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Effectiveness of community intervention in improving bone health behaviors in older adults [with consumer summary]
Plawecki K, Chapman-Novakofski K
Journal of Nutrition in Gerontology and Geriatrics 2013;32(2):145-160
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

An 8-week, bone-health community program addressed risks/lifestyle changes within the Health Belief Model and Theory of Reasoned Action frameworks in a randomized format (treatment group n = 35; control group n = 34). Median week 1 values for calcium (control 963mg; treatment 1,023mg) and vitamin D (81 IU both groups) were below recommendations, increasing throughout the program for both control (1,023mg calcium, 128 IU vitamin D) and treatment (1,005mg calcium, 122 IU vitamin D) groups. There was limited response to the exercise outcome variables, with many not participating in that section of the program. Psychosocial variables were positive for both control and treatment groups at week 1, with no significant difference at postintervention. Regression analysis indicated that those with a positive attitude about calcium intake and belief that they could choose calcium-fortified foods were more likely to have higher calcium intake. Intention to exercise was modified by peer and family support. Community-based programs can translate and use clinical trial key topics and outcomes, but participation bias makes impact results difficult to interpret the effectiveness of the program.

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