Nguyen Vu H
Public Health Program, Department of Health Sciences, School of Health Professions, University of Missouri, 802 Lewis Hall, Columbia, MO 65211, USA.
Osteoporos Sarcopenia. 2017 Mar;3(1):18-31. doi: 10.1016/j.afos.2016.11.004. Epub 2016 Dec 24.
Osteoporosis is a serious public health concern worldwide, and community-based public health programs that increase osteoporosis preventive behaviors are ideal to combat this major public health issue. A review of community-based public health programs for osteoporosis prevention show that programs vary in numerous ways and have mixed results in increasing osteoporosis preventive behaviors, although most programs have had success in significantly increasing calcium intake, only a few programs have had success in significantly increasing weight-bearing exercise. Regarding calcium intake, all community-based public health programs that implemented: 1) at least one theoretical behavior change model, such as the health belief model, or 2) bone mineral density (BMD) testing for osteoporosis screening, have shown success in significantly increasing calcium intake. As community-based public health programs for osteoporosis prevention have shown limited success in increasing weight-bearing exercise, an additional review of community-based public health programs incorporating osteoporosis exercise showed that they have high compliance rates to increase weight-bearing exercise, but require high-intensity weight-bearing exercise of 80-85% 1-repetition maximum to significantly increase BMD to prevent osteoporosis. In the prevention of osteoporosis, for community-based public health programs to be most effective, they should implement theoretical behavior change models and/or BMD testing for osteoporosis screening, along with high-intensity resistance training. Recommendations for future research to further study effective community-based public health programs are also provided.
骨质疏松症是一个全球性的严重公共卫生问题，基于社区的公共卫生项目能够增加骨质疏松症预防行为，是应对这一重大公共卫生问题的理想方式。一项关于基于社区的骨质疏松症预防公共卫生项目的综述表明，这些项目在诸多方面存在差异，在增加骨质疏松症预防行为方面的结果也参差不齐。尽管大多数项目在显著增加钙摄入量方面取得了成功，但只有少数项目在显著增加负重运动方面取得了成功。关于钙摄入量，所有实施了以下措施的基于社区的公共卫生项目：1）至少一种理论行为改变模型，如健康信念模型；或2）用于骨质疏松症筛查的骨密度（BMD）检测，都在显著增加钙摄入量方面取得了成功。由于基于社区的骨质疏松症预防公共卫生项目在增加负重运动方面成效有限，另一项关于纳入骨质疏松症运动的基于社区的公共卫生项目的综述表明，这些项目在增加负重运动方面具有较高的依从率，但需要80 - 85% 1次重复最大值的高强度负重运动才能显著增加骨密度以预防骨质疏松症。在骨质疏松症的预防中，为使基于社区的公共卫生项目最有效，它们应实施理论行为改变模型和/或用于骨质疏松症筛查的骨密度检测，同时进行高强度抗阻训练。还提供了未来研究的建议，以进一步研究有效的基于社区的公共卫生项目。
