W2003: How to motivate parents to promote intake of calcium rich foods among early adolescents
Statement of Issues and Justification
Need and importance Osteoporosis, a disease of the elderly, is most commonly connected to calcium; however it is not generally regarded as a childhood disease. Yet, the origins of osteoporosis putatively occur at the much younger age of 10 to 13 years during the period of peak bone acquisition. Many of the nutrition messages directed at improving intakes of calcium focus on picking a certain number of calcium rich foods (CRF) per day, e.g., the 3-A-Day campaign. The Dietary Guidelines 2005 and MyPyramid point to meeting recommended servings. Parents and caregivers are a dominant influence on eating and activity behaviors of early adolescents and therefore play an essential role in preventing osteoporosis by promoting intake of CRF. However, few messages about improving CRF intake among early adolescents are directed to the parents role. Little is known about what the content of these messages should be, how they would be perceived, and whether they would motivate parents to promote CRF to early adolescents. Key messages could address motivation and/or benefits to behavior change, barriers and strategies to enable parents to promote CRF intake among early adolescents.Previous research from W-1003 identified several relevant factors that positively influenced early adolescents consumption of CRF. Availability of CRF, parental encouragement and expectations regarding beverage consumption, and role modeling were important parental and child-related factors. Some of the same factors have even been shown to be associated with bone mass in early adolescent girls. Therefore, research is needed to develop, test, and measure the effectiveness of messages based on these factors that motivate parents to promote early adolescents consumption of CRF.
Given that little has been done to determine which messages would resonate with parent audiences regarding their role in promoting intake of CRF for their children, we propose to fill this void through qualitative methods. Risk communication literature and social marketing concepts indicate that behavior change involves understanding perceptions and motivations concerning the behaviors of interest. Qualitative research methods provide data that can only come from the persons engaged (or failing to engage) in the behaviors. Understanding whether parents perceive that their child is susceptible to risk from consuming diets low in CRF as well as the belief systems that influence those perceptions are needed to craft messages and develop programming that will motivate parents to change behavior.
Based on the results of focus groups and open-ended interviews that utilize projective techniques, we will first explore parental motivations underlying the factors that influence CRF intake of early adolescents identified in W-1003. Second, we will identify salient actionable messages for use with parents and develop these ideas for message testing. Through testing, we will assess the potential relevance, acceptance, comprehension and potential impact of the pre-determined messages related to making CRF available, encouraging CRF intake, setting expectations regarding beverage consumption, and role modeling intake of CRF. Testing to evaluate the pre-determined messages will also involve projective techniques in conjunction with focus group and individual interviews. In addition, we will clarify preferred education methods and delivery means. Understanding what messages are credible and compelling to parents will inform and guide our future development of a directed nutrition intervention that would be quantitatively evaluated.
Technical feasibility of the research and advantages for doing the work as a multistate effort The qualitative methods proposed for this project have been used previously by the researchers both in their own individual projects and collectively in this on-going multi-state effort (W-191, W-1003). In our experience, individual and focus group interviews are inexpensive data collection methods with recruitment and compensation accomplished easily. This approach has been successful in part because we have access to diverse populations through the Extension service and access to community locations and university buildings to conduct interviews with the populations of interest. In our previous projects, we have been able to recruit large sample sizes including participants from our targeted race/ethnic groups based on access in particular geographic regions. With several experienced nutrition educators, development of messages is feasible; however, expertise will be recruited to enhance the team relative to marketing approaches.
The collaborative efforts of a cohesive group produce high quality research outcomes. Working as an experienced team, this project will benefit from the diverse strengths each investigator brings to the research questions. No single state has the breadth of expertise provided by the collective group. Researchers involved in this proposal possess a wide range of expertise which is directly relevant to the project. Researcher expertise includes consumer behavior and consumer economics, specifically factors that lead to attitude changes as well as identification and evaluation of nutrition-related attitudes and beliefs. Many of the researchers have been involved in developing nutrition education materials and outreach efforts for a variety of audiences (children, adults, minorities, etc.) and have worked in the field with maternal, child and adolescent nutrition programs serving ethnically diverse audiences including Southeast Asians and Mexican Americans. There is shared expertise in work with underrepresented groups with project experience in Hispanic and Asian health and nutrition issues. Several of the researchers have expertise in using both quantitative and qualitative research methods, program evaluation as well as nutritional epidemiology, dietary assessment and analysis and theory-based behavior change interventions.
Several members of the research team have formal appointments as specialists in Cooperative Extension. The remaining members work closely with faculty and staff in Extension in their home states, through research and intervention/outreach projects, so that access to Extension audiences as described in the proposal is feasible and reasonable. A multistate perspective will provide greater abilities to recruit a wide representation of the sample population, which is not feasible for groups working within a more narrow geographic reach. Studying a population from multiple states with diverse demographic characteristics will provide a rich database from which to identify motivations and test messages based on factors that may promote intake of CRF by early adolescents.
Expected impacts We expect that this project will result in: a) A better understanding of the underlying motivations and/or perception of benefits and barriers for parental factors that influence intake of CRF by early adolescent Asian, Hispanic and non-Hispanic white children. These factors include making CRF available, encouraging intake of CRF, setting expectations for beverage consumption, and role modeling intake of CRF. b) A set of messages based on this understanding that are relevant, convey what is intended, culturally appropriate, and likely to impact parental factors that influence intake of CRF by early adolescent children, c) Tested key components for a future osteoporosis prevention program for parents including messages and information about preferred delivery methods and channels.
Back to Top