Banking on Strong Bones Curriculum Promotes Behavior Change

Abstract

The curriculum is designed to increase knowledge/awareness of the role calcium-rich and weight-bearing activities play in building and maintaining strong bones among children and to improve food and beverage choices based on Dietary Guidelines recommendations. Fourth-grade children and their families have participated in the program. Informed by social cognitive theory, this curriculum uses peer modeling, environmental support and goal-setting to promote behavior change. An estimated 70% of pre-teen girls and 60% of pre-teen boys do not meet the daily calcium recommendation, which places them at risk of developing osteoporosis as adults. A 5-lesson curriculum was designed for use in school classrooms during a 5-week time frame. The program includes hands-on activities, calcium tracking, educational displays, follow-up activities for the teacher, participation incentives using “cow coins” and “cow banks”, and optional taste testing activities. Parents/caregivers were provided with weekly newsletters summarizing their child's activities, along with nutrition information, recipes and goal-setting activities. Pre- and post-surveys of children and parents assessed knowledge gain and achievement of nutrition-related goals. Participants (n=9,163; 49.7% male) significantly increased their knowledge of calcium sources, indicated preference for milk over soda/pop, increased their self-reported consumption of calcium-rich foods and decreased their consumption of sweetened beverages (p <.05). About 51% of parents/caregivers reported a positive change in the children's eating habits at home. Classroom nutrition education with parent involvement can promote behavior change to increase calcium consumption.