TitleCalcium Counts Curriculum Improves Fifth-Graders' Knowledge about Calcium-Rich Food
Publication TypeJournal Article
Year of Publication2013
AuthorsLinnell, JD, Briggs, M, Zidenberg-Cherr, S
JournalJournal of Nutrition Education and Behavior
Pagination191 - 193
Date PublishedJan-03-2013


Community-based participatory research (CBPR) can be an effective approach to improving health outcomes, providing the opportunity for researchers and community stakeholders to work together, and tailoring health interventions based on the specific needs of a community.1 In 2011, the Food and Nutrition Services (FNS) personnel at a California school district contacted the University of California, Davis Center for Nutrition in Schools (CNS) to develop a calcium-rich food (CRF) nutrition education program. The district had observed a decline in milk beverage sales and was interested in conducting an intervention because of the designation of calcium as a nutrient of concern in the Dietary Guidelines for Americans 2010.2 The researchers were interested in identifying effective, evidence-based methods to increase calcium intake in children. Thus, the objective of this pilot study was to use a CBPR approach to develop and pilot-test a CRF curriculum among fifth-grade students.


During the curriculum development process, CNS and FNS worked together to identify 3 domains of knowledge for inclusion: calcium–health relationships, food label literacy, and dietary sources of calcium. Instruction regarding nondairy sources of calcium for persons who are lactose intolerant was also identified as a priority.3 The school district requested that the lessons support California State Content Standards for ease of implementation in the classroom.4 Based on the needs identified, CNS developed the CRF curriculum, entitled Calcium Counts.

The lessons were designed to support constructs of the Social Cognitive Theory.5 Reciprocal determinism was supported by involving home and school lunch environments; teachers sent parent newsletters home each week to reinforce lesson concepts, and students created and displayed posters about CRF in the cafeteria. Behavioral capability was incorporated through the lessons themselves, by helping students identify calcium food sources and calcium content on the Nutrition Facts label, and by reminding them about milk availability at school. Finally, self-efficacy was addressed by incorporating goal-setting exercises in each lesson.


Calcium Counts was implemented among fifth-grade students (n = 33) in 2 of 4 randomly selected elementary school classrooms within the school district. Of 68 students, 35 were not included in the analysis owing to noncompletion of consent forms or pre-/post-assessments.

Lessons were 30 minutes in length and were delivered once a week for 4 weeks. Lesson content and activities are described in Table 1. Family newsletters reinforced lesson concepts. Additionally, milk drinking was encouraged with a goal poster allowing students, as a class, to track milk consumption during lunch throughout the implementation period. Calcium Counts was taught by undergraduate nutrition students who received 8 hours of training to achieve content clarity and consistency for each lesson.

Short TitleJournal of Nutrition Education and Behavior