BRIDGING THE GAP IN POST-FRACTURE CARE USING THE RE-AIM FRAMEWORK - INSIGHTS FROM THE OPTIONS STUDY

Sep 29, 2026

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An estimated 10 million older Americans have osteoporosis and face fragility fractures that can lead to disability, reduced quality of life, and higher mortality. Evidence-based post-fracture care remains underused despite effective treatments. The OsteoPorotic fracTure preventION System (OPTIONS) is a multi-modal intervention supporting older adults after lower-limb fractures as they transition between skilled nursing facilities and home. In pre-implementation, RE-AIM guided focus groups to identify facilitators and barriers, informing an OPTIONS implementation toolkit and pilot testing feasibility.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Pre-implementation context

OPTIONS multi-modal intervention

RE-AIM-informed assessment

Study methods and analysis

Interdisciplinary focus groups

Coding and content analysis

Barriers and facilitators

Key barriers

Key facilitators

Toolkit development and pilot phase

Training materials and workflow guides

Feasibility and broader implementation

Innovation in Aging, 2025, Vol. 9, No. S2 1219 Abstract citation ID: igaf122.4080 BRIDGING THE GAP IN POST-FRACTURE CARE USING THE RE-AIM FRAMEWORK: INSIGHTS FROM THE OPTIONS STUDY Gretchen Tucker1, Veysel Baris2, Min Jeoung Kang3, Nancy Latham4, Kumiko Schnock4, Pamela Garabedian5, Denise Orwig6, and Patricia Dykes7, 1. University of Maryland, Baltimore School of Medicine, Baltimore, Maryland, United States, 2. Dokuz Eylul University, Izmir, Izmir, Turkey, 3. Brigham and Womens Hospital, Boston, Massachusetts, United States, 4. Brigham and Women’s Hospital, Boston, Massachusetts, United States, 5. Mass General Brigham, Inc., Somerville, Massachusetts, United States, 6. University of Maryland, Baltimore, Baltimore, Maryland, United States, 7. BWH/Harvard Medical School, Boston, Massachusetts, United States An estimated 10 million older Americans have osteoporosis, a leading risk factor for fragility fractures that often result in disability, diminished quality of life, and increased mortality. Despite availability of effective treatments, evidence-based post-fracture care remains underutilized. The OsteoPorotic fracTure preventION System (OPTIONS) is an integrated, multi-modal intervention designed to improve care for 1220 Innovation in Aging, 2025, Vol. 9, No. S2 community-dwelling older adults following lower limb fractures who transition to skilled nursing facilities and back home. OPTIONS includes clinical decision support tools for providers, patients, and care partners to strengthen fracture prevention efforts across care transitions. In the pre-implementation phase, we used the RE-AIM (Reach, Effectiveness, Adoption, Implementation Maintenance) implementation science framework to explore current fracture care practices in skilled nursing facilities (e.g., exercise, nutrition, and bone health medications) and explored facilitators and barriers to intervention delivery and uptake. We conducted seven interdisciplinary focus groups with physical and occupational therapists, nurses, and dieticians using a semi-structured interview guide. Transcripts were coded and data were analyzed using content analysis. Barriers identified were patients’ complex health conditions, staff turnover, and osteoporosis medication costs. Facilitators included strong communication among staff, access to resources, sufficient training, and training offered in multiple formats. Findings were used to inform development of a practical OPTIONS implementation toolkit, including training materials, workflow guides, and care team resources. The toolkit is currently being tested during the study’s pilot phase to assess feasibility and inform broader implementation. This work aims to improve the delivery of fracture prevention interventions and reduce secondary fracture risk among vulnerable older adults.

FAQs

What problem does the OPTIONS initiative address?

The OPTIONS initiative targets the underutilization of evidence-based post-fracture care among community-dwelling older adults after lower-limb fractures.

How was the pre-implementation work structured?

Pre-implementation used the RE-AIM framework to examine current fracture care practices in skilled nursing facilities and to evaluate facilitators and barriers to intervention delivery and uptake.

What barriers and facilitators were identified for intervention delivery?

Barriers included patients’ complex health conditions, staff turnover, and osteoporosis medication costs. Facilitators included strong staff communication, access to resources, and training delivered in multiple formats.

Sep 29, 2026

Upload by Jasmine