On July 26, 2000 the American Medical Association, American Psychological Association, and the American Academy of Child and Adolescent Psychiatry released a joint statement declaring that entertainment violence can lead to increases in aggressive attitudes, values and behavior in some children.

Director of CMCH Michael Rich represented the American Academy of Pediatrics at the entertainment violence summit in Washington DC. He commented “Children learn the ways of the world by observing and imitating — they cannot help but be influenced by media. The most insidious and potent effect of media violence is to desensitize viewers to ‘real life’ violence and to the hard caused its victims.”

This article profiles successful managers who listen to their customers. Dr. Michael Rich, Director of Video Intervention/Prevention Assessment (VIA) at CMCH, listens to his patients by giving them video cameras and telling them to “show me your life with chronic illness.”

“’Medicine is not a religion; it’s a service industry,’ argues Rich. ‘Yet as doctors, we often block ourselves from getting information that we most need to serve our patients. We need to listen to patients within their framework. They’re the experts, they live with their illness every day. We can learn from them.

The toll of asthma continues to increase, despite important advances in diagnosis and treatment.”

Dr. Michael Rich, Director of Video Intervention/Prevention Assessment (VIA), at CMCH has “devoted himself to helping his patients chronicle their experience with asthma by giving them camcorders and asking them to make video diaries.

From analyzing the videotapes, Rich has seen reasons for noncompliance with disease management: “Asthma is not the number-one issue in the lives of a lot of my patients. They’’ve got other concerns.”

One of the recommendations in an American Academy of Pediatrics policy statement is to make children’s bedrooms media-free.

“Most parents already know not the put a TV in a child’s room. But many readers say they purposefully put the computer there, thinking it opens the door to the child’s personal technological age.”

Dr. Michael Rich, co-author of the AAP statement, says that removing computers from bedrooms is included in the recommendation. His advice is to set limit on how much and when computers are used. “It’s a matter of prioritization. After homework, after family time, after friends, sports, exercise. Kids get sucked in and neglect other parts of their life.”

Young people learn By imitation and music videos provide much to imitate. About 75 percent of the 12-19 year old target audience watches MTV, typically for more than six hours each week.”

Dr. Michael Rich, Director of CMCH, conducted a study (published in Pediatrics) of 518 music videos. He found violence “in 15 percent of the segments: a total of 462 stabbings, shootings, kickings, and punchings – or, on average, six violent acts per two- to three- minute video.

The World Wide Web offers opportunities for patients to learn what their symptoms might mean, or get information about diseases or clinical trials. But not everything on the Internet is quality information. The Wall Street Journal asked a group of experts about sites they recommend for health information.

Dr. Michael Rich thinks the Web is “replacing the brochures we once handed to people. These sites are more easily tailored to the patient’s interest and level of awareness.”

Video Intervention/Prevention Assessment, created by Dr. Michael Rich, Director of CMCH, “could be used not only to monitor the lives of kids with chronic illnesses such as sickle-cell disease, diabetes, and HIV, but also to achieve “complex medical interventions” in cases that involve substance abuse, teen pregnancy, and violence in the home. It could bring the child’s experience to center stage.”

“The largest sampling of music video content to date reveals a disturbing amount of violence, as well as unrealistic views of racial and sexual relationships, according to researchers at the Harvard Medical School.”

Dr. Michael Rich who performed the study says “Our findings raise concern for the effect of violent portrayals in music videos on adolescents’ expectations about their own safety and the way they view people of another gender or race.”

Research in the Journal of the American Medical Association finds that too many kids are on the couch instead of playing outside — 25% of children watch 4 or more hours of TV per day.

The study found that numbers for minority children were even higher. Dr. Michael Rich suggests this may be due to worried parents keeping their children indoors, rather than outside in unsafe neighborhoods, “so kids who would even ten years ago have gone out and played basketball down at the corner playground are not.”

The study also showed that teen girls became more sedentary as they got older. Dr. Rich commented “in the mid to late teens, peer acceptance for boys is predicated on athletic prowess, while for girls, the emphasis is on being lady-like.”