The design and evaluation of a bone health teaching module for secondary school students in NSW, Australia

Issue addressed: The growing prevalence of osteoporosis requires preventative management starting from an early age as peak bone mass is typically reached by age 30. However, current Australian adolescents are not adequately addressing key osteoprotective factors. Alarmingly, around 17% have insufficient vitamin D levels, 55% consume insufficient dietary calcium, and 79% are insufficiently active. Addressing these insufficiencies via bone health education and promoting healthier lifestyle choices are crucial to mitigate the risk of osteoporosis later in life.

Methods: A mixed methods study was undertaken to assess the design and effectiveness of four bone health education modules implemented in PDHPE lessons across NSW secondary schools. Pre- and post-module assessments included a multiple-choice questionnaire on osteoporosis knowledge, and a survey based on the Theory of Planned Behaviour domains to examine influences on healthy bone behaviour. Statistical analysis, qualitative interviews, and focus groups were used to evaluate changes in knowledge and behaviour resulting from the modules.

Results: Participation in bone health teaching modules improved students' knowledge and behaviours related to bone health. Subjective norms had the largest influence regarding behaviour changes. Both students and teachers engaged positively with the bone health modules, which were designed by clinicians and delivered by teachers. SO WHAT?: The modules address knowledge gaps and provide strategies from an early age, empowering students and potentially contribute to improving long term bone health. There is a need to focus on promoting positive peer influence and facilitating easy access to bone-healthy behaviours in secondary education settings.