Use of discussion boards in a theory-based health web site for older adults.

BACKGROUND: Hip fracture, a significant public health problem among older adults, can be prevented using multimodal approaches (e.g., bone-strengthening measures, fall prevention). Many older adults, however, are unaware of this information. With the rapid growth of older adult online users who have a specific interest in health, the Web can serve as a valuable medium to disseminate this information.

OBJECTIVES: The purpose of this study was to explore the impact of the social cognitive theory-based structured hip fracture prevention Web site (TSW) on health behaviors through analysis of discussion board postings and to assess participants' experiences with the discussion board.

METHODS: In an online, randomized controlled study, the effects of a social cognitive TSW, including learning modules and a moderated discussion board, were tested on older adults' health behavior-related outcomes.This was an exploratory qualitative study. The TSW group participants used the learning modules and the discussion board for 2 weeks. Their experiences with the discussion board were explored using an open-ended question. Discussion board postings and qualitative answers were analyzed using content analysis.

RESULTS: Ninety older adults actively participated in the discussion board. Analysis of 316 postings revealed eight themes. Participants shared their current health behaviors and discussed specific health problems and concerns. Many recognized opportunities for improvement and identified motivators to improve health behaviors. They also offered supportive comments to others and shared helpful and practical information. More than half of the participants (n = 65, 74.4%) reported that the discussion board enhanced their learning experiences.

DISCUSSION: The themes developed from the postings showed that moderated discussion boards can be used effectively to change older adults' health behavior. Further research is needed to explore the long-term impact of using this component in online health behavior change interventions.