Effects of a Hip Fracture Prevention Website for Seniors

描述（由申请人提供）：在美国，每年约有340，000名老年人经历髋部骨折。尽管我们对髋部骨折的原因和治疗的认识有了进步，但许多老年人没有足够的关于髋部骨折预防措施的循证信息。随着越来越多的老年人的网络用户和快速发展的技术，网络可以是一个有价值的媒介，改善这种知识差距，促进健康行为的改变。在这项R21探索性应用中，研究人员提出了一项研究，该研究将为老年人开发一个创新的髋部骨折预防网站，并测试其对健康结果的初步影响。本网站将根据社会认知理论（SCT）开发，采用（1）结构化的网络学习模块，将系统地向老年人提供基于证据的健康信息，（2）主持讨论板，将提供交互式社会学习环境和支持的其他优势。将通过比较这个基于理论的结构化网站（TSW）与传统网站（CW）的影响来评估该网站的效果，该传统网站（CW）提供了一系列建议的髋部骨折预防资源链接。本研究是一项采用2组重复测量设计的随机对照试验。结果包括知识（骨质疏松症和髋部骨折），自我效能（钙摄入量，运动和基于网络的学习），结果预期（钙摄入量，运动）和行为变化（钙摄入量和运动水平）的变化。将从两个网站：SeniorNet和《巴尔的摩时报在线》招募160名老年在线用户（年龄>=55岁）。后者主要由非裔美国人用户访问，将有助于确保这一族裔群体的充分代表性。使用混合线性模型比较两个研究组（TSW vs. CW）在三个时间点（基线、治疗结束、3个月随访）的每个结局的变化，招募部位作为随机效应。从这项研究中获得的知识将有助于进一步研究利用网络对老年人的巨大健康促进承诺的方法。如果这项研究表明TSW比CW更有效，将开发一个更大的纵向试验来研究TSW对实际髋部骨折的影响，以及其对老年人健康行为变化的纵向影响。此外，我们会进行跟进研究，以确定这项计划对其他长者健康问题的成效（即：高血压），可以在社区预防或管理。

DESCRIPTION (provided by applicant): Each year, in the United States, approximately 340,000 older adults experience hip fractures. Despite advances in our knowledge of causes and management of hip fractures, many older adults do not have adequate information about evidence based hip fracture preventive measures. With the increasing number of older adult Web users and fast growing technology, the Web can be a valuable medium for ameliorating this knowledge gap and facilitating health behavior change. In this R21 exploratory application, the investigators propose a study that will develop an innovative hip fracture prevention Web site for older adults and test its preliminary effects on health outcomes. This Web site will be developed in accordance with a social cognitive theory (SCT) employing (1) structured Web learning modules that will deliver evidence based health information to older adults systematically and (2) a moderated discussion board that will provide additional advantages of interactive social learning environment and support. The effects of this site will be evaluated by comparing the impact of this theory-based, structured, Web Site (TSW) with the impact of a Conventional Web site (CW) with a list of suggested links to hip fracture prevention resources. The study is a randomized controlled trial employing a 2-group repeated measures design. Outcomes include changes in knowledge (osteoporosis and hip fracture), self-efficacy (calcium intake, exercise, and Web-based learning), outcome expectations (calcium intake, exercise), and behavior change (calcium intake and levels of exercise). A total of 160 older adult online users (age >=55 years) will be recruited from two Web sites: SeniorNet and The Baltimore Times Online. The latter is primarily visited by African American users and will help to ensure adequate representation of this ethnic group. A mixed linear model is used to compare changes in each outcome between the two study groups (TSW vs. CW) across the three time points (baseline, End-Of- Treatment, 3 month follow-up) with recruitment site as a random effect. The knowledge gained from this study will facilitate further research into methods of harnessing the vast health promotional promise of the Web for older adults. If this study demonstrates that TSW is more effective than the CW, a larger longitudinal trial will be developed to examine TSW's effects on actual hip fracture, as well as its longitudinal impact on changing health behaviors among older adults. In addition, a follow-up study will be conducted to ascertain effectiveness of the TSW for other older adults' health problems (i.e., hypertension) that can be prevented or managed in the community.