Uptake of an exercise class and use of bone density measurement after advice by the health insurance fund: results from the osteoporotic fracture prevention program in rural areas (OFRA).

Abstract

OFRA is a large health insurance fund-driven program which aims to reduce the risk of falls and fractures in older people living in rural areas. The programme offered specific mobility and falls prevention classes and bone density measurement by a DXA scan free of charge to more than 10,000 people, and was promoted by staff of the health insurance fund either by a visit at home, or a phone call, or a visit at home and a subsequent phone call. The aim of this study was to analyse the uptake of an exercise class and the use of a DXA scan after advice. Telephone interviews were conducted in a randomly selected subgroup of 780 persons 9months after first contact. Rates of uptake of an exercise class or use of a DXA scan were calculated. Predictors of uptake and use were analysed applying logistic regression models. The rate of uptake after advice for specific mobility and fall prevention class was 29.6%. For DXA scan, the rate of use after advice was 16.7%. Rates of uptake and use increased if the first contact by a visit at home or a phone call was followed by an additional subsequent phone call. A direct motivational approach in older people by a health insurance fund is feasible and results in relevant participation and utilization rates in exercise classes and DXA scans.