A multi- modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS): Rationale, design, and uptake of online study intervention material
A multi- modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS): Rationale, design, and uptake of online study intervention material
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DOI：
10.1016/j.conctc.2016.06.010
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发表时间：
2016-12-15
影响因子：
1.5
通讯作者：
Saag, Kenneth G.
中科院分区：
文献类型：
--
作者：
Danila, Maria I.;Outman, Ryan C.;Saag, Kenneth G.
目的：开发一种创新而有效的教育干预方法，让患者了解骨质疏松治疗的必要性，并确定其在线接受程度的相关因素。方法：将有骨折史且目前未接受骨质疏松治疗的绝经后妇女纳入骨质疏松症风险激活患者(APROPOS)。共有18名不同种族的妇女参加了四个名义小组，确定了骨质疏松症的治疗障碍。我们使用信息、动机、行为技能概念模型开发了一种直接对患者的干预，以减少骨质疏松治疗的潜在可修改障碍。干预包括根据参与者的种族/民族及其调查反应定制的视频：骨质疏松症治疗的排名障碍、推断的治疗障碍、对行为改变的准备情况以及骨质疏松症治疗历史。视频由“讲故事”的叙事组成，基于骨质疏松症患者的经历，由患者确定的种族/民族的女演员描绘。我们还提供了个性化的简短电话通话，然后是旨在促进对视频的理解的交互式语音应答电话留言。结果：为了解决与在线干预摄取相关的因素，我们关注了分配到干预组的参与者(n=1342)。这些参与者92.9%是高加索人，平均年龄(SD)为74.9(8.0)岁，大多数(77.7%)受过一定的大学教育。对自然治疗的偏好是排在第一位的障碍(n=130；27%)，而对颌骨骨坏死的担忧是最常见的障碍(在任何水平；n=322；67%)。总体而言，在干预组中，28.1%(n=377)的参与者在线访问了视频。在调整相关协变量后，提供电子邮件地址的参与者比没有提供电子邮件地址的参与者访问其在线视频的调整后的几率高6.07(95%可信区间4.53-8.14)。结论：我们开发并实施了一种新的定制多模式干预措施，以提高骨质疏松症治疗的启动。调查中提供的电子邮件地址是与在线干预独立相关的最重要因素。这种干预措施的设计和应用可能会对骨质疏松症或其他慢性病的未来研究产生影响。(C)2016由Elsevier Inc.出版。这是一篇CC BY-NC-ND许可证下的开放获取文章
Objective: To develop an innovative and effective educational intervention to inform patients about the need for osteoporosis treatment and to determine factors associated with its online uptake.Methods: Postmenopausal women with a prior fracture and not currently using osteoporosis therapy were eligible to be included in the Activating Patients at Risk for OsteoPOroSis (APROPOS). Four nominal groups with a total of 18 racially/ethnically diverse women identified osteoporosis treatment barriers. We used the Information, Motivation, Behavior Skills conceptual model to develop a direct-to-patient intervention to mitigate potentially modifiable barriers to osteoporosis therapy. The intervention included videos tailored by participants' race/ethnicity and their survey responses: ranked barriers to osteoporosis treatment, deduced barriers to treatment, readiness to behavior change, and osteoporosis treatment history. Videos consisted of "storytelling" narratives, based on osteoporosis patient experiences and portrayed by actresses of patient-identified race/ethnicity. We also delivered personalized brief phone calls followed by an interactive voice-response phone messages aimed to promote uptake of the videos. Results: To address the factors associated with online intervention uptake, we focused on participants assigned to the intervention arm (n = 1342). These participants were 92.9% Caucasian, with a mean (SD) age 74.9 (8.0) years and the majority (77.7%) had some college education. Preference for natural treatments was the barrier ranked #1 by most (n = 130; 27%), while concern about osteonecrosis of the jaw was the most frequently reported barrier (at any level; n = 322; 67%). Overall, 28.1% (n = 377) of participants in the intervention group accessed the videos online. After adjusting for relevant covariates, the participants who provided an email address had 6.07 (95% CI 4.53-8.14) higher adjusted odds of accessing their online videos compared to those who did not.Conclusion: We developed and implemented a novel tailored multi-modal intervention to improve initiation of osteoporosis therapy. An email address provided on the survey was the most important factor independently associated with accessing the intervention online. The design and uptake of this intervention may have implications for future studies in osteoporosis or other chronic diseases. (C) 2016 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license