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Journal of Pediatric Psychology Advance Access originally published online on February 23, 2005
Journal of Pediatric Psychology 2005 30(5):377-386; doi:10.1093/jpepsy/jsi061
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Prevention of Osteoporosis: A Randomi...
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Journal of Pediatric Psychology vol. 30 no. 5 © Society of Pediatric Psychology 2005; all rights reserved.

Prevention of Osteoporosis: A Randomized Clinical Trial to Increase Calcium Intake in Children with Juvenile Rheumatoid Arthritis

Lori J. Stark, PhD1,6, David M. Janicke, PhD2, Ann M. McGrath, PhD3, Laura M. Mackner, PhD4,7, Kevin A. Hommel, PhD1 and Daniel Lovell, MD5,6

1 Division of Psychology, Cincinnati Children’s Hospital Medical Center, 2 Department of Clinical and Health Psychology, University of Florida, 3 Department of Pediatrics, University of Kansas Medical Center, 4 Department of Pediatrics, Columbus Children’s Hospital, 5 Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, 6 University of Cincinnati College of Medicine, and 7 Ohio State University

All correspondence concerning this article should be addressed to Lori J. Stark, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Division of Psychology, SEC-4, Cincinnati, Ohio 45229. E-mail: lori.stark{at}chmcc.org

Received October 1, 2003; revisions received March 15, 2004 accepted April 7, 2004

ObjectiveTo test the efficacy of a behavioral intervention (BI) compared to an enhanced standard of care (ESC) dietary counseling on increasing dietary calcium (Ca) intake in children with juvenile rheumatoid arthritis (JRA).MethodsThree-day food diaries collected at baseline and posttreatment were analyzed for Ca intake in 49 children with JRA randomly assigned to either BI or an ESC treatment.ResultsChildren in the BI (N = 25) demonstrated a significantly greater increase in average dietary Ca intake (M = 839) than children in the ESC (N = 24; M = 420) (F = 14.39; p < .001). Post hoc analysis revealed that children in both groups demonstrated significant gains in dietary Ca intake baseline to posttreatment. A significantly greater percentage of children in the BI (92%) attained the goal of 1500 mg/Ca at posttreatment compared to the ESC (17%), X2 = 28.09; p < .001.ConclusionsBehavioral intervention can have a positive impact on increasing dietary Ca intake. Future research will need to evaluate the maintenance of gains in dietary Ca intake following treatment cessation and the impact of increased Ca intake on bone mineral density.

Key words: Behavioral Intervention; Calcium; Bone Health; JRA.


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