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A review of patient-centred post-fracture interventions in the context of theories of health behaviour change

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Abstract

The purpose of this literature review is to determine whether and to what extent current post-fracture osteoporosis interventions utilize theories of health behaviour change and whether those that are theory-based are more successful in producing desired behaviour changes. Studies were identified by applying additional criteria to the final selection stage of a systematic review of non-surgical osteoporosis interventions in the orthopaedic environment. We identified 42 primary studies targeted at patients and improving post-fracture osteoporosis care. As well as describing the studies (in terms of design, population, interventions, outcomes), we focused on theoretical framework and elements of behaviour change models. The 42 studies included in this review utilized a variety of post-fracture interventions; however, none of them reported using an underlying theoretical base. Only three studies drew on what we felt to be elements of a theoretical framework. The lack of theoretically based studies points to a currently under-utilized area of behaviour change research that could be applied to post-fracture interventions in order to make them more effective. Despite an abundance of literature supporting theories of behaviour change, post-fracture osteoporosis interventions do not report utilizing these theories. Theories of behaviour change could be applied to post-fracture osteoporosis interventions to explain why patients initiate osteoporosis management. Future research should explore the application of theories of health behaviour change to post-fracture interventions.

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Acknowledgments

This study was funded by the Ministry of Health and Long Term Care of Ontario. The views expressed are those of the researchers and do not necessarily reflect those of the Ministry. The study contains material from the first author’s master’s thesis.

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Authors and Affiliations

  1. Mobility Program Clinical Research Unit, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada

    R. Sujic & D. E. Beaton

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    M. A. Gignac

  3. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    R. Sujic, R. Cockerill & D. E. Beaton

  4. Health Care & Outcomes Research, University Health Network, Toronto, ON, Canada

    M. A. Gignac

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  1. R. Sujic
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  2. M. A. Gignac
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  4. D. E. Beaton
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Correspondence to R. Sujic.

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Table 2 Description of the studies included in the review
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Sujic, R., Gignac, M.A., Cockerill, R. et al. A review of patient-centred post-fracture interventions in the context of theories of health behaviour change. Osteoporos Int 22, 2213–2224 (2011). https://doi.org/10.1007/s00198-010-1521-x

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