A Lifestyle Modification Intervention for the Treatment of Osteoporosis

Purpose: The purpose of this evaluation was to evaluate the effectiveness of a multidisciplinary educational and exercise program for individuals at risk for osteoporosis-related fractures.

Methods: The Highmark Osteoporosis Prevention and Education (HOPE) program is an ongoing, 8-week program with two postintervention follow-up assessments at 6 months and 2 years. Adults (n = 375) with osteoporosis or significant risk factors, most already engaged in healthy behaviors, self-selected for participation. Baseline measures included bone mineral density scans; fitness assessments; and surveys of depression, exercise, and nutrition behaviors. At course end and 6-month follow-up, assessments were repeated for fitness measures, depression, and exercise and nutrition adherence. Two-year postprogram assessments included bone mineral density scans and adherence measures.

Results: Paired t-tests showed significant improvements at course end in all measures (p < .0001) for the 87% completing the course. A repeated measure analysis of variance after 2 years with 79% retention indicated that adherence to nutrition recommendations was maintained at 2-year follow-up (p < .0001), whereas exercise adherence decreased but continued to exceed baseline measures (p < .0001). At 2 years, participants averaged two strength training sessions and 131 minutes aerobic exercise per week and consumed an average of 97% and 99% of the recommended calcium and vitamin D.

Conclusions: Although findings of this nonexperimental study are limited because of lack of a control group, the HOPE program suggests that a comprehensive community-based education and behavior change program can significantly reduce risk factors for osteoporosis and related fractures. Participants maintained lifestyle modifications for a minimum of 2 years despite advancing age.