All ETDs from UAB

Advisory Committee Chair

Connie L Kohler

Advisory Committee Members

Diane Clark

Sarah L Morgan

Yu-Mei Schoenberger

Scott W Snyder

Lori W Turner

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Osteoporosis and osteoporosis-related fractures are costly personal and national problems. No cure exists so experts stress early practice of bone protective behaviors, like adequate calcium and vitamin D intake, to prevent osteoporosis and osteoporosis-related fractures. However, young women in the United States do not consume adequate amounts of these two nutrients. Further evaluation to identify cost effective programs to increase calcium and vitamin D consumption in young women is needed. The purpose of this study was to evaluate whether quantitative ultrasound (QUS) with bone strength feedback to a computer-tailored feedback and counseling intervention was needed to increase calcium and vitamin D intake and positively change osteoporosis health beliefs in young women. The Prevention of Osteoporosis in Women (POW) program pilot study randomly assigned 100 women, aged 19 to 25 to two groups. One group of 50 women (group 1) received computer-tailored feedback with brief counseling. The other group (group 2) of 50 women received the same intervention with heel QUS and bone strength feedback. Participants, through computer surveys, rated perceived osteoporosis susceptibility, perceived osteoporosis severity, perceived barriers to recommended vitamin D intake, and perceived barriers to adequate calcium intake immediately before, soon after, and one month after intervention. Average daily calcium and vitamin D intake also were measured through computer surveys immediately before and one month after intervention. All women who received the intervention completed the study. No statistically significant group or interaction effects were observed for all six outcomes. Both groups statistically significantly increased calcium and vitamin D consumption from baseline to one month after the intervention. Both groups also experienced statistically significant decreases in perceived barriers to adequate vitamin D intake. No other within-group findings were found. Most participants found the POW program relevant, enjoyable, influential, and user friendly. In summary, QUS assessment with feedback was not needed to help increase calcium and vitamin D intake and decrease perceived adequate vitamin D intake barriers in young women who received POW computer-tailored feedback with counseling. Further research is needed to find the most cost-effective POW intervention to positively change osteoporosis health beliefs and bone healthy behaviors in young women.

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