Problem: Incidence, prevalence, and outcomes associated with osteoporosis could be significantly altered if current scientific knowledge about this disease were applied. However, there is a wide gap between what is known and the behaviors peri-menopausal women engage in to prevent or manage osteoporosis. Health behavior research related to osteoporosis is critical to identify effective and efficient methods to translate information into behaviors by persons at risk for and with osteoporosis. Aims: The aim of this study was to evaluate a tailored, interactive, computerized intervention designed for osteoporosis prevention prior to use in a large-scale experimental study. Preliminary studies included evaluation of (Aim I) congruence of the intervention with the theoretical framework, (Aim II) accuracy of translation of scientific knowledge into information for peri-menopausal women, and (Aim III) evaluation of the usability of the computer software to deliver the intervention. Method-Participants and Procedure: Characteristics of participants and methods differed by aim. Aim I: Four doctorally prepared nurse scholars expert in theoretical frameworks and use of theoretical models in practice evaluated theoretical congruence. These respondents received a printed document containing the informational content and a copy of An Integrated Model of Health Behavior Change with conceptual and operational definitions. Respondents were requested to evaluate the extent to which content of the intervention (a) supported the model, (b) was consistent with definitions of concepts, and (c) represented theoretical concepts using a 6 point Likert-type scale (0-5). Aim II: Six osteoporosis experts: two physicians, two advanced nurse practitioners, and two doctorally prepared nutritionists evaluated content translation from scientific documents to consumer-ready information. Interventional content was evaluated for accuracy, clarity, and importance of the message segments. Each participant was requested to complete three six point Likert-type scales (0 to 5) for each section of content. Respondents offered additional comments. Aim III: Fifteen, English speaking, peri-menopausal women were recruited from ambulatory clinics, a health education center, and a health fair and asked to evaluate the usability of software. Clinical usability was evaluated with “Complete A Task” questionnaire. A researcher observed whether or not the participant could complete a task by locating information in 2 minutes or less, accuracy of the response, and navigational problems experienced. Participants were asked to “talk aloud” as they answered questions/performed tasks for the researcher to identify and understand problems and issues. Results: The overall mean for theoretical congruence was 4.3 out of a possible 5. Reviewers raised questions related to one of the definitions (goal congruence) in the theoretical framework, how to tailor content to increase self-efficacy, and consistency of content across tailored messages. Overall, reviewers determined the content was accurate, clearly written, and important for women to know. The overall mean score was 4.89 of a possible 5 (mean for accuracy = 4.81, mean for clarity = 4.86, mean for importance = 5). Women were able to use the software with ease and in a timely fashion. Minor technical and labeling problems were identified. Additional findings included women's inability to recall the type of calcium supplement the were taking and their inability to calculate calcium content using food labels despite the provision of directions and practice activities. Conclusions: The tailored, interactive, computerized intervention was consistent with its theoretical underpinnings, accurate, and understandable; and could be easily used by women in clinical or private settings. Prior to conducting a larger experimental study the intervention will need to provide a process that assists women to recall their choice of a supplement and simpler directions with more practice activities to increase accuracy of reading food labels.
Disclosure Information:
Faculty Member's Name: Polly Ryan, PhD, RN, APRN-BC
I have no relationships to disclose.
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