Learning Objective #1: Describe a model bone health educational intervention for older adults in a residential setting

Learning Objective #2: Explain the changes in osteoporosis-related knowledge and reported use of bone health behaviors at 1 week and 5 weeks following the intervention

---

The purpose of this two-phase pilot project was to develop and test a nurse-led bone health educational program with older adults (age 65 and over) living in residential settings. Phase 1 involved development of program content and materials with input from five multidisciplinary consultants for six sessions: osteoporosis-related information, physical activity, fall prevention, nutrition, medications, and calcium supplement content. Phase 2 included testing and implementation of the bone health education program with 6 small groups over a 6-week period. Pretests, which underscored the need for such a program, included a heel ultrasound and measures of osteoporosis-related knowledge and self-reported behaviors. The instruments measuring knowledge and behaviors were repeated at 1 week and 5 weeks following the intervention. Participants (N = 54) included 45 women and 9 men with a mean age of 79 years (S.D. = 7.18). The mean heel bone density T-score was -1.76 (S.D. = 1.20), with 31 (57%) demonstrating low bone mass (i.e., a T-score of -1.0 or below). A frequently-reported modifiable risk was limited physical activity, and common knowledge deficits were related to recommended daily amount of Vitamin D, its importance to bone health, and osteoporosis-specific medicines. Post-test results, using paired t-tests, showed significant increases in knowledge between Times 1 and 2 (t = -10.80, p=.001), 2 and 3 (t = -2.15, p=.04), and 1 and 3 (t = -11.50, p = .001). For the same Times, respectively, the results showed increases in behaviors: t = -4.28 (p=.000), t = -1.39 (p =.20), t = -3.35 (p=.002). The estimate of effect size (d) between Times 1 and 3 using the knowledge scores was high (2.54). The program implementation and results provide groundwork for further testing of this intervention that could be adopted by retirement residences to promote and maintain healthy bone behaviors of older adults.