Improving osteoporosis knowledge and healthy bone habits of rural-dwelling older adults

The purpose of this study was to compare three community-based bone health interventions with rural-dwelling older adults (age 65 years and over) by comparing participants' knowledge and osteoporosis-related behaviors. Changes in knowledge and behaviors of those participating in the different interventions were also of interest. The conceptual framework guiding this study was Fleury's Wellness Motivation Theory. Kiresuk, Smith, and Cardillo's Theory of Goal Attainment Scaling provided a methodological guide for the intervention.

The research design was quasi-experimental using four groups. The first group was included as a control and did not receive an intervention (Group 1). The remaining groups received the following specific bone health intervention: (Group 2) bone health educational booklet; (Group 3) bone health educational booklet, 2 educational sessions, and 2 follow-up phone calls; and (Group 4) all components of Group 3 plus an individualized bone health goal-setting session. All participants received a qualitative ultrasound (QUS), Groups 2, 3, and 4 at the beginning and Group 1 at the end of the study. Seven weeks intervened between the pre- and posttests which assessed osteoporosis-related knowledge, osteoporosis self-management behaviors, and readiness to use positive health behaviors. Participants were recruited from 8 senior centers in rural Central Texas communities; the centers were randomized to study groups. The sample (N = 85) included 69 women and 16 men (Mage = 78, range 65–95). ANOVA and t-tests were used to calculate the differences between and among the groups.

Major findings indicated there were significant increases in osteoporosis knowledge from pretest to posttest in Group 3 [t (18) = -4.89, p = <.001] and Group 4 [t (23) = -3.68, p = <.001] with large and medium effect sizes of η2 = 0.57 and η2 = 0.37, respectively. Group 4 participants significantly increased their performance of healthy bone behaviors [t (23) = -4.15, p = <.001] with a medium effect size of η2 = 0.43. The knowledge of Group 3 was significantly different than that of the control group ( F (3, 81) = 4.17, p = .008) at posttest. Readiness did not demonstrate a role in the changes.