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Gina M. Wingood, ScD, MPH, Ralph J. DiClemente, PhD, Jay M. Bernhardt, PhD, MPH, Kathy Harrington, MPH, MAEd, Susan L. Davies, PhD, MEd, Alyssa Robillard, PhD and Edward W. Hook, III, MD

Gina M. Wingood, Ralph J. DiClemente, Jay M. Bernhardt, and Alyssa Robillard are with Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, Ga. Gina M. Wingood and Ralph J. DiClemente are also with the Emory Center for AIDS Research, Atlanta, Ga. Ralph J. DiClemente is also with University School of Medicine, Department of Pediatrics (Division of Infectious Diseases, Epidemiology and Immunology), Emory University, Atlanta, Ga. Kathy Harrington is with the School of Medicine, Department of Pediatrics, University of Alabama, Birmingham. Susan L. Davies is with the School of Public Health, Department of Health Behavior, University of Alabama, Birmingham. Edward W. Hook III is with the School of Medicine, Department of Medicine, Division of Infectious Diseases, University of Alabama, Birmingham.

Correspondence: Requests for reprints should be sent to Gina M. Wingood, ScD, MPH, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Rd, NE, Room 548, Atlanta, GA 30322 (e-mail: gwingoo{at}sph.emory.edu).

	INTRODUCTION

TOP INTRODUCTION STUDY SAMPLE MEASURES RESULTS DISCUSSION References

 
Rap music videos are a media genre that is attracting considerable attention. Rap music has evolved from African American music forms, with influences from rhythm and blues, fusion, contemporary gospel, and bebop.^1–3 Although there is considerable concern regarding the themes and images expressed in rap music videos, limited empirical research has examined the effect of rap music videos on adolescents’ behavior.⁴ This investigation sought to determine whether exposure to rap music videos at baseline could predict the occurrence of health risk behaviors and sexually transmitted diseases among African American adolescent females over a 12-month follow-up period.

	STUDY SAMPLE

TOP INTRODUCTION STUDY SAMPLE MEASURES RESULTS DISCUSSION References

 
From December 1996 through April 1999, recruiters screened female teenagers residing in nonurban, lower-socioeconomic-status neighborhoods from school health classes and county health department clinics to determine their eligibility for participating in an HIV prevention program. Adolescents were eligible to participate if they were African American females, were between ages 14 and 18, had been sexually active in the previous 6 months, and provided written informed consent.

	MEASURES

TOP INTRODUCTION STUDY SAMPLE MEASURES RESULTS DISCUSSION References

 
Level of exposure to rap music videos, the predictor variable, was determined by asking adolescents to estimate the number of hours they viewed rap music videos during an average day. This was multiplied by the number of days in the week that rap music videos were viewed.

Music video viewing characteristics assessed included the primary type of rap music videos viewed (gangsta, bass, or hip-hop), with whom adolescents usually viewed rap music videos, and where the rap music videos were viewed.

Covariates assessed included age, employment status, involvement in extracurricular activities, participation in religious events, family composition, family’s receipt of public assistance, parental monitoring of adolescents’ whereabouts,⁵ and group assignment to either the HIV intervention or the comparison condition.

Outcomes
Health risk behaviors assessed whether adolescents had hit a teacher, been involved in a fight, been arrested, used alcohol or drugs (either tranquilizers, marijuana, amphetamines, lysergic acid diethylamide [LSD], cocaine, or crack), had multiple sex partners, or used condoms. Adolescents were also tested for 3 sexually transmitted diseases (chlamydia, trichomoniasis, and gonorrhea).^6–8

Data Analysis
Univariate analyses described music video viewing characteristics at baseline. Subsequent bivariate analyses examined the relations among adolescents’ level of exposure to rap music videos at baseline, potential covariates, and the occurrence of health risk behaviors over the 12-month follow-up. Health risk behaviors and covariates significantly associated (P < .05) with exposure to rap music videos in bivariate analyses were included in logistic regression analyses. A separate logistic regression analysis was conducted to examine the relation between level of exposure to rap music videos at baseline and the occurrence of each health risk behavior over the 12-month follow-up. All logistic regression analyses controlled for covariates and the corresponding baseline health risk behavior.⁹

	RESULTS

TOP INTRODUCTION STUDY SAMPLE MEASURES RESULTS DISCUSSION References

 
The study enrolled 522 single African American females. Of those enrolled, 92.2% completed 12-month follow-up assessments. Descriptive statistics on adolescents’ exposure to rap music videos are illustrated in Table 1. The median hours of exposure to rap music videos per week at baseline and at 6- and 12-month follow-up were 14 hours, 14 hours, and 12 hours, respectively, suggesting relatively stable viewing habits. Greater exposure to rap music videos was associated with unemployment and less parental monitoring; therefore, these variables and group assignment were used as covariates in the logistic regression analyses.

Logistic regression analyses illustrated that after controlling for covariates, greater exposure to rap music videos was independently associated with a broad spectrum of health outcomes. Compared with adolescents who had less exposure to rap music videos, adolescents who had greater exposure to rap music videos were 3 times more likely to have hit a teacher; more than 2.5 times as likely to have been arrested; 2 times as likely to have had multiple sexual partners; and more than 1.5 times as likely to have acquired a new sexually transmitted disease, used drugs, and used alcohol over the 12-month follow-up period (Table 2).

	DISCUSSION

TOP INTRODUCTION STUDY SAMPLE MEASURES RESULTS DISCUSSION References

The results may be explained by social cognitive theory.¹⁰ A cornerstone of this theory states that modeling will occur more readily when the modeled behavior is salient, simple, and prevalent and has functional value. Thus, exposure to rap music videos, particularly gangsta rap (the most popular type of music video), which is explicit about sex and violence⁴ and rarely shows the potential long-term adverse effect of risky behaviors, may influence adolescents by modeling these unhealthy practices. Alternatively, African American female teenagers may identify with the characters and themes in rap music videos, and exposure to these videos may reinforce teenagers engaging in such behaviors. Moreover, African American females desiring greater independence may rebel against parental media restrictions. Adolescents striving for independence and autonomy may be more likely to engage in risky behaviors.

Although not specifically referring to rap music videos, Poussaint¹¹ noted that the glorification of drugs, violence, and sex in films is particularly dangerous to young African Americans who are not exposed to many positive role models in the media. This concern is equally, if not more, applicable to African American female adolescents, given their high level of exposure to rap music videos and the degrading portrayal of African American females in many rap music videos.^12,13 Future research on rap music videos should be conducted among different adolescent populations. Additional research should examine whether level of attention to rap music videos and changes in mediators, moderators, and exposure differentially affect the relation between exposure to rap music videos and adolescent health. Furthermore, public health practitioners are ideally suited to educate communities, schools, and advocacy groups about the potential public health risks associated with exposure to rap music videos in African American adolescent females.²

	Acknowledgments

 
This study was supported by a grant from the Center for Mental Health Research on AIDS, National Institute of Mental Health (1R01 MH54412).

Human Participant Protection

The study protocol was approved by the University of Alabama, Birmingham’s committee on human research.

	Footnotes

 
G. M. Wingood and R. J. DiClemente contributed to conception, design, acquisition, and analysis of the data. J. M. Bernhardt contributed to interpretation of the data. K. Harrington and S. L. Davies contributed to data acquisition. A. Robillard contributed substantially to the conception of the data. E. W. Hook III contributed by providing laboratory support for the assessment of sexually transmitted infections. All authors provided intellectual content for this brief.

Peer Reviewed

Accepted for publication June 12, 2002.

	References

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1. DiClemente RJ, Hansen W, Ponton LE. Adolescents at-risk: a generation in jeopardy. In: DiClemente RJ, Hansen W, Ponton L, eds. Handbook of Adolescent Health Risk Behavior. New York, NY: Plenum Publishing; 1996:1–4.

2. Brown JD, Stern SR. Mass media and adolescent female sexuality. In: Wingood GM, DiClemente RJ, eds. Handbook of Women’s Sexual and Reproductive Health. New York, NY: Plenum Kluwer Press; 2002:93–112.

3. Morley J. Introduction. In: Stanley LA, ed. Rap: The Lyrics. New York, NY: Penguin Books; 1992:vii–ix.

4. Jones K. Are rap videos more violent? Style differences and the prevalence of sex and violence in the age of MTV. Howard J Commun. 1997;8:343–356.

5. DiClemente RJ, Wingood GM, Crosby R, et al. Parental monitoring: association with adolescents’ risk behaviors. Pediatrics. 2001;107:1363–1368.[Abstract/Free Full Text]

6. Hook EW III, Ching SF, Stephens J, Hardy KF, Smith KR, Lee HH. Diagnosis of Neisseria gonorrhoeae infection in women by using the ligase chain reaction on patient-obtained vaginal swabs. J Clin Microbiol. 1997;35:2129–2132.[Abstract]

7. Hook EW III, Smith K, Mullen C, et al. Diagnosis of genitourinary Chlamydia trachomatis infections in women by using the ligase chain reaction on patient-obtained vaginal swabs. J Clin Microbiol. 1997;35:2133–2135.[Abstract]

8. Schwebke JR, Morgan SC, Pinson GB. Validity of self-obtained vaginal specimens for diagnosis of trichomoniasis. J Clin Microbiol. 1997;35:1618–1619.[Abstract]

9. Hosmer DW, Lemeshow S. Applied Logistic Regression. New York, NY: John Wiley & Sons; 1989.

10. Bandura A. Social cognitive theory of mass communication. In: Bryant J, Zillmann D, eds. Media Effects: Advances in Theory and Research. Hillsdale, NJ: Lawrence Erlbaum Associates; 1994:61–91.

11. Poussaint AF. Blaxploitation movies: cheap thrills that degrade blacks. Psychol Today. 1974;9:22–32.

12. Gow J. Reconsidering gender roles on MTV: depictions in the most popular music videos of the early 1990s. Commun Rep. 1996;9:151–161.

13. Seidman S. Revisiting sex-role stereotyping in MTV videos. Int J Instructional Media. 1999;26:11–25.

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