They are not bad. But they are very powerful. Johnson focused on the value of applying contemporary persuasion theory to the use of media strategies to influence adolescent behavior. He acknowledged that researchers have not fully explored this approach, so his discussion was largely theoretical.
Researchers have posited at least five different current persuasion theories, he explained, although they converge on several significant points.
That is, when the recipient of a message is highly motivated to expend effort processing it and is well able to grasp the content, there is the potential for the information to alter attitudes, and the content of the message makes a significant difference in the outcome.
However, for a recipient whose motivation and ability are low and who is thinking in a relatively shallow fashion, it is the incidental features in which the message is enveloped that may matter more.
Thus, for example, marketers tend to rely heavily on peripheral cues that require very little attention to process in developing advertisements.
These advertisements succeed because they are repeated over and over, so the message can be imprinted without any effort on the part of the recipient.
Johnson pointed out that children and adolescents are most likely to process in a shallow way and to be receptive to peripheral cues, such as strategies that invoke emotional responses.
Several other factors are likely to affect the way individuals process information, and these change in the course of development. Strong attitudes or habits likely to become more entrenched with age , skepticism which increases with education , and links to peer groups whose attitudes and behavior may be in opposition to a message all tend to make individuals more resistant to messages that seem discrepant in some way. Thus, Johnson explained, it would be logical to expect that media effects would vary with developmental stage.
For preadolescent children, emotional and other nonverbal cues are likely to be most powerful. At that stage, children behave more impulsively than they do later, and the influence of both peers and family are strong.
They are open-minded and not terribly skeptical. By early adolescence, the power of emotional cues decreases somewhat, and peer influence becomes stronger. At this stage, young people may be more responsive to content-rich messages.
Late adolescents begin to resemble adults in their processing. While still responsive to emotional and nonverbal cues as all adults can be , young people at this stage have strong attitudes and are capable of defending them.
Johnson, however, cautioned that this hypothesis has not been clearly verified with empirical research. Researchers have demonstrated the influence that media can have on adolescent health, Johnson said.
The results of a meta-analysis of health promotion interventions done through demonstrated a number of significant effects on changes, as shown in Table Johnson et al. Johnson added, however, that the meta-analysis also showed that effect sizes for health promotion efforts looking not just at media campaigns are generally much smaller for children and youth than for adults, as Figure shows Johnson et al.
He concluded that many factors influence the outcomes. When adolescents are given intensive skills training and supplied with the resources to change their behavior e. Looking more broadly, he reinforced the theme present in many of the workshop discussions that family, community, peer, and other influences all affect the way adolescents process and respond to public health interventions and messages.
Nevertheless, as a Florida antismoking campaign demonstrated, media campaigns can be effective Sly et al. Age in meta-analyses of health promotion literatures. Data from Johnson et al. Borrowing some of the expert advertising strategies from the world of commerce, public health experts have targeted large audiences with specific messages, presented in the media used by those audiences.
Such messages are usually designed to achieve clear goals, such as increasing knowledge or changing specific attitudes or behaviors. However, Brown explained, social marketers typically do not have the resources to sustain these messages for long periods or repeat them, in the way that commercial marketers can—that saturation coverage may be an important component in the success of commercial marketing. Meta-analysis of the effectiveness of social marketing campaigns has shown that, on average, 4 to 8 percent of those exposed to a social marketing campaign change their behavior Derzon and Lipsey, ; Snyder and Hamilton, This may sound small, she acknowledged, but media campaigns can reach many more young people than a school- or community-based program could.
Brown also noted that media campaigns are good at raising awareness of problems but more successful at changing behavior when combined with other measures. She likened them to air support for a military ground campaign. In Montana, for example, a program saturated the media with a message about the harmful effects of methamphetamine use at the same time that law enforcement efforts targeted the problem; the effect was a significant decline in use.
Brown described a television campaign developed by researchers at the University of Kentucky that promoted safer sexual practices. Based on a model of the targeted behaviors which indicated that they should target older adolescents who were highly sensation-seeking and prone to impulsive decision making , the program consisted of public service announcements that saturated particular channels over 21 months.
The advertisements were designed using fast cuts and loud music to appeal to the target audience. Researchers have also begun to use new media to reach adolescents, although this approach has been less thoroughly studied. Most media campaigns are expensive, Brown noted, and researchers have not perfected the art of devising effective messages.
She also acknowledged that the results can be unpredictable and that a campaign could have undesirable unanticipated consequences, such as introducing some young people to a behavior they had not previously considered.
A second approach is to embed public health messages in entertainment programming, which, Brown explained, may produce less resistance in target audiences. The article included interviews with girls about their views and information about ways to avoid pregnancy. Adolescents tend to admire and want to imitate role models they see in the media, so involving a rap star, for example, in a public service campaign can make the message much more palatable to the young people who admire him or her.
Challenges to this approach include identifying sympathetic media producers willing to produce such messages, the difficulty of controlling messages once a celebrity takes on the role, and sustaining the message over time.
Moreover, as with media campaigns, Brown explained, it is very difficult to evaluate the effectiveness of these messages. Promoting media literacy is the third strategy Brown identified for helping adolescents understand public health topics. When adolescents can deconstruct the content in what they see, it is easier for them to analyze and adjust their own media diet. They may also be encouraged to create their own media and to respond actively to what they see. Brown pointed out that there has been little evaluation of this sort of education, and schools and educators have been somewhat reluctant to take it on.
Schools have not been encouraged to view media literacy as an important educational goal, nor have teachers been trained to address this topic.
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