Effectiveness of an e-Book on Bone Health as Educational Material for Adolescents: Single-Group Experimental Study

• Published in: JMIR pediatrics and parenting Vol. 7; p. e56611
• Main Authors: Jamil, Nor Aini, Dhanaseelan, Jashwiny, Buhari, Nurin Athirah
• Format: Journal Article
• Language: English
• Published: Canada JMIR Publications 26-08-2024
• Subjects: Bone density; Design and Evaluation of Patient Education Materials; Diet; E-books; Exercise; Health Education for Children and Adolescents; Innovations and Technology for Healthy Eating Education; Innovations and Technology for Physical Activity Education; mHealth for Patient Education; Original Paper; Osteoporosis and Osteoporosis Prevention; Parent and Child Education on Healthy Eating and Nutrition; Parent and Child Education on Physical Activity; Pediatrics; Teenagers; Kuala Lumpur Malaysia; Malaysia; effectiveness; calcium; educational; bone fragility; sociodemographic; bone health; online questionnaire; Malaysia; bone; teens; calcium intake; osteoporosis; youth; physical activity; e-book; adolescent; diet; behavior change; knowledge
• ISSN: 2561-6722; 2561-6722
• DOI: 10.2196/56611

Improved bone health during adolescence can have lifelong implications, reducing the risk of bone fragility.
This study aims to evaluate the effectiveness of an e-book in increasing knowledge about and promoting healthy practices related to bone health among Malay adolescents in Kuala Lumpur, Malaysia.
A total of 72 adolescents (female: n=51, 71%; age: mean 15, SD 0.74 y) were recruited from selected secondary schools. The participants answered a pretest web-based questionnaire on sociodemographic data, knowledge about osteoporosis, and physical activity. A video call was conducted to assess dietary calcium intake. Participants were provided with a link to an e-book on bone health and instructed to read it within 2 weeks. Postintervention assessments included those for knowledge, physical activity, dietary calcium intake, and acceptance of the e-book.
There was a significant increase in the median knowledge score, which was 40.6% (IQR 31.3%-46.9%) during the pretest and 71.9% (IQR 53.9%-81.3%) during the posttest (P<.001). However, no changes were observed in dietary calcium intake or physical activity levels. Most participants did not meet the recommended calcium requirements (61/62, 98%) and exhibited sedentary behavior (pretest: 51/62, 82%; posttest: 48/62, 77%). The e-book, however, was well accepted, with the majority reporting that they understood the contents (70/72, 97%), liked the graphics (71/72, 99%), and approved of the layout (60/72, 83%) and font size (66/72, 92%) used.
The developed e-book effectively increases knowledge levels related to bone health and is well accepted among participants. However, this educational material did not improve bone health practices. Additional strategies are necessary to bridge the gap between knowledge and behavior change.