Outcome and process evaluation of the Build-A-Bone Osteoporosis Prevention Program.

摘要

Osteoporosis is a commonly occurring bone disease that impacts more than half of the U.S. population over age 50, with women a large majority of the affected population. Debilitating complications include fractures, pain, and a decrease in quality of life. Early recognition, particularly in perimenopausal years, can significantly decrease morbidity and related health-care costs of osteoporosis.;The Build-A-Bone Osteoporosis Prevention Program offers an innovative and unique approach to osteoporosis prevention with a multicomponent experiential skills training program. Whereas the program had never been evaluated since inception, this study was designed to investigate the effectiveness (i.e., behavior change), impact (i.e., fall reduction), and client satisfaction of 83 past participants using retrospective pretest/posttest questionnaires.;The research design was a 2 (repeated measures) X 2 (post hoc risk level) analysis of variance. Research questions addressed both main effects for program outcomes (i.e., time) and interactions between time and risk and examined dependent variables of modifiable risk factors, physical activity, balance, nutrition and dietary patterns, personal health beliefs, and falls. Outcomes were measured using subscale portions of standardized instruments.;Conclusions of this study are positive and suggest that a multicomponent experiential skills training program for osteoporosis prevention can reduce risk factors and falls. Participants reported that their rate of falls had decreased by 50% from prior to the program and significantly increased physical activity. The participants' composite modifiable risk factors decreased significantly. Significant main effects for both time and risk factors were found in nutrition and dietary patterns. Significant main effects for time were found for subscales of the Osteoporosis Health Belief Scale. Dosage and client satisfaction were not related to any examined posttest outcomes, and time since program completion showed no significant main effects or interactions. Process evaluation results indicated high client satisfaction and significant correlations with requests for refresher courses and positive comments of the program's contribution to health.;Certain aspects of osteoporosis prevention were not addressed, including ways to recruit individuals at risk in underserved populations and exploration of the impact of osteoporosis prevention programs on increased bone density based on actual laboratory data. Further research is needed to investigate these factors and advance osteoporosis prevention.