--- title: "Internet osteoporotic fracture risk mgmt program. | Sutter Health" description: "We developed an Internet-based risk- and stage-tailored intervention to promote self-management of fracture risk." url: "https://www.sutterhealth.org/research/publications/osteoporotic-fracture-risk-management-program-1055312543" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Internet osteoporotic fracture risk mgmt program. # An Internet-based risk- and stage-tailored osteoporotic fracture risk management program: Effect on knowledge, attitudes and behaviors Drieling RL, Ma J, Thiyagarajan S, & Stafford RS. _J Women's Health (Larchmt). 20(12):1895-907. doi: 10.1089/jwh.2010.2515. Epub 2011 Oct 4._ 2011-12-01 ## Abstract OBJECTIVE: The 2004 Surgeon General's Bone Health Report calls for innovative interventions to reduce osteoporotic fracture. We developed an Internet-based risk- and stage-tailored intervention to promote self-management of fracture risk. METHODS: We randomized 121 women to receive 18 personalized Internet-based tutorials with behavior modification strategies for nutrition, exercise, and other behaviors (n=61) or to receive standard information (n=60). Tutorials were tailored for 10-year hip fracture risk, osteoporosis knowledge, attitudes about osteoporosis, nutritional intake, and exercise levels. Participants in both groups completed questionnaires at baseline, 3 months, and 6 months. Qualitative data included tutorial evaluation forms and focus groups. Main outcomes were perceived impact of the intervention, and changes in osteoporosis knowledge and beliefs, calcium and vitamin D intake, and exercise levels. RESULTS: At 6 months, 80% of intervention and 92% of control group participants completed the study. The intervention group significantly increased general osteoporosis knowledge (p=0.03) and calcium knowledge (p=0.02) compared with the control group. At 6 months, intervention participants were not significantly more likely to meet recommendations for calcium (OR: 1.39; 95% CI: 0.64-3.0; p=0.40), vitamin D (OR: 1.27; CI: 0.61-2.66; p=0.53), or aerobic (OR: 1.49; 95% CI: 0.63-3.48; p=0.36) or resistance exercise (OR: 1.36; 95% CI: 0.66-2.79; p=0.40) compared with control group participants. Thematic analyses of two focus groups and 794 tutorial evaluation forms, however, indicated that the intervention improved participant ability to implement and maintain healthy behaviors. Participants suggested program refinements including virtual support groups, applications for portable devices, and tailoring of tutorial length. CONCLUSION: The risk- and stage-tailored intervention was associated with improved knowledge but was not associated with significant behavioral improvements. Qualitative results suggest the intervention improved behavior implementation and maintenance. A refined intervention with additional tailoring capabilities could be used with Internet-based fracture risk assessment tools to confront the growing societal burden of osteoporotic fractures. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/?term=An+Internet-based+risk-+and+stage-tailored+osteoporotic+fra) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Musculoskeletal Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Musculoskeletal+Disorders%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Osteoarthritis of the ankle: the role of arthroplasty.](https://www.sutterhealth.org/research/publications/arthroplasty-ankle-osteoarthritis-1055312979) Chou LB, Coughlin MT, Hansen S Jr, Haskell A, Lundeen G, Saltzman CL, Mann RA. J Am Acad Orthop Surg. 16(5):249-59. 2008 May 01 - Publication ### [The "not so simple" ankle fracture: avoiding problems and pitfalls to improve patient outcomes.](https://www.sutterhealth.org/research/publications/complex-ankle-fx-pt-outcomes-1055312981) Hak DJ, Egol KA, Gardner MJ, Haskell A. Instr Course Lect. 60:73-88. 2011 Jan 01 - Publication ### [Peritenolysis and debridement for main body (mid-portion) Achilles tendinopathy in athletic patients: results of 107 procedures.](https://www.sutterhealth.org/research/publications/peritenolysis-debridemt-achilles-tendinopathy-1055312289) Saxena A, Hong BK, Hofer D. J Foot Ankle Surg. pii: S1067-2516(17)30271-5. doi: 10.1053/j.jfas.2017.04.020. \[Epub ahead of print\] 2017 May 31 - Publication ### [Clinically relevant effectiveness of focused extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: a randomized, controlled multicenter study.](https://www.sutterhealth.org/research/publications/extracorporeal-shock-wave-tx-plantar-fasciitis-1055312428) Gollwitzer H, Saxena A, DiDomenico LA, Galli L, Bouché RT, Caminear DS, Fullem B, Vester JC, Horn C, Banke IJ, Burgkart R, Gerdesmeyer L. J Bone Joint Surg Am. 97(9):701-8. doi: 10.2106/JBJS.M.01331. 2015 May 06 - Publication ### [Subtalar joint arthrodesis using a single lag screw.](https://www.sutterhealth.org/research/publications/subtalar-joint-arthrodesis-use-one-lag-screw-1055312972) Haskell A, Pfeiff C, Mann R. Foot Ankle Int. 25(11):774-7. 2004 Nov 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/osteoporotic-fracture-risk-management-program-1055312543#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Internet osteoporotic fracture risk mgmt program."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/osteoporotic-fracture-risk-management-program-1055312543#medicalscholarlyarticle","name":"An Internet-based risk- and stage-tailored osteoporotic fracture risk management program: Effect on knowledge, attitudes and behaviors","headline":"Internet osteoporotic fracture risk mgmt program.","abstract":"OBJECTIVE: The 2004 Surgeon General's Bone Health Report calls for innovative interventions to reduce osteoporotic fracture. We developed an Internet-based risk- and stage-tailored intervention to promote self-management of fracture risk. METHODS: We randomized 121 women to receive 18 personalized Internet-based tutorials with behavior modification strategies for nutrition, exercise, and other behaviors (n=61) or to receive standard information (n=60). Tutorials were tailored for 10-year hip fracture risk, osteoporosis knowledge, attitudes about osteoporosis, nutritional intake, and exercise levels. Participants in both groups completed questionnaires at baseline, 3 months, and 6 months. Qualitative data included tutorial evaluation forms and focus groups. Main outcomes were perceived impact of the intervention, and changes in osteoporosis knowledge and beliefs, calcium and vitamin D intake, and exercise levels. RESULTS: At 6 months, 80% of intervention and 92% of control group participants completed the study. The intervention group significantly increased general osteoporosis knowledge (p=0.03) and calcium knowledge (p=0.02) compared with the control group. At 6 months, intervention participants were not significantly more likely to meet recommendations for calcium (OR: 1.39; 95% CI: 0.64-3.0; p=0.40), vitamin D (OR: 1.27; CI: 0.61-2.66; p=0.53), or aerobic (OR: 1.49; 95% CI: 0.63-3.48; p=0.36) or resistance exercise (OR: 1.36; 95% CI: 0.66-2.79; p=0.40) compared with control group participants. Thematic analyses of two focus groups and 794 tutorial evaluation forms, however, indicated that the intervention improved participant ability to implement and maintain healthy behaviors. Participants suggested program refinements including virtual support groups, applications for portable devices, and tailoring of tutorial length. CONCLUSION: The risk- and stage-tailored intervention was associated with improved knowledge but was not associated with significant behavioral improvements. Qualitative results suggest the intervention improved behavior implementation and maintenance. 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