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Behavioral Ecological Model


This study is designed to determine whether parent training is an effective means of increasing children's consumption of a high calcium diet and increase their strength and aerobic exercise in order to prevent osteoporosis as adults. Children (N=180) will be recruited sequentially. Males and females from different racial /ethnic backgrounds will be included. One child/family will serve as the unit of random assignment. A 2 x 2 x 4 random assignment, repeated measures design will be employed. Children and their parents will be divided into two groups. The experimental group will receive educational and support services for diet and exercise change in the target child (N=90). The control group will obtain similar training for child safety (N=90). Each of these conditions will be divided again at random into two subgroups: one (N=45) will obtain parent training concerning the target topic (i.e. safety or diet and exercise); the second (N=45) will obtain the same instruction plus episodic coaching. Training will require 9 weekly classes and will emphasize principles of behavior and contingency management techniques. Coaching procedures will be provided over 9 months and will assist parents with problem solving in order to refine and maintain parenting skills. Measures will be obtained 4 times, prior to parent training, at the end of parent training (3-months) and repeatedly through out the coaching period. Outcome measures will include 24-hour recall estimates of change in diet, and change in physical activity. These will be validated by objective outcome measures, including 1RM strength and VO2 max fitness measures. Using the state of the art DXA scans, total bone calcium, bone density and specific bone density will be obtained. Body composition will be assessed by DXA. Generalized estimating equations will be employed to estimate main effects, covariates, and interactions to test study hypotheses. Exploratory analyses will include assessment of hypothetical processes, such as parenting practices and child/parent interactions and mediating variables in achieving eating and exercise changes; in achieving changes in bone density. Results will inform clinical and educational procedures for prevention of osteoporosis in males and females from different racial ethnic backgrounds at risk for osteoporosis.

Principal Investigator: Mel Hovell, PhD, MPH

Project Coordinator: Katharine Schmitz, MPH (formerly Kristen Keating, PhD, MPH)

Funded 1999 - 2004

Source: National Institute of Child Health and Human Development


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