A partnership among the University of Arizona's, College of Agriculture and Life Sciences: Cooperative Extension, Department of Nutritional Science and College of Public of Health, formed the Community Health Advancement Partnerships (CHAPS) program to build community based health promotion outreach in Arizona. The Bone Builders Osteoporosis Prevention Education Program started in 1998 as a CHAPS program in Maricopa County. Bone Builders is a train-the-trainer osteoporosis prevention education and social marketing program. The initial goals of Bone Builders were to increase awareness of osteoporosis risk factors and to increase osteoporosis prevention behaviors e.g. eating high calcium foods and increasing physical activity by women aged 25-55 years. The curriculum was based on physical activity bone strengthening research at the University of Arizona and osteoporosis prevention research from other universities.
Bone Builders educates volunteers who want to provide osteoporosis prevention education in their community and worksite settings. Volunteers complete a 2-day training workshop. It is taught face-to-face or by videoconferencing, simultaneously in Phoenix and Tucson. The instructors work in the field of bone health and include University of Arizona faculty, dietitians, pharmacists, physicians, and DEXA technicians. Volunteers receive lesson plans, background information, outreach resources, planning/reporting materials, and a quarterly newsletter. Trained volunteers teach community classes, provided outreach education at health fairs and provide bone density screenings. Volunteers submit quarterly reports that summarize the number of classes taught, number of health fairs attended, and numbers of people reached through the education programs by age, gender, and ethnicity. Osteoporosis risk factor questionnaires, stages of change and knowledge surveys are also collected from the classes taught. The county Extension faculty organizes local volunteers, supplies resources, processes the data collected and coordinates media outreach.
Bone Builders social marketing uses various media, public service announcements, newspaper features, flyers, newsletter articles, posters, printed materials, a website, and an 800 number offering taped osteoporosis information in English and Spanish to build osteoporosis awareness. Eighty thousand brochures and 3500 accompanying posters have been used in physician offices, community centers and worksites. Table 1. gives the statewide totals of people exposed to osteoporosis information through the Bone Builders Program in the last 6 years.
Table 1. Statewide Totals 1998-2003 304 Volunteers trained 969 Classes/25,024 participants 336 Health fairs/40,961 participants 2.7 million Media viewers/readers 27536 Website visitors/ 947,547 hits in 3 years
The Bone Builder classes are successful in increasing the knowledge of class participants. A statewide sample of 2,000 community participants rated their knowledge before a Bone Builder class as 2.5 and 4.5 after the class (1-5 scale; 5 being the highest). A sample of 211 class participants found only 16% did some weight-bearing exercise and 38% had a scan before the class. 79% intended to make changes as a result of the class. When called 4-6 months later, 39% said they actually increased their calcium consumption as a result of the Bone Builders classes, 36% had increased their weight-bearing exercise and 22% acquired a bone density scan.
As a result of a partnership with the Arizona Osteoporosis Coalition and the Arizona Department of Health Services in 1999-2001, Bone Builders has expanded to 7 additional counties and increased its target population to include older adults. Over the last 6 year, partnerships with foundations and state agencies have generated more than $570,000 that has aided in the sustainability of the Bone Builder program.
Community education by community members is an effective way to have a long lasting impact on the lives of individuals. Social marketing, though expensive, is very useful in raising awareness and receptiveness of osteoporosis prevention education. Volunteers, partnerships, and collaborations are critical to the sustainability of the Bone Builders Program.
Faculty Member's Name: Sharon Hoelscher Day, CFCS
I have no relationships to disclose.
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