Using Calcaneal Heel Ultrasounds to Screen for Osteoporosis at Alaska Health Fairs

Using Calcaneal Heel Ultrasounds to Screen for Osteoporosis at Alaska Health Fairs by Heather B. Guess, RN, BSN, MS, FNP-BC MS, Pace University, 1991 BSN, Pace University, 1990 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2018 Abstract Osteoporosis is a major health problem. The Alaska Department of Health and Social Services reports national rates of osteoporosis at 13-18% of women and 3-6% of men over age 50, but current evidence suggests that osteoporosis rates in Alaska are more equal between sexes. Known risk factors for osteoporosis that are very common among Alaskans include arthritis and low vitamin D and calcium levels. The U.S. PreventiveOsteoporosis is a major health problem. The Alaska Department of Health and Social Services reports national rates of osteoporosis at 13-18% of women and 3-6% of men over age 50, but current evidence suggests that osteoporosis rates in Alaska are more equal between sexes. Known risk factors for osteoporosis that are very common among Alaskans include arthritis and low vitamin D and calcium levels. The U.S. Preventive Services Task Force (USPSTF) recommends dual-energy x-ray absorptiometry (DXA) scans of the hip and lumbar spine as the gold standard of screening for osteoporosis; however, DXA scans are expensive, not portable, and not practical for screening small populations. Calcaneal heel ultrasound (CHU) scans are a USPSTF-recognized alternative to the DXA scan and can reach these small populations. Guided by the PRECEDE-PROCEED model, this project sought to evaluate the effectiveness of offering CHU scans at health fairs in Alaska. The de-identified data from the CHU dataset (N = 494) were analyzed to determine any differences in bone health based on sex and age. Alaskans over 50 years of age were significantly more likely to have osteopenia or osteoporosis (X = 28.2, df =4) than those < 50 years old. No significant difference in bone health as determined by T-scores was noted between men and women, suggesting that Alaskan men should also be screened. Educational materials on bone health were readily available at the health fairs for anyone interested. Health fair attendees are routinely asked for feedback and their responses related to the CHU scan were summarized and were unanimously positive. This project contributes to positive social change by increasing awareness of osteoporosis in Alaskans. Using Calcaneal Heel Ultrasounds to Screen for Osteoporosis at Alaska Health Fairs by Heather B. Guess, RN, BSN, MS, FNP-BC MS, Pace University, 1991 BSN, Pace University, 1990 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2018 Dedication I would like to dedicate this project to my parents. They both always supported me and made me feel that I could accomplish anything I set my mind to. While I know I never told them enough how much they meant to me, I also know they would both be very proud. Thank you, Mom and Dad! Acknowledgments There are so many people to acknowledge and thank for their support. First, I would like to thank Sharon, Tom and Andrei at Alaska Health Fair for all their patience and support of my project. Their dedication to the people of Alaska is heartwarming. I would like to thank Ruth and Vicki for allowing me to bunk with them when I went back to Alaska for practicums. I also need to thank my Committee Chair, Dr. Fowles. She demonstrated an infinite amount of patience and I would not have completed the DNP process without her. Lastly, I thank my husband, Arlin, and my children, Kelly and Andrew for their love and support of my desire to obtain my DNP. They have put up with changes in travel plans, listened to me vent, offered suggestions, and filled in gaps around the house as needs arose. I could not have done this without them.