Impact of a nutrition education program to increase intake of calcium-rich foods by Chinese-American women.

Chinese-American women have a high risk of osteoporosis. However, their calcium intake has been reported previously as considerably below the Dietary Reference Intake. Increasing consumption of calcium-rich foods, many of which are also fortified with vitamin D, is a safe way to increase their calcium and vitamin D intake. This study's objective was to pilot-test an intervention to help Chinese-American women incorporate calcium-rich foods into their diet. This intervention was evaluated using a quasi-experimental study with a nested design and pre-, immediate post-, and 3-month follow-up assessments. Calcium and vitamin D intake, Theory of Planned Behavior constructs, and knowledge were measured at three time points. First-generation Chinese-American mothers between 35 and 55 years old (n=141) were recruited from six weekend Chinese schools. Three Chinese schools each were randomly assigned to the experimental (n=71) or control group (n=70). The experimental group received a free heel scan and six weekly interactive lessons designed based on the Theory of Planned Behavior. The control group received six weekly nonrelated financial lessons by mail. Changes for each measure were assessed by linear mixed model with repeated measures adjusted for confounding variables. Compared to the control group, the experimental group improved all measures considerably, except two subjective norm constructs (normative belief and motivation to comply) at post-assessments. The experimental group significantly increased its baseline calcium (t=7.898, P<0.001) and vitamin D intake (t=6.609; P<0.001) at posttest and this increase was retained at follow-up. Results suggest that this theory-based intervention is effective for increasing the dietary calcium and vitamin D intake of Chinese-American women.