Striving to be Strong: Self-management
Condition: Osteoporosis; Health Behavior
MeSH terms: Osteoporosis
Study type: Interventional

Summary: 
      The vast majority of people want to be healthy and often make a change to be healthier.
      Change that is begun is seldom maintained. Osteoporosis is an example of one condition where
      people are encouraged to regularly engage in preventative health behaviors. This is a study
      testing a new approach to helping women engage in osteoporosis health behaviors. This new
      approach includes beliefs, self-regulating skills and abilities, and social facilitation
      delivered via a cell phone app. If effective, this approach could be tested with other health
      behaviors.
    

Detailed description: 
      The goal of this project is to test the efficacy a theory based, patient-centered,
      dynamically tailored intervention delivered via a cell phone app. The four aims of this
      project are to: 1) Test the efficacy of the intervention to improve long term maintenance of
      osteoporosis prevention health behaviors in midlife women, 2) evaluate moderators and
      mediators of long-term engagement in health behaviors, 3) describe processes of health
      behavior change and evaluate differences within and between subjects using Ecological
      Momentary Assessments (EMA) as a complement to traditional measures and 4) evaluate the
      utility of The Individual and Family Self-Management Theory to explain health behavior
      change. In the U.S., over 35 million women either have or are at high risk for osteoporosis
      at an anticipated cost of greater than $25 billion by 2025. Osteoporosis affects 1 out of 2
      White women, is rapidly growing among populations of color and causes high chronic disease
      burden worldwide. Less than 6% of women regularly engage in the basic health promotion
      behaviors. The vast disparity between the high prevalence of osteoporosis and the low number
      of people who engage in preventative care highlights this condition as one of many striking
      examples of the crucial role behavior change could play in improving health and decreasing
      health care costs. New knowledge suggests enhancing knowledge and beliefs, self-regulation
      skill and abilities, and social facilitation leads to self-management and improved health
      outcomes. It is hypothesized that the more an intervention integrates health behavior change
      processes into daily activities the more likely it is to increases one's capacity to
      self-manage. The work proposed is significant because it focuses on the serious and prevalent
      condition of osteoporosis; tests the application of a theory based, patient-centered, dynamic
      intervention designed to improve outcomes; and, decisively bundles new knowledge about
      methodologies, intervention processes, and delivery media to provide a cohesive foundation
      for intervention development and testing. Innovative aspects include use of EMAs as a
      complementary approach to providing feedback and measuring behavior change processes; testing
      a newly identified health behavior change theory; and development and evaluation of a cell
      phone app, one type of m-Health. Through technological advances we now have the capacity to
      integrate health behavior change processes into every day activities via a cell phone app but
      the effectiveness of the app to change health behaviors has not been demonstrated
      empirically. A three-group randomized controlled longitudinal design with data collected at
      baseline, 3, 6, 9, and 12 months will be used. A convenience sample of 288 (96 per group)
      community dwelling women will be enrolled. Outcomes will be evaluated with self-report,
      behavioral performance, and bio-behavioral measures, including DXA and vitamin D. The
      expected outcomes are achievement of an increase in women's initiation and long term
      maintenance of osteoporosis self-management behaviors and stabilization of bone mineral
      density.
    

Intervention name(s): Striving; Boning-Up; Personal Choice
Intervention type(s): Behavioral; Behavioral; Behavioral
Other intervention name(s): S2BS
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Repeated measures randomized clinical trial
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: self-management; m-Health