title: Commercial Television Exposure, Fast Food Toy Collecting, and Family Visits to Fast Food Restaurants among Families Living in Rural Communities.
abstract: OBJECTIVE
  To assess the associations between children's exposure to television (TV) networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants.
  
  
  METHODS
  One hundred parents of children 3-7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's TV viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association.
  
  
  RESULTS
  Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (aOR 2.84 for each 1-unit increase in the child's commercial TV viewing scale, P < .001); toy collecting partially mediated that positive association.
  
  
  CONCLUSIONS
  Higher exposure among children to commercial TV networks that aired child-directed ads for children's fast food meals was associated with more frequent family visits to those fast food restaurants. Child desire for toy premiums may be a mediating factor.
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH. Electronic address: Jennifer.A.Emond@Dartmouth.edu.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Emond
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Bernhardt
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Diane
authors.initials: D
authors.lastname: Gilbert-Diamond
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH.
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
mesh_terms: D000329:Advertising; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005190:Family; D057140:Fast Foods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009511:New England; D010988:Play and Playthings; D012147:Restaurants / Q000706:statistics & numerical data*; D012424:Rural Population; D013690:Television / Q000706:statistics & numerical data*