and adolescent academic achievement (Anderson et al., 2001).

Much less is known about the effects of video games and computer technologies, but some theorists have proposed that the interactive character of these activities makes them more potent than television as sources of sensorimotor skill, intellectual stimulation, and messages about violence and other social behaviors (Calvert and Tan, 1994; Cocking and Greenfield, 1996; Greenfield, 1994). Researchers have demonstrated academic gains in young children of both genders, using developmentally appropriate software (i.e., software allowing children to control the program and make decisions) in academic settings in such skill areas as verbal ability, problem solving, and creativity (Haugland and Wright, 1997).

Cultural Environment

Culture is often defined by the ideas, beliefs, and values coupled with the rituals and practices of social groups, including but not limited to families. Betancourt and Lopez suggest that culture refers to “a distinct system of meaning or a cognitive schema that is shared by a group of people or an identifiable segment of the population” (García Coll and Magnuson, 2000, p. 97). Miller and Goodnow define cultural practices as “actions that are repeated, shared with others in a social group, and invested with normative expectations and with meanings or significances that go beyond the immediate goals of the action” (National Research Council and Institute of Medicine, 2000, p. 60). Thus, practices to prevent and promote health and provide treatment have to make sense and be congruent with these systems of meanings and practices. In addition, any self-report on health is embedded in these cultural constructions.

In the United States, the relationship of culture to health outcomes and their measurement is particularly significant because of the growth in diverse populations. It is estimated that by 2050, children of color will account for a majority of children in this country (Institute of Medicine, 1997). Consequently, dominant notions of health—mostly based on middle-class, northern European beliefs and practices—are increasingly out of alignment with the traditions, customs, and beliefs of those with other ancestries.

Culture affects health in many ways. One is by promoting daily activities and routines that reflect culturally defined goals and values that interact and influence developmental processes, inclusive of health (Gallimore et al., 1993; Rogoff, 1990). These routines can include, for example, health-promoting habits such as culturally prescribed foods and activities that provide adequate nutrition and caloric intake or patterns of mother-infant interaction (e.g., Harwood, 1992).

Culture also affects health by providing caregivers (and eventually children themselves) with an understanding of development and health: culture offers the context for defining what is a problem, explaining why the problem exists, providing possible treatments, and indicating who should respond (Groce and Zola,



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