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Strong Bones for a Lifetime Educational Program

Providing a multidisciplinary approach through education.

Photo of Kathleen Morgan
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What challenges or opportunities are you trying to address within the problem? (200 characters or less)

Inform individuals, patients about the modifiable and non-modifiable risks. Inform them about menopause, medications, nutrition, smoking, alcohol, genetics, physical activ calcium, D, treatment, falls

Older adults who fracture need the education on steps to prevent a second fracture. They have a more vested interested now to be compliant. Participating in an educational program and/or a 24 week program like Project Healthy Bones in New Jersey can go a long way to prevent a second fracture.

Who is your target end user and why will they be interested? (650 characters or less)

I have recently taught Strong Bones for a Lifetime to 120 older adults. From their comments, I could tell the information they learned was an integral part of their osteoporosis prevention, treatment and management. There were many favorable comments after the program on what they learned. Education is central to prevention. A patient's journey through a fracture and then on to further prevention, treatment and management is critical They must be engaged as part of the process and learning. The statistics are startling as to the few patients that are screened, then the few patients that have secondary care after the initial fracture and further follow-up care. We have to do a better job of helping older adults have the best healthy life they can with the areas of chronic disease that can be preventable. This starts with more effective screening in the doctors office and encouraging patients to be healthy bone advocates for themselves and their family like I do for my family.

How is your idea scaleable? (650 characters or less)

I am a professor with Rutgers Cooperative Extension, New Jersey.. There is a Cooperative Extension in every Land Grant University across the nation. Within the Cooperative Extension system, there are educators in every state that can teach about osteoporosis prevention, treatment and management. We are in the process of trying to get a program launched to the national level. One of them is an osteoporosis education program. There are a cadre of educators in Cooperative Extension that can already teach a program like this. It is their mandate to take education to the community to solve local problems. We know osteoporosis is a big local problem.

What do/will you measure to know if your solution worked? (500 characters or less)

I have been on sabbatical for the past 6 months. My sabbatical project was teaching the Strong Bones for a Lifetime to older adults. With the 120 older adults that I have educated, I provided an identical pre and a post-test to determine if they learned what was taught to them. I am in the process of analyzing that data. When you do any type of applied research, you have had to put this through our Rutgers Institutional Review Board. With everything that is conducted/taught within Cooperative Extension, there is always an evaluation component. It is an expectation to show impact of the programs that have been taught.

What is the current stage of development of your idea?

  • Pilot: We have started to implement the idea as a whole with a first set of real users. The feasibility of an innovation is tested in a small-scale and real world application (i.e. 3-15% of the target population)

If you were to become a Top Idea, would you want to actively participate in piloting your idea?

  • I want my idea piloted, and I prefer to do my own piloting in collaboration with the health system and with assistance from the Challenge partner

Company / Organization Name, if applicable (140 characters or less)

Department of Family and Community Health Sciences Rutgers Cooperative Extension Rutgers, the State University of New

Website (if applicable)

Tell us about yourself or your team (500 characters or less)

II am a Full Professor at Rutgers University. My doctoral work looked at the racial and ethnic disparity in screening African American women for osteoporosis. I have been a member of the New Jersey Interagency Council on Osteoporosis for 20+ years. I was one of the leaders who initiated the Project Healthy Bones program in NJ over 20 years ago. It is a peer-led program. I am a professional member of the National Osteoporosis Foundation and I serve as an Ambassador. The beginning of my career was very focused on osteoporosis education, treatment and management. I was then asked to serve as the department chair which I did for 12 years. I stepped down last year and am now fully engaged again in osteoporosis education. I am a very strong advocate for all individuals. Health Equity is a very important topic to me in all areas of health including osteoporosis.

Location (50 characters)

Martin Hall 88 Lipman Dr. New Brunswick, NJ

What is your legal / organizational structure?

  • We are a formal part of a University or Research Institution

Innovator/Organizational Characteristics

  • Female-led organization

How did you hear about the Challenge?

  • OpenIDEO announcement email

Why are you participating in this Challenge?

I am a strong advocate and ambassador for individuals having the best bone health that they can. We strongly need to have osteoporosis awareness increase and have more prominence among health professionals including primary care physicians. Primary care physicians don't screen patients as they should. Heart disease, cancer, diabetes are all very serious chronic diseases. We need physicians to make osteoporosis screening a priority for all older women and men. Fractures are debilitating!

How does your idea help more people who have had a first fracture either 1) discover they have osteoporosis or 2) access/navigate care?

Numerous osteoporosis associations, alliances, foundations and national health care agencies in the U.S and the world have agreed that a Fracture Liaison Service (FLS) is the optimal model of a patient centered protocol to deliver secondary preventive care for patients suffering fragility fractures caused by osteoporosis. There are many successful FLS models in the U.S. I mention it here as there are only a few hundred FLS in the nation and they can be integral to reducing secondary fractures. A critical component of the FLS is patient education. This is where Strong Bones for a Lifetime comes in. Strong Bones for a Lifetime provides the patient the critical information necessary to make lifestyle changes in the area of nutrition, protein, dietary calcium vitamin D, lifestyle changes, falls prevent/safe movements. Fractures especially hip fractures are traumatic, often leaving the patient fearful of how they will manage their lives, Strong Bones can be very important in this area.

How is your idea new in the world or how does it build on existing interventions?

My idea about utilizing Fracture Liaison Services more for secondary fracture prevention is not new. A new way to education physicians on osteoporosis and FLS is. Project ECHO is an innovative telehealth for Orthopedic physicians to acquire new skills and competencies. When physicians become a partner in the ECHO Movement, they have better access to rural and underserved communities, reduced disparities, better quality and safety, rapid dissemination of best practices. ECHO promotes consistency in care and practice and provides greater efficiency. Education is a significant part of an FLS and Strong Bones for a Lifetime is a central component of the FLS helping patients to reduce secondary fractures. Strong Bones for a Lifetime provides the critical endpoint of care with an FLS when the patient is discharged back to the community and their daily lives. How should they eat? What do they need to know about falls prevention and safe movements and general osteoporosis management.

Please upload your journey map. Be sure your journey map shows when your user is introduced to the idea and when/how they access it, and illustrates which moments in the Challenge Journey Map your journey map touches.

I tested my idea with a colleague Dr. Jeffrey Levine. He is familiar with my program, Strong Bones for a Lifetime. He felt it would be a good adjunct to an FLS program. He recommended an FLS that had orthopedic physicians on their staff as opposed to all of the physicians being in private practice. Dr. Levine feels strongly about patient education, he does quite a bit himself. He was very instrumental in my research topic for my doctoral degree in the areal of health disparities.

Who did you test your idea with, what did you learn, and how did you evolve your concept?

In April, 2019, I was invited to attend a conference on Health Disparities in D.C. A panel member presented his work utilizing Project ECHO, an innovative telehealth way of educating physicians. The state of NJ has one of the highest rates of maternal morbidity and mortality. I spoke to an obstetrician in a NJ urban city where there is a high rate of maternal morbidity and mortality. After talking to her, we both agreed that physician education was vital is the situation would ever change. I researched Project ECHO and felt that if Obstetrical Physicians had the opportunity to participate in an ECHO tarted to this maternal issue, lives could be saved. I was no sooner home from the conference when I was invited to participate in a Project ECHO on Fracture Liaison Services. It really opened my eyes at how they could easily educate physicians while they watched the ZOOM video in their office. When it came to the Open IDEO, I had to think out of the box and Strong Bones for a LIfetime is an educational program that stands alone, it will not prevent fragility fractures on its own, I felt it would need to be paired with something else. The FLS and Project ECHO are proven winners in the area of preventing secondary fragility fractures and providing education. Strong Bones for a Lifetime is the endcap of education for the FLS program. It is the osteoporosis management information that patients need to implement healthy lifestyle strategies.

Please upload your Business Model Canvas

My Value Propositions focus on Fracture Liaison Services, Project Echo and Strong Bones for a Lifetime. There are numerous key partners from an Orthopedic physician as the champion, nurse coordinator, primary care physician. Key activities are Project ECHO, patient centered care, Strong Bones for a Lifetime, An FLS has been evaluated by 159 publications showing its efficacy. I feel very mislead by this section, I wrote mine out in a word doc and it can't be uploaded. I also did Power Point

Please upload your team video.

I uploaded my video to YouTube, Every time I put the URL in the URL line, it disappears. You can go to YouTube and put in Strong Bones for a Lifetime, it will be my picture and a colleague, it will say my name and Open IDEO Project.


Join the conversation:

Photo of Manisha Laroia

Hi Kathleen Morgan 
Hope your idea prototyping is on in full swing!
In gratitude and in support of your future work, we would like to invite you to join the final Innovation Coach Office Hours as you continue your innovation learning journey:

Make, Try, Show, Test, Build
Ashutosh Biltharia, Designer and Engineer, MFA, Interaction Design, Umea Institute of Design, Sweden. 10am PST August 5th.

Building Partnerships in Design
Susan Jackewicz, Principal at Takhi Associates, Boston, Massachusetts. 10am PST August 9th.

Love the Problem, Scale the Solution
Chris Cochella, Managing Partner at Sequoia Group, Salt Lake City, Utah. 9 am PST August 12th.

Sign up here to attend

Photo of Susannah Bailin

Wonderful! I can be reached at and texted at 2039815755. Let's chat next week. Looking forward, Susannah

Photo of Susan Jackewicz

Hi! Kathleen Morgan 
Thank you for posting your research idea, and for all your past work advocating for women's health. I'm not an expert in research, but am curious about a couple of things:
1) In the Strong Bones for a Lifetime course you taught, was it designated for just women, or were men included? I know sometimes it's difficult to mix the sexes (yoga, Pilates, boot camps, etc) and have equal impact for what you're trying to teach. A lot of emphasis is put on women and osteoporosis, but am wondering if you think something of a different nature should be presented to the men to be impactful?
2) As an educator, do you think there's a need with this topic to have different approaches for different learning styles? Would that add or be superfluous? In two ways - A) segmenting younger people 50-70, and "older old" 75+? B) visual learners vs. those more fact/numbers oriented?
Thank you for joining the Challenge.
Kind regards,
OpenIDEO Innovation Coach

Photo of Kathleen Morgan

Good Afternoon Susan,
Thank you so much for your response. The Strong Bones is for all individuals. I have had men in almost all of the programs that I taught. When men get osteoporosis, it is usually later than women unless it is due to medications or chronic disease.
Yes after teaching 10 programs, I would definitely say that two teaching styles would be appropriate for two age groups. My program is a little bit longer than an hour. While it is evidence based, it is not graphs, etc. I am finding that the more older populations don't often want to participate more more than an hour, but then some do. There are a lot of variables. I am going to a center this month of older adults and the program coordinator actually told me to not present the program as they most likely would not engage, so I am going to talk with them about falls prevention. I feel this is a message that is important and understandable. I have been saying for several years that we have to spend more time educating the 50 year old individuals so that they have better health when they get to their 70's. My program would easily be targeted to the 50-70 year old individuals. I have had some younger women in the program for various reasons. I do go over the current medications, and how they are prescribed. I don't like to generalize about age groups, but it has been my experience that some of the much older population isn't interested in medication. Senior Centers provide amazing programs to older adults, one group described chair yoga, every bit of physical activity is beneficial at that age. I hope this answered your questions Susan. Thank you again. Best wishes for your day. Kathleen