| Title |
Investigators | Department | Objectives | Approach Keywords | Progress Reports | Impact Statements | Publications | |
Project * COL00213A(See Project History for COL00213) |
|
| Title | Parent and Household Influences on Calcium Intake Among Preadolescents |
| Investigator(s) | Auld, GW; |
| Department | Food Science and Human Nutrition |
| Objectives | 1. Identify factors (knowledge, attitude, behavior, and environment) associated with total calcium intake among the parents of preadolescent children using qualitative methods. 2. Identify parental factors (knowledge, attitudes, behavior, and environment) related to total calcium intake of their preadolescent children using qualitative methods. 3. Quantify the salient parental and preadolescent factors (attitudes, knowledge, behaviors, and environment) that predict total calcium intake of the preadolescent using quantitative methods. 4. Develop and test potential messages and dietary strategies among parents and preadolescents based on the salient factors related to preadolescent calcium intake. |
| Approach | The study population will consist of parents and preadolescents (11-12 years); both genders and four ethnic groups (Hispanic, white, Asian American, and mixed)will be included. Both qualitative (open-ended interviews) and quantitative (motivator/barrier (MBQ)and food frequency (FFQ) questionnaires) will be used to address the objectives. Parents (n=160) of preadolescents most responsible for food preparation will be interviewed to determine the influences on calcium intake of the child and parent using tenets from the Social Learning Theory. A parent M/B questionnaire will be developed and validated, based on interview responses. Parent/child pairs (n = 1600 pairs)will be surveyed using the parent MBQ and previously developed child MBQ and calcium based FFQ. Based on results from above, five or more nutrition strategies to improve calcium intakes of parents and preadolescents will be developed and tested. |
| Keywords | calcium, preadolescent, osteoporosis, Social Learning Theory, ethnicity |
| Progress Reports | |
| 2003 | Osteoporosis affects 15-24 million Americans, including half the women over 45 years of age, and results in annual health care costs of $7-10 billion. The greater the bone density prior to the onset of bone loss, the lower the risk of developing osteoporotic fractures. Since over 95% of bone mass accrues during adolescence, calcium intake during this time is critically important for maximizing bone mass and reducing risks for developing osteoporosis. Calcium intake among adolescent girls, and many boys, is well below recommendations. Objectives: 1. Identify factors (knowledge, attitude, behavior, and environment) associated with total calcium intake among the parents of preadolescent children using qualitative methods. 2. Identify parental factors (knowledge, attitude, behavior, and environment) associated with total calcium intake among their preadolescent children using qualitative methods. 3. Quantify the salient parental and preadolescent factors that predict total calcium intake of the preadolescents using quantitative methods. 4. Develop and test potential educational messages and dietary strategies among parents and preadolescents based on the salient factors related to preadolescent calcium intake. The study population will consist of parents and preadolescents (11-12 years); both genders and four ethnic groups (Hispanic, white, Asian American, and mixed). In 2003, open-ended interviews were conducted with 16 parents of Hispanic or white children. Over 200 interviews have been or will be conducted by the stations involved in this project to determine the influences on calcium intake of the child and parent using tenets from the Social Learning Theory. All interview data will be analyzed at Colorado State University. This will be a huge, detailed qualitative data base that includes information on understudied cultural and age groups. This data will lead to the development of evaluation tools to assess and quantify 1) the motivators, barriers and influences on calcium intake among parents and preadolescents and 2) the calcium intake of parents - a previous AES study led to the development of motivator and barrier (MBQ) and food frequency (FFQ) questionnaires for 11-16 year old children in these cultural groups. |
| 2004 | Osteoporosis is the most readily identifiable health issue associated with inadequate calcium intake. Obtaining sufficient calcium during adolescence helps ensure adequate mineralization of the skeleton to ensure bone health late in life. Results obtained from a previous multi-state project highlighted that familial factors play an important role in calcium intake of youth. However, little information is know about these factors, particularly among different ethnic groups. Therefore, this multi-state project involving 13 states is actively examining parental factors (knowledge, attitudes, behaviors, environment) and their influence on calcium intake fo children in early adolescence (11-14 yoa) from race/ethnic groups most at risk for osteoporosis. 206 interviews were competed with parents of preadolescents (16 in Colorado; half with Hispanic parents). Colorado coded all transcripts, using NVIVO software, and is coordinating the analysis of the interviews. Initial analyses is being used to develop1) a parent motivator/barrier questionnaire to assess parental influences on calcium intake of parents and their children and 2) education messages and formats. More detailed analyses will be used to develop manuscripts. |
| 2005 | Osteoporosis is the most readily identifiable health issue associated with inadequate calcium intake. Obtaining sufficient calcium during adolescence helps ensure adequate mineralization of the skeleton to ensure bone health late in life. Results obtained from a previous multi-state project highlighted that familial factors play an important role in calcium intake of youth. However, little information is known about these factors, particularly among different ethnic groups. Therefore, this multi-state project involving 13 states is actively examining parental factors (knowledge, attitudes, behaviors, environment) and their influence on calcium intake of children in early adolescence (11-14 yoa) from race/ethnic groups most at risk for osteoporosis. During the past year, the Colorado PI helped test a questionnaire to assess parental influences on the calcium intake of pre-adolescent children. A number of steps were taken (or are in progress) to establish the validity and reliability of the questionnaire. Items were based on results from the previous years interviews with 206 parents. The initial draft was cognitively tested with 15 Hispanic and Non-Hispanic White parents in Colorado. The questionnaire was modified, based on parents comments, and another group of parents were recruited to help establish the reliability of the tool through both a test/re-test (same parents completed the tool twice 7-10 days apart) and statistical verification of internal consistency. The statistical analyses will be done at CSU. Manuscripts based on analysis of the parent interviews are being prepared by subcommittees of W1003 scientists; one, describing the methodology, has been submitted. |
| 2006 | Osteoporosis is the most readily identifiable health issue associated with inadequate calcium intake. Obtaining sufficient calcium during adolescence helps ensure adequate mineralization of the skeleton to protect bone health late in life. Results obtained from a previous multi-state project highlighted that familial factors play an important role in calcium intake of youth. However, little information is known about these factors, particularly among different ethnic groups. Therefore, this multi-state project (13 states) is actively examining parental factors (knowledge, attitudes, behaviors, environment) and their influence on calcium intake of children in early adolescence (11-14 yoa) from three race/ethnic groups (Hispanic, non-Hispanic white, and Asian) most at risk for osteoporosis. During the past year , the Colorado station helped analyze data from two pilot studies of the parent motivator/barrier questionnaire (PMBQ) to assess parental influences on the calcium intake of pre-adolescent children. Items were based on results from earlier interviews with 206 parents . 166 parents completed the PMBQ in Pilot 1 and 29 completed a reformatted PMBQ in Pilot 2; 94 children, matched with parents, also completed a parallel questionnaire in Pilot 1. The reliability of the PMBQ was established through both a test/re-test (same parents completed the tool twice 7-10 days apart) and statistical verification of internal consistency. Psychometric properties of the PMBQ were confirmed using the matching parent's and children's data. Seventeen of the original 20 proposed scales met acceptable standards, including expert review agreements (n=17) and Cronbach's alpha values that indicated internal consistency. These scales were grouped into one of two constructs of the Social Cognitive Theory: environment (social and physical) or personal (attitude and preferences). Reliability testing using Pearson correlation coefficients could only be completed for 7 of the scales; values ranged from 0.68 to 0.85. Further construct validity testing was done comparing the results to characteristics of the respondents. The knowledge questions differed significantly by education level and ethnic group. Many of the parent scales were correlated with scales from the children's questionnaire, most as predicted. The final PMBQ in combination with the child's motivator/barrier questionnaire and a calcium-based food frequency questionnaire will be given to 105 matching parent/child pairs in each state beginning in the fall of 2006. Several manuscripts based on analysis of the parent interviews have been submitted and one, describing the methodology, has been accepted. |
| Impact | |
| 2003 | The qualitative data base will provide detailed information on understudied populations. The validated questionnaires developed for this (and the previous) project will benefit future research with these populations as no comparable tools exist. |
| 2004 | The results of this project will be used to identify factors that influence the calcium consumption of early adolescents. The information can be used to design effective, tailored nutrition intervention for early adolescent and their parents. The improvement in calcium intake among early adolescents may reduce the burden for osteoporosis in the future. The information on parental factors influencing food intakes of their children is likely applicable to other health-related behaviors such as those related to obesity. Thus, the messages found effective for improving bone health may be useful for minimizing the development of other health problems including obesity and Type 2 diabetes. The qualitative data base will provide detailed information on understudied populations. The validated questionnaires developed for this (and the previous) project will benefit future research with these populations as no comparable tools exist. |
| 2005 | The results of this project will be used to identify factors that influence the calcium consumption of early adolescents. The information can be used to design effective, tailored nutrition intervention for early adolescent and their parents. The improvement in calcium intake among early adolescents may reduce the burden for osteoporosis in the future. The information on parental factors influencing food intakes of their children is likely applicable to other health-related behaviors such as those related to obesity. Thus, the messages found effective for improving bone health may be useful for minimizing the development of other health problems including obesity and Type 2 diabetes. The qualitative data base will provide detailed information on understudied populations. The validated questionnaires developed for this (and the previous) project will benefit future research with these populations as no comparable tools exist. |
| 2006 | Results of this project will be used to identify factors that influence the calcium consumption of early adolescents. The information can be used to design effective, tailored nutrition intervention for early adolescent and their parents. Improvement in calcium intake among early adolescents may reduce the burden for osteoporosis in the future. The information on parental factors influencing food intakes of their children is likely applicable to other health-related behaviors such as the development of obesity. Messages found effective for improving bone health may be useful for minimizing the development of other health problems including obesity and Type 2 diabetes. The validated questionnaires developed for this (and the previous) project will benefit future research with these populations as no comparable tools exist. |
| Publications | |
| 2003 |
Novotny R., Boushey C., Bock M.A., Peck L., Auld, G., Bruhn, C., Gustafson, D., Gabel K., Jensen, J.K., Misner S., Read M., (2003). Calcium intake of Asian, Hispanic and white youth. Journal of the American College of Nutrition, 22(1):64-70. |
| 2004 |
Jensen, J.K., Gustafson, D., Boushey, C., Auld, G., Bock, M.A., Bruhn, C., Gabel, K., Misner S ., Novotny, R., Peck, L., Read, M. (2004). Development of a food frequency questionnaire to measure calcium intake among multi-ethnic youth. Journal of the American Dietetic Association, 104:762-769. Montgomery, H., Schroeder, M., Inglis-Widrick, R, Young, L., Auld, G. (2004). Finding whole grains and calcium rich food sources on supermarket shelves. The Forum for Family and Consumer Issues. |
| 2005 |
Diker, A., Auld, G., and W1003 Scientists. 2005. How NVivo can be used to reliably analyze large qualitative data sets. J. Nutr. Educ. Behav. 37(Suppl 1):S59. Reicks, M., Goldbert, D., Edlefsen, M. 2005. Parental influences on intake of calcium-rich foods by preadolescent Hispanic, Asian and Non-Hispanic White children. FASEB J. 19(4):A460 Schoemer, S.L., Reckase, R.R., and Olson, B.E. 2005. Role of parental influence on barriers to calcium intake in preadolescents, specific to fortified foods and supplement use. J. Nutr. Educ. Behav. 37(Suppl 1):S63. Vue, H. and Reicks, M. 2005. Individual and environmental influences on intake of calcium-rich foods by Hmong preadolescent girls. FASEB J. 19(5):A977. Yang, J., Olson, B., Want, C., W1003 Investigators, Boushey, C.J. 2005. Use of dietary supplements among parents and their early adolescent child from Asian, Hispanic, and Non-Hispanic White families. FASEB J. 19(4):A28. |