The J(amaican and) U(nited) S(tates) Media? Programme is a culturally-tailored food-focused media literacy preventive intervention designed to promote healthier eating habits among remotely acculturating early adolescents and their mothers in Jamaica (i.e., they have internalized American culture) and are exposed to U.S. food advertising. The JUS Media? Programme consists of a 2-session face:face weekend workshop for adolescent-mother pairs supplemented by 8 weeks of SMS/text messages to reinforce workshop themes. Adolescents and their mothers learn critical thinking skills to combat the unhealthy food messages they encounter in food advertising, particularly advertising on U.S. cable TV. The efficacy of the JUS Media? Programme was evaluated with a small experimental study utilizing a randomized controlled trial design among adolescents and mothers in Jamaica.

The Western diet is common in the United States and has a lot of salt, sugar, and fat. Modern globalization has shifted eating habits in many countries toward this unhealthy Western diet. For example, U.S. cable TV in other countries promotes this Western diet through advertisements for junk foods and sugary drinks. This is a major concern because experimental research studies show that seeing food advertising while watching TV leads to eating more food afterwards. Research studies also show that people who watch a lot of TV tend to think that junk food is not that harmful.

Researchers now believe that some people living outside the U.S. are drawn to the U.S. culture and lifestyle and can become "Americanized" through a process called remote acculturation. These Americanized people in other countries such as Jamaica are mostly teenagers, but sometimes also adults. Americanized people outside the United States are even more likely to adopt the unhealthy Western diet even though they have never lived in the United States. In research the investigators did before getting this grant, they showed that Americanized youth and mothers in Jamaica watched more hours of U.S. cable daily and also ate more unhealthy food. This led them to develop a new healthy eating education program for Americanized families in Jamaica that highlighted the role of U.S. media - the "J(amaican) U(nited) S(tates) Media? Programme". The JUS Media? Programme teaches young people and mothers to question the health messages in food advertising on U.S. cable TV so that they can be smarter and healthier consumers. For example, the JUS Media? Programme covers the recommended food guidelines in Jamaica and teaches adolescents and their mothers the principles of media literacy, such as to think about "who is the source of this message?" "what do they want you to do?" and "what information is missing?". Finally, the JUS Media? Programme teaches participants to use these media literacy principles to challenge unhealthy food advertisements by creating smart, funny parody versions called subvertisements.

In this project,the investigators evaluated how well the JUS Media? Programme worked for 7th graders and their mothers in Jamaica. About 30 adolescents and their mothers got a 2-session workshop, another 30 families got the workshop and text messages, and another 30 families did not get any part of the program.

Inclusion criteria:

• 7th grader enrolled in the participating schools and present at school on the days of recruitment.

Exclusion criteria for each adolescent or mother seeking to enroll:

• mother/student was not born in Jamaica
• mother/student is not a Jamaican citizen
• mother/student is a citizen (including dual citizen) of the United States
• mother/student has not lived in Jamaica for the past 15 years (mother) or 8 years (student)
• mother and student do not live together
• mother has been primary guardian for <5 years
• study screening scores show no U.S. TV usage or no affinity for the U.S. culture, and very low junk food consumption

Participants were not told what arm of the intervention they were in (i.e., they were not told if they were receiving the intervention or not).