title: Parent/Child training to increase preteens' calcium, physical activity, and bone density: a controlled trial.
abstract: OBJECTIVE
  To test effects of parent/child training designed to increase calcium intake, bone-loading physical activity (PA), and bone density.
  
  
  METHODS
  Two-group randomized controlled trial.
  
  
  METHODS
  Family-based intervention delivered at research center.
  
  
  METHODS
  117 healthy children aged 10-13 years (58.1% female, 42.7% Hispanic, 40.2% White). Ninety-seven percent of participants had at least one parent graduate from high school and 37.2 % had at least one parent graduate from a 4-year university.
  
  
  METHODS
  Children and parents were randomly assigned to diet and exercise (experimental) or injury prevention (control) interventions. Children were taught in eight weekly classes how to engage in bone-loading PA and eat calcium-rich foods or avoid injuries. Parents were taught behavior management techniques to modify children's behaviors.
  
  
  METHODS
  Measures at baseline and at 3, 9, and 12 months included 24-hour diet and PA recalls, and bone mineral density (BMD) by dual-energy x-ray absorptiometry.
  
  
  METHODS
  Analysis of variance and generalized estimating equations (GEE) assessed group by time differences. Comparisons were conducted separately for boys and girls.
  
  
  RESULTS
  For boys, cross-sectional differences between experimental and control groups were achieved for 3- and 9-month calcium intake (1352 vs. 1052 mg/day, 1298 vs. 970 mg/day, p < .05). For girls, marginal cross-sectional differences were achieved for high-impact PA at 12 months (p < .10). For calcium intake, a significant group by time interaction was observed from pretest to posttest for the full sample (p = .008) and for girls (p = .006) but not for boys. No significant group by time differences in calcium were observed across the follow-up period. No group by time differences were observed for high-impact PA. Among boys, longitudinal group by time differences reached significance for total hip BMD (p = .045) and femoral neck BMD (p = .033), even after adjusting for skeletal growth. Similar differential increases were observed among boys for bone mineral content (BMC) at the hip (p = .068) and total body (p = .054) regions. No significant group by time interaction effects were observed for girls at any bone site for BMD. For BMC, control girls showed a significant increase (p = .03) in spine BMC compared to intervention girls.
  
  
  CONCLUSIONS
  This study demonstrated that parent/preteen training can increase calcium intake and attenuate the decline in high-impact PA. Results suggest that more powerful interventions are needed to increase activity levels and maximize bone mineral accrual during preadolescent years.
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California 92123, USA. mhovell@projects.sdsu.edu
authors.forename: Melbourne F
authors.initials: MF
authors.lastname: Hovell
authors.forename: Jeanne F
authors.initials: JF
authors.lastname: Nichols
authors.forename: Veronica L
authors.initials: VL
authors.lastname: Irvin
authors.forename: Katharine E
authors.initials: KE
authors.lastname: Schmitz
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rock
authors.forename: C Richard
authors.initials: CR
authors.lastname: Hofstetter
authors.forename: Kristen
authors.initials: K
authors.lastname: Keating
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Stark
mesh_terms: D000293:Adolescent; D015519:Bone Density; D002118:Calcium / Q000008:administration & dosage*; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006630:Hispanic or Latino / Q000193:education; D006801:Humans; D008297:Male; D010290:Parents; D044469:Racial Groups / Q000193:education; D012959:Socioeconomic Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000517:prevention & control
chemical_list: D002118:Calcium