Osteoporosis is a public health problem implying an increased risk of fractures. Successful fracture prevention contributes to prevention and treatment of osteoporosis as well as reduction of accidents from falling. Determinants such as lifestyle and environmental factors depend on human behaviour. In order to obtain a deeper understanding of the behavioural changes needed for fracture prevention, the aim of this study was to explore women's experience of living with osteoporosis and related lifestyle changes. In-depth interviews with 13 women diagnosed with osteoporosis were analysed according to the grounded theory method. The data formed a pattern in which developing healthy risk awareness is the key to motivating risk reduction behaviour as part of a fracture preventing lifestyle. The other five categories are elements in achieving healthy risk awareness: accepting having fragile bones, living with fear, needing to learn, and having confidence as well as experiencing a sense of social context. These findings might be useful to understand better the motivational process underpinning fracturepreventing behaviour among women with osteoporosis.

The aim of this study was to explore the development of interprofessional collaboration aiming to improve secondary prevention of osteoporosis by studying this topic expansively from the perspectives of different stakeholders. The method used was a longitudinal single case study with both qualitative and quantitative data sources. The findings elucidate that the bottom-up structure used triggers a freedom to act for the professionals and a changed leadership. Such an approach seems to make managers aware of the need for a horizontal organizational focus that, in this case, was crucial for developing interprofessional collaboration. Furthermore, the study shows that continuous feedback was central to motivate professionals to collaborate. Constructive feedback was created by interprofessional and patient-centered interaction skills, facilitated by confirming leadership promoting ability to recognize the efficacy of joint collaboration. The interprofessional collaboration resulted in an improved chain of care with increased transparency and collective control with benefits for both patients and providers. Outcomes at the system level showed an appreciable increase in patients investigated for osteoporosis: 88% were followed up in primary care and nearly half had improved their health behavior. The implementation of a bottom-up structure where leaders and professionals are developing interdependency, measuring collective performance and using feedback loops generated, in this case, motivational forces for interprofessional collaboration. It is reasonable to assume that these findings could be transferable to similar healthcare settings.

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If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to explore interprofessional experiences of incorporating fracture prevention activities in clinical practice inspired by an empowerment approach. Design/methodology/approach -Data collection consisted primarily of focus groups interviews, systematized and analyzed by the grounded theory method. The study took place in a health-care district in a county in Sweden and involved health professionals from primary health care and orthopaedic departments. Findings -The findings generated the core category forming a learning culture in managing to incorporate fracture prevention activities in clinical practice. In this learning culture, new forms of interaction with patients were practised and the collaboration developed between multidisciplinary teams added meaning and triggered personal and collective learning in particular about the need for breaking professional patterns, creating more empowering meetings, making the preventive links visible and constructing a greater sense of prevention within the community. Practical implications -The findings show that learning processes through patient-centred interaction and face-to face collaboration based on the professionals' own requests and experiences can be an important motivator to promote fracture prevention activities. Originality/value -This study provides some interprofessional elements in achieving a learning culture concerning health education and fracture prevention.

The potential importance of psychological aspects in relation to risk factors for fractures and preventing unhealth behaviour has rarely been investigated in the field of osteoporosis. This study explores some psychological aspects and health behaviour of people detected to have osteoporosis at the time of a forearm fracture. Moreover, it aims at revealing subgroups within this population with clinical relevance for managing secondary prevention actions. Data collection was based on questionnaires and physical tests. Eighty-five individual were analysed. The results confirm earlier research on a similar population having relatively good self-reported health behaviour. The individuals reported high quality of life, high amount of physical activity and low alcohol intake. A majority reported good osteoporosis knowledge, a high sense of coherence (mean = 74) and high activity-specific balance confidence (mean = 81). Furthermore, hierarchical cluster analysis indicated a typology of two subgroups where 75% matched a health-resilient group while 25% matched a health-vulnerable group. The vulnerable group had a significantly lower sense of coherence SOC (p = 0.02) and activity-specific balance confidence, ABC (p = 0.001). This pattern was confirmed from behavioural aspects but only regarding one traditional risk factor namely the history of fractures. The health-vulnerable group achieved a significantly weaker physical profile, less reported time spent outdoo...