title: A randomized field trial for the primary prevention of osteoporosis among adolescent females: Comparison of two methods, mother centered and daughter centered.
abstract: BACKGROUND
  Osteoporosis is a serious public health. Since the majority of bone mass occurs during adolescence, primary prevention is important. Probably mother's participation in health education interventions leads to promote health behaviors in children.
  
  
  OBJECTIVE
  To assess a lifestyle modification intervention focused on mothers and students has an impact on osteoporosis preventive behaviors in adolescent girls.
  
  
  METHODS
  It is a randomized field trial in female high schools. 210 girls aged between 11 and 15 were randomly selected. Students in groups A and C and mothers in group B were selected Through the sampling frame. Our lifestyle modification was based on group based education in the public girls' high schools. Subjects in the intervention groups participated in three educational sessions. Students' osteoporosis preventive behaviors were measured by using a lifestyle questionnaire consisting of items assessing nutrition, physical activity and sun exposure. Repeated measure ANOVA at baseline, 4 week, 2 months and 6 months and were used to analyze the data.
  
  
  RESULTS
  After 1 month, diet and sun exposure scores increased significantly (P < 0.001) but it was higher in group B compared with group A. (About diet P < 0.001 and sun exposure = 0. 001). After 6 months, diet and sun exposure status in the group A approximately decreased to baseline, while in group B, diet components were significantly different compared to baseline (P < 0.001). There was no change in physical activity.
  
  
  CONCLUSIONS
  Osteoporosis prevention intervention of adolescent can be effective when parents or girls participate in training sessions, but education is associated with better outcomes when focused on mothers.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hourieh
authors.initials: H
authors.lastname: Ansari
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ziba
authors.initials: Z
authors.lastname: Farajzadegan
authors.affiliation: Department of Hematology-Oncology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Hajigholami
authors.affiliation: Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Zamzam
authors.initials: Z
authors.lastname: Paknahad
keywords: Community intervention; daughter centered; lifestyle; mother centered; osteoporosis; primary prevention