Dissemination of a Theory-Based Bone Health Program in Online Communities

在在线社区中传播基于理论的骨骼健康计划

• 批准号: 8266894
• 负责人: EUN-SHIM NAHM
• 金额: $ 49.03万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8266894
• 关键词: Academic Medical Centers; Activities of Daily Living; Address; Adoption; Adult; Advisory Committees; Age; Aging; American; Baltimore; Binding Sites; Bone Density; Bone Diseases; Calcium; Caring; Collaborations; Communities; Community Healthcare; Community Practice; Control Groups; Data Collection; Development Plans; Dimensions; Effectiveness; Electronics; Exercise; Exhibits; Fall prevention; Foundations; Fracture; Frequencies; Goals; Grant; Guidelines; Health; Health Promotion; Health Resources; Health Services Research; Health behavior; Health behavior change; Hip region structure; Home environment; Incidence; Individual; Intake; Internet; Intervention; Knowledge; Life; Linear Models; Long-Term Effects; Maintenance; Maryland; Measures; Methodology; Methods; Modeling; Modification; Nature; Osteoporosis; Outcome; Outcome Measure; Pain; Participant; Pharmacotherapy; Physical activity; Prevention strategy; Preventive; Primary Health Care; Provider; Public Health; Randomized Controlled Trials; Research; Resources; Safety; Schools; Screening procedure; Self Efficacy; Site; Smoking; Source; Target Populations; Testing; Time; Trust; United States; United States National Institutes of Health; University Hospitals; Use Effectiveness; Vitamin D; Woman; age related; base; bone health; calcium intake; cost; design; diet and exercise; disorder prevention; dissemination research; evidence base; expectation; experience; falls; follow-up; group intervention; high risk; improved; innovation; interest; literacy; member; men; nutrition; prevent; programs; rapid growth; social cognitive theory; statistics; theories; tool; usability; user-friendly

DESCRIPTION (provided by applicant): Bone health is a significant public health issue in the United States. An estimated 10 million Americans age 50 and older are living with osteoporosis, and approximately 50% of women and 25% of men over age 50 will experience an osteoporosis-related fracture in their remaining lifetime. Recent research advancements have produced effective measures to improve and maintain bone health, including exercise, diet, screening tests, pharmacotherapies, and fall prevention strategies. These findings, however, have not been fully incorporated into the daily lives of adults, and many are unaware of the magnitude of bone-health problems. Only 11-44% of adults at high risk for osteoporosis take calcium and vitamin D supplements, and one third of women over age 55 have not discussed bone health issues with their care providers. Greater efforts must be made to effectively disseminate evidence-based research findings to improve bone health behaviors of the public. The Internet, with its increasing popularity, can be an effective tool in this endeavor. Despite a great deal of available online health resources, there has been a lack of research investigating effective methods to package and deliver these resources to yield positive public health outcomes. Our prior R21 grant project showed some preliminary effectiveness of using a social cognitive theory (SCT)-based online health promotion intervention. Expanding upon our prior findings and using an innovative approach combining two models of the SCT and the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), in this proposal, we propose a large scale online study (N = 768) that will compare the long-term impact of two SCT-based online bone health interventions in adults age 50 and older targeting two large online communities (SeniorNet, MyHealtheVet). The two interventions are (1) an 8-week SCT-based Online Bone Health (TO-BoneHealth) program and (2) a 12-month TO-BoneHealth Plus program, including the TO-BoneHealth program followed by biweekly theory- based eNewsletters with follow-up of each individual's bone health behaviors ("booster" intervention) for 10 months. The interventions' impact will be assessed on the following dimensions of the modified RE-AIM framework: (a) Effectiveness (knowledge, selected bone health behaviors, fall incidence, initiation of a discussion about bone health with a primary care provider, eHealth literacy); (b) Reach (number of participants the program reached); (c) Implementation (program usage); and (d) Maintenance (participants' bone health behavior maintenance). The Effectiveness dimension will be assessed using a randomized controlled trial employing a 3-group design (2 intervention and 1 control groups) with repeated measures (baseline, 8 weeks, 6, 12, and 18 months). The primary analytic approach for the Effectiveness dimension will involve mixed linear models analyses. Other impact dimensions will be assessed using descriptive statistics. With the rapid growth of online communities, findings from this study will significantly contribute to current eHealth practice and research and serve as a dissemination model for other health promotion projects targeting online communities. PUBLIC HEALTH RELEVANCE: Bone health is a significant public health issue in the United States, with approximately 10 million Americans age 50 and older living with osteoporosis. Several effective measures have been found to improve and maintain bone health. Many individuals, however, are unaware of the significance of bone health problems and do not follow recommended guidelines for bone health behaviors. Maximizing the popularity of the Internet, this innovative study will examine the impact of two online motivational health promotion interventions on improving mature adults' bone health behaviors. With the rapid growth of active online communities, findings from the proposed study will significantly contribute to public health by advancing current face-to-face health promotion efforts to online settings serving as a model approach.

描述（由申请人提供）：骨骼健康是美国重大的公共卫生问题。估计有1000万50岁及以上的美国人患有骨质疏松症，大约50％的女性和50岁以上的男性将在其剩余一生中经历与骨质疏松相关的骨折。最近的研究进步已采取有效的措施来改善和维持骨骼健康，包括运动，饮食，筛查测试，药物治疗和秋季预防策略。但是，这些发现尚未完全纳入成年人的日常生活中，许多人没有意识到骨骼健康问题的严重性。只有11-44％的骨质疏松症风险高的成年人服用钙和维生素D补充剂，而55岁以上的女性中有三分之一没有与其护理人员讨论骨骼健康问题。必须采取更大的努力来有效传播基于证据的研究结果，以改善公众的骨骼健康行为。互联网越来越受欢迎，可以成为这项努力的有效工具。尽管有大量可用的在线卫生资源，但缺乏研究调查有效的方法来包装和提供这些资源以产生积极的公共卫生结果。我们先前的R21赠款项目显示了使用基于社会认知理论（SCT）的在线健康促进干预措施的初步有效性。在这项建议中，扩展了我们先前的发现，并使用一种创新方法结合了两个模型和RE-AIM框架（触及，有效性，采用，实施，实施，维护），我们建议一项大规模的在线研究（n = 768），将比较两个基于SCT的在线骨健康干预措施对50岁和老年人的较大的在线社区的长期影响。这两种干预措施是（1）为期8周的基于SCT的在线骨骼健康（To-Bonehealth）计划和（2）一个12个月的bonehealth Plus计划，包括To-Bonehealth计划，然后进行双周理论上的Enewsletters，并随访了每个人的骨骼健康行为（“ Booster” Intervention）10个月。干预措施的影响将在修改后的Re-AM框架的以下维度上进行评估：（a）有效性（知识，选择的骨骼健康行为，跌倒，发病率，与初级保健提供者有关骨骼健康的讨论，EHEALTH识字率）； （b）到达（该计划达到的参与者人数）； （c）实施（程序使用）； （d）维护（参与者的骨骼健康行为维持）。有效性维度将使用随机对照试验进行评估，该试验采用3组设计（2个干预组和1个对照组）进行了重复测量（基线，8周，6、12和18个月）。有效性维度的主要分析方法将涉及混合线性模型分析。其他影响维度将使用描述性统计数据进行评估。随着在线社区的快速发展，这项研究的发现将极大地为当前的EHEADH实践和研究，并成为针对在线社区的其他健康促进项目的传播模型。公共卫生相关性：在美国，骨骼健康是一个重大的公共卫生问题，大约有1000万美国人50岁及以上的骨质疏松症。已经发现了一些有效的措施可以改善和维持骨骼健康。但是，许多人没有意识到骨骼健康问题的重要性，并且不遵循建议的骨骼健康行为指南。这项创新的研究最大程度地提高了互联网的普及，将研究两种在线动机促进干预措施对改善成年人骨骼健康行为的影响。随着活跃在线社区的快速增长，拟议的研究的发现将通过将当前面对面的健康促进工作推进到作为模型方法的在线环境，从而为公共卫生做出重大贡献。

项目成果

Osteoporosis Preventive Practice Between Veteran and Nonveteran Older Adults: Findings From Patient-Reported Data.

• DOI: 10.1097/nor.0000000000000297
• 发表时间: 2016
• 期刊: Orthopedic nursing
• 作者: Nahm ES;Charters K;Yoo E;Keldsen LM;Zhu S
• 通讯作者: Zhu S

Testing reliability and validity of the eHealth Literacy Scale (eHEALS) for older adults recruited online.

• DOI: 10.1097/cin.0000000000000146
• 发表时间: 2015-04
• 期刊: Computers, informatics, nursing : CIN
• 作者: Chung SY;Nahm ES
• 通讯作者: Nahm ES

Reliability and validity of the revised Osteoporosis Knowledge Test.

修订后的骨质疏松症知识测试的可靠性和有效性。

• DOI: 10.1891/1061-3749.22.2.342
• 发表时间: 2014
• 期刊: Journal of nursing measurement
• 影响因子: 0.7
• 作者: Qi,Bing-Bing;Resnick,Barbara;Nahm,Eun-Shim
• 通讯作者: Nahm,Eun-Shim

Dissemination of a theory-based online bone health program: Two intervention approaches.

基于理论的在线骨骼健康计划的传播：两种干预方法。

• DOI: 10.1177/1460458213505573
• 发表时间: 2015
• 期刊: Health informatics journal
• 影响因子: 3
• 作者: Nahm,Eun-Shim;Resnick,Barbara;Bellantoni,Michele;Zhu,Shijun;Brown,Clayton;Brennan,PatriciaF;Charters,Kathleen;Brown,Jeanine;Rietschel,Matthew;Pinna,Joanne;An,Minjeong;Park,BuKyung;Plummer,Lisa
• 通讯作者: Plummer,Lisa