Annual/Termination Reports:

[01/06/2009] [02/22/2010] [11/29/2010] [12/06/2011] [01/07/2013] [12/14/2013]

Report Information

Participants

Carol Boushey
Dept. of Foods & Nutrition
Purdue University
Stone Hall, Room 202
700 W State St
West Lafayette IN 47907-2059 765.496.6569
boushey@purdue.edu
fax: 765.494.0674

Christine M. Bruhn Center for Consumer Research
Food Science and Technology
University of California Davis
Davis CA 95616-8598 530.752.2774
cell: 530.219.2888
cmbruhn@ucdavis.edu
fax: 530.752.4759

*Mary Cluskey
Nutrition and Exercise Sciences
Oregon State University
200 Milam Hall
Corvallis, OR 97331-5103 541.737.0960
cluskeym@oregonstate.edu
fax: 541.737.6914

Laltha Devareddy Dept. of Food Science
University of Arkansas
2650 N Young Ave
Fayetteville, AR 72704 479.575.4474
ldevared@uark.edu

Miriam Edlefsen
Dept. of Food Science & Human Nutrition
Washington State University
FSHN 120
Box 646376
Pullman WA 99164-6376 509.335.1395
medlefsen@wsu.edu
fax: 509.335.4815

Susie Goodell Dept. of Food, Bioprocessing & Nutrition Sciences
218 Schaub Hall
North Carolina State University
Raleigh, NC 27502 919.513.2632
susie_goodell@ncsu.edu
fax:919.515.4694

Carolyn Gunther The Ohio State University
1787 Neil Ave
Campbell Hall 341
Columbus, OH 43210 614.292.5125
gunther22@osu.edu

Paul Johnston Dept. of Nutrition, Dietetics & Food Science
S-249 ESC
Brigham Young University
Provo, UT 84602 801.422.6874
Paul_Johnston@byu.edu

Scottie Misner
Dept. of Nutritional Sciences
309 Shantz
University of Arizona
Tucson AZ 85721-0038 520.621.7123
misner@ag.arizona.edu
fax: 520.621.9446

Rachel Novotny
University of Hawaii
Ag Sci 302I
1955 East-West Rd
Honolulu, HI 96822

*Beth Olson Food Science and Human Nutrition
Michigan State University
2112 S. Anthony
East Lansing MI 48824-1224 517.355.8474 x 113
cell: 517.881.8988
olsonbe@msu.edu
fax: 517.353.6343

Marla Reicks
Food Science and Nutrition
University of Minnesota
1334 Eckles Ave
St Paul MN 55108-6099 612.624.4735
mreicks@umn.edu
fax: 612.625.5272

*Siew Sun Wong
Nutrition and Food Science Department
Utah State University
1200 E 750 N
Logan, UT 84322-8700 435.797.3464
siewsun@cc.usu.edu
Fax: 435.797.2379


April Mason, Administrative Advisor 210 Gibbons Bldg.
1501 Campus Delivery
Colorado State University
Fort Collins, CO 80523-1501 970.491.5841
April.Mason@colostate.edu
F: 970.491.4267

Brief Summary of Minutes

2008 W-1003/2003 Meeting-November 5-7
How to motivate parents to promote intake of calcium
rich foods among early adolescents

Holiday Inn Metrodome, 1500 Washington Ave S., Minneapolis, Minnesota 55454 Phone: (612) 333-4646 Fax: (612) 333-7910

Nov 5 Wednesday
Avalon meeting room at the Holiday Inn. Room- 6-8 pm.

Welcome and introductions-present: Marla, Scottie, Carolyn, Carol, April, Christine, Mary, Paul, and Susie.

Thanks to Marla for developing our new proposal-W-2003.

Each member provided a brief review of their research activities.
Christine gave new members a brief history and background on previous projects. Our current project looks at the findings from previous project and focuses on those factors that led to effective parenting.
Marla-briefly discussed segmentation analysis and how our data can be used for analysis.
Carol-reviewed project rules: how we contribute to the project, authorship, on publications.
" Review of 2007 minutes-the minutes were previously approved.
" Registration fee for the meeting is $60 made out to the University of Minnesota.
" State reports: Send papers to Scottie to be sure our records are complete. All members please update as to MS and PhD degrees completed and posters presented at professional societies.
" Christine-stressed- Adherence to Timelines and how to use new research tools in suitable manner.
" New members: NIMSS
1. Paul Johnston-BYU-has interests in international nutrition with projects in Bolivia-calcium (in grains) in cookies, increase vegetable intake and has another project in Ecuador-milk
2. Carolyn Gunther- The Ohio State University-Research and Administrative appointment with interests in calcium and body weight and nutrition education
3. Susie Goodell-NC State University-a newbie-interested in eating behavior-caregivers and preschool children relationships
4. Latha Devareddy-University of Arkansas

" Appointed Carol Boushey and Mary Cluskey as a subcommittee to nominate next years chair and secretary



Nov 6 Thursday
Room 364, West Bank Office Building (WBOB), U of MN
Walking directions were provided with a map.
8:00 Continental breakfast
8:30 Welcome to additional members who were introduced-Laltha-U of Ark, Osteoporosis & bench scientist, Leslie Cradler-new honors student with Carol Boushey.

Paul Johnston was introduced, a special guest from BYU. He has an Agricultural background in animal nutrition and now also works in human international nutrition. He has guided students from Latin America and Africa toidentify a nutrition problem within their own country, then design and carry out a plan to reduce the problem. Calcium intake in these countries is only about 10% of daily requirement.

Paul presented several examples of international interventions.
" One such example explored the potential of using indigenous the grains: Canahua, Quinoa, Amaranth. These grains have high lysine, protein and fatty acid content compared with wheat and corn. The thought that perhaps high calcium content grains could be used in products (cookies) for use in school or breakfast program in developing countries. The cookies were tested at different levels of calcium fortification with children in Bolivia. Acceptance topped out at 300 mg of calcium. Their usual dietary intake consisted of potatoes and dehydrated potatoes. Malnutrition and stunting is common. Anemia is endemic.

" When families move to the cities, they reject their previous native foods. In order to increase vegetable intake, BYU researchers have started subterranean gardens with the children.

" Ecuador: Anemia occurs with animal ownership. Animals are raised for income not for intake. Calcium intake is low and milk is not shared with the children. There is no tradition of drinking milk. Shelf life is poor. Beverage intake consists of coca cola and water. Pictures of chicks illustrate the effect of diet (coca cola, water and milk) on growth.
Paul would like to join the W 2003 research group. Another colleague at BYU interested in community nutrition research in low income populations is Dr. Rickelle Richards. The group enthusiastically welcomed Paul and his colleague.

Status of W 20003
Project objectives as stated in the approved proposal were reviewed. The previous project (W 1003) has not been terminated but renewed. The title is different, but the goal to understanding motivators and barriers within parent child relationships remains the same.
Christine presented a list of journals to consider for manuscripts describing our findings. See Journals for Calcium Rich Food Articles  (see attachment)


Policy & Procedures of W-1003:
The Policy and Procedures used in W 1003 were updated. (See P&P attachment).

All publications should be sent to Christine/Scottie for the end-of-year Annual Report.

Objectives of W 2003 - -
" Segment parents into homogenous subgroups based on promotion of CRF to early adolescents.
" Explore motivations and/or perceived benefits and barriers underlying parental factors which include making CRF available, encouraging intake of CRF, setting expectations for beverage consumption, and role modeling intake of CRF to early adolescents.
" Identify relevant messages and delivery methods that will motivate parents to promote CRF to early adolescents.

10:30- Segmentation/Cluster Analysis presentation.
Dennis Degeneffe
Research Fellow-specializes in segmentation
The Food Industry Center

MySurvey-Food and Beverage Occasion Questionnaire - handout
Dennis Degeneffe illustrated Cluster Analysis using an example data he prepared several years ago for Pillsbury. The analysis usually takes about 40 weeks
The analysis uses demographics, life stage, lifecycle and attitudes-to place people into group that reflect their response to specific practices, such as meal choice and eating behavior. Using a battery of questions with 30% agreement respondents can be segmented into meaningful groups that can then be targeted with marketing or educational information. His analysis uses Cluster Analysis and
Conical Factor Analysis-to identify a linear relationship between set of attitudinal questions.

Best solutions
profound
stable (80% accurate)
actionable
Uses:
targeting
depth of understanding
developing products
crafting communication messages,
delivering messages

Pillsbury Study-How We Eat
Food Segment Summary-Clusters
food attitudes-Each has a distinct different approach to eating
Mainstream Nurturing Cooks=love
Healthy Traditional Cooks-balanced foods, lower fat, and traditional
Healthful Explorers- Organic, creative experimental cooks
Weary Providers-compromise-Stressful, meals are balancing, harmony at mealtime
Food on Demand-other things get in the way but enjoy food
Mobile Munchers-grazers, busy on the go
Traditional Recipients-catered-want someone else to prepare to fix

How to Shop-contains many of the same categories as food segments
Born to shop-Love it
Savvy game playing-competitive shoppers
Budget weary-frustrated
Practical and systemic-planners
It's just groceries-has a pantry of food
Haven't a plan-haphazard shoppers
Want out of it-annoyed-internet shopping

Intervention
Need State-Consumer needs
Emotional Connections Higher needs
Nurture Family
Convenience
Hunger lower needs
Nutritional Taste experience

% Eating total eating occasions
Healthy Express-21%- Breakfast & Lunch-High attention to health
Comforting Interludes-14% eaten as a child, enjoyment-Med/high
Indulgent Escapes-snacks-low
Nurturing Family meals-18%-dinner-medium
Sensible meals-16%-high
Fast fueling-15%-low
(see Appetite-pdf online for segment classifications or groups)

Implications for Intervention:
Need themes
Attention to healthful eating
Receptivity to improving nutrition
( for better clarification-see attachment of Dennis's ppt)

Decision for the group-should we try to segment our data find different groups? i.e. find parental groups who want to provide for their children. Do factor analysis on our data? then find the segments. Encourage parents who are doing right and how can we reach those that aren't?

Three Concerns of Dennis on our data: range of statements, we have too many questions with missing data. Allowing respondents to reply don't knows also limits suitability of our data for cluster analysis. Factor analysis-don't have to have all the data but you do need all data for cluster analysis.

Focus on W 2003
Review of Time line (see p.15 of new proposal):
Objectives 1-segment and
Objective 2-motivators and barriers-perhaps both objectives 1 & 2 can be done in concert.

In W-2003 we'll do focus groups to determine calcium intakes.
We discussed techniques to obtain information: use card sorts, pictures with bubbles, story telling, word association, refrigerator, 3 restaurant occasions: fast food-pizza, burger and regular restaurant, breakfast and lunches, grocery store, and after-school occasion (snacks), convenience store, and on-the-go eating. Use probes to get segments and do content analysis.
(Volunteers to write questions for the above techniques include: Marla, Mary and Susie)

Look at benefits or barriers 4 factors associated with CRF:
such as availability,
parental modeling,
benefits
barriers
strategies
distribution channels
encouragement, and
expectations.

Goal: Why & How do they get these behaviors, determine answers to these questions.

Objective 3- describe preferred messages, delivery methods and channels to get these messages. Ask parents: What could I do to get this parent to do it? Use probes-under each category

Sample parents using:
Diversity
Race/ethnicity
SES
Choose parents:
involved in low income programs
after-school programs
YMCAs
boys, girls clubs
religious groups


W HA AS AA(bl)
AR X X X
AZ X X
CA X X X
HI X X
IN X
MN X X
NC X X
OH X X X
OR X X
UT X
UT/BYU X X
WA X X

3 focus groups/state with 9-12 per group

Sub group characteristics of parental behaviors for message tailoring
Have parents telling what they do or projecting what they think is happening in the picture.
36 focus groups-parents may be from each group. In the past we've not found any differences in race or ethnic group. With focus groups, you continue to do groups until you don't get any new information.

Training on focus groups. Book by Krueger outlines focus group procedures. (Christine will provide reference).

IRB approval: Christine will submit initially for IRB approval and will send information for others to use as a model. The procedure will include pre-testing the questions, holding focus groups, and finally message testing as specified in project objectives. The IRB approval will be submitted after the group developing the questions has submitted a draft.

Nov 7 Friday
Room 310 from 8-1, Room 364 from 1-5 WBOB, U of MN
8:00 Recap of previous day's decisions of the group:
Each state will do 3 focus groups of parents of 10-13 year children.
Groups will be mixed and include diverse ethnic groups. Additionally, we're seeking volunteers reflective of the SES of our state.
One group will put together pictures and questions for the focus group (Marla, Mary, and Susie).
Christine will put together the initial IRB for approval.

Friday, we reviewed the results of the previous projects' data upon which we based the new project.

Leslie Cradler from the Purdue's Honor's program, presentation: (see attachment of Leslies ppt)

Are adolescents' attitudes toward calcium rich foods and intakes of dietary calcium related to the presence of grandparent(s) living in the household?
(data presented are from funny box data, certain questions were routinely skipped possibly due to placement/or design of the FF Questionnaire)

Justification:
Statistics: Osteoporosis cost is estimated to $19 billion/yr
Multi-component interventions are most effective.
Girls who met adequate intake were most likely to be served milk by mothers and likewise by fathers.
Family's structure can affect calcium intake.
Single parent household was more likely to be more food insecure, more anemic.
With good relationship with grandparents, grandparents do want to be part of child's choices and well-being.
FFQ and YOU and YOUR FOOD survey calcium intake can predict CRF.
Children with grandparents (8.5%) in the household had a higher calcium intake.
Relate methods to total calcium intake
Analysis relate to factors to primary exposure and total psychosocial factors. No adjustment was made for family composition.
Gender-girls had lower calcium intake than boys.
Children with no grandparents had a lower taste for CRF.
Children's intake was reportedly higher than parent's intake.
Discovery is part of the research experience.

Beth Olson from Michigan State University was introduced. Beth has a PhD student doing work with Asian Indian parents with infants 0-1 year.

Carol-data analysis (has all of the scans):
sentinel child-survey referred to this child, parents=n695
age: early adolescent defined as age 10-14
gender
relationship to child Q23
# children<18 yr
age of adult
gender-7.8% men
total >18yr in house
education-35%
employment status-majority were FT
spouse/partner
race/ethnic group-(Re-look at this-double check-Asian numbers look small)
Q34
Questionnaire-look at data set
V1=ID numbers
Characteristics, dietary information, cross tabs of 11 states
Child characteristics- check on these as MISSING kids-(Ask Miriam)

The W-2003 meeting location for 2009 will be Nov. 18-21 at UC-Davis.

Carol's analysis SPSS 16 continued:
She presented testing of the tool, 2 pilot tests, scales, constructs and subscales.
Everyone has an identifier.
Either we can ask for these calculations from Carol (do duplicate fields) or have someone from our institution do analysis.
Culture/tradition for parent
concern-3 scales for this (look at # of missing fields) 1-5 scale higher score is more positive.
Quantitative variables
Parent role modeling 1-dairy only V122
Knowledge questions Q16 & Q17, Q22, V96 & V97 55% answered Ca correctly
broccoli-3 ½ cups
boys need more Ca than girls
Vitamins can help obtain Ca
cups of milk
Eating out occasion V81
Family meal together-most eat dinner together

FFQ review:
Ca intake--how individuals respond to different foods.
FFQ is designed to separate high end from low end intakes (W-191-Carol, Rachel, Keith, Deb used the means approach).
FFQ was developed for adolescents.
Convergent or (?) validity is associated with bone. Longitudinal data also tracks with bone.
Implausible levels were set at less than 100 or over 2500.
Parent outliers were around 2.6% while child outliers were 4.1%.

FFQ Decisions:
age for age-go with parent's decision on how old child is-age is significant.
gender-no decision
0 is boy and 1 is girl
education-NS
employment-NS
Parents expectation of beverage 0.02 significance
Convenience .036 sig.
Availability .032 sig.
Parenting scale never did come out.
Quartiles of intake-must transform data
Probability plot-distributes normally

Garry Auld joined the group via Skype after 1:45pm MST. Carol showed outliers. Knowledge manuscript-see p.7 child/parent pairs.
(A whole analytical method exists for dyad analysis and is often done by human development or family studies professionals).
Potential confounding factors
respondent at home or not at home-Q32 keep in, Q33 throw out
parent intake-dependent variable but sig.

Writing groups:
Paper 1: What predicts a child's calcium intake?

Paper 2: Parent and child interrelationship
Attitudinal, weight concerns-do they go together? Family influence and the child. Generational differences? What do you drink out of the restaurant? Do scales, gender-match? More discussion (Christine, Beth, Scottie)

Paper 3: like NHANES, adjust for each individual state (AZ-reference state) sampling.

Paper 4: Parental intake
(Marla, Siew Sun, Miriam, Susie and others) need child intake (check to see where missing children questionnaires are >150 missing-AZ, MI, MN)

Paper 5: Rank foods by ethnicity
Describe variation, decide on one of four objectives and determine appropriate analysis i.e. Principle Components-along scale of a certain food-check for missing data (Garry, Siew Sun, Miriam, PhD student).

Paper 6: Eating out
Divide by frequency of eating out and calcium intake. The higher the score, the greater the parental expectations (Mary, Christine, Marla and Miriam-have had a conference call).

Knowledge paper: Quantitative data: awareness of what child is eating, how important are foods, (Christine, Carol, Carolyn)


Nov 8 Saturday 8-12 am
Avalon room at the Holiday Inn
8:30.discussion of W 2003 continued.



Changes in P & P:
Include role of new people on the project, original intellectual contributions may participate in authorship, fees for abstracts, page charges, amounts over $100 will be negotiated.

Acknowledgements should read:
W-2003 is a multistate research project funded through the Agricultural Experiment Station at the participating land grant universities.

W-2003 Tasks:
IRB-Christine

Timeline:
February 1st & conference call to review draft of Pilot questions, then revise questions
Mid Feb-IRB submitted
Mid-March/April-Training on focus groups, highlight references, pilot testing with pictures
May-revise pilot questions & pictures
May-September-conduct focus groups
Nov.19-complete focus groups & check on message development by experts for Davis meeting
Next year-2010- start data analysis

Carol:
Check on missing children's data for W-1003 with Miriam and Wendy-are these scanning errors? This could be serious!!
Asian (56) and Hispanic numbers seem to be incorrect
check race/ethnic group
check front of questionnaire for state:
Parents-normal P Plot
Food-Calcium intake
Female-256 mg less Ca- significant
high school, some college
not employed outside the home
Asian women have even less calcium than children
Calcium variables
F calcium-per day

Next years chair and secretary:
Christine will continue as Chair (with reminders from Mary and Carol).
Scottie will become secretary for 2009.

Methods:
Marla has begun with methods paper (with Jennie's paper) and how things were coded.
Data: check on race/ethnic groups
Scottie-check on V1-V171
Marla- check on V169-V262

Near the end of the meeting, we met by Paper group interest.:
Marla, Mary, Susie, Laltha, Miriam (call):Important Foods and Eating Out
Marla, Susie-Parental Influence-motivators
Christine, Scottie, Beth-

**((for further clarification of minutes, see the following attachments- Paul Johnstone's summary comments, Dennis deGeneffe's ppt, Leslie Cradler's ppt, dyad paper, W-2003 member list & others, P&P updates, Publications for Annual Report-Marla, journal review for CRFs ))

Accomplishments

Adequate calcium intake as an adolescent is crucial for sufficient mineralization of the skeleton to ensure bone health later in life. Many early adolescent children in the United States do not consume enough calcium from food and beverages to meet the recommended intake, while intake varies based on the race/ethnicity of the child. Family environmental factors, both physical and social, have been implicated for their overall influence on eating patterns and diet quality of children and adolescents including adequate calcium intake. The purpose of the project was to identify these factors and their relationship to intake of calcium rich foods by early adolescents. This task was accomplished in several steps. Initial in depth interviews were conducted with about 200 parents of Asian, Hispanic and non-Hispanic white early adolescents across 12 states. Results were used to develop a parent motivator-barrier questionnaire (Parent MBQ). After establishing that the new instrument had acceptable psychometric properties, it was used with a previously developed Child MBQ to collect survey data from about 600 parent-child pairs across 8 states. Participants were recruited from 4-H, Scouts and church groups. Data analysis is currently underway to establish predictive models for the manner in which household characteristics and parental practices influence intake of calcium rich foods by early adolescent children as well as their parents. Additionally, some PIs completed projects specific to their state. These are detailed in individual state reports.

Publications

Cluskey M, Auld G, Edlefsen M, Zaghloul, S, Bock MA, Boushey CJ, Bruhn C, Goldberg D, Misner S, Olson B, Reicks M, Wang C. Calcium knowledge, concern, and expectations for intake among parents of Asian, Hispanic, and non-Hispanic white early adolescents. The Forum for Family and Consumer Issues. Winter 2008, 13(3). http://ncsu.edu/ffci/publications/<br /> <br /> Edlefsen M, Reicks M, Goldberg DL, Auld, GW, Bock A, Boushey CJ, Bruhn CM, Cluskey M, Misner SL, Olson BH, Wang C, Zaghloul S. Strategies of Asian, Hispanic, and non-Hispanic White parents to influence young adolescents intake of calcium-rich foods, 2004 and 2005. Preventing Chronic Disease 2008;5(4) October. http://www2.cdc.gov/pcd/issues/2008/oct/07_0174.htm<br /> <br /> Cluskey M, Edlefsen M, Olson B, Reicks M, Goldberg DL, Auld, GW, Bock A, Boushey CJ, Bruhn CM, Misner SL, Olson BH, Wang C, Zaghloul S. At home and away-from-home eating patterns influencing preadolescents intake of calcium rich foods as perceived by Asian, Hispanic and non-Hispanic White parents. J Nutr Educ Behav. 2008;40:72-79.<br /> <br /> Yang J, Boushey CJ, Olson BH, Auld G, Bock MA, Boushey CJ, Bruhn C, Cluskey M, Edlefsen M, Goldberg D, Misner S, Olson B, Wang C, Zaghloul S. Intentional purchase of calcium-fortified foods observed among Asian, Hispanic, and non-Hispanic white parents of early adolescents. Submitted to Journal Am Diet Association 2008 (in review) <br /> <br /> <br /> Olson, BH, Chung, KR, Reckase, M, Schoemer, S. Parental Influences on Dairy Intake in Children, and their Role in Child Calcium Fortified Food Use," In press, Journal of Nutrition Education and Behavior.<br /> <br /> <br /> Abstracts<br /> Roth-Yousey L, Asche K, Schroeder M, Reicks M. Assessment of parent and child perceptions of rules and expectations regarding beverage intake. FASEB J. 2008 22:44.2. <br /> <br />

Impact Statements

1. Several parental psychosocial factors were found to be significantly associated with calcium intake among early adolescents and their parents. These included parents expectations for childs intake of beverages and the availability of calcium rich foods. Parents calcium intakes were significantly associated with the parents perception of the importance of calcium sources for children, parental encouragement of the consumption of CRF, and parental role modeling to consume CRF.

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Report Information

Participants

Christine Bruhn-University of Callifornia-Davis, Marla Reicks-University of Minnesota, Mary Clusky-Oregon State, Carolyn Gunther-Ohio State Univeristy, Beth Olson-Michigan State University, Susan Welsh-USDA NIFA, Siew Sun Won-Utah State University, Suzie Goodell-North Carolina State University, Latha Devareddy-University of Arkansas, Stephanie Jensen-University of California-Davis graduate student, Scottie Misner-University of Arizona, Rickelle Richards-Brigham Young University, Rachel Novotny-University of Hawaii.

Brief Summary of Minutes

Accomplishments

Short-term Outcomes: Identify those factors that predict household characteristics and parental practices that influence parents to adopt behaviors that result in higher intake of calcium rich foods.<br /> Outputs: Data from the previous research project was entered, verified, and statistical analysis completed. <br /> Activities: Teams were identified to prepare manuscripts based upon data collected from almost 600 parent-child pairs. <br /> Milestones: Scripts to explore key parental drivers were developed. These will be pilot tested in the next project period, revised if necessary, and completed. Writing teams will submit manuscripts for review.

Publications

No new publications during this period.

Impact Statements

1. Several parental psychosocial factors were found to be significantly associated with calcium intake among early adolescents and their parents. These included parent&lsquo;s expectations for child&lsquo;s intake of beverages and the availability of calcium rich foods. Parents calcium intakes were significantly associated with the parent&lsquo;s perception of the importance of calcium sources for children, parental encouragement of the consumption of CRF, and parental role modeling to consume CRF.

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Report Information

Participants

Carol Boushey-Purdue; Christine Bruhn-UC-Davis; Marla Reicks-UMN; Mary Clusky-Oregon State; Carolyn Gunther-OSU; Susan Welsh-USDA NIFA; Siew Sun Wong-USU; Latha Devareddy-UAR; Scottie Misner-UAZ; Rickelle Richards-BYU; Deborah Maddy, Oregon State-Project Administrator.

Brief Summary of Minutes

A major focus of this annual meeting was discussing the review of analysis of the survey data collection from the previous project and the finalization of the methods and instruments for the new project for the multi-state research group. Discussion included segmentation results based on final data for the parent motivator-barrier questionnaire and food frequency data from parent child pairs and the acculturation paper. Suggestions were given for finalizing and submitting these two papers. This analysis was completed at Purdue University. The findings included mean scores on psychosocial scales and correlations between parent and child responses and relationships to calcium consumption. Representatives from states discussed their efforts (successful and unsuccessful) from pilot test focus groups using newly developed recruitment tools, screening forms, nominal group technique and focus group procedures for the new project. New methodologies for exploring and understanding what motivates behaviors for the consumption of calcium rich food (CRF) intakes were discussed. Future paper topics were discussed and working groups assigned. Action Items for members were outlined. They included: Protocol changes, NGT/FG Data Analysis Protocol, Assigned Numbers for each participating state, and the Revised Timeline. All working documents will be uploaded onto the Basecamp website for members and will be maintained by OSU.

The Chair and Reporter of W2003 for next year are Carolyn Gunther and Rickelle Richards, respectively. The date for next years meeting is Oct. 12-15, 2011 in Corvalis, OR.

Accomplishments

Inadequate calcium intake is the single most recognizable health issue identified with osteoporosis. Ten million Americans have been diagnosed with osteoporosis, with almost 34 million individuals having low bone mass. Each year, bone fractures result from osteoporosis and over half of Americans over 50 years of age are expected to experience osteoporotic-related bone fractures in their lifetime. Hip fractures are more likely than heart attacks, stroke or cancer to lead to functional impairment and related morbidities. The economic burden of these fractures exceeds $20 billion annually. <br /> <br /> Early adolescence (ages 10-13 years) is a critical period in the lifecycle for bone mineralization. Peak bone density can occur as early as 16 years of age for the hip, and mid-20s for other bones. Adequate calcium intake during this time of growth is crucial to ensure bone health in later life. However, studies indicate that early adolescent children consume only 60 to 80% of the 1300 mg Adequate Intake level of calcium recommended by the Institute of Medicine. These data indicate that American children are at risk for osteoporosis later in life, with its associated health risks. Asian, Hispanic and non-Hispanic White populations face a higher risk of developing osteoporosis, and thus prevention is key for these groups. <br /> <br /> The W-2003 project is focused through messaging parents helping motivate the intake of calcium rich food among their children from race/ethnic groups most at risk for osteoporosis. The project will also develop new novel techniques tools looking specifically at things parents can do to motivate intake of calcium-rich foods in their early adolescents. <br /> <br /> Researchers in all participating states submitted IRB and consent forms from their institutions. Some participated in recruiting subjects from various groups within their communities to practice using newly developed tools. In addition to data analysis, two additional articles have been submitted to peer-reviewed journals for publication, based on data from the qualitative interviews. Other articles for publication based on the finalized quantitative data from the surveys were determined and participants were assigned to leading or supportive roles in getting the papers submitted.<br />

Publications

Manuscripts:<br /> <br /> 1.Reicks M, Ballejos M, Goodell LS, Gunther C, Richards R, Wong SS, Auld G, Boushey C, Bruhn C, Cluskey M, Misner S, Olson B. Zaghhoul S. Individual and family correlates of calcium-rich food intake among parents of early adolescent children. J Am Diet Assoc. In press. Accepted Sept 2010.<br /> <br /> 2.Cluskey M, Auld G, Edlefsen M, Zaghoul S, et al. Parental knowledge, concern, and expectations for calcium intake of Asian, Hispanic, and non-Hispanic White early adolescents. Journal of Community Nutrition (in progress)<br /> <br /> 3. Landon R. Jones, Hal L. Black, Clayton M. White, N. Paul Johnston, Meghan E. McGee, Seth W. Donahue, and Dennis L. Eggett. 2010. Effects of Calcium-Loading on Egg Production in Ring-Necked Pheasants. Journal of Wildlife Management 74,(6):1295-1300. <br /> 4. Janette L. Smith, N. Paul Johnston, Kirk A. Dearden, Dennis L. Eggett, Alison K. Campbell. 2010. The Impact of Altitude and Diet on Anemia in School-Aged Children in Lago San Pablo, Ecuador ICAN: Infant, Child, & Adolescent Nutrition October 2010 2: 288-293.<br /> <br /> Abstracts:<br /> <br /> Reicks M, Ballejos M, Wong SS, Boushey C, Bruhn C, Cluskey M, Misner S, Olson B. Individual and family correlates of calcium intake in parents of early adolescent children. International Society for Behavioral Nutrition and Physical Activity Annual Meeting, Minneapolis, MN, June 2010.<br />

Impact Statements

1. " New scripts for focus groups, data collection procedures (blended approach of focus groups and nominal group technique), materials to be used in parent sessions (e.g., pictures of calcium rich foods and beverages), and recruitment and survey tools were developed.
2. " Some pilot test data were collected on parents using practice groups that potentially influence calcium intake of Asian, Hispanic and non-Hispanic White early adolescents. These factors may also be applicable to other health-related behaviors, such as the development of overweight and obesity, and intake of fruits and vegetables. Most studies have overlooked race/ethnic differences in calcium intake among minority youth and their families. This study seeks to more accurately assess ways parents influence calcium intake, by taking into consideration similarities and differences among these three racial/ethnic groups.
3. " The information from this project may be used to design more effective osteoporosis prevention programs, tailored to Asian, Hispanic, and non-Hispanic White families with early adolescents. Early adolescents in these racial/ethnic groups are at higher risk for osteoporosis, and a critical period during the lifecycle for bone growth is early adolescence.
4. " The data from this project will serve as the basis for future research, which will seek to explore novel approaches to positively influence families in encouraging, role modeling and providing access to healthy, calcium-rich foods for adolescents.

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Report Information

Participants

Ballejos, Miriam (medlefsen@wsu.edu)  Washington State University
Bruhn, Christine (cmbruhn@ucdavis.edu)  University of California, Davis
Cluskey, Mary (cluskeym@oregonstate.edu)  Oregon State University
Gunther, Carolyn (Gunther.22@osu.edu)  Ohio State University
Johnston, Paul (paul_johnston@byu.edu)  Brigham Young University
Misner, Scottie (misner@ag.arizona.edu)  University of Arizona
Reicks, Marla (mreicks@umn.edu)  University of Minnesota
Richards, Rickelle (Rickelle_richards@byu.edu)  Brigham Young University
Watters, Corilee (WattersC@ctahr.hawaii.edu)  University of Hawaii
Wong, Siew Sun (siewsun@cc.usu.edu)  Utah State University

Brief Summary of Minutes

A major focus of this annual meeting was discussing the qualitative (Nominal Group Technique/Focus Group) and sociodemographic data collection and analysis. Nearly all sites had completed data entry at the time of the annual meeting. The top benefits for parents in relation to making calcium-rich foods and beverages (CRF/Bs) available, setting rules/expectations about consuming CRBs, and role modeling the consumption of CRF/Bs were discussed. The focus group transcripts were partially analyzed by each site; facilitators and barriers from each script (availability, rules/expectations, role modeling) were reported and similar findings were noted between sites. Collectively, the NGT and FG results were used as formative information about how messaging to parents should be developed. A marketing expert  Kathryn Stroppel, Director of Communications and Alumni Relations, College of Public Health and Human Sciences at Oregon State University  presented information on how to approach message development. Based on her presentation and a presentation by a W-2003 member (Miriam Ballejos), NGT/FG data results were summarized into creative briefs for each script. [Note: Creative briefs outline key ideas/information needed to aid in emotional-based message development, which is the next step in this current project.] The research questions that will underlie the future manuscript related to the NGT/FG data were also discussed and a writing group was assigned. It was decided at the time of the meeting that data from FG only sessions (i.e., those with n<6 participants without NGT) would be included in the analysis. Action items for members were outlined and included completing: sociodemographics data entry and focus group transcriptions; formal focus group coding, reconciliation, use of qualitative computer software for organizing data (Nvivo), and documents summarizing key themes from focus group data. It was also decided that members would determine avenues for having a professional team create emotion-based messaging based from our NGT/FG analysis; and begin outlining our next project proposal. All working documents will be uploaded onto the Basecamp website for members and will be maintained by Ohio State University.

The Chair and Reporter of W-2003 for next year (2011-2012) are Siew Sun Wong and Rickelle Richards, respectively. The date for next years meeting is Nov 7-10, 2012 and will be held at UC-Davis (Davis, CA).

Accomplishments

Inadequate calcium intake is the single most recognizable health issue identified with osteoporosis. Ten million Americans have been diagnosed with osteoporosis, with almost 34 million individuals having low bone mass. Each year, bone fractures result from osteoporosis and over half of Americans over 50 years of age are expected to experience osteoporotic-related bone fractures in their lifetime. Hip fractures are more likely than heart attacks, stroke or cancer to lead to functional impairment and related morbidities. The economic burden of these fractures exceeds $20 billion annually. <br /> <br /> Early adolescence (ages 10-13 years) is a critical period in the lifecycle for bone mineralization. Peak bone density can occur as early as 16 years of age for the hip, and mid-20s for other bones. Adequate calcium intake during this time of growth is crucial to ensure bone health in later life. However, studies indicate that early adolescent children consume only 60 to 80% of the 1300 mg Adequate Intake level of calcium recommended by the Institute of Medicine. These data indicate that American children are at risk for osteoporosis later in life, with its associated health risks. Asian, Hispanic and non-Hispanic White populations face a high risk of developing osteoporosis, and thus prevention is key for these groups. <br /> <br /> The W-2003 project is focused on how to motivate parents to promote intake of calcium-rich foods and beverages in their early adolescents. Specifically, the current project is aimed at developing tailored messages to help parents encourage the intake of calcium rich food and beverages among their children. The nature of the project (i.e., multistate) allows for a sampling across a spectrum of race/ethnic groups, increasing the generalizability of the results. <br /> <br /> To date, 18 NGT/FG sessions (n>6 participants in each session) and 5 FG only sessions (n<6 participants at each session) were conducted across 7 states (AZ, CA, HI, MN, OH, OR, UT). The total sample size was 156 and by script: availability (n=46); rules/expectations (n=52); role modeling (n=58). From the results of the NGT analysis, the top 3 perceived benefits were similar across parenting practices and included:<br /> <br /> Making CRF/B Available Rules & Expectations Role Modeling<br /> Childs bone/teeth health & growth Childs general health Childs health<br /> Familys healthy eating habits/choices Parents positive emotions Familys general health<br /> Childs mental health & school performance Childs current bone health Familys dietary intake/choices<br /> Other noteworthy accomplishments achieved in the past year: Two articles from the previous W-1003 quantitative survey study were published (see references below). Two additional articles from the W-1003 project were submitted for publication in February and August 2011 (see references below). Another article stemming from the W-1003 project is in progress. Finally, a new writing team was assigned to summarize the findings presented at this years annual meeting. <br />

Publications

1. Reicks M, Edlefsen M, Goodell LS, Gunther C, Richards R, Wong SS, Auld G, Boushey C, Bruhn C, Cluskey M, Misner S, Olson B. Zaghhoul S. Individual and family correlates of calcium-rich food intake among parents of early adolescent children. J Am Diet Assoc. 2011;111:376-384.<br /> <br /> 2. Reicks M, Degeneffe D, Ghosh K, Bruhn C, Goodell LS, Gunther C, Auld G,Ballejos M, Boushey C, Cluskey M, Misner S, Olson B, Wong S, Zaghloul S. Parent calcium-rich-food practices/perceptions are associated with calcium intake among parents and their early adolescent children. Public Health Nutr. 2011 Jun 1:1-10. [Epub ahead of print]<br /> <br /> 3. Vyduna JL, Boushey CJ, Auld GW, Bruhn CM, Cluskey M, Edlefsen M, Misner S, Olson B, Reicks M, Schram J, Wang C, Zaghloul S. Formative study design to identify parental psychosocial factors related to consumption of calcium-rich foods of their early adolescent children. BMC Pediatrics. (submitted Feb 2011)<br /> <br /> 4. Cluskey M, Wong SS, Ballejos M, Reicks M, Richards R, Auld G, Boushey C, Bruhn C, Misner S, Olsen B, Zaghloul S. Dietary sources of calcium among Asian, Hispanic and non-Hispanic White parents and early adolescent children by parent place of birth. Appetite. (submitted Aug 2011).<br />

Impact Statements

1. NGT/FG data collection was completed by 8 sites (AZ, CA, HI, MN, OH, OR, Utah-USU, Utah-BYU).
2. NGT/FG data were analyzed to develop creative briefs that will be used in the next step of developing messages for parents of early adolescents based on their responses about barriers and motivators of making CRFs available, having rules/expectations about consuming CRFs, and role modeling the consumption of CRFs
3. The information from this project may be used to design more effective osteoporosis prevention programs, tailored to Asian, Hispanic, and non-Hispanic White families with early adolescents. Early adolescents in these racial/ethnic groups are at high risk for osteoporosis, and a critical period during the lifecycle for bone growth is early adolescence.
4. The data from this project will serve as the basis for future research, which will seek to explore novel approaches to positively influence families in encouraging, role modeling and providing access to healthy, calcium-rich foods and beverages for their early adolescent children.

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Report Information

Participants

Ballejos, Miriam (medlefsen@wsu.edu)
Bruhn, Christine (cmbruhn@ucdavis.edu)  University of California, Davis
Cluskey, Mary (cluskeym@oregonstate.edu)  Oregon State University
Gunther, Carolyn (Gunther.22@osu.edu)  Ohio State University
Johnston, Paul (paul_johnston@byu.edu)  Brigham Young University
Misner, Scottie (misner@ag.arizona.edu)  University of Arizona
Hongu, Nobuko Kay (hongu@email.arizona.edu)  University of Arizona
Reicks, Marla (mreicks@umn.edu)  University of Minnesota
Richards, Rickelle (Rickelle_richards@byu.edu)  Brigham Young University
Watters, Corilee (WattersC@ctahr.hawaii.edu)  University of Hawaii
Wong, Siew Sun (Siewsun.wong@oregonstate.edu)  Oregon State University

Brief Summary of Minutes

This years annual meeting focused on two main topics: 1) establishing an evaluation plan for testing messages developed by WSU and those planned for development through Ohio State University (W-2003); and 2) formulating the outline for the next 5-year proposal (W-TEMP-3003).

One of our main tasks at this annual meeting was to develop the methodological approach for testing messages in this final year of W-2003. The data collection plan will include two phases, utilizing both qualitative (for pre-testing of messages) and quantitative (for final testing of messages). A Message Testing Subgroup was created, which will primarily be responsible for developing the questions for the qualitative pre-testing and quantitative survey, with subsequent submission to the entire W-2003 group for feedback and approval.

Mary Cluskey (Oregon State University) gave a presentation on the ten steps of developing a social marketing plan, which was applied to our next 5-year proposal. As a group, we formulated the proposals objectives, outlined the methods for each objective, and determined the outcomes or projected impacts of implementing the proposal components.

The Chair and Reporter of W-2003/pending W-3003 for next year (2012-2013) are Rickelle Richards and Carolyn Gunther, respectively. Next years annual meeting will be held at University of Arizona (Tucson, AZ), with the date still to be determined.

Accomplishments

Inadequate calcium intake is the single most recognizable health issue identified with osteoporosis. Ten million Americans have been diagnosed with osteoporosis, with almost 34 million individuals having low bone mass. Each year, bone fractures result from osteoporosis and over half of Americans over 50 years of age are expected to experience osteoporotic-related bone fractures in their lifetime. Hip fractures are more likely than heart attacks, stroke or cancer to lead to functional impairment and related morbidities. The economic burden of these fractures exceeds $20 billion annually. <br /> <br /> Early adolescence (ages 10-13 years) is a critical period in the lifecycle for bone mineralization. Peak bone density can occur as early as 16 years of age for the hip, and mid-20s for other bones. Adequate calcium intake during this time of growth is crucial to ensure bone health in later life. However, studies indicate that early adolescent children consume only 60 to 80% of the 1300 mg Adequate Intake level of calcium recommended by the Institute of Medicine. These data indicate that American children are at risk for osteoporosis later in life, with its associated health risks. Asian, Hispanic and non-Hispanic White populations face a high risk of developing osteoporosis, and thus prevention is key for these groups. <br /> <br /> The W-2003 project is focused on how to motivate parents to promote intake of calcium-rich foods and beverages in their early adolescents. Specifically, the current project is aimed at developing tailored messages to help parents encourage the intake of calcium rich food and beverages among their children. The nature of the project (i.e., multistate) allows for a sampling across a spectrum of race/ethnic groups, increasing the generalizability of the results. <br /> <br /> Development of Test Messages and Evaluation Plan. Through guidance provided by a marketing group, we prepared three creative briefs for developing and testing test messages, focusing on calcium-rich foods and beverages (CRF/B) availability, rules and expectations, and role modeling of calcium-rich beverages (CRB) intake. In addition to three existing posters developed by WSU, Ohio State University will develop three sets of emotional and rational-based test message and graphic. The group has identified target audience and channel for data collection in all participating states, and drafted a survey for message-testing. <br /> <br /> W_TEMP-3003 Proposal (2013-2018). A 5-year proposal for implementing a social marketing campaign to influence parental and early adolescents behaviors was submitted for review.<br /> <br /> Manuscripts. The group responded to reviewer comments on three manuscripts. New writing groups were formed for two additional manuscripts.<br />

Publications

Manuscripts:<br /> <br /> 1. Gunther C, Bruhn C, Cluskey M, Reicks M, Richards R, Wong SS, Auld G, Ballejos ME, Boushey CJ, Misner S, Novotny R, Olson B. Individual and family level determinants of calcium knowledge among parents of early adolescent children. Journal of Nutrition Education and Behavior. Under review.<br /> 2. Roth-Yousey LL, Asche K, Schroeder M, Reicks M. Validation and reliability of a beverage tool measuring psychosocial and environmental factors associated with early adolescent (EA) beverage consumption. Journal of Adolescent Health. Under review.<br /> <br /> 3. Roth-Yousey, LL. A parent-early adolescent intervention to reduce sweetened beverage consumption through home environment parenting practices. University of Minnesota Dissertation, 2011. http://purl.umn.edu/120010<br /> <br /> 4. Reicks M, Degeneffe D, Ghosh K, Bruhn C, Goodell LS, Gunther C, Auld G, Ballejos M, Boushey C, Cluskey M, Misner S, Olson B, Wong S, Zaghloul S. Parent calcium-rich-food practices/perceptions are associated with calcium intake among parents and their early adolescent children. Public Health Nutr. 2012;15(2):331-340.<br /> <br /> <br /> Abstracts:<br /> <br /> 1. Siew Sun Wong, Carolyn Gunther, Marla Reicks, Rickelle Richards, Christine M Bruhn, Mary Cluskey, Scottie Misner, Corilee Watters, Miriam Bellajos. Perceptions of Key Parental Benefits from Practices that Promote Intake of Calcium-Rich Foods and Beverages (CRF/B) in Preadolescent Children. Experimental Biology Annual Meeting. San Diego, CA, April 2012. <br /> <br /> 2. Reynolds A, Gunther CW. (2012) Perceptions of benefits underlying key parent practices that promote intake of calcium rich foods and beverages in early adolescent children. Poster presentation, Ohio State University, Denman Research Forum and Russell Klein Symposium, Columbus, OH.<br />

Impact Statements

1. Specific (2012-2013): " Three creative briefs were developed based on NGT/FG data collected by 8 sites (AZ, CA, HI, MN, OH, OR, Utah-USU, Utah-BYU). " Three initial messages for parents of early adolescents were developed by WSU based on parents responses about barriers and motivators of making CRFs available, having rules/expectations about consuming CRFs, and role modeling the consumption of CRFs.
2. Broad: " The information from this project may be used to design more effective osteoporosis prevention programs, tailored to Asian, Hispanic, and non-Hispanic White families with early adolescents. Early adolescents in these racial/ethnic groups are at high risk for osteoporosis, and a critical period during the lifecycle for bone growth is early adolescence. " The data from this project will serve as the basis for future research, which will seek to explore novel approaches (such as social marketing campaign) to positively influence families in encouraging, role modeling and providing access to healthy, CRF/B for their early adolescent children.

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Report Information

Participants

Ballejos, Miriam (medlefsen@wsu.edu), Washington State University (no longer at this location)
Banna, Jinan (jcbanna@hawaii.edu), University of Hawaii
Biltekoff, Charlotte (cbiltekoff@ucdavis.edu), University of California, Davis
Boushey, Carol J. (cjboushey@cc.hawaii.edu), University of Hawaii
Bruhn, Christine (cmbruhn@ucdavis.edu), University of California, Davis
Cluskey, Mary (cluskeym@oregonstate.edu), Oregon State University
Devareddy, Latha (ldevared@uark.edu), University of Arkansas (no longer at this location)
Goodell, Suzie (suzie_goodell@ncsu.edu), North Carolina State University
Gunther, Carolyn (Gunther.22@osu.edu), Ohio State University
Johnston, Paul (paul_johnston@byu.edu), Brigham Young University
Misner, Scottie (misner@ag.arizona.edu), University of Arizona
Hongu, Nobuko Kay (hongu@email.arizona.edu), University of Arizona
Reicks, Marla (mreicks@umn.edu), University of Minnesota
Richards, Rickelle (Rickelle_richards@byu.edu), Brigham Young University
Watters, Corilee (cwatters@hawaii.edu), University of Hawaii
Wong, Siew Sun (Siewsun.wong@oregonstate.edu), Oregon State University

Brief Summary of Minutes

W2003 Annual Meeting Minutes
Site: Tucson, AZ
Hosts: Scottie Misner; Kay Hong

Day 1: 11-6-13; 6:00-8:15pm
Attendees: Rickelle Richards (BYU); Marla Reicks (Univ of MN); Charlotte Biltekoff (UC-Davis); Kay Hongu (Univ of AZ-Tucson; Siew Sun Wong (Oregon State Univ); Scottie Misner (Univ of AZ-Tucson); Mary Cluskey (Oregon State Univ); Christine Bruhn (UC-Davis); Jinan Banna (Univ of HI); Carolyn Gunther (Ohio State Univ); Paul Johnston (BYU)

Note: Deb Maddy flight from Phoenix was cancelled, which led to late arrival
1. Welcome and introductions (Rickelle).
2. Review meeting agenda (Rickelle).
3. Review logistical plan for 2013 meeting (Scottie and Kay).
4. Approve meeting minutes from 2012 annual meeting (all in favor).
5. Discuss annual (final) report for W2003.
Action item 1: Rickelle and Carolyn will take lead on preparing.
Action item 2: All investigators prepare/send list of abstracts, presentations, thesis, etc for inclusion in final report. Send information to Carolyn.
6. Review summary and comparison documents generated from message testing (interviews) (Rickelle).
Action item: Each investigator assigned to specific parent topic (3 members per topic), review the documents before Thursday meeting.
7. Item to ponder: Shall we send out call for new members when new project is approved (Colorado State Univ; Washington State Univ; Missouri; others?)
_____________________________________________________________________________________
Day 2: 11-7-13, 7:45am-5:00pm
Attendees: Rickelle Richards, Deb Maddy, Jinan Banna, Marla Reicks, Mary Cluskey, Siew Sun Wong, Paul Johnston, Christine Bruhn, Carolyn Gunther, Scottie Misner, Kay Hongu, Charlotte Biltekoff
1. Updates/reminders from Deb Maddy:
a. Final report for W2003 is due Dec 2014.
b. Revised proposal for new project (WDC033) is due in Jan 2014. Deb felt that the reviewer comments (both peer and committee levels) were positive, constructive, helpful, able-to-be addressed. Reviewer feedback indicated primary weakness related to limited methodological detail. Deb noted that we may have different panel of reviewers in next review of proposal.
2. Finalize methods section for interviews (message testing); 10-13 age (target age); primary food preparer in the home; live in US for at least 12 months; English speaking; Hispanic and Asian (Marla)
3. Meet in small groups to review results from message testing. Decide on which messages will be tested in upcoming survey study.
Action item: Carolyn and Rickelle will narrow which will be used in survey study.
4. Update from DC: Jane Clary Loveless, USDA NIFA
a. Childhood obesity AFRI grant decisions have been made (~55 apps received; 4 funded); next RFA will be released in Jan 2014  LOI required; future research/RFA may focus on strategies to minimize food waste
5. Discussion of W1003 and W2003 papers
Action item: Christine will follow up again with former grad student (Stephanie)
a. Main paper: Carol Boushey is working on revisions.
Action item: Christine will follow up with Carol
b. Knowledge paper (Carolyn): change (primary) focus of paper on relationship of calcium knowledge score (parents) and parent practices that relate to increased calcium intake in kids. Carolyn will work on the revise and resubmit of paper, most likely to Journal of Extension and Human Sciences
c. Acculturation paper (Mary): Mary will work to change focus of paper: food/beverage sources of calcium by race/ethnicity; journal possibility: International Journal of Child Health and Nutrition
d. Focus group paper (Rickelle): table for now; Rickelle will look at it at the beginning
e. Survey paper: Marla (1st author); core writing group: Rickelle, Jinan, Siew Sun, Carolyn, Paul
6. Discussion of WDC033 proposal (Mary)
_____________________________________________________________________________________
Day 3: 11-8-13, 8:30am-5:00pm
Attendees: Rickelle Richards, Jinan Banna, Marla Reicks, Mary Cluskey, Siew Sun Wong, Paul Johnston, Christine Bruhn, Carolyn Gunther, Scottie Misner, Kay Hongu, Charlotte Biltekoff
1. Review days agenda (Rickelle)
2. Break into small groups
a. Work on message revisions, survey design (Marla, Christine, Jinan)
b. Work on WDC003 proposal revisions (Mary, Charlotte)
c. Work on annual and terminal reports (Rickelle, Carolyn)
3. Reconvene to discuss message revisions and survey development
Action item: Carolyn will communicate suggested revisions to Alyson Flynn (graphic artist); survey development is on hold until this happens
4. Next annual meeting is tentatively scheduled for Hawaii in 2015, either the week of Mar 11-14 or week of Mar 18-21. Marla Reicks/Rickelle Richards will serve as chair/co-chair and Kay Hongu will serve as secretary.
5. 3 subcommittees will be formed: 1) W2003 wrap up (includes survey study): Marla (lead), Carolyn, Jinan, and Kay; 2) WDC003 revisions: Mary (lead), Siew Sun, Rickelle, Marla, Carolyn, Scottie; 3) Plan and organize 2015 annual meeting: Jinan (lead), Marla, Kay
6. Discuss WDC003 proposal: Issue/Justification due on Nov 15 2013; work on finalizing on Sat morning).
7. Regular monthly conference calls scheduled for 3rd Wed of the month from Jan 2013 to May 2013 (1pm ET).
_____________________________________________________________________________________
Day 4: 11-9-13, 830am-11am
Attendees: Rickelle Richards, Jinan Banna, Marla Reicks, Mary Cluskey, Siew Sun Wong
1. Work on Issue/Justification section of WDC003 proposal

Accomplishments

Objective 1: Segment parents into homogenous subgroups based on promotion of CRF to early adolescents.<br /> <br /> We identified three distinct parent subgroups based on parental factors associated with intake of CRF by early adolescents to serve as a basis for the development of tailored messages to motivate parents to promote intake of CRF. We conducted a quantitative segmentation study using questionnaire data from a cross-sectional convenience sample of 509 parents and their early adolescent children previously collected as part of W-1003 (years 2006-2007). The three parent CRF practice/perception segments included Dedicated-Milk Providers/Drinkers (49 %), Water Regulars (30 %) and Sweet-Drink-Permissive Parents (23 %). Dedicated-Milk Providers/Drinkers were somewhat older and more likely to be non-Hispanic White than other groups. Calcium intakes from all food sources, milk/dairy foods and milk only, and milk intakes, were higher among early adolescent children of Dedicated-Milk Providers/Drinkers compared with early adolescents of parents in other segments. Soda pop intakes were highest for early adolescents with parents in the Water Regulars group than other groups. Dedicated-Milk Providers/Drinkers scored higher on culture/tradition, health benefits and ease of use/convenience subscales and lower on a dairy/milk intolerance subscale and were more likely to report eating family dinners daily than parents in the other groups.<br /> <br /> The descriptive characteristics of these subgroups were presented to the W-2003 multistate partners at an annual meeting and used, in part, to inform the development of tailored messages to motivate parents to promote intake of CRF. We published these findings in a peer-reviewed publication as follows:<br /> <br /> Reicks M, Degeneffe D, Ghosh K, Bruhn C, Goodell S, Gunther C, Auld G, Ballejos M, Boushey C, Cluskey M, Edlefsen M, Misner S, Olson B, Richards R, Wong SS, Zaghhoul S. Parent calcium-rich-food practices/perceptions are associated with calcium intake among parents and their early adolescent children. Public Health Nutr. 2012;15(2):331-340.<br /> <br /> Objective 2: Explore motivations and/or perceived benefits and barriers underlying parental factors which include making CRF available, encouraging intake of CRF, setting expectations for beverage consumption, and role modeling intake of CRF to early adolescents.<br /> <br /> Eighteen Nominal Group Technique (NGT)/Focus Group (FG) sessions (n>6 participants in each session) and 5 FG only sessions (n<6 participants at each session) were conducted with Asian and Hispanic parents across 7 states (AZ, CA, HI, MN, OH, OR, UT), generating information about parental perceptions of motivators, benefits and barriers underlying factors in making calcium-rich foods (CRF) available, encouraging intake of CRF, setting expectations for beverage consumption, and role modeling intake of CRF to early adolescents. The total sample size was 156 and by script: availability (n=46); rules/expectations (n=52); role modeling (n=58). <br /> <br /> From the results of the NGT analysis, the top 3 perceived benefits were similar across parenting practices and race/ethnicity, and included: (1) providing emotional rewards for parents, (2) promoting childrens health, and (3) providing nutritional benefits for children. Facilitators and barriers of parental behaviors were identified through FG sessions. For setting expectations for children to consume calcium-rich beverages, the following barriers were identified: childrens dislike of CRF or preference for other beverages than milk; school, TV, or family member negatively influenced childrens food choices; inadequate financial resources; and parents unaware or have limited time to be concerned about childs diet. Parents expressed the following barriers in making CRF available: time or convenience; cost; availability and accessibility to CRF; and traditional cultural food patterns not including CRF. For role modeling intake of CRF, barriers identified by parents were: limited time to make balanced meals; limited financial resources; and childrens preferences for other foods besides CRF.<br /> <br /> Facilitators for parents setting expectations for children to consume CRF included decreasing competing factors that discourage children to consume CRF and helping children establish set routines or eating habits. For making CRF available, facilitators included combining CRF with other food items desirable to children, such as chocolate syrup; parents being knowledgeable about nutrition and eating CRF themselves; planning ahead; and establishing habits in the home. Facilitators for role modeling included making CRF easily accessible to children at home and start healthy habits with children when they are young. Collectively, the NGT and FG results were used as formative information about how messaging to parents should be developed, which was used to accomplish objective 3 of our project. <br /> <br /> Based on the NGT/FG findings, we currently have a paper under review in a peer-reviewed journal:<br /> Richards R, Reicks M, Wong SS, Gunther C, Cluskey M, Ballejos M, Bruhn C, Johnston NP, Misner S, Watters C. Identification of parental benefits derived from practices that promote intake of calcium-rich foods and beverages among early adolescent children. J Nutr Educ Behav., under review.<br /> <br /> Objective 3: Identify relevant messages and delivery methods that will motivate parents to promote CRF to early adolescents.<br /> <br /> Using data from previously conducted focus groups and with guidance from a professional marketing group, we prepared three creative briefs, one for each parent practice (availability, rules/expectations, role modeling), which served as the basis for designing the test messages. Test messages, which included both tag line phrases and accompanying graphics and rolled into the form of a poster, were developed by graphic design and marketing experts at Washington State University and Ohio State University. For each parent practice, examples of emotion- and fact-based tests messages were developed to test the differential effectiveness of each type of message. The group developed a protocol for message testing via individual interviews. Data collection occurred in 6 states: CA, HI, OH, OR, MN, UT. Results from the interviews were processed, synthesized and the messages that participants responded most favorably to were selected for use in future online survey study, which will allow quantification of responses to the messages by the target audience. Note: messages are currently undergoing revisions by a graphic arts/marketing specialist to make adjustments according to participant feedback. Once this process is complete, the survey study will be initiated.<br />

Publications

1. Cluskey M, Auld G, Edlefsen M, Zaghloul, S, Bock MA, Boushey CJ, Bruhn C, Goldberg D, Misner S, Olson B, Reicks M, Wang C. Calcium knowledge, concern, and expectations for intake among parents of Asian, Hispanic, and non-Hispanic white early adolescents. The Forum for Family and Consumer Issues. Winter 2008;13(3). http://ncsu.edu/ffci/publications/<br /> <br /> 2. Edlefsen M, Reicks M, Goldberg DL, Auld, GW, Bock A, Boushey CJ, Bruhn CM, Cluskey M, Misner SL, Olson BH, Wang C, Zaghloul S. Strategies of Asian, Hispanic, and non-Hispanic White parents to influence young adolescentsintake of calcium-rich foods, 2004 and 2005. Preventing Chronic Disease 2008;5(4) October. http://www2.cdc.gov/pcd/issues/2008/oct/07_0174.htm<br /> <br /> 3. Cluskey M, Edlefsen M, Olson B, Reicks M, Goldberg DL, Auld, GW, Bock A, Boushey CJ, Bruhn CM, Misner SL, Olson BH, Wang C, Zaghloul S. At home and away-from-home eating patterns influencing preadolescentsintake of calcium rich foods as perceived by Asian, Hispanic and non-Hispanic White parents. J Nutr Educ Behav. 2008;40:72-79.<br /> <br /> 4. Cluskey M, Auld G, Edlefsen M, Zaghoul S, Bock A, Boushey C, Bruhn C, Misner S, Olson B, Reicks M, Zaghoul, S. Calcium knowledge, concern and expectations for intake among parents of Asian, Hispanic and Non-Hispanic White early adolescents. The Forum for Family and Consumer Issues. 2008;13(3). http://ncsu.edu/ffci/publications/<br /> <br /> 5. Olson, BH, Chung, KR, Reckase, M, Schoemer, S. Parental Influences on Dairy Intake in Children, and their Role in Child Calcium Fortified Food Use. J Nutr Educ Behav. 2009;41(1):53-7.<br /> <br /> 6. Reicks M, Ballejos M, Goodell LS, Gunther C, Richards R, Wong SS, Auld G, Boushey C, Bruhn C, Cluskey M, Misner S, Olson B. Zaghhoul S. Individual and family correlates of calcium-rich food intake among parents of early adolescent children. J Am Diet Assoc. 2011;111(3):376-84.<br /> <br /> 7. Reicks M, Edlefsen M, Goodell LS, Gunther C, Richards R, Wong SS, Auld G, Boushey C, Bruhn C, Cluskey M, Misner S, Olson B. Zaghhoul S. Individual and family correlates of calcium-rich food intake among parents of early adolescent children. J Am Diet Assoc. 2011;111:376-384.<br /> <br /> 8. Roth-Yousey, LL. A parent-early adolescent intervention to reduce sweetened beverage consumption through home environment parenting practices. University of Minnesota Dissertation, 2011. http://purl.umn.edu/120010<br /> <br /> 9. Reicks M, Degeneffe D, Ghosh K, Bruhn C, Goodell LS, Gunther C, Auld G, Ballejos M, Boushey C, Cluskey M, Misner S, Olson B, Wong S, Zaghloul S. Parent calcium-rich-food practices/perceptions are associated with calcium intake among parents and their early adolescent children. Public Health Nutr. 2012;15(2):331-340.<br /> <br /> 10. Cluskey M, Petersen R, Wong SS. Language and Dietary Adaptation among Hispanic Immigrants. The Forum for Family and Consumer Issues, submitted August, 2013.<br /> <br /> 11. Stephanie Ann Jensen. 2012. Factors Influencing Consumer Food Choices: Exploring Individual and Environmental Influences with Qualitative and Quantitative Approaches. PhD Dissertation, University of California, Davis.<br /> <br /> 12. Peterson R. A Qualitative Study of the Dietary Acculturation among Long-term Hispanic Immigrants. Oregon State University Masters Thesis, June, 2013.<br /> 13. Richards R, Reicks M, Wong SS, Gunther C, Cluskey M, Ballejos M, Bruhn C, Johnston NP, Misner S, Watters C. Identification of parental benefits derived from practices that promote intake of calcium-rich foods and beverages among early adolescent children. J Nutr Educ Behav., under review.<br /> <br /> 14. Cluskey M, Wong SS, Ballejos M, Reicks M, Richards R, Auld G, Boushey C, Bruhn C, Misner S, Olsen B, Zaghloul S. Dietary sources of calcium among parents and their early adolescent children in the United States by parent race/ethnicity and place of birth. J Immigr Minor Health, under review.<br /> <br /> Abstracts<br /> 1. Glas JL, Boushey CJ, Auld GW, Bruhn CM, Cluskey M, Edlefsen M, Misner S, Olson B, Reicks M. Development of a tool to identify psychosocial factors associated with consumption of calcium rich foods among parents of early adolescent. J Am Diet Assoc 2007; (suppl):A13. <br /> <br /> 2. Roth-Yousey L, Asche K, Schroeder M, Reicks M. Assessment of parent and child perceptions of rules and expectations regarding beverage intake. FASEB J. 2008 22:44.2.<br /> <br /> 3. Reicks M, Ballejos M, Wong SS, Boushey C, Bruhn C, Cluskey M, Misner S, Olson B. Individual and family correlates of calcium intake in parents of early adolescent children. International Society for Behavioral Nutrition and Physical Activity Annual Meeting, Minneapolis, MN, June 2010.<br /> <br /> 4. Siew Sun Wong, Carolyn Gunther, Marla Reicks, Rickelle Richards, Christine M Bruhn, Mary Cluskey, Scottie Misner, Corilee Watters, Miriam Bellajos. Perceptions of Key Parental Benefits from Practices that Promote Intake of Calcium-Rich Foods and Beverages (CRF/B) in Preadolescent Children. Experimental Biology Annual Meeting. San Diego, CA, April 2012.<br /> <br /> 5. Reynolds A, Gunther CW. (2012) Perceptions of benefits underlying key parent practices that promote intake of calcium rich foods and beverages in early adolescent children. Poster presentation, Ohio State University, Denman Research Forum and Russell Klein Symposium, Columbus, OH.<br /> <br /> 6. Gunther C, Banna J, Bruhn C, Cluskey M, Wong SS, Richards R, Reicks M. Development and testing of fact- and emotion-based messages to motivate parents to engage in practices that promote intake of calcium among 10-13 year-old children. Experimental Biology Annual Meeting. San Diego, CA, April 2014.<br />

Impact Statements

1. Through this project, W-2003 Multistate partners gained a better understanding of attitudes and perceptions regarding parental practices associated with CRF intakes of early adolescents, which allowed for the development and testing of tailored messages. Information from this project may be used to design more effective osteoporosis prevention programs among families with early adolescents, and will serve as the basis for future research by this team.

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