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Health Education Research Advance Access published online on March 21, 2008
Health Education Research, doi:10.1093/her/cyn009
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Psychosocial, environmental and behavioral factors associated with bone health in middle-school girls

Shreela V. Sharma1,*, Deanna M. Hoelscher2, Steven H. Kelder2, R. Sue Day1 and Albert Hergenroeder3

1 The University of Texas Health Science Center at Houston, School of Public Health Michael and Susan Dell Center for Advancement of Healthy Living
2 The University of Texas School of Public Health, Austin Regional Campus Michael and Susan Dell Center for Advancement of Healthy Living
3 Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA

Correspondence to: * Correspondence to: S. Sharma. E-mail: shreela.v.sharma{at}uth.tmc.edu

The purpose of this study was to identify the psychosocial, environmental and behavioral factors associated with calcium intake, physical activity and bone health in a cohort of adolescent girls. Baseline data (N = 718 girls, mean age: 11.6 ±0.4 years) from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study conducted in Texas, 2001–03, were utilized for the analyses. Hierarchical linear regression was used to examine the associations of interest. Confounders adjusted for included ethnicity, menarchal status, body mass index and lactose intolerance. Several psychosocial and behavioral factors were significantly associated with bone quality. These included knowledge of calcium content of foods (β = 0.08, P = 0.016), self-efficacy toward consuming calcium-rich foods (β = 0.16, P = 0.047), physical activity self-efficacy (β = 0.20, P = 0.002), physical activity outcome expectations (β = 0.5, P = 0.004), family encouragement to do physical activity (β = 0.96, P = 0.027), friend engagement in physical activity (β = 1.3, P = 0.001) and participation in sports teams (β = 1.7, P < 0.001). Self-efficacy, social support and participation in sports teams appear to be strongly associated with bone health in adolescent girls. Future health education/health promotion programs need to address these factors for effective primary prevention of osteoporosis in this population.

Received on September 5, 2007; accepted on January 3, 2008


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