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                                                       Calendar No. 585
109th Congress                                                   Report
                                 SENATE
 2d Session                                                     109-323

======================================================================



 
      CHILDREN AND MEDIA RESEARCH ADVANCEMENT ACT OR THE CAMRA ACT

                                _______
                                

               September 5, 2006.--Ordered to be printed

                                _______
                                

Mr. Enzi, from the Committee on Health, Education, Labor, and Pensions, 
                        submitted the following

                              R E P O R T

                         [To accompany S. 1902]

    The Committee on Health, Education, Labor, and Pensions, to 
which was referred the bill (S. 1902) to amend the Public 
Health Service Act to authorize funding for the establishment 
of a program on children and the media within the Centers for 
Disease Control and Prevention to study the role and impact of 
electronic media in the development of children, having 
considered the same, reports favorably thereon with an 
amendment in the nature of a substitute and recommends that (as 
amended) do pass.

                                CONTENTS

                                                                       
  I. Purpose and Summary of the Bill..................................1
 II. Background and Need for the Legislation..........................2
III. Legislative History and Committee Action.........................2
 IV. Explanation of Bill and Committee Views..........................3
  V. Cost Estimate....................................................5
 VI. Application of Law to the Legislative Branch.....................7
VII. Regulatory Impact Statement......................................7
VIII.Section-by-Section Analysis......................................7

 IX. Changes in Existing Law..........................................8

                   I. Purpose and Summary of the Bill

    The purpose of the Children and Media Research Advancement 
Act is to establish a centralized research program within the 
Federal Government to examine the impact of electronic media on 
children and adolescents. Children today live and develop in a 
world of media, where access is at the fingertips of almost 
every child. This emerging digital world is well known to 
children, but its effects on their development are not well 
understood. Reports vary as to the amount of time that children 
spend either watching media or engaged in activities on a 
computer screen. However, we know very little about how 
exposure to media, particularly the newer interactive media, 
affects children's development.
    S. 1902 amends Title III of the Public Health Service Act 
to establish a program within the Centers for Disease Control 
and Prevention to examine the role and impact of media on 
children's and adolescents' cognitive, social, emotional, 
physical and behavioral development, and to award research 
grants based on a coordinated research agenda. The bill calls 
on the Centers for Disease Control and Prevention to contract 
with the National Academies or other entity to review, 
synthesize, and report on existing research on children and 
media, and to establish priorities for a subsequent research 
program on the impact of media on children.

              II. Background and Need for the Legislation

    The committee directs the National Academies or other 
entity to perform such a review and to establish such research 
priorities by working with recognized experts in the relevant 
field of study. Taking into consideration these 
recommendations, the Centers for Disease Control and Prevention 
will--subject to appropriations--and in coordination with the 
Director of the National Institutes of Health award research 
grants to examine the role of media in children's cognitive, 
social, emotional, physical, and behavioral development. Such 
research will examine all forms of electronic media, including 
television, movies, DVDs, interactive video games, cell phones, 
digital music, and the Internet. It may examine effects among 
children of all ages--from infancy through adolescence.
    Not later than 15 months after the bill is enacted, the 
National Academies or other entities shall submit a report 
reviewing and synthesizing research on children and media to 
the Director of the Centers for Disease Control and Prevention 
and the appropriate committees of Congress. Not later than the 
end of the calendar year 2012, the Centers for Disease Control 
and Prevention shall submit to Congress a report synthesizing 
and reporting on the research conducted pursuant to grants 
authorized under this act and elsewhere.
    There are still many unanswered questions about media's 
impact on children. For example, while Congress may agree that 
there is a need to protect our children from online 
pornography, there is insufficient research on whether, when, 
how, and to what extent inadvertent exposure to online 
pornography affects children, their behavior, moral values, and 
standards of decency. We also know very little about how to 
address even the most practical of questions, such as how to 
prevent children from falling prey to adult strangers who 
approach them online.

             III. Legislative History and Committee Action

    During the first session of the 109th Congress, S. 579, the 
``Children and Media Research Advancement Act'' or the ``CAMRA 
Act'' was introduced on March 9, 2005. CAMRA was re-introduced 
on October 20, 2005 as S. 1902. S. 1902 modified S. 579 by 
specifying that the Director of the Centers for Disease Control 
and Prevention rather than the Director of the National 
Institute of Child Health and Human Development would oversee 
the research provided for by CAMRA, as this research 
complements ongoing efforts by the Centers for Disease Control 
and Prevention.
    The Committee on Health, Education, Labor, and Pensions 
reported S. 1902 favorably with an amendment in the nature of a 
substitute on March 8, 2006, by unanimous consent.

            IV. Explanation of the Bill and Committee Views

    The committee believes there is a need for the Federal 
Government to sponsor research on the impact of media on 
children and there is precedent for Congressional interest. For 
example, Congress passed the Children's Television Act to 
promote media that foster positive values like helping, 
sharing, and cooperating among children. Congress also passed 
the Children's Online Privacy Protection Act (COPPA) to 
safeguard children from exploitation as they explore the 
Internet. In addition, Congress passed the Communications 
Decency Act and the Children's Internet Protection Act to 
shield children from exposure to sexually-explicit online 
content that may be harmful to minors.
    The committee believes media can have positive and negative 
effects on children's health, behavior and development, but 
there is insufficient knowledge of the nature of these effects. 
We have only some limited knowledge of the effects of 
children's exposure to established media, and even less is 
known about the effects of new, electronically based media. The 
committee therefore believes that we need more research in 
these areas. The committee wants to better understand how 
interactive media can promote positive health awareness and 
lifestyles. The committee views positively the development of 
interactive media products to promote health--including 
``exergames'' to promote physical activity, and media products 
to train physicians and other medical professionals, to help 
people manage chronic pain and other health conditions, and to 
enhance cognitive development and educational outcomes. The use 
and effectiveness of such products should be a subject of 
research.
    The committee agrees with the view that time spent with 
computers can be good for children, teaching them the skills 
that they will need for success in the 21st century. The 
committee also expects that research could examine how the 
newest kinds of interactive programs designed to teach as they 
entertain can foster academic development and ensure that no 
child is left behind. The committee would expect that research 
could reveal more about how time spent with computers is 
different from time spent in front of the television. Perhaps 
it can help us understand some of the underlying mechanisms 
that facilitate or disrupt children's learning from different 
media? Can academic development, for example, be fostered by 
the use of interactive online programs designed to teach as 
they entertain? Thus, research can help us understand the 
underlying mechanisms that facilitate or disrupt children's 
learning from different media. In addition, research is needed 
to understand the impact of marketing in electronic media on 
children and their health and development, including 
traditional television advertising as well as online 
``stealth'' marketing including advergames and pop-up ads and 
new forms of marketing such as advertisements on cellar phones.
    The committee also believes that research in children is 
needed to more fully understand the effects of violence in 
media. Research is needed to understand the effects of violence 
in new media technologies, including what features of violent 
video games produce the strongest effects, whether the context 
or venue in which a child plays such games moderates the 
effects, and which children are most likely to be affected by 
violent video games. The committee is also interested in 
electronic media products marketed for toddlers and babies less 
than 3 years of age, as media products for very young children 
proliferate, it is important to better understand the impact of 
such products.
    The committee believes that the research conducted pursuant 
to the legislation could help ensure that the recommendations 
and public policy decisions made by Congress will be grounded 
in objective behavioral, social, and scientific research. At 
present no Federal research agency has the responsibility to 
oversee and set a coherent media research agenda that can guide 
public policy decisions. The committee anticipates that the 
research will cover all forms of electronic media, including 
television, movies, DVDs, interactive video games, cell phones, 
digital music, and the Internet, and will examine children of 
all ages. The legislation created by the committee also calls 
for a report to Congress about the results and conclusions of 
this research program.
    The committee believes by passing the Children and Media 
Research Advancement Act the Congress can advance knowledge and 
enhance the constructive effects of media while looking to 
minimize negative effects.Specifically, the Centers for Disease 
Control, in cooperative arrangements with the National Academy of 
Sciences and the Institute of Medicine will be directed by this 
legislation to look at the following areas in which media may have an 
impact on aspects of development of children:
          Cognitive. The role and impact of media use and 
        exposure in the development of children and adolescents 
        within such cognitive areas as language development, 
        attention span, problem solving skills (such as the 
        ability to conduct multiple tasks or ``multitask''), 
        visual and spatial skills, reading, and other learning 
        abilities.
          Physical. The role and impact of media use and 
        exposure on children's and adolescents' physical 
        coordination, diet, exercise, sleeping and eating 
        routines, and other areas of physical development.
          Socio-Behavioral. The influence of interactive media 
        on children's and adolescents' family activities and 
        peer relationships, including indoor and outdoor play 
        time, interaction with parents, consumption habits, 
        social relationships, aggression, prosocial behavior, 
        and other patterns of development.
    To do our very best by children, the committee believes we 
must make public policy decisions on the basis of sound 
behavioral and social scientific research. Today, Federal 
agencies fund media research in a piecemeal fashion resulting 
in a patchwork quilt of studies and findings. CAMRA is intended 
to coordinate research projects and contribute to the 
development of a comprehensive view of the role of media in 
children's cognitive, social, emotional, physical, and 
behavioral development.
    The Kaiser Family Foundation (KFF) recently released a 
report on electronic media in the lives of infants, toddlers, 
and preschoolers-ages 0 to 6 years old. The study found that 
children today are reared in a media saturated environment. 
According to the study, 99 percent of all children live in a 
home with a TV set and 50 percent of these children live in a 
home with three or more TVs of which 36 percent have a TV in 
their bedroom. Thirty percent of children ages 0 to 3 years and 
43 percent of 4 to 6 year olds have a TV in their bedroom.
    The committee believes that parents have the primary 
responsibility to examine the positive and negative effects 
media may have on their children--whether it encourages 
creativity in children or has the capability of harmful affects 
on children. However, there is insufficient information to 
enable parents to make informed decisions about how media, 
particularly the newer digital media, affects children's 
health, education, and development. America is a media-rich 
society, but despite the incredible amounts of information, we 
still lack the most important piece of all--the effect that 
media has on our children.
    It is essential to provide parents and guardians with the 
most accurate information and current research on the impact of 
media has on their children. In spite of the lack of research, 
parents already feel very strongly about what is portrayed in 
the media. According to a recent study by Common Sense Media, 
approximately 9 out of 10 American parents believe today's 
media contribute to their own children becoming too 
materialistic, using more coarse and vulgar language, engaging 
in sexual activity at younger ages, experiencing a loss of 
innocence too early, and behaving in violent or anti-social 
ways.
    Hopefully, through a better understanding of the power of 
media, we can use it in a healthy and productive way to educate 
our children and give parents helpful tools to raise their 
children.

                            V. Cost Estimate

                                     U.S. Congress,
                               Congressional Budget Office,
                                   Washington, DC, August 17, 2006.
Hon. Mike Enzi,
Chairman, Committee on Health, Education, Labor, and Pensions,
U.S. Senate, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 1902, the Children 
and Media Research Advancement Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Tim 
Gronniger.
            Sincerely,
                                          Donald B. Marron,
                                                   Acting Director.
    Enclosure.

S. 1902--Children and Media Research Advancement Act

    Summary: S. 1902 would direct the Centers for Disease 
Control and Prevention (CDC) to promote research on the effects 
of electronic media on children. The bill would authorize the 
appropriation of such sums as are necessary to implement those 
policies. Based on information from CDC and comparison with 
similar activities, assuming appropriation of necessary funds, 
CBO estimates that implementing S. 1902 would cost less than 
$500,000 in 2007 and about $5 million over the 2007-2011 
period. S. 1902 would not affect direct spending or receipts.
    S. 1902 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would not affect the budgets of state, local, or tribal 
governments.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of S. 1902 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                                       By fiscal year, in millions of dollars--
                                                                    --------------------------------------------
                                                                       2007     2008     2009     2010     2011
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Estimated authorization level......................................        1        1        1        1        1
Estimated outlays..................................................        *        1        1        1        1
----------------------------------------------------------------------------------------------------------------
Note: *= increase of less than $500,000. Amounts do not sum to totals in the text because of rounding.

    Basis of estimate: S. 1902 would modify the Public Health 
Service Act to require the CDC to pursue research on the 
effects of electronic media--including television, movies, 
DVDs, video games, digital music, the Internet, and cell 
phones--on childhood development. In particular, the CDC would 
be required to contract with either the National Academy of 
Sciences or another research organization to conduct a study 
summarizing existing research on the topic and to provide 
recommendations for future research. Taking account of the 
recommendations of that report, the Director of the CDC would 
then be required to provide grants to fund research on the 
effects of electronic media on the cognitive, physical, and 
socio-behavioral development of youth. The bill would authorize 
the appropriation of such sums as may be necessary for that 
research for fiscal years 2007 through 2011.
    We estimate that the CDC would require the appropriation of 
$1 million for 2007 to contract with the National Academy of 
Sciences or a similar organization for the initial report. In 
subsequent years the CDC would fund research in each of the 
three areas targeted by the bill--at a cost of about $400,000 
per area per year--for a total of about $1.2 million per year 
for fiscal years 2008 through 2011. That estimate is based on 
comparison with past CDC activities and information provided by 
CDC staff, Based on historical rates of spending for funds 
appropriated to CDC, and assuming appropriation of the 
necessary amounts, CBO estimates that implementing S. 1902 
would cost less than $500,000 in 2007 and about $5 million over 
the 2007-2011 period.
    Intergovernmental and private-sector impact: S. 1902 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would not affect the budgets of state, 
local, or tribal governments.
    Estimate prepared by: Federal costs: Tim Gronniger. Impact 
on state, local, and tribal governments: Leo Lex. Impact on the 
private sector: Peter Richmond.
    Estimate approved by: Peter H. Fontaine, Deputy Assistant 
Director for Budget Analysis.

            VI. Application of Law to the Legislative Branch

    The committee has determined that there is no impact of 
this law on the Legislative Branch.

                    VII. Regulatory Impact Statement

    In accordance with paragraph 11(b) of rule XXVI of the 
Standing Rules of the Senate, the committee has determined that 
there will be no increase in the regulatory burden imposed by 
this bill.

                   VIII. Section-by-Section Analysis


Section 1. Short title

    ``Children and the Media Research Advancement Act'' or the 
``CAMRA Act.''

Section 2. Purpose

    This section indicates that the purpose of the Act is to 
enable the Centers for Disease Control and Prevention to 
examine the role and impact of electronic media in children's 
development, and to provide a report to Congress summarizing 
research in this area.

Section 3. Research on the Role and Impact of Electronic Media in the 
        Development of Children and Adolescents

    This section requires the Centers for Disease Control and 
Prevention to contract with the National Academies of Science 
(NAS) or another appropriate entity to review, synthesize, and 
report on the research concerning the effect of exposure to 
media on children and adolescents' cognitive, physical, and 
socio-behavioral development, and to establish research 
priorities in this area. The NAS or other entity shall review, 
synthesize and report on scientifically valid and peer reviewed 
studies in its report. The committee assumes that the National 
Academies or other entity will conduct this review and 
establish these research priorities by convening a panel of 
media experts through the Institute of Medicine and other 
relevant Divisions and Boards, including the Board on Children, 
Youth and Families.
    Taking into account these recommendations, the Centers for 
Disease Control and Prevention is required to award grants for 
research concerning the role and impact of electronic media in 
children's development--subject to appropriations. This 
research shall focus on the impact of such factors as the 
format, length of exposure, age of youth, nature of parental 
involvement, and venue (i.e., the place or setting in which 
media is consumed, such as at school or at home). It may also 
focus on the impact of direct and indirect media content. 
Direct media content refers to media content that is not 
intended to promote or sell a product. Indirect media content 
refers to media content that is intended to promote or sell a 
product, including advertising, ``advergames,'' product 
placement, and other forms of marketing. However, the program 
will not duplicate other research including other Federal 
Research activities.
    To receive a grant under this section, entities shall 
submit applications to the Director of the Centers for Disease 
Control and Prevention at such time, in such manner, and 
containing such information as the Director requires. They 
shall use amounts received under the grant to carry out 
activities as described in this subsection.
    Not later than 15 months after the bill is enacted, the 
report prepared by the National Academies or other entity shall 
be submitted to the Director of the Centers for Disease Control 
and to the appropriate committees of Congress. Not later than 
December 31, 2012 the Secretary of Health and Human Services, 
acting through the Director of the Centers for Disease Control, 
shall submit a report synthesizing the findings of research 
provided for by CAMRA and other related research to the 
appropriate committees of Congress.
    This section further authorizes to be appropriated to carry 
out this section such sums as may be necessary for 2007 through 
2012.

                      IX. Changes in Existing Law

    In compliance with rule XXVI paragraph 12 of the Standing 
Rules of the Senate, the following provides a print of the 
statute or the part or section thereof to be amended or 
replaced (existing law proposed to be omitted is enclosed in 
black brackets, new matter is printed in italic, existing law 
in which no change is proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



     TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE


                   Part A--Research and Investigation


IN GENERAL

           *       *       *       *       *       *       *


                      Part P--Additional Programs


SEC. 399L. [280G] CHILDREN'S ASTHMA TREATMENT GRANTS PROGRAM.

    (a) Authority To Make Grants.--
          (1) In general.--* * *

           *       *       *       *       *       *       *


SEC. [399O] 399P. [1280K-4] GRANTS TO FOSTER PUBLIC HEALTH RESPONSES TO 
                    DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, 
                    AND STALKING.

    (a) Authority To Award Grants.--* * *

           *       *       *       *       *       *       *


SEC. 399Q. RESEARCH ON THE ROLE AND IMPACT OF ELECTRONIC MEDIA IN THE 
                    DEVELOPMENT OF CHILDREN AND ADOLESCENTS.

    (a) In General.--Subject to the availability of 
appropriations, the Secretary, acting through the Director of 
the Centers for Disease Control and Prevention (referred to in 
this section as the ``Director''), shall enter into a contract 
with the National Academy of Science or another appropriate 
entity to review, synthesize, and report on research, and 
establish research priorities, regarding the roles and impact 
of electronic media (including television, motion pictures, 
DVD's, interactive video games, digital music, the Internet, 
and cell phones) and exposures to such media on youth in the 
following core areas of development:
          (1) Cognitive.--Cognitive areas such as language 
        development, attention span, problem solving skills 
        (such as the ability to conduct multiple tasks or 
        ``multitask''), visual and spatial skills, reading, and 
        other learning abilities.
          (2) Physical.--Physical areas such as physical 
        coordination, diet, exercise, sleeping and eating 
        routines.
          (3) Socio-behavioral.--Socio-behavioral areas such as 
        family activities and peer relationships including 
        indoor and outdoor play time, interactionswith parents, 
consumption habits, social relationships, aggression, and positive 
social behavior.
    (b) Research Program.--
          (1) In general.--Taking into account the report 
        provided for under subsection (a), the Secretary, 
        acting through the Director and in coordination with 
        the Director of the National Institutes of Health, 
        shall, subject to the availability of appropriations, 
        award grants for research concerning the role and 
        impact of electronic media on the cognitive, physical, 
        and socio-behavioral development of youth.
          (2) Requirements.--The research provided for under 
        paragraph (1) shall comply with the following 
        requirements:
                  (A) Such research shall focus on the impact 
                of factors such as media content (whether 
                direct or indirect), format, length of 
                exposure, age of youth, venue, and nature of 
                parental involvement.
                  (B) Such research shall not duplicate other 
                Federal research activities.
                  (C) For purposes of such research, electronic 
                media shall include television, motion 
                pictures, DVD's, interactive video games, 
                digital music, the Internet, and cell phones.
          (3) Eligible entities.--To be eligible to receive a 
        grant under this subsection, an entity shall--
                  (A) prepare and submit to the Director an 
                application at such time, in such manner, and 
                containing such information as the Director 
                shall require; and
                  (B) agree to use amounts received under the 
                grant to carry out activities as described in 
                this subsection.
    (c) Reports.--
          (1) Report to the director.--Not later than 15 months 
        after the date of the enactment of this section, the 
        report provided for under subsection (a) shall be 
        submitted to the Director and to the appropriate 
        committees of Congress.
          (2) Report to congress.--Not later than December 31, 
        2012, the Secretary, acting through the Director, shall 
        prepare and submit to the appropriate committees of 
        Congress a report that--
                  (A) synthesizes the results of--
                          (i) research carried out under the 
                        grant program under subsection (b); and
                          (ii) other related research, 
                        including research conducted by the 
                        private or public sector and other 
                        Federal entities; and
          (B) outlines existing research gaps in light of the 
        information described in subparagraph (A).
    (d) Authorization of Appropriations.--There is authorized 
to be appropriated to carry out this section, such sums as may 
be necessary for each of fiscal years 2007 through 2012.

           *       *       *       *       *       *       *