Effects of a Hip Fracture Prevention Website for Seniors

描述（由申请人提供）：在美国，每年大约有34万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知识有所进步，但许多老年人对基于证据的髋部骨折预防措施缺乏足够的信息。随着老年网络用户数量的增加和技术的快速发展，网络可以成为改善这种知识差距和促进健康行为改变的有价值的媒介。在这个R21探索性申请中，研究者提出了一项研究，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。该网站将按照社会认知理论（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)一个有节制的讨论板，将提供交互式社会学习环境和支持的额外优势。通过比较这个以理论为基础的、结构化的网站（TSW）与传统网站（CW）的影响，并提供髋部骨折预防资源的建议链接列表，来评估这个网站的效果。本研究为随机对照试验，采用两组重复测量设计。结果包括知识（骨质疏松和髋部骨折）、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）和行为改变（钙摄入量和运动水平）的变化。将从两个网站：SeniorNet和The Baltimore Times online中招募160名老年在线用户（年龄b> =55岁）。后者主要由非裔美国人用户访问，并将有助于确保这一族裔群体的充分代表性。混合线性模型用于比较两个研究组（TSW vs. CW）在三个时间点（基线，治疗结束，3个月随访）的每个结果的变化，招募地点为随机效应。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。如果本研究证明TSW比CW更有效，将开展更大规模的纵向试验，以检验TSW对实际髋部骨折的影响，以及其对老年人健康行为改变的纵向影响。此外，政府亦会进行一项跟进研究，以确定长者健康福利计划对其他长者健康问题（例如高血压）的成效，而这些问题在社区内是可以预防或管理的。

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.