Date of Conferral



Doctor of Nursing Practice (DNP)




Eileen Fowles


In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical record (EMR) alert system with an additional bone health education in the patient instruction menu can improve participation by 11 health care providers (HCPs). Prior to the participants receiving the fact sheet, the knowledge, health beliefs, and perceived risks for developing osteoporosis were measured using the Revised Osteoporosis Knowledge Test (ROKT) and the Osteoporosis Health Belief Scale (OHBS). Although 87% of participants identified menopause as a major osteoporosis risk factor, fewer women (33%) knew that surgical removal of the ovaries was also a risk factor and half agreed or strongly agreed that calcium and exercise can prevent osteoporosis. After receiving the fact sheet, the participants had an average confidence score of 62% on the Osteoporosis Self-Efficacy Scale (OSES) for engaging in exercise and an average confidence score of 65% for adhering to calcium intake guidelines. Furthermore, the EMR alert system facilitated 100% documentation by HCPs. These results indicated the fact sheet can motivate premenopausal women to engage in osteoporosis preventive behaviors. Importantly, the EMR reminder with education fact sheet can facilitate the active involvement of HCPs in patient education.