Annual/Termination Reports:

[12/17/2002] [12/22/2003] [01/11/2006] [01/11/2007] [01/07/2008]

Report Information

Participants

Auld, Garry (auld@cahs.colostate.edu)-Colorado State University;
Bock, Ann (abock@nmsu.edu)-New Mexico State University;
Boushey, Carol (bousheyc@cfs.purdue.edu)-Purdue University;
Bruhn, Christine (cmbruhn@ucdavis.edu)-University of California, Davis;
Edlefsen, Miriam (medlefsen@wsu.edu)-Washington State University;
Jacobs, Jim (jjj@uwyo.edu)-University of Wyoming-Administrative Advisor;
Jensen, Keith (slfj3@cc.usu.edu)-Utah State University;
Misner, Scottie (misner@ag.arizona.edu)-University of Arizona;
Olson, Beth (olsonbe@msu.edu)-Michigan State University;
Weese, Jean (jweese@aces.edu)-Auburn University;
Welsh, Susan (swelsh@csrees.usda.gov)-CSREES Representative

Brief Summary of Minutes

This year‘s meeting focused on the termination of W-191 and the implementation of the new project W-1003. The discussion of W-191 centered on the summary and analysis of data and publications to report results of the project. Part of the meeting was devoted to the implementation of W-1003. During this part of the meeting, policies and rules to be followed during the project were reviewed and established, a Recruitment document was drafted for the project, an Interview document was drafted, and a group worked on calcium supplement and fortified foods. To complete the various tasks associated with this research project, a projected time line was established for the coming year and interview assignments were established for each of the participating states. The next meeting of W-1003 will be October 1-4,2002 at Colorado State University.

Accomplishments

Multi-million dollar grant: The multi-state relationships established through W-191 and the new knowledge generated by the project formed the basis of a $3.75 million grant awarded through USDA&lsquo;s IFAFS (Initiative for Future Agriculture and Food Systems) for a four-year project entitled "Improving Bone Health in Adolescence Through Targeted Behavioral Intervention."<br /> <br><br /> <br>New research tools:<br /> <br><br /> <br>In developing and validating a calcium-specific food frequency questionnaire for Asian-, Caucasian-, and Hispanic-American adolescents, the W-191 research team has made available a unique tool for their use as well as by other researchers and practitioners interested in assessing calcium intake among youth.<br /> <br><br /> <br>Based on the project&lsquo;s focus group research, the team has also developed and tested the reliability of a motivator/barrier questionnaire to assess factors that serve to encourage or discourage intake of calcium-rich foods by Asian-, Caucasian-, and Hispanic-American youth. This one-of-a-kind tool will also be useful to other researchers and practitioners.<br /> <br><br /> <br>A deeper understanding of and appreciation for diversity: Most studies on calcium intake of adolescents have failed to address ethnic differences. This likely has led to under reporting of calcium intake among minority youth. In contrast, W-191 seeks to accurately assess calcium intake by Asian-, Caucasian-, and Hispanic-American adolescents, being cognizant of and sensitive to similarities and differences among these three ethnic/racial groups. (The project focuses on these three groups because they face a higher risk of developing osteoporosis.)

Publications

Auld, G., Bock, M.A., Boushey, C., Bruhn, C., Gabel, K., Gustafson, D., Holmes, B., Misner, S., Novotny, R., Peck, L., Pelican, S., Pond-Smith, D. Read, M. 2002. Perspectives on intake of calcium rich foods among Asian, Hispanic and white preadolescent and adolescent females. Journal of Nutrition Education and Behavior, 34:242-251.<br /> <br><br /> <br>Gabel, K., Auld, G., Bock, M.A., Boushey, C., Bruhn, C., Gustafson, D., Holmes, B., Misner, S., Novotny, R., Peck, L., Pelican, S., Pond-Smith, D., Read, M., Wolfe, F. 2002. Relationship of gender to motivators and barriers of drinking milk by adolescents - results from focus groups. Journal of Adolescent Health.<br /> <br><br /> <br>Read, M., Novotny, R., Auld, G., Bock, M.A., Bruhn, C., Gabel, K., Gustafson, D., Holmes, B., Peck, L., Pelican, S., Pond-Smith, D., Wolfe, F.H. 2002. Age differences in milk consumption as a snack and by eating location. Topics in Clinical Nutrition, 17(4):55-62.<br /> <br><br /> <br>Novotny, R. Boushey, C., Bock, M.A., Peck, L., Auld, G., Bruhn, C., Gustafson, D., Gabel, K., Jensen, J.K., Misner, S., Read, M. 2002. Calcium Intake of Asian, Hispanic and white youth. Journal of the American College of Nutrition.

Impact Statements

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Report Information

Participants

Auld, Garry (auld@cahs.colostate.edu)-Colorado State University;
Bock, Ann (abock@soil-physics.nmsu.edu)-New Mexico State University;
Boushey, Carol (bousheyc@cfs.purdue.edu)-Purdue University;
Bruhn, Christine (cmbruhn@ucdavis.edu)-University of California, Davis;
Edlefsen, Miriam (medlefsen@wsu.edu)-Washington State University;
Goldberg, Dena (denagold@uwyo.edu)-University of Wyoming;
Cluskey, Mary (cluskeym@oregonstate.edu)-Oregon State University;
Misner, Scottie (misner@ag.arizona.edu)-University of Arizona;
Olson, Beth (olsonbe@msu.edu)-Michigan State University;
Reicks, Marla (mreicks@umn.edu)-University of Minnesota;
Wang, Chang (wangl@mis.net)-Kentucky State University;
Yang, Jimin (yang23@purdue.edu)-Purdue University;
Zaghloul, Sahar (zaghloul@hawaii.edu)-University of Hawaii

Brief Summary of Minutes

The focus of the meeting centered on the Calcium Intensive Interviews being conducted by members of project W-1003, with emphasis on data collection and analysis. The group also discussed completing the analysis of data and publications for W-191. There was a presentation on writing impact statements by Mike Harrington, Executive Director for the Western Region Agricultural Experiment Stations. Impacts of W-191 and W-1003 were discussed and the group agreed to develop a regional impact statement that will be submitted to the Western Region. To provide leadership on the various tasks associated with W-1003, four committees were established to focus on the following topics; Adult scale to develop a draft of MBQP; Analysis of Interviews; Education Strategies; and Food Frequency for Adults. The data from W-1003 will be analyzed at a single location and three states will provide cost estimates for conducting the survey analyses. A timeline was established for completing tasks during the coming year. The next meeting of W-1003 will be in late October of 2004 at the University of Minnesota.

Accomplishments

Theme: Healthy Society<br /> <br><br /> <br>Issue: Kids calcium intake is well below the 1300 mg Adequate Intake level for calcium set by the Institute of Medicine. Recent data from the USDA&lsquo;s Continuing Survey of Food Intakes by Individuals estimated the mean calcium intake of girls aged 6-11 years to be 865 mg/day, whereas girls aged 12-19 years were consuming an average of 773 mg/day. While boys generally consume more calcium, data indicate that 6-11 year olds consume 984 mg/day and 12-19 year olds consume 1,145 mg/day, they still do not get a sufficient level of calcium. Research suggests that peak bone density can occur as early as age 16 for the hip and the early mid-twenties for other bones. Thus, during this time of maximum bone growth, the children of America are not consuming sufficient calcium to reach peak bone mass; potentially leaving them vulnerable to osteoporosis later in life.<br /> <br><br /> <br>Osteoporosis is the most readily identifiable health issue associated with inadequate calcium intake and is responsible for more than 1.5 million fractures annually. The health care costs associated with osteoporosis are estimated at $13.8 billion per year for osteoporotic-related fractures alone. One in three women and one in eight men 50 years and older will experience an osteoporotic-related fracture in their lifetime. An average of 24% of hip fracture patients 50 years and older die in the year following fracture and hip fracture is more likely than heart attack, stroke, and/or cancer to lead to functional impairment.<br /> <br><br /> <br>Resolution: In a prior project (W-191), this group worked with schools and separate focus groups of boys and girls to learn about calcium intake. Results were used to develop a food frequency and motivation/barrier questionnaire for multicultural kids to learn about kids calcium intake. Questionnaires specific to calcium in the diet had not been available for kids prior to this study. The members of W-1003 are now finding out how parents and household factors influence calcium intake in teens. Based on results, interventions will be developed to prevent osteoporosis in later life.

Publications

Jensen, J.K., Gustafson, D., Boushey, C., Auld, G., Bock, M.A., Bruhn, C., Gabel, K., Misner S.,Novotny, R., Peck, L., Read, M. (In press). Development of a food frequency questionnaire to measure calcium intake among multi-ethnic youth. Journal of the American Dietetic Association.<br /> <br> <br /> <br>Gabel, K., Auld G., Bock, M.A., Boushey, C., Bruhn, C., Gustafson, D., Holmes, B., Misner S., Novotny, R., Peck, L., Pelican, S., Pond-Smith, D., Read, M., Wolfe, F. (In press). Relationship of gender to motivators and barriers of drinking milk by adolescents - results from focus groups. J. Adolescent Health.<br /> <br><br /> <br>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.

Impact Statements

1. This group has developed information on what motivates or prevents kids from eating foods high in calcium and used this to increase calcium intake among Asian, Hispanic, and White youth. In this new effort, both parents as well as kids will be surveyed to learn how parents or the household influence the kids' calcium intake. From this information, the members of W-1003 will design nutrition messages that will increase dietary calcium intake.

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Report Information

Participants

Auld, Garry (auld@cahs.colostate.edu)  Colorado State University;
Boushey, Carol (boushey@purdue.edu)  Purdue University;
Bruhn, Christine (cmbruhn@ucdavis.edu)  University of California Davis;
Cluskey, Mary (cluskeym@oregonstate.edu)  Oregon State University;
Edlefsen, Miriam (medlefsen@wsu.edu)  Washington State University;
Misner, Scottie (misner@ag.arizona.edu)  University of Arizona;
Olson, Beth (olsonbe@msu.edu)  Michigan State University;
Reicks, Marla (mreicks@umn.edu)  University of Minnesota;
Zaghloul, Sahar (zaghloul@hawaii.edu)  University of Hawaii at Manoa;
Jacobs, Jim (jjj@uwyo.edu)  University of Wyoming;

Brief Summary of Minutes

A major agenda item at this year's annual meeting was reviewing results from the survey polite test. Main items of discussion were development of the polite-test survey questions, the Principle Components Factor Analysis and development of proposed scales. After this discussion, considerable time was devoted to revising the parent survey and establishing a timeline for pilot testing the survey and for states to conduct the survey. Recruitment of subjects and administration of the survey received considerable discussion at the meeting. Another significant item discussed at the meeting was development of a revised project proposal and a request for an extension of the existing project because of the time needed to develop the adult MBQ. In particular, pilot testing indicated the modifications were needed before continuing with the survey. The group also devoted time to work on existing papers and to review proposed papers from research being conducted by W-1003.

The Chair and Reporter of W-1003 for next year are Miriam Edlefson and Mary Cluskey, respectively. The date and location selected for next year's meeting is November 8-11, 2006 in Tucson, AZ.

Accomplishments

During this past year members of W-1003 focused on the development of the parent MBQ survey and pilot testing that survey. Results of that pilot test indicated that some modifications were needed before the continuing with the collection of data. Those modifications were made during the committees annual meeting.<br /> <br /> Obtaining sufficient calcium during adolescence helps ensure adequate mineralization of the skeleton to ensure bone health later in life. National dietary intake data show that preadolescent children (10-13 years of age) are only getting about 60-80% of the calcium recommended. Research suggests that peak bone density can occur as early as age 16 for the hip and the early mid-twenties for other bones. Inadequate calcium intake during this critical transition period may increase the risk for osteoporosis later in life. Ten million individuals are estimated to have osteoporosis in the US while almost 34 million more are estimated to have low bone mass. In 2005, it was projected that the economic burden of incident osteoporotic fractures would be almost $17 billion and $209 billion over the next decade. Half of Americans older than 50 years will experience an osteoporotic-related fracture in their lifetime. This multistate project is actively examining parental factors such as knowledge, attitudes, behaviors, and environment and their influence on calcium intake of children in early adolescence from race/ethnic groups most at risk for osteoporosis. During the past year, a parent motivator-barrier questionnaire (MBQ-P) was developed and tested to identify parental influences on child intake of calcium-rich foods. Cognitive-pretesting of questionnaire items was completed by 7 states with 32 parents. Pretest results were used to revise questionnaire items prior to pilot-testing. For the pilot-test, parents completed questionnaires on two occasions to establish test-retest reliability. Parent/child pairs also completed questionnaires under the same conditions projected for the final implementation of the survey. Pilot-test data from 124 parents were collected from 9 states and results were used to make significant changes to the draft questionnaire requiring another round of pilot-testing. Principal component analysis will assess the internal validity of the psychosocial scales identified by the parental questionnaire. Experts will review the questionnaire to establish construct validity. Revisions will be made to the MBQ-P based on pilot testing results prior to final implementation of the survey. Qualitative interview data collected in the past project year were also analyzed. Coded transcript segments were sorted using NVIVO software. Segments were analyzed using thematic content analysis procedures regarding influences of parental role modeling, expectations and meal patterns on calcium intake of preadolescent children. Results showed that regular meal patterns provided adequate opportunity for children to consume calcium-rich foods; however, snack foods often did not include calcium-rich foods. Most parents reported eating calcium-rich foods and drinking milk, thereby acting as role models for children. Parent-child conversations about food and health focused on the need to moderate or increase intake of specific foods such as milk. Parents used various strategies to help children eat healthy foods but had few expectations for children to eat specific foods or to drink milk with meals.

Publications

Curtis, C.S. Parent and Household Influences on Calcium Intake in Preadolescent Children in Arizona. MS Thesis. The University of Arizona. 163 pp. 2005.<br /> <br /> 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.<br /> <br /> Reicks, M., Goldberg, 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.<br /> <br /> Schoemer, S.L. Parental Influences and Their Role in Supplement and Calcium-Fortified Food<br /> Use in Preadolescents. MS Thesis. Michigan State University. 172 pp. 2005.<br /> <br /> Schoemer, S.L., Reckase, M.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.<br /> <br /> Steward, E. Familial Influence(s) on Preadolescent Milk Consumption in Asians and Hispanics. MS Thesis. University of California, Davis. 2005.<br /> <br /> Vue, H. Individual and Environmental Influences on Intake of Calcium-Rich Foods by Hmong Preadolescent Girls. MS Thesis. University of Minnesota. 143 pp. 2005.<br /> <br /> 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.<br /> <br /> Yang, J., Olson, B., Wang, C., W1003 Investigators, and 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):A428.

Impact Statements

1. This project will provide information to design effective, tailored, osteoporosis prevention programs based on improving calcium intake by early adolescents. This project focuses on Asian, Hispanic, and non-Hispanic White subgroups at highest risk for osteoporosis during the critical transition period in the lifecycle for bone growth.
2. This project will add to the limited information available on parental factors that influence calcium and dietary intake of Asian, Hispanic, and non-Hispanic preadolescent children. This information is also applicable to other health-related behaviors such as those involved in the development of overweight and obesity.
3. This project developed a tested instrument that assesses parental influence on eating behaviors of preadolescent children and has been shared with other researchers via publications and presentations.

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Report Information

Participants

Auld, Garry (auld@cahs.colostate.edu)  Colorado State University
Boushey, Carol (boushey@purdue.edu)  Purdue University
Bruhn, Christine (cmbruhn@ucdavis.edu)  University of California, Davis
Cluskey, Mary (cluskeym@oregonstate.edu)  Oregon State University
Edlefsen, Miriam (medlefsen@wsu.edu)  Washington State University
Goldberg, Dena (dgoldberg@carilion.com)  University of Wyoming
Misner, Scottie (misner@ag.arizona.edu)  University of Arizona
Olson, Beth (olsonbe@msu.edu)  Michigan State University
Reicks, Marla (mreicks@umn.edu)  University of Minnesota
Wang, Chang (changzheng.want@kysu.edu)  Kentucky State University
Wong, Siew Sun (siewsun@cc.usu.edu)  Utah State University
Zaghloul, Sahar (zaghloul@hawaii.edu)  University of Hawaii

Brief Summary of Minutes

A major focus of this annual meeting was discussing survey collection methods, and planning future projects for the multi-state research group. Main items of discussion included pilot test results for the parent motivator-barrier questionnaire with analysis completed at Purdue University. The findings included mean scores on psychosocial scales and correlations between parent and child responses. The timeline for completing the project was reviewed and slightly modified. Representatives from states discussed their efforts (successful and unsuccessful) for recruiting and administering parent and child surveys, such as: which groups to contact, methods for contacting various community groups, and compensation for participation. A discussion took place about how to complete Phase IV of the current project  the development of key communication/education strategies  resulting in several plans and goals. Data entry and preliminary analysis of 166 completed survey pairs was reviewed. A new proposal for the next 5-year multi-state project was discussed, based on results from the data analyzed so far, and future paper topics were anticipated and working groups assigned.

The Chair and Reporter of W1003 for next year are Mary Cluskey and Scottie Misner, respectively. The date for next years meeting is Nov. 7 - 10, 2007 in Spokane, WA.

Accomplishments

Osteoporosis is the single most recognizable health issue identified with inadequate calcium intake. Approximately 10 million individuals are estimated to have osteoporosis in the United States, with almost 34 million individuals having low bone mass. Each year, more than 1.5 million 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. The economic burden of these fractures was projected to be $17 billion in 2005. <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-1003 project is focused on developing a tool to identify how parental and household factors  such as parental knowledge, attitudes, behaviors, and environment - influence calcium intake in early adolescents from race/ethnic groups most at risk for osteoporosis. The project also utilizes a survey developed by a previous multi-state research project (W-191), looking specifically at early adolescent perceptions of calcium-rich foods. Both survey tools provide a more complete picture of factors affecting the calcium intake of early adolescents and their families. <br /> <br /> During the past year, members of W-1003 focused on the finalization of the Parent Motivator Barrier Questionnaire (MBQ) survey. Principal component analysis was completed to assess the internal validity of the psychosocial scales identified by the parental questionnaire. Expert review of the questionnaire was completed to establish construct validity. Survey questions and format were finalized, and the survey tool was printed and distributed to all participating members for data collection. Researchers in all participating states began the process of recruiting subjects from various groups within their communities. Approximately 166 parent and child survey pairs were distributed, filled out, and collected in Hawaii, Oregon, and Washington. These survey pairs were scanned, and preliminary analysis of the results indicate that some modifications in the scanning software program are needed before further surveys are scanned for data analysis. In addition to data collection, three articles have been submitted to peer-reviewed journals for publication, based on data from the qualitative interviews. Two additional articles are at different stages of completion, and should be submitted for publication during 2007.<br /> <br /> A timeline for data collection and analysis was outlined during the annual meeting. The goal for completing survey collection is May, 2007. Data analysis will take place during summer months (June through August), so that papers can be started during September through November, 2007. In addition to data collection and analysis, the group will also continue the process (started at the annual meeting) of developing and fleshing out the next 5-year multi-state project goals, objectives and methods.<br />

Publications

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 based on parental roles to influence intake of calcium-rich foods by Asian, Hispanic, and non-Hispanic white early adolescents. Submitted to the Journal of the American Dietetic Association<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. Submitted to the Journal of Nutrition Education and Behavior<br /> <br /> Auld, GW, Diker A, Bock A, Boushey CJ, Bruhn CM, Cluskey M, Edlefsen M, Goldberg DL, Misner SL, Olson BH, Reicks M, Wang C, Zaghloul S. A decision tree to determine appropriateness of NVivo® in analyzing qualitative data sets. Journal of Nutrition Education and Behavior In press. <br /> <br /> <br /> <br />

Impact Statements

1. " The team has developed and tested the reliability of a MBQ to assess parental and household factors that encourage or discourage intake of calcium-rich foods by Asian, Hispanic and non-Hispanic White early adolescents. This unique tool will also be useful to other researchers and practitioners, and has been disseminated to others through presentations and publications.
2. " Data are being collected on parental and household factors that potentially influence calcium intake of Asian, Hispanic and non-Hispanic White preadolescents. 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 factors influencing 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 examine more completely family and household influences on early adolescents dietary and calcium intake.

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Report Information

Participants

Auld, Garry (auld@cahs.colostate.edu)  Colorado State University
Boushey, Carol (boushey@ purdue.edu)  Purdue University
Bruhn, Christine (cmbruhn@ucdavis.edu)  University of California, Davis
Cluskey, Mary (cluskeym@oregonstate.edu)  Oregon State University
Edlefsen, Miriam (medlefsen@wsu.edu)  Washington State University
Misner, Scottie (misner@ag.arizona.edu)  University of Arizona
Olson, Beth (olsonbe@msu.edu)  Michigan State University
Reicks, Marla (mreicks@umn.edu)  University of Minnesota
Wong, Siew Sun (siewsun@cc.usu.edu)  Utah State University
Zaghloul, Sahar (zaghloul@hawaii.edu)  University of Hawaii

Brief Summary of Minutes

A major focus of this annual meeting was discussing the analysis of the survey data collection; interpretation of results and the finalization of the future project proposal for the multi-state research group. The main items of discussion included scales and correlation results based on preliminary data for the parent motivator-barrier questionnaire and food frequency data from parent child pairs. This analysis has been completed at Purdue University. The findings included mean scores on psychosocial scales and correlations between parent and child responses and relationships to calcium consumption. The timeline for finalizing all data collection and analysis was reviewed. Representatives from states discussed their efforts (successful and unsuccessful) for recruiting and administering parent and child surveys, and problems inherent in gathering this large data set. A discussion took place regarding submission and documentation of significant finding in the literature and in building on this project in the forthcoming project. New methodologies for exploring and understanding what motivates behaviors for the consumption of calcium rich food (CRF) intakes were discussed and the group integrated some new approaches into the proposal for the on-going project. A draft proposal for the next 5-year multi-state project was reviewed, based on results from the data analyzed so far, and future paper topics were anticipated and working groups assigned.

The Chair and Reporter of W1003 for next year are Christine Bruhn and Siew Sun Wong, respectively. The date for next years meeting is Nov 5-8, 2008 in Minneapolis, MN.

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-1003 project is focused on developing tools to identify how parental and household factors  such as parental knowledge, attitudes, behaviors, and environment - influence calcium intake in early adolescents from race/ethnic groups most at risk for osteoporosis. The project also utilizes a survey developed by a previous multi-state research project (W-191), looking specifically at early adolescent perceptions of calcium-rich foods. Both survey tools provide a more complete picture of factors affecting the calcium intake of early adolescents and their families. Based on the outcomes of the tools (from the w-1003 data), the upcoming project proposal will address determining how to influence the family and environmental related motivators and obstacles for the consumption of calcium rich foods. <br /> <br /> During the past year, members of W-1003 focused on the collection of data of the Parent Motivator Barrier Questionnaire (MBQ) survey and the previously validated food frequency instrument. Principal component and correlation analysis revealed psychosocial scales and how those scales correlate with calcium consumption among adolescents. All data analysis was not complete at the time of the annual meeting, and as the data set is complete, further analysis will be used to finalize the proposed model for calcium consumption. Researchers in all participating states participated in recruiting subjects from various groups within their communities. Data collection at the time of the annual meeting was approximately 60% of the data collection goals. These completed survey pairs were scanned, and preliminary analysis of the results indicate some directions for the predictive calcium consumption model. In addition to data collection, two additional articles have been submitted to peer-reviewed journals for publication, based on data from the qualitative interviews. 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 /> <br /> In addition to data collection and analysis, the group finalized the process (started at the annual meeting) of developing and approving for submission the next 5-year multi-state project goals, objectives and methods.<br />

Publications

1. Edlefsen M, Reicks M, Goldberg D, Auld G, Bock MA, Boushey CJ, Bruhn C, Cluskey M, Misner S, Olson B, Wang C, Zaghloul S. Asian, Hispanic, and non-Hispanic white early adolescents: Parental perspectives on strategies to influence intake of calcium-rich foods. Preventing Chronic Disease (in press)<br /> <br /> 2. 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 2007 (in revision) <br /> <br /> 3. Cluskey M, Edlefsen M, Olson B, Reicks M, Auld G, Bock A, Boushey C, Bruhn C, Goldberg D, Misner S, Yang C, Zaghoul S. At home and away from home eating patterns influencing pre-adolescents intake of calcium rich foods as perceived by Asian, Hispanic, and non-Hispanic parents. J Nutr Educ Behav (in press)<br /> <br /> <br /> 4. 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 /> Abstracts:<br /> <br /> 1. Glas JL, Boushey C, Auld GW, Bruhn M, 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 adolescents. To be presented at the American Dietetics Association Food and Nutrition Conference & Exposition, Philadelphia PA, September 30-October 2, 2007.<br /> <br /> <br />

Impact Statements

1. The team has gathered approximately 640 parent child pair surveys among Asian, non-Hispanic white and Hispanic adolescents. In some cases this data collection has been conducted as part of nutrition education activities for willing participants. This data will be unique in providing a model for prediction of calcium consumption based on familial and environmental factors.
2. Data are being collected on parental and household factors that potentially influence calcium intake of Asian, Hispanic and non-Hispanic White preadolescents. 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 factors influencing 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 as proposed will seek to explore methods to influence and motivate families in encouraging, role modeling and providing access to healthy foods for adolescents.

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