Skip to main content
SpringerLink
Log in

Educational booklet reinforces knowledge of osteoporosis and influences intentions to improve bone health in previously diagnosed and treated patients

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

We examined individuals’ experiences using an educational booklet developed by the Ontario Osteoporosis Strategy. The booklet appeared to motivate individuals to make changes to their existing management of their bone health and served as a reference tool reaffirming current practices and beliefs for others.

Introduction

The purpose of this study was to examine individuals’ experiences of the educational booklet and explore the influence of the booklet on individuals’ beliefs and actions regarding their bone health.

Methods

Eligible individuals were those who had been prescribed medication to treat low bone mass. One-on-one telephone interviews were conducted over an 18-month period. Participants were interviewed for approximately 1 hour and asked to provide their feedback on the booklet, and to discuss what they were doing with respect to the recommendations made in the booklet.

Results

We interviewed 50 participants who ranged in age from 58 to 89. The overall impression of the booklet was positive. Participants described the language in the booklet as clear and easy to understand. Participants stated that they would have appreciated receiving this tool at the onset of their diagnosis. Forty-two participants had already taken action, or expressed an intention to make changes, to their existing routines to improve their bone health. In contrast, eight participants used the booklet to reaffirm current practices and beliefs. For these individuals, the recommendations made in the booklet were consistent with what they had already been doing.

Conclusion

The booklet can engage patients in discussions about bone health. The booklet appeared to motivate individuals to make changes to their existing routines in an effort to achieve better health outcomes for their bone health. Providing a tool like this to people recently diagnosed with a bone health issue may prove to be beneficial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group. Geneva

  2. Sale JEM, Frankel L, Thielke S, Funnell L (2017) Pain and fracture-related limitations persist 6 months after a fragility fracture. Rheumatol Int 37(8):1317–1322

    PubMed  Google Scholar 

  3. Gheorghita A, Webster F, Thielke S, Sale JEM (2018) Long-term experiences of pain after a fragility fracture. Osteoporos Int 29(5):1093–1104

    CAS  PubMed  Google Scholar 

  4. Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E (2001) Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 12(4):271–278

    CAS  PubMed  Google Scholar 

  5. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733

    CAS  PubMed  Google Scholar 

  6. Papaioannou A, Kennedy CC, Ioannidis G, Sawka A, Hopman WM, Pickard L, Brown JP, Josse RG, Kaiser S, Anastassiades T, Goltzman D, Papadimitropoulos M, Tenenhouse A, Prior JC, Olszynski WP, Adachi JD, CaMos Study Group (2009) The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study. Osteoporos Int 20(5):703–714

    CAS  PubMed  Google Scholar 

  7. Lee SR, Ha YC, Kang H, Park YG, Nam KW, Kim SR (2013) Morbidity and mortality in Jeju residents over 50-years of age with hip fracture with mean 6-year follow-up: a prospective cohort study. J Korean Med Sci 28(7):1089–1094

    PubMed  PubMed Central  Google Scholar 

  8. Ioannidis G, Papaioannou A, Hopman WM, Akhtar-Danesh N, Anastassiades T, Pickard L, Kennedy CC, Prior JC, Olszynski WP, Davison KS et al (2009) Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study. CMAJ 181(5):265–271

    PubMed  PubMed Central  Google Scholar 

  9. Sale JE, Beaton DE, Bogoch ER, Elliot-Gibson V, Frankel L (2010) The BMD muddle: the disconnect between bone densitometry results and perception of bone health. J Clin Densitom 13(4):370–378

    PubMed  Google Scholar 

  10. Cadarette SM, Beaton DE, Gignac MA, Jaglal SB, Dickson L, Hawker GA (2007) Minimal error in self-report of having had DXA, but self-report of its results was poor. J Clin Epidemiol 60(12):1306–1311

    PubMed  Google Scholar 

  11. Kingwell E, Prior JC, Ratner PA, Kennedy SM (2010) Direct-to-participant feedback and awareness of bone mineral density testing results in a population-based sample of mid-aged Canadians. Osteoporos Int 21(2):307–319

    CAS  PubMed  Google Scholar 

  12. Jo WS, Cho EH, Kang BJ, Kwon GD, Ha YC, Jang S, Kim HY (2018) The impact of educational interventions on osteoporosis knowledge among Korean osteoporosis patients. J Bone Metab 25(2):115–121

    PubMed  PubMed Central  Google Scholar 

  13. Arora C, Sinha B, Malhotra A, Ranjan P (2017) Development and validation of health education tools and evaluation questionnaires for improving patient care in lifestyle related diseases. J Clin Diagn Res 11(5):JE06–JE09

    PubMed  PubMed Central  Google Scholar 

  14. Tussing L, Chapman-Novakofski K (2005) Osteoporosis prevention education: behavior theories and calcium intake. J Am Diet Assoc 105(1):92–97

    PubMed  Google Scholar 

  15. Ha M, Hu J, Petrini MA, McCoy TP (2014) The effects of an educational self-efficacy intervention on osteoporosis prevention and diabetes self-management among adults with type 2 diabetes mellitus. Biol Res Nurs 16(4):357–367

    PubMed  Google Scholar 

  16. Blalock SJ, DeVellis BM, Patterson CC, Campbell MK, Orenstein DR, Dooley MA (2002) Effects of an osteoporosis prevention program incorporating tailored educational materials. Am J Health Promot 16(3):146–156

    PubMed  Google Scholar 

  17. Drieling RL, Ma J, Thiyagarajan S, Stafford RS (2011) An internet-based osteoporotic fracture risk program: effect on knowledge, attitudes, and behaviors. J Women's Health (Larchmt) 20(12):1895–1907

    Google Scholar 

  18. Beaudoin C, Bessette L, Jean S, Ste-Marie LG, Brown JP (2014) The impact of educational interventions on modifiable risk factors for osteoporosis after a fragility fracture. Osteoporos Int 25(7):1821–1830

    CAS  PubMed  Google Scholar 

  19. Alvaro R, Pennini A, Zannetti EB, Cittadini N, Feola M, Rao C, D'Agostino F, Vellone E, Tarantino U (2015) Bone care nurses and the evolution of the nurse’s educational function: the Guardian Angel® research project. Clin Cases Miner Bone Metab 12(1):43–46

  20. Bessette L, Davison KS, Jean S, Roy S, Ste-Marie LG, Brown JP (2011) The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial. Osteoporos Int 22(12):2963–2972

    CAS  PubMed  Google Scholar 

  21. Morfeld JC, Vennedey V, Muller D, Pieper D, Stock S (2017) Patient education in osteoporosis prevention: a systematic review focusing on methodological quality of randomised controlled trials. Osteoporos Int 28(6):1779–1803

    PubMed  Google Scholar 

  22. Francis KL, Matthews BL, Van Mechelen W, Bennell KL, Osborne RH (2009) Effectiveness of a community-based osteoporosis education and self-management course: a wait list controlled trial. Osteoporos Int 20(9):1563–1570

    CAS  PubMed  Google Scholar 

  23. Laslett LL, Lynch J, Sullivan TR, McNeil JD (2011) Osteoporosis education improves osteoporosis knowledge and dietary calcium: comparison of a 4 week and a one-session education course. Int J Rheum Dis 14(3):239–247

    PubMed  Google Scholar 

  24. Danila MI, Outman RC, Rahn EJ, Mudano AS, Redden DT, Li P, Allison JJ, Anderson FA, Wyman A, Greenspan SL, LaCroix A, Nieves JW, Silverman SL, Siris ES, Watts NB, Miller MJ, Curtis JR, Warriner AH, Wright NC, Saag KG (2018) Evaluation of a multimodal, direct-to-patient educational intervention targeting barriers to osteoporosis care: a randomized clinical trial. J Bone Miner Res 33(5):763–772

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Sandelowski M (2000) Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Res Nurs Health 23(3):246–255

    CAS  PubMed  Google Scholar 

  26. Sandelowski M (2010) What’s in a name? Qualitative description revisited. Res Nurs Health 33(1):77–84

    PubMed  Google Scholar 

  27. Patton M (2002) Qualitative research in evaluation methods, 3rd edn. Sage Publications, Thousand Oaks, CA

    Google Scholar 

  28. Ryan P, Sawin KJ (2009) The individual and family self-management theory: background and perspectives on context, process, and outcomes. Nurs Outlook 57(4):217–225 e216

    PubMed  PubMed Central  Google Scholar 

  29. Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD, Scientific Advisory Council of Osteoporosis Canada (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182(17):1864–1873

    PubMed  PubMed Central  Google Scholar 

  30. Novick G (2008) Is there a bias against telephone interviews in qualitative research? Res Nurs Health 31(4):391–398

    PubMed  PubMed Central  Google Scholar 

  31. Sturges JE, Hanrahan KJ (2004) Comparing telephone and face-to-face qualitative interviewing: a research note. Qual Res 4(1):107–118

    Google Scholar 

  32. Creswell JW (1998) Qualitative inquiry and research design: choosing among five traditions. Sage Publications, Thousand Oaks, CA

    Google Scholar 

  33. Malterud K (2001) Qualitative research: standards, challenges, and guidelines. Lancet 358(9280):483–488

    CAS  PubMed  Google Scholar 

  34. Kvale S (1996) Interviews: an introduction to qualitative research interviewing. Sage Publications, Thousand Oaks, CA

    Google Scholar 

  35. Block ES, Erskine L (2012) Interviewing by telephone: specific considerations, opportunities, and challenges. Int J Qual Methods 11(4):428–445

    Google Scholar 

  36. QSR International Pty Ltd (2012) NVivo qualitative data analysis Software, Version 10 edn. QSR International Pty Ltd, Doncaster

    Google Scholar 

  37. Spencer L, Ritchie J, O'Connor W (2003) Analysis: practices, principles and processess. In: Ritchie J, Lewis J (eds) Qualitative research practice: a guide for social science students and researchers. Sage Publications, Thousand Oaks, pp 199–218

    Google Scholar 

  38. Campbell JL, Quincy C, Osserman J, Pedersen OK (2013) Coding in-depth semistructured interviews: problems of unitization and intercoder reliability and agreement. Sociol Methods Res 42(3):294–320

    Google Scholar 

  39. Dixon-Woods M, Cavers D, Agarwal S, Annandale E, Arthur A, Harvey J, Hsu R, Katbamna S, Olsen R, Smith L et al (2006) Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Med Res Methodol 6:35

    PubMed  PubMed Central  Google Scholar 

  40. CASP (Qualitative) Checklist https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf

  41. Finlay L (2002) “Outing” the researcher: the provenance, process, and practice of reflexivity. Qual Health Res 12(4):531–545

    PubMed  Google Scholar 

  42. Jootun D, McGhee G, Campus H, Lanarkshire, Marland GR (2009) Reflexivity: promoting rigour in qualitative research. Nurs Stand 23(23):42–46

  43. Morse J (1994) Designing funded qualitative research. In: Denzin, NK & Linoln, YS (eds.) Handbook of Qualitative Research, 2nd edn. Sage Publications Ltd., Thousand Oaks

  44. Jeihooni AK, Hidarnia A, Kaveh MH, Hajizadeh E, Askari A (2015) Effects of an osteoporosis prevention program based on health belief model among females. Nurs Midwifery Stud 4(3):e26731

    PubMed  PubMed Central  Google Scholar 

  45. Nguyen VH (2016) Osteoporosis knowledge assessment and osteoporosis education recommendations in the health professions. Osteoporos Sarcopenia 2(2):82–88

    PubMed  PubMed Central  Google Scholar 

  46. Becker MH (1974) The health belief model and sick role behavior. Health Educ Monogr 2(4):409–419

    Google Scholar 

  47. Becker MH, Maiman LA (1975) Sociobehavioral determinants of compliance with health and medical care recommendations. Med Care 13(1):10–24

    CAS  PubMed  Google Scholar 

  48. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A (2001) Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 20(6):64–78

    CAS  Google Scholar 

  49. Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Decis Process 50(2):179–211

    Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge the Regional Integration Leads and staff of Osteoporosis Canada for their assistance with recruitment for the study. We would also like to thank all the participants who took part in the study.

Funding

This study has been supported through funding by the Ontario Ministry of Health and Long Term Care through the Ontario Osteoporosis Strategy.

Author information

Authors and Affiliations

  1. Musculoskeletal Health & Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    D. N. Linton, T. M. Inrig, L. Frankel & J. E. M. Sale

  2. Ontario Osteoporosis Strategy, Osteoporosis Canada, 201-250 Ferrand Drive, Toronto, ON, M3C 3G8, Canada

    J. Porteous, H. Eatson, R. Chepesiuk, T. Long & R. Jain

  3. Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor, 155 College Street, Toronto, ON, M5T 3M6, Canada

    J. E. M. Sale

Authors
  1. D. N. Linton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Porteous
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Eatson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Chepesiuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Long
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. M. Inrig
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. Frankel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. R. Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. E. M. Sale
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. N. Linton.

Ethics declarations

The study was approved by the Research Ethics Board at St. Michael’s Hospital. All patients gave their informed verbal consent prior to the commencement of each interview.

Conflict of interest

None.

Disclaimer

The views expressed are those of the authors and do not necessarily reflect those of the Ministry.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Linton, D.N., Porteous, J., Eatson, H. et al. Educational booklet reinforces knowledge of osteoporosis and influences intentions to improve bone health in previously diagnosed and treated patients. Osteoporos Int 31, 1703–1711 (2020). https://doi.org/10.1007/s00198-020-05392-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-020-05392-2

Keywords

Search

Navigation