Assessment of the Effectiveness of the Healthy Living Awareness Program for the Prevention of Osteoporosis Based on the Information- Motivation- Behavioral Skills Model in University Students: A Randomized Controlled Trial

This study adopted a randomized controlled trial pretest, posttest, and follow-up research design. The study was conducted between March and August 2021 at a public university in Türkiye. The study adhered to the CONSORT (Consolidated Standards of Reporting Trials) guidelines. Participants were randomized into intervention and control groups. Eligible students were randomized to intervention group or control group using block randomization technique. Blinding in the study was not feasible. Blinding could not be performed because the researchers were aware of the interventions and carried out the implementation. The intervention group attended the HLAPPO-IMB, which had three stages: information, motivation, and behavioral skills development. The control group did not undergo the intervention.

The study population consisted of 125 fifth-semester nursing students in the fall term of the 2020-2021 academic year. The undergraduate nursing programs in Türkiye are eight-semester programs. The mean Osteoporosis Knowledge Test (OKT) scores were used to determine the sample size. Power analyses were performed based on the difference between two independent means by G*Power 3.1.9.7. A power analysis was performed to determine the sample size in line with the literature [OKT: experimental group X̅±SD: 18.95±4.98 and control group X̅±SD: 15.18±3.88]. The results showed that a sample of 76 would be large enough to detect significant differences (0.84 effect size, 0.05 level of error, and 95% power). All students who met the inclusion criteria were recruited to avoid missing data. The first sample consisted of 87 participants, who were randomized to intervention (n=43) and control (n=44) groups. However, one student from the intervention group declined to participate. Therefore, the final sample consisted of 86 participants.

The data were collected using a personal information form, the Osteoporosis Knowledge Test (OKT), the Osteoporosis Health Belief Scale (OHSB), the Osteoporosis Self-Effective Scale (OSES), and the International Physical Activity Questionnaire Short Form (IPAQ-SF).

The personal information form: This form was prepared by the researchers. The form consisted of 30 items on sociodemographic characteristics and factors that might affect bone mineral density. Each participant's BMI, body weight, and body height were calculated based on his/her self-report.

Osteoporosis knowledge test: The instrument consists of 24 items. The total score ranges from 0 to 24, with higher scores indicating more osteoporosis-related knowledge.