Lesson Plan: Osteoporosis Treatments in
Older Women
Title of Health Intervention
Part A: Exercise as an Effective
Method of Therapy for Bone Health
Health Topic and Intended Audience
What is
Osteoporosis? Osteoporosis is associated with the aging process. As we age, the
processes of our bodies change, this includes our bones. Bones are not solid.
They are living parts and under constant reconstruction. The processes at work
are removing damaged bone and replacing stressed and damaged bone continually. These are usually occurring in unison or in
balance. When the process is altered by age or external factors, the bones may
be removed at a higher rate than replacement, causing the structure of bones to
become weakened. Weakened bones break from the simplest activities, minor bumps
or falls (Carmona & Moritsugu, 2004).
Why is it
important to know the facts about osteoporosis? The U.S. National Library of
Medicine (2012) states that approximately half the women over 50 will suffer
from a fracture of the hip, wrist, or vertebra of the spine in their lifetime. The
Center for Disease Control and Prevention [CDC] (2012) lists the number of
woman 50 and older with osteoporosis of the hip as 10%. This seems a low
percentage until you think about the entire population of women in this age
group. This equates to 4.5 million women.
Men fair a little better at 2% or 0.8 million men 50 years and older
with osteoporosis of the hip (para. 1). The CDC (2012) provides statistical
data of the number of hospital discharges for hip fractures in 2009 alone as
279,000 (para. 2).
These statistics
show that older Americans, specifically older American women, are at risk and
need tools to reduce the effects or to stall the development of
Osteoporosis. Lifestyle changes are
prominent in a woman’s battle against this ultimately debilitating condition.
Treatments include medications, dietary supplements, and weight-bearing or
strength exercises. Knowing what combinations will work best for an individual
is difficult to determine. The more
information one can gather, along with discussions with health care
professionals, will increase a woman’s success in their campaign for better
bone health.
The local
health care facility Women’s Clinic has implemented a six-week educational series
on hot health topics focusing on women. This session is focused on older women and
their bone health. Although, the session will focus on an audience of older
woman (age 50 and older), all information is relevant to any age woman or man. The
topics for this session will be diet and exercise therapy, methods to improve
bone strength and, ultimately, reduce fractures in older osteoporotic women.
Setting
Women’s Clinic at Good Samaritan
Hospital (Eva Hill
Conference room).
The Eva Hill
Conference room has a capacity for 80 people. The session will use half of the
room for discussion and presentation and the other half as a
demonstration/activity area. This
session will accommodate up to 30 participants.
Sessions will be
presented on Saturday morning’s beginning at 11a.m. This time and day appears
to accommodate the most number of participants.
It will be easier for those who work during the week to attend. Retirees will be free of their usual week day appointments. The start time will allow for early risers to
complete morning errands and allow late risers the time to arrive. The time is also at a “brunch” hour that
would better accommodate a light refreshments menu.
Refreshments will
be set up in the adjoining refreshment area located at the rear of the
conference room. This will allow participants to mingle without interfering
with in coming participants. An
information/sign-in desk will be located outside the entrance to the conference
room. Handout packets will be available for pick-up at sign-in and distribution
during the introduction period.
Seating for
presentations will face the center of the room with the presenter set up in
front. A table positioned behind and to the side of the presentation area for
extra handouts, displays, props, etc.
Chairs will be positioned in line with ½ size conference tables, leaving
an area free of tables and chairs to accommodate those with wheelchairs. Have ready 8-10 hospital bed tables, as
needed, for wheelchair participants for use as a writing table.
Estimated Time
The entire session
will last for 90 minutes and will be broken into two segments; first segment,
(part A) exercise and osteoporosis and second, (part B) diet to help build bone
strength. Each segment will use approximately
30 minutes of the session, allowing for a 5-10 minute break between segments
and 15-20 minutes at the end of the session for evaluation and additional
question and answer time.
Materials Needed
Room:
12
- ½ size Conference tables (Seating 2-3 per table)
8-10
Hospital bed tables
40
Chairs
3 –
Full Size Banquet style Tables (1 – for Sign-in & 2 – for Presentation
& Display)
Extra
Pens/Pencils
A
few magnifying glasses
Additional Personnel:
Sign-in
table - 2 people
Refreshment
table – 1 person
These
three people will also be available to help during activities and evaluation
times.
Refreshments:
Healthy choices of calcium rich foods and
beverages
Plates
& Napkins
Utensils
Cups
Trash
receptacle
Presentations:
Exercise: Props
for weight-bearing exercise (i.e. soup/vegetable cans, free weights, bags of
beans, etc
Foods: Plastic
food props or pictures of various foods (high in calcium and vitamin D and some
that are not)
Activities:
Introduction: quick ice breaker: Groups
of 3-4, no other materials needed
Exercises Demonstration:
Warm
up/stretching exercises: Balls, cards, poster target, prizes for “winners”
Tai Chi moves,
Weight-bearing:
Modified free-weight and stretching for chair bound participants as the need
presents.
Foods: (Pictures)
examples of calcium rich foods include vitamin content and other foods that may
not have high calcium or any calcium (Have participants pick out three foods
they think are rich in calcium & vitamin D.
Have them rank these in highest to lowest in calcium content.)
Sign-In and Evaluation:
15-20 Extra Pre-questionnaires
15-20 Extra Handout
packets
Participant list
30 Post-Evaluation
tools
30 Extra
pens/pencils
Guiding Health Education Theory or Model
The following
three models are intertwined in the understanding of any health issue. Health Belief Model (HBM). The study by Gerend,
Erchull, Aiken, & Maner (2006), looked at
the perceived risk of susceptibility to osteoporosis in women 40 and older with
a median age of 62.5. Using a sample of 358 women not diagnosed with
osteoporosis, the researchers reported 63% of these women felt their risk for
developing osteoporosis was low. These women felt that personal actions would
affect their susceptibility to osteoporosis and showed to be dependant on their
understanding of their risk factors. The
study showed the more they understood about the risk factors and treatments,
the lower they perceived their risk to be for developing the condition. Perceived
susceptibility is one of the key concepts of the Health Belief Model (Gilbert,
Sawyer, & McNeill, 2011, p. 58).
Because osteoporosis is a silent condition, one does not
know there is a problem until a fracture occurs. Therefore, a woman may be thinking her bones
are as strong as ever or not thinking about them at all. Older women in this
category tend to not think about what they could be doing to prevent or delay
the onset of osteoporosis. If the thought does occur that osteoporosis could
happen to them, it is followed with, “The doctor will prescribe something to
make it better”. The other thought that occurs is that of age or ‘I’m too old
to start now to do any good’. The health educator must address and over come
both types of thoughts in HBM; the first, the procrastinator or one who puts a
large amount of faith into a doctor to make everything better and second, the
defeatist attitude. The research data from Gerend, Erchull, Aiken, & Maner
(2006), describes a large number of women who may not believe they will develop
osteoporosis. Therefore, it is the health educator’s duty to help them
understand the risks for developing osteoporosis and give them the motivation
and tools to combat it. Other key points
to HBM are the perceived benefits, perceived barriers, perceived severity and
the motivational factors to cause the individual to take action.
Transtheoretical
Model (TTM). Gilbert, Sawyer, & McNeill (2011), explains this theory as
several theories combined and focused on Stages of Change Theory; which is
comprised of five levels or stages: pre-contemplation, contemplation,
preparation, action and maintenance (p59). The reasoning for the preparation
and execution of an intervention of a health concern is spurred from the need
and desire for action. In the case of this educational intervention on
osteoporosis, women had to have the desire to learn more either after being
diagnosed or having a scare directing their thought toward developing osteoporosis. Registering for the class and attending are
both preparation and action steps.
Maintenance would be the follow through on the information learned. In all steps the risks and benefits (pros and
cons) are considered. This model allows
the educator the freedom to alter a health intervention to the needs and
desires for change in the audience (p. 59). A pre-assessment could be the tool used to
determine the flow of the presentation.
Social Cognitive
Theory (SCT). This model uses
“interpersonal aspect[s] of behavior” (Gilbert, Sawyer, & McNeill, 2011, p.
61) to provide the framework for an intervention. There are several concepts that are a part of
SCT that work to build and reinforce the other. This theory uses the
individual’s knowledge, the situation and environment, as well as expectations,
among others, to promote change of behavior.
One of the most
important for behavior change is self-efficacy or the confidence a person has
in their ability to perform a particular action (I can do it, because I believe
I can do it). Barriers play a large role
in this thought process. If an
individual believes the barriers are too great then the individual will not
succeed in the endeavor or even try. Osteoporosis
can cause fear of fracture, which in turn causes fear of hospitalization, fear
of impairment or disability, or even, fear of death. The barrier of fear can cause an individual
to take no action. This thinking must be
reversed for the fear will ultimately induce the condition they are trying to
avoid, through doing nothing.
Goal
The goal of this
session is to improve the understanding of the worth of diet and exercise in treating
or reducing the risks associated with Osteoporosis in older women.
·
Part A: Provide examples of exercises that are
useful in increasing muscle tone, balance, and strength.
·
Part B: Introduce participants to foods shown to
be beneficial for bone strength.
Objectives:
For Exercise:
Program Outcomes and Learning Domains
Part A: Exercise
Program Outcome
Objective #1: At the conclusion of the exercise segment, 85% of the
participants will be able to list two exercises used for balance, muscle tone
and strength (Cognitive domain).
Program Outcome
Objective #2: 50% of the participants will accept exercise as a form of
treatment for osteoporosis by choosing at least two of the exercises listed on
the post evaluation form to tryout. (Affective domain)
Program Outcome
Objective #3: 75% of the participants will imitate the demonstrated
exercises or participate in the activities. (Psychomotor domain)
Part
B: Food
Program Outcome
Objective #1: At the conclusion of the diet segment, 85% of the
participants will be able to list two new foods containing calcium &
vitamin D (Cognitive domain).
Program Outcome
Objective #2: 50% of the participants will accept dietary changes as a form
of treatment for osteoporosis by choosing at least two new foods listed on the
post evaluation form to include in their diet. (Affective domain)
Program Outcome
Objective #3: 75% of the participants will sample some of the foods from
the refreshment trays provided and list these on the post evaluation form.
(Psychomotor domain)
Process Objectives:
Program Process
Objective #1: Verify that the
community service ads were listed in the newspaper and delivered over the radio
at least one week before the session date.
Program Process
Objective #2: Determine the number
of participants that have registered for the Osteoporosis session by reviewing
the sign-up list from registration.
Program Process
Objective #3: Order refreshment (food and drinks) at least one week ahead
to be delivered and set up in Eva Hill Conference room by 945am the morning of
the session.
Program Process
Objective #4: Have prepared at least 40 handout packets by Thursday before
the session date.
Procedures
Advertisement:
Information
on the six-week series on Women’s Health
is posted at the community centers in the area. It is also sent to churches,
Women’s clinics and hospitals, physician and dental offices, high school and
college student services, and the YMCA. The information is also sent to local newspaper,
radio and television community service desks to be run in their classified ads
section and during community service spots.
Registration:
Registration
for the series or each session will be made through the Women’s Clinic at Good
Samaritan Hospital. Contact the Clinic’s
registration desk for details. Seating
is limited to 30 and preference will be given to women aged 50 and older,
younger as space is available. The
addition of popular topics (as determined by the number on a waiting list for
each session) will influence their addition to future health issues series.
At
registration for this session each participant will be given or sent a Resource
packet that will include a questionnaire on their knowledge of osteoporosis and
treatments. Participants are requested
to bring the completed questionnaire and the packet to the session. The questionnaire will be gathered and used as
a pre-assessment of the participant’s knowledge.
Pre-Introduction: Have participants arrive early (15 – 30
minutes early) for light refreshments and informal introductions. Have extra questionnaires and resource packets
available at sign-in for those who forgot to bring theirs.
Introductions:
Instructor introduction:
Good morning! I’m glad everyone is here to talk
with me about what we can do to treat osteoporosis. My name is Marsha Cox and I am your presenter today. Just a little bit about me: I have a master’s
degree from Midwestern
State University
in Radiologic Education. I have worked
as a radiologic technologist for 17 years and an educator for the past 10
years. For four years I worked with physicians and patients providing bone
densitometry scanning (primarily, DEXA) and patient education on Osteoporosis
and non-medication treatments. Today, we will discuss how exercise and diet can
be used to potentially counter the effects of osteoporosis, and how easy they
can be added to your daily lives. But first, let’s get to know you.
Everyone please put yourselves into groups
of 3 or 4. Take about 5 minutes to
introduce yourselves to your group, then decide on a spokesperson and finally,
tell one thing you would like to know or do know about osteoporosis and treatments.
The groups need to decide on one common item to use in your group’s
introduction when we all come back together. The spokesperson will then
introduce the group and their common thought on Osteoporosis and treatments.
Participant Introduction:
Quick ice breaker: 15 minutes
This activity
serves multiple purposes. First, by forming groups there is now a bonding started
allowing for some commonality among the participants, there are now groups
instead of individuals. This may help
when other group activities begin.
Second, learning begins at an early stage. By having each member offer
something about the condition or treatment gives insight into what is known or
what is needed to fill in. Some groups
may offer a question of what they would like to know, either prompting
additional discussion or a place to emphasize a portion of the presentation.
Groups of 3-4 & take five minutes total to decide on a
spokesperson and have each participant introduce themselves to the others in
their group and tell one thing they would like to know or do know about
Osteoporosis and treatments. Decide on the common topic the group would like to
know about Osteoporosis. Regroup and have each spokesperson introduce their
group members (first names only) and topic of interest. (Have a
short discussion or acknowledgement of the topics presented)
Demonstration and Participation
Okay, now, answers to a
few of the big questions. What is
Osteoporosis? Does everyone get it? Can its effects be stopped or reversed? What
kinds of treatments are available to help strengthen bones? Doctors will prescribe hormone replacement
therapy as one form of treatment, but that topic will be reserved for another
course. Today, we will discuss some
things you can do at home. Our topic is
exercises and foods that are beneficial to bone health.
First, the basics. What
is Osteoporosis? It is a weakening of
the bones making them brittle and fragile; to the point of breaking easily from
everyday bumps and simple falls. This
happens for several reasons, primarily, from aging, but also from certain medications,
and other health concerns that leach calcium and vitamin D from bones (Carmona
& Moritsugu, (2004); National Institute of Arthritis and Musculoskeletal and Skin Diseases, (2012);
Medline Plus, (2012).
Does everyone get it;
No, not everyone. This condition affects
mostly women but men can develop osteoporosis as well. The Center of Disease Control and Prevention
(2012) reports that as many as 4.5 million women over age 50 have a diagnosis
of osteoporosis of the hip; that is equal to 1 in 10 women living in American. Look around the room today, at least 3 of you
can have osteoporosis in you hip. Men do
develop osteoporosis but at a much lesser rate (1 in 50).
Can its effects be stopped or reversed? In
many cases, yes; osteoporosis can be slowed or delayed. With some, bone can be
stimulated to grow; however, it may not grow as rapidly or as much as when you
were 30 years old and at your peak bone growth.
What kinds of treatments are available to help strengthen bones? Under
your health care providers’ advice and direction you could manage the effects of
osteoporosis and help develop stronger bones.
As mentioned earlier, Hormone Replacement Therapy (HRT) can help and
more information can be found at the American College of Rheumatology (2012)
website, listed on the website page in your handouts. Our focus today will be on some
of the everyday things you can do to help your bones to be stronger. The two
magic words: Diet and Exercise.
Let’s start with Exercise:
But you say you don’t have osteoporosis, so why should you exercise? It is
never too late to start nor too early either.
The longer you keep bone mass the less osteoporosis will be a bother to
you. As you may have heard from your doctor, on the TV or from a friend,
weight-bearing exercise is best for bone health. Remember your doctor is your first step,
discuss what you like to do, what you need to do, and what you can do before
starting any exercise program. What are weight-bearing exercises? Some examples
are running, brisk walking; free weights, golf, dancing, Yoga, racquet sports, kickboxing
or a step class, anything that gets you up and moving is good (WebMD, 2007). But what if you are not at a point where you
can walk two blocks or do yoga? What can you do to start?
Let’s get creative and
UP!
Activities
Part A Exercises:
Stretches
Stretching is always a good place to start.
But if you have been diagnosed, do not do
stretches that require you to bend at the waist or twist the spine. Balance
exercises such as tai chi or something as simple as trying to balance
yourself on one foot for several seconds are a good beginning place. Simple
stretches:
The Arthritis Foundation (2012) suggests
several stretching exercises that can be used for individuals in a seated
position or standing.
o Arm circles backward for 30 seconds (big
circles & little circles); end with wrist circles, wrist bends for a few
seconds each and then fingers open and closed for 10 seconds.
o Stretching the chest and shoulder muscles is
not a usual movement in everyday use and these muscles get tight. Stretching
them is a good idea. Stand or sit on a stool (no back). Sit up straight, hold
your head level to the floor; raise your arms to put your hands about the level
of your ears. Now squeeze your should blades together by moving your arms
toward your back. Relax. Repeat for 5 – 10 repetitions.
o Seated straight leg raises for 30 seconds
(about 5-10 repetitions each leg);
o Knee ball squeeze (squeeze ball between
knees for 5 second repetitions for 60 seconds or 10 – 12 times);
o Ham string and calf stretches are good.
There are many others to use see the website
pages for other resources and variations of these movements. We could have a
class on just stretching exercises but we are only giving you some ideas to
start with today. Exercise can be in many forms. So, now that we have our arms
limbered let’s play a game.
Toss Game
Everyone needs to return to their groups
from our earlier introduction. Each team will have a circle target that each
team member will need to sail (toss) their cards and land in it. Each member
will have two tosses, one person at a time.
If their cards land outside the circle (partially or completely),
retrieve the cards and go to the back of the teams’ line and go again. Object is to be the first team to have all
their cards completely in the circle. (Play the game). This is
a good one for groups, say at church functions or community center days.
Posture Exercises
For these you do not want to strain your
neck or back. Gently lean back to
comfortably stretch out and strengthen the back by following these directions:
Directions:
- Sit with your middle and lower back well-supported in a chair.
- Move your head straight back as far as possible.
- Keep your chin level with the floor and look straight ahead. Do not tilt your chin or forehead.
- Hold your head back in this position for 3 or 4 seconds.
- Then relax back into your normal posture for a second or two.
- Now repeat 5 times. Do this exercise several times a day.
Tai Chi Movements
Classes for Tai Chi can be found at
colleges, the Y, even churches and community centers. I will demonstrate a few
of the movements. Some of the movements
for the upper body can be performed while seated. These are good for warm ups
of the arms. Breathing is very important in any routine. Tai Chi coordinates
movement with breathing. (See
handout).
Weight-Bearing Exercises
Weight-bearing exercise means to be up on
your feet and moving. Some exercises to start with:
o If you are fit and able, walking or running
is excellent.
o Step aerobics (not a full routine to start,
just a few minutes);
o Free Weights (wrist/leg weights attached or
held during your exercise routine) Soup cans or bags of beans work as held weights.
o Any one for badminton or tennis? These are
good for many reasons. You are moving several areas of your body (arms, legs,
back, etc) and you are moving across the court, almost running!
Water aerobics is a good form of strength
exercise but not the best for weight bearing, same for swimming.
Impact exercises are a good place to start
(even from a chair). Stay seated, lift on leg off the floor a few inches, hold
then drop it to the floor. Start with just an inch or two off the floor and
work up to higher. The sudden stop will
help strengthen the bones of your feet and ankles. This should be discussed
with your doctor before you begin these.
What are some other activities that you can
think of that you have tried or would like to try?
(short discussion) I hope this has shown you
that exercises do not need to be at a gym or strenuous; you don’t need fancy or
expensive equipment; a workout does not need to be hours long (short and several
throughout the day is better). The key is to get started. So, talk to your
doctor first and choose something you like to do.
Questions? (Discussion as needed)
Let’s
take a short break and regroup to discuss foods for bone health.
Part B Diet:
We have all heard that our bodies need the
right foods to stay healthy; nutrients like minerals and vitamins are necessary
for strong bones and teeth as well as the immune system. Calcium and vitamin D
are two of these. Calcium without vitamin D is not enough. Vitamin D is
necessary for the body to absorb the calcium.
We all know that milk and cheese are good sources of calcium. Do you
know of other foods that are high in calcium? (wait for a few responses) Some
you may know others you may not yogurt, cheese, and ice cream; dark green
leafy vegetables, such as broccoli, collard greens, and spinach; sardines and
salmon with bones; tofu; almonds; and foods with added calcium, such as orange
juice, cereals, and breads (Smith, 2012, para. 2). What about vitamin D? Vitamin D
occurs naturally from two sources, from the direct exposure of sunlight to our
skin and through our diet. Supplements are also available to those who do not
get enough from the sun or diet. Do you
know what vitamin D sources are foods? How
about fortified dairy products, egg yolks, saltwater fish, and liver. (Review the food list from the
handouts)
Know your foods and food additives. Did you
know there are foods and food additives that actually work against bone
strength? Salt or sodium is one such additive.
Other substances that are thought to cause calcium to leave the body
through urine are caffeine and carbonated drinks.
Handouts
Information
Brochure
Exercise:
o Tai
Chi information handout,
o Mayo
Clinic Exercising with Osteoporosis: The safe way,
o Two-Minute
Moves for Pain Relief,
o Posture
Exercises,
o How
to Stretch with Osteoporosis,
Diet:
o Food
lists
o Recipes
List of Resources:
o Surgeon
General Report website,
o Interactive
website on Osteoporosis
Evaluation
Post-evaluation: Thank participants for
joining the session today. Explain that the evaluation they are asked to fill
out now will help to understand what areas were covered well and which ones may
need further refinement. Twenty
minutes is allotted for completion of the post evaluation and any last
questions before departure. Gather
evaluations.
Clean up the room
according to the specifications of the hospital.
Anticipated Problem(s) and Solution(s)
1. Non participation in activities
due to health conditions or resistance to participation
a. Be sure their questions are answered about
the exercises and they have the handouts to follow when they return home.
2. Low reading level or poor eye sight without
correction devices
a. There are three other people available to
help those in need of aid with reading the information on the evaluations.
b. Magnifying glasses may be of help to some.
Have these ready if needed.
c. Several of the handouts have been printed in
larger font and has bolding to make the print easier to see.
3. Participants arrive late or not
at all.
a. Arriving late will cause some information to
be missed. Be sure to summarize the information and refer to the handouts in
their packets.
b. The handout packets were distributed at
registration. If they do not attend the session, they will at least have the handouts
to review and the websites to go to for answers to questions.
References
Academy of Dental Therapeutics and Stomatology.
(n.d.). Educational goals and objectives: A guide to developing learner based
instruction. Retrieved from http://www.ineedce.com/courses/1561/PDF/ed_goals_objctvs.pdf
Arthritis Today (Arthritis Foundation).
(2012). Two-Minute moves for pain relief. Retrieved from http://www.arthritistoday.org/fitness/stretching-and-flexibility/2-minute-workout.php
Carmona, R. H. and Moritsugu, K. P. (2004). The
2004 Surgeon General’s report on bone health and osteoporosis. U.S. Department of Health and Human Services. Retrieved
from http://www.surgeongeneral.gov/library/reports/bonehealth/OsteoBrochure1mar05.pdf
Center
for Disease Control and Prevention [CDC]. (2012). Osteoporosis: Data for the U.S. Fast Stats. Retrieved from http://www.cdc.gov/nchs/fastats/osteoporosis.htm
Gerend, M. A., Erchull, M. J., Aiken, L. S., and Maner, J. K. (2006). Reasons and risk: Factors underlying women’s perceptions of susceptibility to osteoporosis. Maturitas, 55 (3), 227-237, 20 October 2006. doi:10.1016/j.maturitas.2006.03.003 Retrieved from http://www.cof.org.cn/pdf/2006/5/Reasons%20and%20risk.pdf
Gilbert,
G. G., Sawyer, R. G., & McNeill, E. B. (2011). Methods of
instruction/intervention. In G. G. Gilbert, R. G. Sawyer, & E. B. McNeill
(Eds.), Health education: Creating strategies for school and community
health (3rd Ed., pp. 97-184). Sudbury, MA:
Jones and Bartlett.
Medline
Plus. (2012). Osteoporosis. Retrieved from http://www.nlm.nih.gov/medlineplus/osteoporosis.html
National Center for Complimentary and Alternative
Medicine at the National Institutes of Health. (2012). Tai Chi: An
introduction. Retrieved from http://nccam.nih.gov/health/taichi/introduction.htm
National Institute of Arthritis
and Musculoskeletal and Skin Diseases [National Institute of Health,
NIH]. (2012). Senior Health. Retrieved from http://nihseniorhealth.gov/osteoporosis/toc.html
National Institute of Arthritis
and Musculoskeletal and Skin Diseases [National Institute of Health,
NIH]. (2012). X-Plain Osteoporosis Reference Summary. Published by Patient Education Institute. Retrieved from http://www.nlm.nih.gov/medlineplus/tutorials/osteoporosis/htm/index.htm
National Institute of Arthritis
and Musculoskeletal and Skin Diseases [National Institute of Health,
NIH]. (2012). Osteoporosis overview. Retrieved from http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/overview.asp
National
Osteoporosis Foundation [NOF]. (2012). Posture exercises. Retrieved from http://www.nof.org/articles/16
Smith, H. R. (2012). Treatment of osteoporosis. EMedicineHealth.
Retrieved from http://www.emedicinehealth.com/treatment_of_osteoporosis/page4_em.htm#nutrition_and_osteoporosis_treatment
U.S. National Library of Medicine
[NLM]. (2012).
Osteoporosis – overview. A.D.A.M.
Medical Encyclopedia. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001400/
USDA. (n.d.). USDA National Nutrient Database for
Standard Reference, Release 17. Retrieved from http://www.nal.usda.gov/fnic/foodcomp/Data/SR17/wtrank/sr17a301.pdf
WebMD. (2007). Weight-bearing exercise: 8 workouts for strong bones. Retrieved from http://www.webmd.com/osteoporosis/living-with-osteoporosis-7/exercise-weight-bearing
Appendix A: Information Flyer
for Women’s Health: A 6-week Series
Good Samaritan Hospital Women’s Clinic
520 S. 7th Street 812-885-8011
Presents
a 6-week series on Women’s Health
Each
week different topics will be presented and discussed. Sessions will last 1 – 1
½ hours.
Participants
should be ready by 11am for fun,
interactive, educational experiences.
Session 1 – January 5, 2013 Topic: Heart
Disease and Women
Women's
Heart Foundation reports that 8 million women in the U.S. are living with heart
disease.
Session 2 – January 12,
2013 Topic:
Cancer is
Number Two
Lifestyle
choices can help prevent at least one-third of all cancers. Breast cancer is
number two on this list. Come hear about the number one cancer in women.
Session 3 – January 19, 2013 Topic: Stroke and Women
Stroke in third on the list for
concern in women; do you know the signs?
Session 4 – January 26, 2013 Topic: Alzheimer’s Disease
More
than half of the 4.5 million Americans living with this condition are women
Session 5 – February 2, 2013 Topic: Diabetes and
Pregnancy
American Diabetes Association
notes that among African American, Native American, Asian American women and
Hispanic women/Latinas, the prevalence of diabetes is two to four times higher
than among white women.
Session 6 – February 9, 2013 Topic: Women with Osteoporosis
Osteoporosis is a silent disease.
You might not know you have it until you break a bone. What can you do to reduce risks? Treatments
will be discussed that you may be able to do at home.
Register
for the sessions of your choice or the entire series at the
Women’s
Clinic Registration Desk. Arrive 30 minutes early for each session.
Appendix B: Pre-Assessment
Questionnaire: Women’s Health –
Osteoporosis
Please fill out this survey
on the knowledge you have about Osteoporosis and of treatments. You will need to bring this with you to the
session on Saturday, February 9th.
The results will be used to design future sessions on women’s health.
The following questions are a
multiple choice format. Please answer
all questions.
1.
What is your age? (Please indicate which
age range you fall into.)
35–44 o
45–54 o
55–64 o
65–74 o
75+ o
2.
What is the highest grade in school
you attended?
(Circle
your highest Grade completed below)
a. Middle
School-Junior High 7 8
b. High School 9 10 11 12
c. Some
College
<1
year 1-2 years >2years
3.
Primary reason for attending today’s
session is: (choose 1)
a. I
have been diagnosed with osteoporosis and want to know more
b. I
have a family history of osteoporosis but not diagnosed with it.
c. I
have begun to trip and fall, so my family insisted I come
d. Signed
up for the entire series of sessions and this one was included.
4.
Choose the one that best defines
osteoporosis
a. Arthritis
b. Brittle Bone Disease
c. Scoliosis
d. None of the Above
5.
Treatments for osteoporosis: Which of
the following is not considered
good methods for strengthening bones or reducing osteoporosis?
a. Balanced Diet
b. Medication (hormone replacement
therapy)
c. Swimming
d. Weight-bearing exercise
6.
How much exercising do you do per
week?
a. 0 – 1 hour
b. More than and hour but less than 2
hours
c. More than 2 hours but less than 3
hours
d. Greater than 3 hours
7.
What do you do for exercise?
Fill in the blank with
your activity or activities ______________________________________________________________________________________________________________________
8.
Of the following foods, which is a
good source of calcium?
a. Broccoli
b. Almonds
c. Salmon
d. Milk
9.
What would you like to get most
from today’s session? (Choose 1)
a. more
information about calcium and vitamin D in my diet
b. more
information about types of exercise for bone strength
Appendix C: Post
Assessment Evaluation for Women’s Health
– Osteoporosis
1.
Was
the day and start time set for this session a good time for you?
a. Yes b. No
If Not, When would have been better?
Day: ______________________ Hour: _________________
2. Was the information presented at a
level acceptable for your understanding?
a. Yes, I understood most of the
information
b. Most of the time I understood the
information
c. No, I had to ask many questions to
understand the information
d. I was lost most of the time
3. Did you participate in the exercise
portion of the presentation?
a. Yes b. No c.
Could not due to health issues
4. Did you find the exercise
instructions easy to follow?
a. Yes b. No c. Will try them at home
5. Will you try at least 2 of the
presented exercises in your weekly routine?
a. Yes b. No c. Maybe
6. Which two will you try to add to your
weekly routine?
___________________________________________________________
7. What would be the most likely reason
for you to not add these exercises to your routine?
a. Time issues (scheduling)
b. Hard to exercise alone (motivation)
c. Health issues
d. Other: (please specify)
________________________________________________________________________________________________________________
8. Did you try any of the foods offered
today?
a. Yes b No
9. Was the food part of your reason for
attending?
a. Yes b. No c.
Did not know there would be food.
10. Did you find the food choices good
for better understanding some of the food choices in a diet high in calcium and
vitamin D?
a. Yes b. No
11. Will you look at the list of calcium
rich foods offered in the handouts and add at least two new foods in your diet?
a. Yes b No
12. Which two new foods are you most
likely to try? ___________________________________________________________
13. Which of the following do you think
would keep you from adding these new foods to your diet?
a. Cost
b. Availability
c. Health condition
d. Other: (please explain)
_____________________________________
14. What would you have included that was
not included? ___________________________________________________________
Handout Packet will be available at the session.
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