Study Design: Pre-test/post-test control group research design to test the effectiveness of an osteoporosis educational in-service program with female high school students. Background: Peak bone mass and density occur at critical critical periods primarily during adolescence. Girls developmentally start off with a lesser peak bone mass than boys and suffer more osteoporosis consquences as adult women. Purpose: To determine if adolescent girls who participate in an in-service educational program about osteoporosis and bone density development will have improved knowledge about osteoporosis and improved confidence in health behaviors for bone density development as well as improved bone-health lifestyle behaviors compared to adolescents who do not participate in an in-service educational program. Methods and Measures: Eighty four girls from two high schools in a north eastern city school district participated. One school was randomly determined as the treatment and the other as the control group. Pretests on knowledge, self-efficacy, calcium intake, and previous day physical activity were collected in the treatment and control groups. Two to three days after the initial testing, an educational in-service program about osteoporosis and osteoporosis prevention was presented to the treatment group during a 50-minute class-time block. Time was allowed for planned discussion and a calcium-rich snack. No educational in-service program was given to control group participants. Approximately a week after the educational in-service, the four test instruments were again given to all students. The differential effects of intervention vs. no intervention were determined using 2 x 2 analyses of variance. Seven dependent variables from the four test instruments were analyzed. Results: 1) Significant differences were found for the main effect of time and the main effect of group on all measures of the Osteoporosis Knowledge Test: total scores, exercise subscale scores, and calcium subscale scores. The scores were much higher at posttest for the treatment group while posttest scores remained similar to pretest scores for the control group. 2) Scores for improved confidence for conducting activities related to osteoporosis prevention were encouraging. While there were no main effects for group or time of testing, there was a significant interaction of the two. The treatment group showed significantly greater increases for self-efficacy from pretest to posttest compared to participant scores in the control group. 3) Although the interaction analyses for the behavioral tests were also significant, both for calcium consumption and metabolic equivalent task (MET) values of physical activity, performance trends did not exhibit patterns like that of the OKT and OSES, and may be misleading. Conclusion: An osteoporosis educational in-service can significantly improve overall knowledge in high school girls as well as their confidence for exercising and calcium consumption; however, it is not clear that an educational in-service alone is an adequate intervention to change nutrition or exercise lifestyle behaviors.
