title: A lifestyle modification intervention for the treatment of osteoporosis.
abstract: OBJECTIVE
  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.
authors.affiliation: Highmark Blue Cross Blue Shield, Pittsburgh, Pennsylvania 15222, USA. janine.pearson@highmark.com
authors.forename: Janine A
authors.initials: JA
authors.lastname: Pearson
authors.forename: Emily
authors.initials: E
authors.lastname: Burkhart
authors.forename: W Bradley
authors.initials: WB
authors.lastname: Pifalo
authors.forename: Tina
authors.initials: T
authors.lastname: Palaggo-Toy
authors.forename: Kelly
authors.initials: K
authors.lastname: Krohn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054598:Blue Cross Blue Shield Insurance Plans; D015444:Exercise; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000628:therapy*; D010414:Pennsylvania; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors