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CompletedNCT03405103S2BSUpdated Jan 26, 2018

Striving to be Strong: Self-management

An interventional study of Striving and Boning-Up in Osteoporosis and Health Behavior, sponsored by University of Wisconsin, Milwaukee. Completed. Open to female participants aged 40 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-01-26.

Sponsored by University of Wisconsin, Milwaukee · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
290
Allocation
Randomized
Ages
40 Years to 60 Years
Sex
Female
01

Study summary

The vast majority of people want to be healthy and often make a change to be healthier. Change that is begun is seldom maintained. Osteoporosis is an example of one condition where people are encouraged to regularly engage in preventative health behaviors. This is a study testing a new approach to helping women engage in osteoporosis health behaviors. This new approach includes beliefs, self-regulating skills and abilities, and social facilitation delivered via a cell phone app. If effective, this approach could be tested with other health behaviors.

Read the detailed description

The goal of this project is to test the efficacy a theory based, patient-centered, dynamically tailored intervention delivered via a cell phone app. The four aims of this project are to: 1) Test the efficacy of the intervention to improve long term maintenance of osteoporosis prevention health behaviors in midlife women, 2) evaluate moderators and mediators of long-term engagement in health behaviors, 3) describe processes of health behavior change and evaluate differences within and between subjects using Ecological Momentary Assessments (EMA) as a complement to traditional measures and 4) evaluate the utility of The Individual and Family Self-Management Theory to explain health behavior change. In the U.S., over 35 million women either have or are at high risk for osteoporosis at an anticipated cost of greater than $25 billion by 2025. Osteoporosis affects 1 out of 2 White women, is rapidly growing among populations of color and causes high chronic disease burden worldwide. Less than 6% of women regularly engage in the basic health promotion behaviors. The vast disparity between the high prevalence of osteoporosis and the low number of people who engage in preventative care highlights this condition as one of many striking examples of the crucial role behavior change could play in improving health and decreasing health care costs. New knowledge suggests enhancing knowledge and beliefs, self-regulation skill and abilities, and social facilitation leads to self-management and improved health outcomes. It is hypothesized that the more an intervention integrates health behavior change processes into daily activities the more likely it is to increases one's capacity to self-manage. The work proposed is significant because it focuses on the serious and prevalent condition of osteoporosis; tests the application of a theory based, patient-centered, dynamic intervention designed to improve outcomes; and, decisively bundles new knowledge about methodologies, intervention processes, and delivery media to provide a cohesive foundation for intervention development and testing. Innovative aspects include use of EMAs as a complementary approach to providing feedback and measuring behavior change processes; testing a newly identified health behavior change theory; and development and evaluation of a cell phone app, one type of m-Health. Through technological advances we now have the capacity to integrate health behavior change processes into every day activities via a cell phone app but the effectiveness of the app to change health behaviors has not been demonstrated empirically. A three-group randomized controlled longitudinal design with data collected at baseline, 3, 6, 9, and 12 months will be used. A convenience sample of 288 (96 per group) community dwelling women will be enrolled. Outcomes will be evaluated with self-report, behavioral performance, and bio-behavioral measures, including DXA and vitamin D. The expected outcomes are achievement of an increase in women's initiation and long term maintenance of osteoporosis self-management behaviors and stabilization of bone mineral density.

02

Conditions studied

  • Osteoporosis
  • Health Behavior

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Keywords

  • self-management
  • m-Health
03

Who can participate

Ages eligible
40 Years to 60 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • healthy (able to participate in physical activity, not receiving medical care for chronic condition, not taking medications that would affect bone, greater than 5 years post treatment for cancer) not pregnant or lactating speaks and reads English consumes at least 200 mg less recommended amount of dietary calcium

Exclusion criteria

Exclusion Criteria:

  • diagnosis of osteoporosis, history of fragile fracture, does not engage in vigorous activity more than 2 times a week
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Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
290 participants (actual)

Study arms

  • Experimental
    Striving

    Striving vs Boning-up \& Personal Choice

    Behavioral: Striving

  • Active comparator
    Boning-up Standard Education

    Boning-up vs Striving and Personal Choice

    Behavioral: Boning-Up

  • Sham comparator
    Personal Choice

    Personal Choice vs Striving \& Boning-up

    Behavioral: Personal Choice

Interventions

  • BehavioralStriving

    Also known as: S2BS

  • BehavioralBoning-Up
  • BehavioralPersonal Choice
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What researchers measure

Primary outcomes

  1. Change in Bone Mineral Density

    Bone Mineral Density obtained via Dual Energy x-ray absorptiometry

    Time frame: Baseline and 12 months

Secondary outcomes

  1. Calcium Focused Food Diary

    mg of calcium obtained via food as measured by Calcium Focused Food Diary. Calculated daily for 3-days. Total mg of calcium across 3 measurement days used .

    Time frame: Baseline, 3, 6, 9, and 12 months

  2. Physical Activity Questionnaire (IPAQ)- Short Form: Measure of time and intensity of persons engagement in physical activity.

    Self-report of frequency and intensity of engagement in common leisure time (non-work related) Physical Activites. Calculated score accounts for time and METs. Data are collected over a 7-day period of time across pre-specified categories of leisure time activities and total score calculated by adding totals obtained for each day. Sub-totals of low, medium, and vigorous activities. Higher the score is associated with higher level of activities.

    Time frame: Baseline, 3, 6, 9, and 12 months

  3. Balance

    4 stage Balance Test: Ability to hold one of four positions for 45 seconds. Positions inclue eyes open, both feet on ground: eyes closed both feet on ground: eyes open, one foot on ground; eyes closed, one foot on ground. Scored by adding total seconds across 4 positions.

    Time frame: Baseline and 12 months

  4. Stand Test

    Leg strength: time it takes participant to stand and sit ten times, Measured in seconds.

    Time frame: Baseline and 12 months

  5. 6-minute walk test

    Functional Status: measure of distance walked in 6 minutes. Measured in feet and inches

    Time frame: Baseline and 12 months

  6. Functional Movement Screen (adaptation)

    Strength and Balance. Test includes four movements specifically hurdle step, in-line lunge, straight leg raise, and squat. All movements were video taped from two positions (front and side). Certified professionals evaluated the videoed four movement and scored each movement using a standardized scoring template. Individual scores are obtained for each of the four movement and a total score is obtained by adding the scores from the four movements. Scores for each movement include 0=pain and score of 1-3 with 3 indicating the best performance.

    Time frame: Baseline and 12 months

  7. Engagement in Self-regulation processes: "What are you doing today"/ DOTs

    Ecological Momentary Assessments. Osteoporosis prevention focuses on four behaviors: calcium intake, balance, core and leg strength, and physical activity. For each of the four behaviors the participant indicates (using a yes or no response) if they engaged in any of the self-regulation processes (e.g., setting a goal, making a plan, engaging in the behavior, monitoring) for each of the 4 behaviors (calcium, balance, strength, and physical activity. For each of these four behaviors participants select all of the component of the Self-regulation process

    Time frame: Over 12 months a total of 284 text message were sent to each participant via newly designed app. Score included frequency of behavior and self-regulation process for 4 week periods over 12 months.

  8. vitamin D

    serum vitamin D level measured in nmole/L

    Time frame: Baseline and 12 months

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Study locations

No study locations are listed for this record.

07

References and documents

Individual participant data

Plan to share: Undecided — Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03405103
Lead sponsor
University of Wisconsin, Milwaukee
Collaborators
Marquette University, Medical College of Wisconsin
Responsible party
Polly Ryan, PhD, RN, FAAN (Researcher, University of Wisconsin, Milwaukee) — Principal investigator
First posted
Jan 19, 2018
Start date
Oct 1, 2012
Primary completion
May 15, 2016
Completion
Jun 30, 2016
Last update
Jan 26, 2018

Study contacts

Polly A Ryan, PhD
principal investigator · University of Wisconsin, Milwaukee

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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