1. Osteoporosis Prevention Recognizing the Importance of Calcium Consumption at a Young Age Backgrounder: Melissa Raney Identifier: Noël Konken Evaluator: Nikki DeAngelis Manager: Leila Shinn

2. Outline  Needs and Prioritization  Previous Studies  Program Goals  Topics  Financial Planning  Behavior Theory: Stages of Change  Evaluation  Knowledge and SOC Survey Questions

3. Need and Prioritization Key Words: “Top Nutritional Concerns in America” Search Engine: Google  Choice #1: Calcium Intake Education for Adolescents  Choice #2: Type II Diabetes Prevention in Native Americans  Choice #3: Fiber Intake Education in Adults

4. Need and Prioritization  10 million Americans have osteoporosis, 18 million are at high risk of developing osteoporosis, and 34 million are at risk for osteopenia  By late adolescence, 90% of peak bone mineral density should be reached  Risk of bone fractures  Early diagnosis of osteoporosis  $500-8,600 per person saved in health care per year if preventative measures on osteoporosis are taken (NBCI)

5. Previous Studies  Based off of 6 similar studies  Often times, short term improvement was noted  Participants often times asked to keep a journal  Relies on self-reporting  Bone scans as a pre-test  Requires equipment, money, and trained staff  Implemented exercise in addition to calcium  Calcium often provided as a supplement

6. Program Goals 1.Identify calcium rich foods that include plant products as well as dairy products 2.Aim for 2-3 servings of calcium rich foods per day 3.Identify why calcium is an important mineral to consume at a young age

7. Topics Session 1Session 2Session 3Session 4 Lecture Movie on Osteoporosis The Importance of Calcium in the Diet Reading Food Labels The Importance of Physical Activity & Calcium Consumption Activity Pre-Test and Food Frequency Questionnaire Recognizing Calcium Rich Foods Identifying Calcium Rich Foods by Reading Food Labels Exercise Stations Handout Food Logs & Fact Sheet on Osteoporosis How/When to Include Calcium Rich Foods in Meals/Snacks & Examples of Calcium Rich Foods Instructional Food Label & Sample Grocery List Exercise Examples Component of SOC Pre-ContemplationContemplationPreparationAction

8. Financial Planning  Supplies Needed:  Handouts for education  Other educational materials (handouts, movies, etc.)  Food logs  Pre and post tests  Samples of different calcium rich foods  Projected Cost: $150

9. Behavior Theory: Stages of Change  Good model to use because it describes how people acquire a positive behavior, in our case regularly consuming calcium rich foods  Utilize survey responses to assess progress towards reaching the goals for our program

10. Behavior Theory: Stages of Change  Pre-Contemplation: Not concerned or aware of calcium intake  Contemplation: Early classes will raise awareness of the importance of calcium in the diet and the future, severe consequences of inadequate intake  Preparation: We will educate them on how to include more calcium in their diet and which foods are calcium rich  Action: Provide take-home resources to encourage behavior change  Maintenance: Only 4 sessions long – hard to prevent relapse. Have follow-up survey 3 months later to assess participant’s adherence

11. Evaluation  Formative Evaluation  Quantitative  Data from food frequency questionnaires  Qualitative  Personal interviews and focus groups

12. Evaluation  Summative evaluation  Pre and post-tests/surveys  Readability; clear, concise questions  Ranking-style Answers

13. Evaluation: Survey Questions  How many servings of dairy do you eat daily?  How many times a week do you eat broccoli, spinach, or collard greens?  Do you drink milk with lunch?  Do you consume yogurt or cheese on a regular basis?

14. Evaluation: SOC Survey Questions  How likely are you to exercise 5 or more days per week?  Do you believe you consume enough calcium on a daily basis?  How serious do you believe the health consequences of inadequate calcium consumption to be?  How confident are you that you can include a serving of dairy at breakfast?  How confident are you that you can include -3 servings of calcium rich foods per day in your diet?

15. Summary  Who?  Illinois Extension Educators to Teach Adolescents (12- 18)  What?  Importance of Calcium in Prevention of Osteoporosis  Where?  School  When?  Four sessions (45-60 minutes long) during class  How?  Related lectures, handouts, and activities  Why?  Prevalence of osteoporosis  Prevention starts now