1. RESEARCH POSTER PRESENTATION DESIGN © 2015
www.PosterPresentations.com
Background: Bone health education is beneficial to start in childhood to build healthy
bones prior to reaching peak bone mass. Knowledge of influences and values can be used
to improve selection of bone-healthy behaviors.
Objectives: The study aimed to determine factors that influence bone-health behaviors
and increase bone-health knowledge in a school-aged population.
Methods: A pretest, posttest and 21-day posttest, quasi-experimental study tested the
efficacy of Batter Up For Bone Health (BU4BH) intervention based on Social Cognitive
Theory (SCT) constructs measuring factors the impact bone-healthy behaviors. School and
summer camp settings were used. Statistical testing (SPSS Version 22) included Chi-square
tests, t-tests and ANOVA’s. A Principal Components Analysis was performed on
SCT questions with Cronbach alpha evaluating the internal reliability of new variables.
Results: A total of 168 participants [school (n=99); camp (n=69)] completed BU4BH. There
was an increase in bone health knowledge gained (p=0.003). Participants were likely to be
influenced by others drinking milk (p<0.0001). The participants (94%, n=112) felt that it
was “very important” for kids their age to have healthy bones. At 21-day post-test,
participants (63%, n=78) planned to eat foods that are healthy for their bones.
Conclusions: Children are influenced by the behaviors of others, thus educating teachers
and parents to be positive role models can contribute to bone healthy behaviors.
Participants displayed increases in self-efficacy showing that an interactive bone health
intervention (BU4BH) can increase knowledge, promote self-efficacy and instill beneficial
bone health behaviors.
ABSTRACT
INTRODUCTION & OBJECTIVES
Batter-up for Bone Health (BU4BH) is a one day intervention
incorporating active learning to strengthen knowledge related to
bone health within the framework of baseball: Calcium (pitching
mound), Vitamin D (first base), Ground force activity (2nd base),
Joint force activity (3rd base) and MyPlate meal planning (home
plate).
Behavioral theory component: The BU4BH program used the Social
Cognitive Theory (SCT) to examine personal, social and
environmental influences on children’s bone healthy behaviors
questions comparing family members, peers, and teachers
influences on impacting children’s bone healthy behaviors in
addition to knowledge-based questions on bone health
Tools: Pre-test, post-test, post-test at 21 days.
Study settings: School (physical education class) and summer camp
School received nutritional and physical activity tips during the
three week break. The camp did not.
Ages: 7-11 years old
Statistical analysis: Data were analyzed using IBM SPSS Statistics
(Version 22). Environment and behavior questions were analyzed by
running a Principal Components Analysis (PCA) to re-group the
data into fewer, stronger factors. Cronbach alpha evaluated the
internal reliability of new variables.
MATERIALS & METHODS RESULTS STRENGTHS & LIMITATIONS
Strengths:
● BU4BH is framed within SCT constructs
● Activities reinforce SCT influences
● Assessment tool incorporated social cognitive theory constructs
Limitations:
● Constraints for time allotted to run the game, perform
assessment
● Language barriers during the camp session
CONCLUSIONS & IMPLICATIONS
Bone health is important to the school-age population
Positive bone health behaviors will be modeled
Influences were similar between genders
Influencers and understanding bone health importance can
motivate positive bone health practices
Others drinking milk are a positive influence in school-age child
drinking milk
School environment has limited impact on nutrition behaviors
Self-efficacy plays a role in behavior changes and motivation
School-age children believe in their ability to identify and choose
bone-healthy foods and activities
ACKNOWLEDGEMENTS
Researchers are grateful to the respective administrators, teachers
and BU4BH participants.
Introduction:
Promoting bone health in school-age, prior to adolescence, may
positively impact bone healthy behaviors prior to reaching peak
bone mass. A better understanding on how a child’s behavior guides
his or her decision-making process, especially regarding food
choices and healthy behaviors, is helpful in reaching the school-age
children to strengthen bone-building habits. Studying the impact of
various constructs of behaviors through theory-based interventions
has emerged as a key component for instilling proper lifestyle
changes in favor of improved health. Influencers that impact one’s
decision-making process include (but are not limited to)
environment, parental role modeling, health beliefs, perceived
susceptibility of disease, and peer influence. Knowing what
motivates and influences those behaviors are critical to improve
understanding and target messages and interventions to promote
positive bone healthy behavior change in the school-age
population.
BU4BH Objectives:​
1.Improve bone health knowledge and behaviors for school-age
population.​
2.Educate children on foods rich in vitamin D and calcium. ​
3.Promote physical activities that support healthy bone
development.​
1Nutrition Department, Benedictine University, Lisle, IL
Factors Influencing School-age Children to Choose Bone Healthy Behaviors
Karen Plawecki1, PhD RD LDN, Sarah Allaben, MS RD LDN, Erica Auriemme, MS RD LDN, Alexis Blandine, MS RD LDN,
Kiah Ehrke, MS RD LDN, Ellen Hashiguchi, MS MPH RD LDN, Maggie Tignanelli, MS RD LDN
Location Participants Females Males
School 59% (n=99) 51 48
Camp 41% (n=69) 38 31
Principal Components Analysis (PCA): Pre-test
Questions New variable Cronbach
Alpha
When I see my (friends, teachers, adults at
home, brothers, sisters) drinking milk, I’m
more likely to drink milk
Drinking milk .863
I like to eat what my teachers eat or when I
see my teacher eat something, I like to eat
that food too. My friends and I eat the
same foods.
School
environment
.666
I like the same foods my parents like or like
to eat what my parents eat. I like to eat
what my friends eat.
Home
environment
.580
My family eats the same foods at mealtime. n/a n/a
Principal Components Analysis (PCA):21-day Post test
Questions New variable Cronbach
Alpha
When I see my (friends, teachers, adults at
home, brothers, sisters) drinking milk, I’m
more likely to drink milk
Drinking milk .885
I like to eat what my friends/teachers eat.
When I see my friends/teachers eat
something, I like to eat that food too.
School
environment
.295
I like to eat what my parents/friends eat. My
family eats the same foods at mealtime.
Home
environment
.604
BU4BH Timeline
Examining Self-Efficacy in
Post-test “It is easy to choose a
snack that is good for your
bones” (n=92)
Response Yes Chi-
Square
P-
Value*
Always 45
39.30 0.0001Often 25
Sometimes 19
Never 3
DEMOGRAPHICS​
*effect size: 0.81 (large)
Statement: “It is important for kids my
age to have healthy bones.”
Response
(n=119)
Yes Chi-
Square
P-
Value
Effect
Size
Very
Important
112
198.17 0.0001 0.94
(Large)Kind of
Important
6
Somewhat
Important
1
Examining Self-Efficacy in
Post-test “It is easy to choose
and activity that is good for your
bones.” (n=74)
Response Yes Chi-
Square
P-
Value*
Always 40
15.60 0.0001Often 21
Sometimes 13
Never 0
*effect size: 0.83 (large)
Ethnicity Participants
Caucasian 53% (n= 89)
Hispanic 33% (n=55)
African American 1% (n=1)
Hispanic & White 5% (n=8)
Other 7% (n=12)