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. ? ?
| Nahm, Eun-Shim; Bausell, Barker; Resnick, Barbara et al. (2011) Online research in older adults: lessons learned from conducting an online randomized controlled trial. Appl Nurs Res 24:269-75 |
| Nahm, Eun-Shim; Barker, Bausell; Resnick, Barbara et al. (2010) Effects of a social cognitive theory-based hip fracture prevention web site for older adults. Comput Inform Nurs 28:371-9 |
| Nahm, Eun-Shim; Resnick, Barbara; DeGrezia, Mary et al. (2009) Use of discussion boards in a theory-based health web site for older adults. Nurs Res 58:419-26 |
