Examination of an Osteoporosis Prevention Program: process evaluation and recommendations.Abstract: Osteoporosis osteoporosis (ŏs'tēō'pərō`sĭs), disorder in which the normal replenishment of old bone tissue is severely disrupted, resulting in weakened bones and increased risk of fracture; osteopenia is a crippling crip·ple n. 1. A person or animal that is partially disabled or unable to use a limb or limbs: cannot race a horse that is a cripple. 2. A damaged or defective object or device. tr.v. condition that often results in premature mortality and significant morbidity that is manifested in the form of fractures, bone deformity Deformity See also Lameness. Calmady, Sir Richard born without lower legs. [Br. Lit.: Sir Richard Calmady, Walsh Modern, 84] Carey, Philip embittered young man with club foot seeks fulfillment. [Br. Lit. , and pain. Osteoporosis is a serious public health problem that affects 25 million people in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , 80% of whom are women. National health objectives indicate an urgent need to reduce deaths due to falls, reduce the incidence of hip fractures hip fracture Orthopedic surgery A femoral fracture which affects 1/6 white ♀–US during life Epidemiology 250,000/yr–US Specifics Proximal femur; 90+% femoral neck, intertrochanteric; 5-10% are subtrochanteric Risk factors Tall, thin ♀, , and increase the number of women educated about osteoporosis. Strategies for preventing osteoporosis include maximizing peak bone mass and minimizing bone losses through health education and health promotion programs. This study describes the process evaluation of an Osteoporosis Prevention Program for middle-aged women utilizing the Health Belief Model and provides recommendations for future programs. ********** Osteoporosis is a crippling condition that of ten results in premature mortality and significant morbidity that is manifested in the form of fractures, bone deformity, and pain (Krall & Dawson-Hughes, 1999). It is a serious public health problem that affects 25 million people in the United States, 80% of whom are women (McBean, Forgac & Finn, 1994). Osteoporosis is responsible for more than 1.5 million fractures annually including hip fracture, a life-threatening outcome (Krall & Dawson-Hughes, 1999). Hip fracture results in severe disability and even death: 20% of persons who experience a hip fracture die within a year (McBean, Forgac & Finn, 1994). National expenditures related to this disease are estimated at $17 billion annually; this cost is estimated to triple by the year 2040 (Melton mel·ton n. A heavy woolen cloth used chiefly for making overcoats and hunting jackets. [After Melton Mowbray, an urban district of central England.] , Thamer & Ray, 1997). National health objectives indicate an urgent need to reduce deaths due to falls, reduce the incidence of hip fractures, and increase the number of women educated about osteoporosis (U.S.D.H.H.S, 2000). People who enter adulthood with low peak bone mass are at greatest risk of developing osteoporosis and associated fractures (Hansen, Overgaard, Riis, Christiansen, 1991). Lifestyle factors, including calcium intake and physical activity, account for approximately 20% of the variance in peak bone mass (Rubin, Hawker, Peltekova, Fielding, Ridout, Cole, 1999). Therefore facilitating healthy behaviors may maximize peak bone mass and slow bone loss. Medical treatment interventions are unable to completely reverse the effects of osteoporosis; therefore strategies designed to maximize peak bone mass and reduce bone loss later in life include prevention through health education and health promotion (Mark & Link, 1999). Studies examining the evaluation of osteoporosis prevention education are limited, and those that are available focus on impact data (Blalock et al., 2000; Jamal et al., 1999; Sedlak, Doheny & Jones, 2000). While impact studies are valuable, process evaluation examinations are crucial to the development and implementation of effective prevention programs. The purpose of this article is to describe the process evaluation of an Osteoporosis Prevention Program for middle-aged women using the Health Belief Model as a theoretical framework and to provide recommendations for future programs. HEALTH BELIEF MODEL COMPONENTS The Health Belief Model (HBM HBM Human Body Model HBM Human Brain Mapping HBM Hottinger Baldwin Messtechnik GmbH (German company) HBM High Bone Mass HBM Hybrid Bilayer Membrane HBM Humming Bird Medal HBM Her/His Britannic Majesty ) is a conceptual framework For the concept in aesthetics and art criticism, see . A conceptual framework is used in research to outline possible courses of action or to present a preferred approach to a system analysis project. used to understand health behavior (Becket beck·et n. Nautical A device, such as a looped rope, hook and eye, strap, or grommet, used to hold or fasten loose ropes, spars, or oars in position. [Origin unknown.] Noun 1. & Rosenstock, 1984). It can provide guidelines guidelines, n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. in determining program effect via changes in the HBM components. The HBM addresses five major components for compliance with recommended health action: perceived barriers of recommended health action, perceived benefits of recommended health action, perceived susceptibility susceptibility the state of being susceptible. Refers usually to infectious disease but may be to physical factors such as wetting or to psychological factors such as harassment. of the disease, perceived severity of the disease and cues to action. In addition, there are modifying factors that can effect behavior compliance. Modifying factors include media, health professionals, personal relationships, incentives, and self-efficacy of recommended health action. The Osteoporosis Prevention Program addressed these components in order to determine the process evaluation. How the Osteoporosis Prevention Program addressed these components follows. OSTEOPOROSIS PREVENTION PROGRAM Funding was obtained from the CommunityCare Foundation of Springdale, Arkansas For the Fayetteville-Springdale-Rogers Metropolitan Area (Northwest Arkansas), see . Springdale is a city in Washington and Benton counties in the northwestern region of Arkansas in the United States. to conduct an Osteoporosis Prevention Program to target 300 middle-aged women. This program was comprised of three components: educational classes, bone mineral density bone mineral density n. See bone density. bone mineral density A measurement of bone mass, expressed as the amount of mineral–in grams divided by the area scanned in cm2. See Bone densitometry. testing, and individual consultation. Process evaluation data were obtained in several ways. Researchers recorded attendance at activities as well as informal comments and statements made directly to program staff or to fellow participants. In addition, written process evaluation data were collected. Immediately following the program, subjects were asked to complete surveys that included two open-ended questions A closed-ended question is a form of question, which normally can be answered with a simple "yes/no" dichotomous question, a specific simple piece of information, or a selection from multiple choices (multiple-choice question), if one excludes such non-answer responses as dodging a . They were asked what aspects they enjoyed most about the program and what suggestions they had for future programs. These responses were categorized cat·e·go·rize tr.v. cat·e·go·rized, cat·e·go·riz·ing, cat·e·go·riz·es To put into a category or categories; classify. cat and are displayed in Table 1. Discussion of these responses is provided throughout this paper. EVALUATION OF RECRUITMENT EFFORTS According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. the HBM, perceived severity is an important component of health behavior change Behavior change refers to any transformation or modification of human behavior. Such changes can occur intentionally, through behavior modification, without intention, or change rapidly in situations of mental illness. . A flyer was developed to increase perceived severity. It included a list of dangers of osteoporosis, a graphic image of a spine, a photo of a disfigured dis·fig·ure tr.v. dis·fig·ured, dis·fig·ur·ing, dis·fig·ures To mar or spoil the appearance or shape of; deform. [Middle English disfiguren, from Old French desfigurer woman with the disease, and contact information about the Osteoporosis Prevention Program. This flyer was distributed to a variety of targeted settings including the local university, the school systems, libraries, community centers, hair and beauty salons, shopping centers shopping center, a concentration of retail, service, and entertainment enterprises designed to serve the surrounding region. The modern shopping center differs from its antecedents—bazaars and marketplaces—in that the shops are usually amalgamated into , the mall, grocery stores, health department offices, hospitals, clinics and doctors' offices. Recruitment efforts were also conducted by way of the local university daily e-mail announcements, newspapers, television and radio networks. These efforts resulted in 102 participants attending the Orientation Class. Cues to action were utilized during the first class. Attendees of the Orientation Class were instructed and reminded to tell their friends about the program and, as a result, 290 additional potential participants registered for subsequent sections of the Orientation Class. Clearly, word-of-mouth from initial participants was more effective than traditional recruitment efforts. Women appear to be effective disseminators of information; program planners can utilize this valuable information when planning the recruitment stage of future programs. The target goal was to obtain 300 middle-aged female participants. We greatly exceeded our target goals as 392 people attended the initial orientation class. Even more phone calls were received and a waiting list for future programs was developed. Of the initial 392 attendees, 369 met the study criteria and were, therefore, eligible to participate in the full study that included bone mineral density testing and individual consultation. Efforts were made to recruit women of all races and socioeconomic status socioeconomic status, n the position of an individual on a socio-economic scale that measures such factors as education, income, type of occupation, place of residence, and in some populations, ethnicity and religion. . Health Departments and clinics that provide medical care to underserved populations were included when distributing recruiting materials. In addition, the primary researcher contacted health care providers who worked with underserved populations to explain the program and encourage recruitment. Unfortunately, these efforts failed to recruit substantial minority and underserved populations. The majority of subjects were White (93%); 3 percent were African American African American Multiculture A person having origins in any of the black racial groups of Africa. See Race. , 2% were Asian and 2% were Hispanic. The mean age was 49 years, and ages ranged from 30 to 64 years. Most subjects were well educated with the average years of education equivalent to a college-level bachelor's degree. Future efforts should include effective methods of recruiting from all populations. PROCESS EVALUATION OF EDUCATIONAL CLASSES Four classes were designed to educate and provide skill acquisition information to assist women in making lifestyle modifications to improve bone health. The four class topics were: * general information about osteoporosis and orientation to the program, * improving calcium intake through low fat food selections, * selecting and utilizing calcium supplements, and * initiating and adhering to a weight bearing exercise program. The educational classes took place from January to May of 2001. To address the HBM program component of reducing barriers, common barriers that deter participant participation in health promotion programs for women were examined. These include inconvenient in·con·ven·ient adj. Not convenient, especially: a. Not accessible; hard to reach. b. Not suited to one's comfort, purpose, or needs: inconvenient to have no phone in the kitchen. program days and time, inaccessible inaccessible Surgery adjective Unreachable; referring to a lesion that unmanageable by standard surgical techniques–eg, lesions deep in the brain or adjacent to vital structures–ie, not accessible. See Accessible. location, lack of childcare, lack of time and excessive cost. This program was designed to reduce these common barriers. To make the class times convenient, eight sessions of each class were offered each month at a variety of times (morning, afternoon and evening) to accommodate the various scheduling needs of participants. Classes were held at a centrally located state-of-the-art community center that provided free childcare services as well as adequate parking. To reduce the barrier of lack of time, each of the four classes lasted one hour and the screening and individual consultation required approximately an hour and a half; therefore the total contact time commitment for the entire program was five and a half hours. To overcome another common barrier, cost, the program was offered free to participants as funding was obtained from a local private organization. The efforts to reduce barriers were effective as attendance and participation in classes were positive; 381 people attended the Nutrition Class; 375 women participated in the Supplements Class; and 350 women attended the Exercise Class. Participants were attentive and interactive. They showed interest and asked questions. Many positive comments of appreciation were received. According to the HBM, perceived severity is an important component. A common barrier to osteoporosis prevention is the erroneous belief Noun 1. erroneous belief - a misconception resulting from incorrect information error misconception - an incorrect conception that osteoporosis is not serious. To increase perceived severity and to encourage participation in the entire program, during the orientation class, negative outcomes associated with the disease were presented including death, crippling, disfigurement dis·fig·ure tr.v. dis·fig·ured, dis·fig·ur·ing, dis·fig·ures To mar or spoil the appearance or shape of; deform. [Middle English disfiguren, from Old French desfigurer , fractures, emotional suffering, depression and loss of independence. To demonstrate the severity of the health threat of osteoporosis, during the first class, a picture of a woman with a severe stooped stoop 1 v. stooped, stoop·ing, stoops v.intr. 1. To bend forward and down from the waist or the middle of the back: had to stoop in order to fit into the cave. posture and a protruding pro·trude v. pro·trud·ed, pro·trud·ing, pro·trudes v.tr. To push or thrust outward. v.intr. To jut out; project. See Synonyms at bulge. abdomen abdomen, in humans and other vertebrates, portion of the trunk between the diaphragm and lower pelvis. In humans the wall of the abdomen is a muscular structure covered by fascia, fat, and skin. was included in the educational materials. According to Klohn and Rogers (1991), motivation to prevent osteoporosis remained high among women in their study if they believed it was highly visible or disfiguring. The orientation class appeared to be effective at enhancing perceived severity. According to the HBM, perceived susceptibility is an important construct. Another common barrier to osteoporosis education is low perceived susceptibility reflected in the false belief that osteoporosis only happens to old women. In a study by Anderson, Auld auld adj. Scots Old. Adj. 1. auld - a Scottish word; "auld lang syne" old - of long duration; not new; "old tradition"; "old house"; "old wine"; "old country"; "old friendships"; "old money" & Schiltz (1996), women were aware about osteoporosis, but they were unconcerned about the harm to them specifically as individuals. Kasper, Peterson, Allegrante, Galsworthy, & Gutin (1994) reported that most women in their study believed they would not develop osteoporosis and practiced behaviors that were detrimental to bone health. To increase perceived susceptibility, a slide of normal healthy bone (from a 75 year old woman) and a slide of weak osteoporotic bone (from a 47 year old woman) were presented during the Orientation Class. To further increase perceived susceptibility, incidences of osteopenia, osteoporosis, and osteoporotic fractures among U.S. women of all ages were included. The concept of osteoporosis as the silent thief was discussed to illustrate that this disease progresses without outward symptoms until the disease progress is severe, often resulting in fracture. The Orientation Class appeared to be effective at enhancing perceived severity and susceptibility. Regarding aspects of the program that they enjoyed most, the vast majority of the responses related to the satisfaction of the classes: 65% of the participants reported that they preferred the educational classes; 31% reported that they were most pleased to be receiving accurate information; 16% were pleased with the heightened educational awareness created by the program; 11% preferred the handouts; and 9% appreciated the instructors' knowledge. Some participants voiced suggestions relating to relating to relate prep → concernant relating to relate prep → bezüglich +gen, mit Bezug auf +acc the classes. Thirteen percent stated that they were vegetarians and desired less emphasis on dairy products dairy products dairy npl → produits laitier dairy products dairy npl → Milchprodukte pl, Molkereiprodukte pl as a way to obtain calcium. One of the instructors was not well received by 8% of the participants. Most of the comments regarding the physical activity class were positive and 12% suggested more demonstrations of exercises. Ten percent were pleased with the convenience of the class times while 8% suggested that the classes be held at a different location. Cues to action were effective in the Nutrition Class and Supplements Class in helping women make purchases of new products to improve their bone health. In addition to providing educational materials and information, the program provided a framework for women to obtain the social support necessary to make positive behavior changes. Several women attended the classes with a friend or friends. Some women made new friends in the classes and others seemed to enjoy encountering former acquaintances. Women displayed attitudes of emotional support and helpfulness. During the nutrition class, several participants made plans to share meals and try new calcium-rich recipes. During the exercise class, some women made arrangements to exercise together. BONE MINERAL DENSITY TESTING The second component of the program, bone mineral density testing, was an effective perceived benefit of the program. Three hundred and forty two women participated in this component of the program, which exceeded our goal of reaching 300 women. Each participant received bone mineral density testing of the left hip, spine and total body using dual energy X-ray absorptiometry Dual energy X-ray absorptiometry (DXA, previously DEXA) is a means of measuring bone mineral density (BMD). Two X-ray beams with differing energy levels are aimed at the patient's bones. (DEXA DEXA, n.pr See dual-energy x-ray absorptiometry. ) technology. A full table Lunar LUNAR. That which belongs to the moon; relating to the moon as a lunar month. See Month. Prodigy An online information service that provides access to the Internet, e-mail and a variety of databases. Launched in 1988, Prodigy was the first consumer-oriented online service in the U.S. was used for testing. Bone mineral density testing was an effective participation incentive. The participants expressed appreciation for being able to have their bone density tested without having to pay a fee. Regarding aspects of the program that they enjoyed most, 22% appreciated being able to receive a bone density exam. Perceived susceptibility was greatly enhanced for women who had abnormal bone density results. The computer soft-ware generated detailed printouts regarding bone density and body composition. These included color printouts of bone density levels, graphic images of the hip, spine and total body, t-score and z-scores, and graphs displaying their readings along with future projections based on normal rates of loss. The total body printout (PRINTer OUTput) Same as hard copy. included bone density and body fat and provided a graph of chronic disease risk based on percent of body fat. INDIVIDUAL CONSULTATION AND REFERRAL To enhance perceived susceptibility and severity, three hundred and forty two women received an individual consultation. Of the 369 eligible attendees of the orientation class, 342 women completed the entire program, which demonstrates an impressive 93% retention rate. To maximize participation in this component, participants received consultations immediately following their bone density exams. The Principle Investigator who is a Registered Dietitian registered dietitian, n See dietitian, registered. conducted these consultations. The individual consultation was provided to explain the test results and to provide individualized in·di·vid·u·al·ize tr.v. in·di·vid·u·al·ized, in·di·vid·u·al·iz·ing, in·di·vid·u·al·iz·es 1. To give individuality to. 2. To consider or treat individually; particularize. 3. advice, empowerment and encouragement. Participants were provided with the color printouts of their bone density results with graphic images and graphs. Participants were also given with pre-prepared packets that included literature from the National Osteoporosis Foundation The National Osteoporosis Foundation (NOF) is an American voluntary health organization dedicated to osteoporosis and bone health. Its headquarters are in Washington, D.C.. regarding osteoporosis prevention and bone density testing. Additional literature was included for specific situations and conditions as appropriate. CONCLUSION Osteoporosis is a serious public health problem that affects 20 million U.S. women (McBean, Forgac & Finn, 1994). National health objectives indicate an urgent need to increase the number of women educated about osteoporosis (U.S.D.H.H.S, 2010). The most effective osteoporosis reduction strategies include prevention through health education and health promotion (Mark & Link, 1999). Studies examining the process evaluation of osteoporosis prevention education are limited. The purpose of this paper was to describe the process evaluation of an Osteoporosis Prevention Program through the use of the HBM. Process evaluation data provided documentation of success regarding the implementation of the Osteoporosis Prevention Program. Recruitment efforts exceeded goals and attrition Attrition The reduction in staff and employees in a company through normal means, such as retirement and resignation. This is natural in any business and industry. Notes: was low. To maximize recruitment, program planners can use word-of-mouth by initial participants in addition to traditional recruiting methods. Future programs need to explore strategies for reaching underserved populations in program recruitment. The Osteoporosis Prevention Program was well attended and received. The classes contained accurate, valuable educational materials designed to enhance perceived severity and susceptibility and to provide valuable skill acquisition techniques. The use of health behavior theory Behavior theory can refer to:
n. Variant of rhymer. , 1997, pg. 13-14). Using the HBM enabled planners to address the perceived barriers, the perceived susceptibility, and the perceived severity of osteoporosis prevention that lead to non-compliance with recommended strategies. This study confirms the value of utilizing the Health Belief Model in program planning. It would have been difficult to define areas of investigation without the HBM. Classes were offered at a convenient location and at a variety of times. Childcare services were provided. Overcoming these common barriers to program participation for women can assist in implementing a successful program. Providing an avenue for social support among women can enhance the effectiveness of osteoporosis education programs. More studies are needed to examine process evaluation to assist in program design and implementation. In addition, research is needed regarding how to effectively recruit underserved populations for osteoporosis prevention education programs. Acknowledgments: We express our appreciation to CommunityCare Foundation of Springdale, Arkansas for funding the Osteoporosis Prevention Program. REFERENCES Anderson, J. E., Auld, G. W., & Schiltz, C. M. (1996). Young women and osteoporosis: aware but unconcerned. Journal of Wellness Perspectives, 12, 63-69. Becker, M.H., & Rosenstock, I. M. (1984). Compliance with medical advice. In A. Steptoe & A. Matthews (ed.), Health care and human behavior. London: Academic Press. Pp. 135-152. Blalock, S. J., Currey, S. S., DeVellis, R. F., DeVellis, B. M., Giorgino, K. B., Anderson, J. J. B., Dooley, M. A. & Gold, D. T. (2000). Effects of educational materials concerning osteoporosis on women's knowledge, beliefs, and behavior, American Journal of Health Promotion, 14, 161-169. Glanz, K., Lewis, EM., Rimer, B.K. (1997). (Eds.) Health Behavior and Health Education: Theory, Research, and Practice. San Francisco San Francisco (săn frănsĭs`kō), city (1990 pop. 723,959), coextensive with San Francisco co., W Calif., on the tip of a peninsula between the Pacific Ocean and San Francisco Bay, which are connected by the strait known as the Golden : Jossey-Bass Publishers. Hansen, M. A., Overgaard, K., Riis, B. J., Christiansen, C. (1991). Role of peak bone mass and bone loss in postmenopausal post·men·o·paus·al adj. Of or occurring in the time following menopause. postmenopausal Change of life Gynecology adjective Referring to the time in ♀ when menstrual periods stop for ≥ 1 yr osteoporosis: 12 year study. British Medical Journal The British Medical Journal, or BMJ, is one of the most popular and widely-read peer-reviewed general medical journals in the world.[2] It is published by the BMJ Publishing Group Ltd (owned by the British Medical Association), whose other , 303, 961-964. Jamal, S. A., Ridout, R., Chase, C., Fielding, L., Rubin, L. A., & Hawker, G. A. (1999). Bone mineral density testing and osteoporosis education improve lifestyle behaviors in premenopausal pre·me·no·paus·al adj. Of or relating to the years or the stage of life immediately before the onset of menopause. premenopausal adjective women: A prospective study. Journal of Bone and Mineral Research, 14, 2143-2149. Kasper, M. J., Peterson, M. G., Allegrante, J. P., Galsworthy, T. D., & Gutin, B. (1994). Knowledge, beliefs, and behaviors among college women concerning the prevention of osteoporosis. Archives of Family Medicine, 3, 696-702. Klohn, L. S., & Rogers, R. W. (1991). Dimensions of the severity of a health threat: the persuasive effects of visibility, time of onset, and rate of onset on young women's intentions to prevent osteoporosis, Health Psychology, 10, 323-329. Krall, E. A., & Dawson-Hughes, B. (1999). Osteoporosis. In M.E. Shils, J .A. Olson, M. Shike, & A.C. Ross (Eds.), Modern nutrition in health and disease (pp. 1353-1364). Baltimore, MD: William & Wilkins. Mark S., & Link, H. (1999). Reducing osteoporosis: Prevention during childhood and adolescence. Bulletin of the World Health Organization, 77, 423-425. McBean, L.D., Forgac, T., & Finn, S.C. (1994). Osteoporosis: visions for care and prevention--a conference report. Journal of the American Dietetic Association The American Dietetic Association (ADA) is the United States' largest organization of food and nutrition professionals, with nearly 65,000 members. Approximately 75 % of ADA's members are registered dietitians and about 4 % are dietetic technicians, registered. , 94, 668-671. Melton, L.J. III; Thamer. M., Ray, N.E (1997). Fractures attributable to osteoporosis: Report from the National Osteoporosis Foundation. Journal of Bone and Mineral Research, 12, 16-23. National Cancer Institute. (1997). Theory at a glance: A guide for health promotion practice. Retrieved January 7, 2004, from http://cancer.gov/cancerinformation/theory-at-a-glance/page3. Rubin, L. A., Hawker, G. A., Peltekova, V., Fielding, L., Ridout, R., Cole, D. E. (1999). Determinants of peak bone mass: Clinical and genetic analyses in a young female Canadian cohort. Journal of Bone Mineral Research, 14, 633-643. Sedlak, C. A., Doheny, M. O., Jones, S. L. (2000). Osteoporosis education programs: Changing knowledge and behaviors, Public Health Nursing, 17, 398-402. United States. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS . (2000). Healthy People 2010. With Understanding and Improving Health and Objectives for Improving Health. 2"a ed. Washington, D.C: U.S. Government Printing Office. HEALTH EDUCATION RESPONSIBILITY AND COMPETENCY COMPETENCY, evidence. The legal fitness or ability of a witness to be heard on the trial of a cause. This term is also applied to written or other evidence which may be legally given on such trial, as, depositions, letters, account-books, and the like. 2. ADDRESSED Responsibility IV: Evaluating Effectiveness of Health Education Programs Competency C: Interpret results of program evaluation Program evaluation is a formalized approach to studying and assessing projects, policies and program and determining if they 'work'. Program evaluation is used in government and the private sector and it's taught in numerous universities. . Sub-competency 6: Make recommendations from evaluation results Lori W. Turner, PhD, RD Amy Gray, MS Sharon B. Hunt, EdD Ches Jones, PhD Lori W. Turner, Ph.D., RD. is an Associate Professor of Health Science in the Department of Health Science, Kinesiology kinesiology Study of the mechanics and anatomy of human movement and their roles in promoting health and reducing disease. Kinesiology has direct applications to fitness and health, including developing exercise programs for people with and without disabilities, preserving , Recreation and Dance at the University of Arkansas The University of Arkansas strives to be known as a "nationally competitive, student-centered research university serving Arkansas and the world." The school recently completed its "Campaign for the 21st Century," in which the university raised more than $1 billion for the school, used . Amy Gray, MS, is a graduate from the University of Arkansas and the University of South Florida • • [ . Sharon B. Hunt, Ed.D. is Professor and Department Head in the Department of Health Science, Kinesiology, Recreation and Dance at the University of Arkansas. Ches Jones, Ph.D. is an Associate Professor of Health Science in the Department of Health Science, Kinesiology, Recreation and Dance at the University of Arkansas. Address ali correspondence to Lori W. Turner, Ph.D., RD., Department of Health Science, Kinesiology, Recreation and Dance, College of Education and Health Professions, 309 H PER Building, University of Arkansas, Fayetteville, AR 72701, PHONE: 479.575.4670, FAX: 479.575.5778, E-MAIL: lori@uark.edu
Table 1: Participant Written Feedback Regarding the Osteoporosis
Prevention Program
Feedback Percent of
Subjects
Favorite Aspect of the Program (a)
Educational Classes 65%
Received accurate information in program 31%
Bone density exam 22%
Heightened awareness 16%
Handouts provided in classes and consultation 11%
Convenient class times 10%
Instructors' knowledge 9%
Suggestions for future programs (b)
Conduct follow-up program 14%
Emphasize non dairy products for obtaining
calcium 13%
Provide more demonstrations of exercises 12%
Hire a better informed instructor for a
nutrition class 8%
Hold classes at a different location 8%
(a) Percentages do not add up to 100% because participants could
select more than one aspect.
(b) Percentages do not add up to 100% because all participants did
not have suggestions and participants were encouraged to provide
more than one suggestion.
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