Author ORCID Identifier

Date of Award


Degree Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Susan E. Breslin, DNP

Second Advisor

Carole Gardner, MD



Americans experience an estimated 2 million fragility fractures annually. Women over age 50 bear the higher burden of this condition and have a 1-in-2 lifetime risk of suffering a fracture. About half of people who experience a hip fracture never regain their previous level of function. Seven and half percent of those who suffer a fragility fracture die within 90 days of the event. The total cost for all fractures in the year 2025 is predicted to be $18 billion for American women. The purpose of this project was to provide older women with knowledge and tools to enable changes in health behaviors and reduce their risk of suffering a fracture. To meet that goal, participants were provided with educational material about changes they can make to improve their bone health. Literature reviews found that education on diet, exercise and smoking cessation were the most common non-pharmaceutical methods of preventing fractures. Information about the project, the pre-survey and screening questions was mailed to 1805 women between the ages of 65 and 75 from a convenience sample of members who belong to an integrated health plan. Women with a diagnosis of a cognitive disorder or dementia; a diagnosis of osteoporosis or who take medicines for osteoporosis; who reside in a custodial care setting; and/or who are under the care of hospice or the palliative care team were excluded. Women who met the criteria and agreed to participate were mailed educational materials on osteoporosis, screening, bone healthy diets and fall prevention once a week over a period of four weeks. Participants indicated little increased knowledge after the intervention. Participants indicated that they adhered to healthy, active lifestyles before the outreach and so few lifestyle changes were reported. There was a significant difference in the scores for the pre-test (M=63.79, SD=19.95) and the post-test (M=52.87, SD=21.39); t (28) =2.932, p = 0.007. These results indicate that education via this method did not increase participants’ knowledge.